Clinical Updates: April 2025

Your monthly clinical update covering:

VVED Consultations for small infants

• New requirement: VVEDconsultation for non-transport of infants ≤28 days
• Strong recommendation for 29days–3 months
• Driven by patient safety reviewand expert consensus
• Not about removing autonomy —it’s about adding clinical support

RSI Checklist Update

• Addition of a pop-off valve checkfollowing a critical safety event
• Prevents misdiagnosis of failedventilation
• Reinforces value of checklists,even for experienced clinicians

Advanced Paramedic PracticeProposal

• Public consultation open
• Framework for advanced practiceregistration in primary care and critical care
• Facilitates further advancementssuch as prescribing rights and scope self-determination
• Big implications for AVparamedics — see link in show notes to respond

STEMI Transfer Pilot

• ALS paramedics trialing regionalSTEMI transfers
• Target: stable patientspost-thrombolysis
• Reflects data showing most STEMIpatients are low risk

Patient Safety Focus

• Standing height falls in theelderly: don’t underestimate risk
• Rhythm misinterpretation:shockable rhythms missed or misidentified
• No link between junior staff anderror rates — we all share responsibility, we are all vulnerable

Guideline Monitoring:Palliative Care CPG

• 9.9% increase in patients dyingat home — great outcome
• No major change in meds given —possibly due to barriers in the current CPG
• Evidence supports simplifying CPG

Case Reports on Viva Engage

• Recent cases: paediatricrespiratory failure, polypharmacy overdose, snake bite
• Submit your own case via the Vivatemplate

Paper of the Month: PACKMaNTrial

• RCT comparing ketamine vsmorphine for trauma pain
• Found no difference ineffectiveness
• Points to multimodal analgesia asa next step in research, which is already AV’s approach

Equipment

• Check Pop-off Valve position atstart of shift
• “Resus Ready” campaign comingsoon
• Cardiac Monitor ReplacementProgram- New device coming
• Discussion underway: do we needto carry everything all the time?

Professional DevelopmentOpportunities

• Critical Care Summit – May 15–16,Essendon
• Grand Rounds (CPG + RMH collab) –May 27, Sunshine Hub or virtual
• Trauma Grand Rounds – June 18 atRoyal Children’s or online

Small steps to transform youpractice

• Deliberate practice = highperformance, visualisation and mental rehearsal make a difference
• Practice rhythm recognition
• Rehearse SITREPs

Resources
Paramedic analgesia comparing ketamine and morphine in trauma (PACKMaN): a randomised,double-blind, phase 3 trial

Palliative paramedicine: An interrupted time series analysis of pre-hospital guideline efficacy

Proposal to regulate advanced practice paramedics

Rhythm recognition

Get in touch

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James: ⁠⁠⁠@JamesOz1⁠⁠ | @jamesoz1.bsky.social

Ben: ⁠@ben_meadley⁠

Linkedin

James

Ben

Producer: Liam Hennebry