The latest JRCALC update is here! There’s a brand new guideline on Delirium, as well as changes to existing guidelines such as Glycaemic Emergencies in Adults and ChildrenAlcohol-use DisordersLimb TraumaHeat Related IllnessesBreech BirthCOPDAdrenalineALS in Children and ALS.

Let’s start with a quick overview from Dr Simon Brown, JRCALC Editorial Lead.

There’s a BRAND NEW guideline on Delirium.

This is a completely new guideline for JRCALC. Delirium is often not recognised and is associated with poor outcomes. Delirium must be considered in conjunction with the Acute Behavioural Disturbance (ABD) and Agitated Patients guidelines that are already in JRCALC.

Matt Ward, Consultant Paramedic and Head of Clinical Care at West Midlands Ambulance Service, who helped develop this new guideline, is going to tell you more.

There’s been a full review and update to the Glycaemic Emergencies in Adults and Children guideline.

It now includes more information and images about devices, such as insulin pumps. There’s also added guidance on pre-hospital ketone testing which should be performed when indicated and where ketone meters are available. Finally, there’s a brand new section on diabetes mental health and diabulimia.

An update has been made to the Alcohol-use Disorders guideline as part of the review into the Glycaemic Emergencies in Adults and Children guideline.

A new paragraph is included on alcoholic ketoacidosis which can occur when a person who is alcohol dependent or has had a prolonged alcohol binge, abruptly stops drinking and at the same time stops eating.

Find out more by watching this update video with Tom Merriman, Paramedic at North West Midlands Ambulance Service, who’s supported the review of this guideline.

There has been a revised standalone guideline for the management of Breech Birth with a new algorithm.

This has been informed by evidence where it is available and learning from adverse incidents and coroners’ inquests. It gives guidance on practical procedures and manoeuvres to deliver a breech baby, with images, photos and links to short video clips, and includes specific guidance on when to leave scene immediately, details around when birth is imminent or not imminent, maternal positioning (semi recumbent and all fours positions), timings and when to perform manoeuvres if needed.

Listen to Dawn Kerslake, Consultant Midwife at South East Coast Ambulance Service, who supported the review of the Breech Birth guideline.

The guideline for Limb Trauma has a had a full review and update.

It has new guidance and images on fracture reduction and management of patella dislocation, as well as more detail on hip fractures.

Watch Mark Hodkinson, Consultant Paramedic – Critical Care with Thames Valley Air Ambulance, who led the review of the Limb Trauma guideline, as he explains more.