Paramedic education faces challenges in preparing students for the complex and nuanced realities of clinical practice. Simulated practice learning (SPL), an innovative approach used in nursing education, is proposed as an adaptable option that can be used to meet these needs. Gaps in undergraduate nursing curricula addressed by SPL have identified parallels with those in paramedic education, including around the application of theory to practice, exposure to and involvement in high-stakes incidents, development of clinical management and professionalism and emotional preparedness for clinical practice. By identifying these shared gaps, this article proposes a four-step framework to support the integration of SPL into paramedic curricula. Based on evidence, the framework is designed in line with student needs, feasibility and sustainability for institutions, as well as practice partner expectations. SPL has been successfully incorporated into nursing education, and this article concludes that it represents a viable and scalable option for paramedic education.

The treatment of pain in the prehospital setting is suboptimal. The scope of paramedic practice is broadening, with more medicines becoming available to these professionals, including ketamine for pain management. A systematic literature review was carried out to examine the safety and efficacy of ketamine for adult trauma in a prehospital setting and its suitability for paramedics working outside an enhanced care scope of practice. Ketamine is effective in hypovolaemic patients and a preferred option for critically ill and hypotensive patients; it is particularly effective in alleviating trauma-based pain when used with opiates such as morphine or fentanyl. Side effects are rare and easily managed. Ketamine is a safe and effective addition to prehospital analgesia for adult trauma patients and safe for paramedics working outside an enhanced care scope of practice to administer. Advancing paramedics' understanding of the co-administration of ketamine and morphine versus ketamine alone would support decision-making in trauma-based patient.

Background: As the role of the UK paramedic expands and the NHS is increasingly stretched, it has become commonplace for paramedics to attend patients nearing the end of life. Despite this, many paramedics lack confidence when attending end-of-life patients owing to the complex clinical and emotional nature involved. Aim: This study aimed to understand the determinants that affect UK paramedic confidence when attending end-of-life patients and how they can be addressed. Method: A rapid literature search of databases for current evidence was carried out; 35 abstracts and titles were identified and, after screening, 10 eligible papers were reviewed. Findings: Themes included a lack of training, limited out-of-hours community support, fear of legal or disciplinary action and complex decision-making. Conclusion: There needs to be improvements in the training and education of UK paramedics for end-of-life patients and an increase in end-of-life community out-of-hours support.

Paramedic education is underpinned by multiple pedagogical approaches, of which simulation-based learning, case-based learning and problem-based learning are pivotal. These methods support the development of clinical reasoning and enhance learner progression. However, access to high-fidelity simulation and pressures on placement capacity create inconsistent opportunities for self-directed study. Generative artificial intelligence (Gen AI) offers a potential supplement, enabling interactive and adaptable learning experiences. This continuing professional development (CPD) article presents a case study of a final-year paramedic student who engaged with a Gen AI tool to practise complex case-based and problem-based learning. The learner used prompt engineering to frame the tool as a ‘medical expert’, generating scenarios with evolving information. The Gen AI provided feedback, branching pathways and quizzes. Analysis of this interaction is aligned with key educational frameworks and demonstrates how Gen AI supported active learning. While promising, the approach highlights the need for critical appraisal of outputs, awareness of ethical and equity considerations, and alignment with CPD standards to ensure safe and effective application in paramedic education.

Background: Family presence during resuscitation (FPDR) has been a subject of debate within prehospital and emergency care. Despite increasing advocacy for FPDR, there is limited research on its effects in the prehospital setting, and on the experiences of those involved. This review seeks to explore what is known about FPDR and identify gaps in knowledge that may aid future research. Aim: This study aimed to analyse the effects of family presence during resuscitation (FPDR). Method: A scoping review of the literature compared prehospital FPDR guidelines worldwide and explored the experiences and perspectives of family and healthcare professionals in prehospital and emergency medicine. Results: Guidelines for paramedics support FPDR in the UK and worldwide; however, little is known about its effects on relatives and healthcare professionals in prehospital settings. Four themes were identified: patient care; relatives' wellbeing; healthcare professionals' perspectives; and organisational factors. Conclusion: It is crucial that paramedics feel equipped to support family members during and after cardiopulmonary resuscitation, and that relatives feel supported and empowered in the complex decision-making process. To enable such support to relatives in the prehospital environment, paramedics must receive education and specific guidance on medical ethics concerning FPDR. Education for healthcare professionals should be implemented to inform ethical decisions, thus supporting FPDR in clinical practice.

Background: Heart failure (HF) is complex and difficult to diagnose in prehospital settings, leading to potential overuse of treatments such as intravenous (IV) furosemide. This prompted a scoping review to assess its effectiveness in managing acute left ventricular failure (ALVF) in emergency contexts. Aim: This study aims to enhance understanding of IV furosemide use in high-acuity prehospital emergencies and its implications for future diuretic therapies. Methods: A scoping review was conducted on literature exploring the use of IV furosemide in high-acuity emergency settings. Results: Three main themes emerged: the accuracy of ALVF diagnosis and its impact on outcomes; the influence of transport times on furosemide administration; and the potential risks of furosemide outweighing its benefits. Conclusion: IV furosemide can alleviate HF symptoms, but prehospital diagnostic challenges may increase the risk or harm to patients, with alternative treatments offering more benefits and fewer adverse effects.