Ity was that paramedics confidence was frequently low in having the ability to know when it was and was not secure to leave a seizure patient in the scene. Participants stated scant focus was given to seizure management, especially the postseizure state, inside simple paramedic training and postregistration education opportunities. Traditionally, paramedic education has focused on the assessment and procedures for treating patients with lifethreatening conditions. There is a drive to now revise its content material, so paramedics are improved prepared to perform the evolved duties expected of them. New curriculum guidance has not too long ago been created for higher education providers.64 It does not specify what clinical presentations need to be covered, nor to what extent. It does though state paramedics have to be in a position to “understand the dynamic relationship involving human anatomy and physiology. This should include all major body systems with an emphasis on cardiovascular, respiratory, nervous, digestive, endocrine, urinary and musculoskeletal systems” ( p. 21). And, that they must be capable to “evaluate and respond accordingly for the healthcare wants of sufferers across the lifespan who present with acute, chronic, minor illness or injury, health-related or mental health emergencies” ( p. 35). It remains to be seen how this will likely be translated by institutions and what understanding students will acquire on seizures.Open Access We would acknowledge right here that any curriculum would have to reflect the workload of paramedics and there are going to be other presentations competing for slots within it. Dickson et al’s1 evidence may very well be helpful here in prioritising attention. In examining 1 year of calls to a regional UK ambulance service, they located calls relating to suspected seizures were the seventh most typical, accounting for three.3 of calls. Guidance documents and tools It really is critical to also consider what might be carried out to support currently certified paramedics. Our second paper describes their understanding requires and how these might be addressed (FC Sherratt, et al. BMJ Open submitted). Another crucial issue for them although relates to guidance. Participants said the lack of detailed national guidance on the management of postictal individuals compounded difficulties. Only 230 on the 1800 words committed to the management of convulsions in adults within JRCALC19 relate towards the management of such a state. Our findings recommend this section warrants order F 11440 revision. Having mentioned this, proof from medicine shows altering and revising guidelines does not necessarily imply practice will transform,65 66 and so the influence of any changes to JRCALC should be evaluated. Paramedic Pathfinder is a new tool and minimal evidence on its utility is accessible.20 The majority of our participants said it was not helpful in advertising care quality for seizure patients. In no way, did it address the issues and challenges they reported. Indeed, one criticism was that the alternative care pathways it directed them to didn’t exist in reality. Last year eight wellness vanguards had been initiated in England. These seek to implement and explore new ways that distinct parts of the urgent and emergency care sector can function with each other in a much more coordinated way.67 These could possibly deliver a mechanism by which to bring concerning the enhanced access to option care pathways that paramedics want.62 This awaits to become noticed. Strengths and PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20363167 limitations That is the first study to explore from a national perspective paramedics’ views and experiences of managi.