Staff attending the arrest will need to be trained to provide support to the clinician that is performing the intubation, such as preparing and passing the equipment JRCALC and RCUK Guidance: maximising the chance of success including airway management and pad placement. Full review and update of ACS. This includes a new section on health inequalities, women and racial differences. Strengthened wording, re. need to reduce on-scene time if possible. Diazepam oil in water emulsion is now a discontinued medicine, so this presentation will be removed from JRCALC. Diazepam solution will remain. Aim for a systolic blood pressure (SBP) > 100 mmHg. Administration of fluids and adrenaline detailed. (See adrenaline above).

We are pleased to receive questions relating to the JRCALC Guidelines, however in the first instance we recommend that you liaise with appropriate senior clinicians within your organisation to clarify a guideline or area of practice.The decision to terminate resuscitation has been increased to 30 minutes from 20 minutes: If, following ALS interventions, the patient has been persistently and continuously asystolic for 30 minutes and all reversible causes have been identified and corrected, resuscitation may be discontinued except in cases listed below. Case scenarios on pre-hospital practice, covering a range of topics including overdose, paediatrics, pain management, head injury and sepsis. We will endeavour to answer your question promptly having consulted with JRCALC experts as necessary. Of the questions we receive there are often common themes; below is a searchable facility to review the questions and answers given. Reviewed and updated by NARU. Updated guidance on Conducted Energy Devices (Tasers) and for their assessment, management and removal,

This new guideline will be placed in the General Guidance section. A short section on human factors will remain in ‘Out-of-Hospital Cardiac Arrest: Overview’. The Joint Royal Colleges Ambulance Liaison Committee guidelines are the essential resource for paramedics, although the principles are also applicable to the work of all pre-hospital clinicians. Guidance on the assessment and management of this common presentation. Includes differential diagnosis, red flags, serious pathologies for hospital conveyance and guidance on those patients that may be suitable for community management or referral to primary care, pharmacological and non-pharmacological pain management, advise on simple exercises and safety netting. Women who are pregnant and/or breastfeeding should have tranexamic acid administered in life threatening haemorrhage. The guidance is updated to place more emphasis on administering hydrocortisone for trauma as well as medical conditions, due to the physiological stress on the body for steroid dependent patients. This follows a coroner’s inquest where a patient died as a result of an acute adrenal crisis, caused by Addison’s disease and precipitated by the trauma of a fall and fractured hip. Insufficient administration of steroid medication by medical professionals was found to be a contributory factor in this patient’s death.Reference list entry: Joint Royal Colleges Ambulance Liaison Committee and Association of Ambulance Chief Executives (2019) JRCALC clinical guidelines[app]. Version XX. Bridgwater: Class Publishing. Available from https://jrcalcplus.co.uk[accessed XX].