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of spontaneous circulation chapters contain further information about the use of drugs covered in section 7 but applied to a cardiac arrest situation.

       Medical Emergencies section (JRCALC Guidelines, section 3)

This section contains a large amount of specific information relating to a breadth of medical emergencies commonly encountered by paramedics in practice. Section 3 starts with two chapters giving an overview of medical emergencies in adults and children which contain general information relating to medical emergencies and patient assessment (see Table 2.1). The text then focuses on a number of specific aspects of medical emergencies in more detail within which drugs identified in section 7 could be applied.

      Each of these chapters is then further split into subsections: an introduction, incidence, severity and outcome, pathophysiology and assessment and management. This provides a comprehensive overview of each medical emergency and how it should be managed by paramedics in practice. Paramedics should refer to this section to see whether a particular drug is used to treat a certain condition and where that drug fits into patient management.

      Clinical consideration

      Both hydrocortisone and adrenaline 1:100 have anaphylaxis listed as an indication in their chapters in the Medicines section (section 7). However, the Allergic Reactions Including Anaphylaxis chapter, in the Medical Emergencies section (section 3), should be referred to for more information about where these drugs fit into the management plan for such patients.

Table 2.1 Examples of emergency conditions covered in section 3.

Acute coronary syndrome	Hyperventilation syndrome
Abdominal pain	Hypothermia
Allergic reactions (including anaphylaxis)	Implantable cardiovascular defibrillator
Altered levels of consciousness	Management of resuscitation of patients with left ventricular assist devices
Asthma in adults and children	Meningococcal meningitis and septicaemia
Cardiac rhythm disturbances	Mental health presentations
Chronic pulmonary disease	Mental Capacity Act
Convulsions in adults	Respiratory illness in children
Convulsions in children	Sickle cell crisis
Dyspnoea	Sepsis
Febrile illness in children	Stroke/transient ischaemic attack
Gastrointestinal bleeding	Traumatic chest pain
Glycaemic emergencies in adults and children	Overdose and poisoning in adults and children
Headache	Paediatric gastroenteritis
Heart failure	Pulmonary embolism
Heat‐related illness

Paramedics need to be aware that just referring to the indications in the Medicines section (section 7) may not give full information about where a drug fits into an ambulance service protocol for management of a certain patient condition, and so the JRCALC guidance in the Medical Emergencies section (section 3) should always be referred to alongside the Medicines section in order to ensure best approach and correct patient management.

       Trauma section (JRCALC Guidelines, section 4)

The Trauma section is laid out in a similar structure to the Medical Emergencies section. The initial two chapters give an overview of trauma emergencies in adults and children and the subsequent chapters each contain information about a specific trauma emergency and its paramedic management (see Table 2.2).

      All the individual chapters follow a similar format, offering information about the incidence, severity and outcome, pathophysiology and assessment and management of each trauma emergency. In relation to drugs and their use in emergency situations, the Trauma chapter should be used similarly to the Medical Emergencies chapters. Each chapter can be used to find more information about drugs used in the treatment of a given emergency and, more specifically, exactly where a particular drug fits into the treatment and management plan for patients in practice. Paramedics should use this information in conjunction with the Medicines section (section 7) and specific drugs within it, in order to find not only information about when a drug should be used and how it fits into a particular management plan, but also information to ensure the drug is administered correctly, thus reducing the possibility of drug errors.

       Maternity Care (JRCALC Guidelines, section 5)

      The notion of two lives scenarios (i.e. mother and baby) presents the paramedic with numerous challenges specific to this area of care. This section begins with an overview of obstetric emergencies and contains chapters that guide the paramedic through the management of a range of maternity‐related presentations. Similarly to the previous sections, paramedics should refer to and check the protocols for each given maternity situation to confirm whether drug therapy is appropriate for a given maternal presentation. After checking the Maternity Care section, further information about dosage or specific drug actions should be sought in the Medicines section (section 7).

       Special Situations (JRCALC Guidelines, section 6)

      This section contains chapters about specific situations paramedics may encounter and includes information about major, high‐risk and complex incidents such as individuals requiring care interventions but who have been incapacitated by police or other security services. Within this section there are two chapters relating specifically to medicines.

       Atropine for CBRNe (chemical, biological, radiological and nuclear explosives).

       DuoDote® auto‐injector (atropine combined with pralidoxime).

      These two chapters contain information about the presentation, indications, actions, contraindications, cautions and side‐effects of these drugs in relation to organophosphate and nerve agent poisoning.

Table 2.2 Examples of specific trauma emergency conditions and management covered in section 4.

Abdominal trauma	Thoracic trauma
Head injury	Falls in older adults
Limb trauma	Burns and scalds
Spinal injury and spinal cord injury	Electrical injuries
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