Advanced Paramedic Practitioner Course

Working closely with our colleagues in the London Ambulance Service, the Institute of Pre-Hospital Care designed a course aimed at their newly appointed Advanced Paramedic Practitioners.

A novel role, the Advanced Paramedic Practitioner (APP) was developed by the London Ambulance Service in 2014. This programme has given senior paramedics an opportunity to develop additional skills thus providing an enhanced service for the people of London. The Institute was proud to be involved in developing and delivering the trauma module of their initial training programme.


The module consisted of:

Lectures from experts in pre-hospital trauma care including the following subjects:

  • Gold standards in pre-hospital orthopaedics
  • Worldwide trauma systems
  • Midazolam science
  • Ketamine science
  • Human factors in pre-hospital care
  • Lasting power of attorney and end of life decisions
  • The medico-legal position on paramedic sedation
  • Pre-hospital head injury management
  • The Royal College of Anaesthetists Guidance on sedation
  • Anticoagulants in trauma patients

The programme covers practical ‘fully immersive scenarios’ on a breadth of major trauma subjects. Medical students from Barts and the London School of Medicine and Dentistry took ‘acting lessons’ so that the teaching on the use of ketamine for sedation could be made as realistic as possible.


In addition, paramedics took part in the  OPEG   (Oral presentation to Peer and Expert Group) process for learning and delivered high standard presentations on the following subjects:

  • The benefit of chest compressions in traumatic cardiac arrest
  • The trauma post-mortem examination
  • Performing thoracostomy in traumatic cardiac arrest
  • Textbook signs of bleeding, and reality
  • Mechanisms of injury in trauma patients – are the textbooks correct?
  • The identification of airway obstruction in the emergency operations centre
  • Trauma outcome scores
  • Which inotrope should advanced paramedics carry?
  • Pre-hospital blood tests in trauma patients
  • The effects of prescribed medication on the physiological response to trauma in the elderly
  • Prognosis in severe brain injury
  • The evolution of vehicle design and the Haddon Matrix of injury prevention

Paramedics were assessed with a multiple choice question paper.