Royal College of Paramedics Stage

Mental capacity is often tested in the most complex, high-pressure moments of frontline care, where legal, ethical, and operational decisions must be made quickly and confidently. This session explores mental capacity assessment in practice through a case-based approach, examining the real-world challenges faced by emergency service professionals.

Drawing on specialist expertise in mental health law, the session highlights how clinicians can navigate uncertainty, apply legislation effectively, and make defensible decisions in the field. It also considers the wider implications for practice, education, and co-production, linking these insights back to current research in out-of-hospital care.

In this session, Joe Dent explores stroke recognition from the traditional FAST (Face, Arms, Speech, Time) assessment through to the subtle and posterior presentations it can miss. The session opens with FAST as a simple, rapid screening tool for identifying facial droop, arm weakness and speech difficulty, and emphasises the critical importance of time in initiating urgent care and supporting early decision-making in out-of-hospital environments.

It then builds on these principles to examine atypical stroke presentations, particularly posterior circulation strokes, where symptoms such as balance disturbance, visual changes and non-specific neurological deficits may go undetected by FAST alone. Through a clinically focused, practical lens, the session equips clinicians with a broader awareness of both common and overlooked stroke presentations, strengthening clinical judgement and improving early recognition across the full spectrum of time-critical neurological emergencies.

This session explores physiology-guided resuscitation and its growing role in improving outcomes from cardiac arrest. Physiology-guided approaches allow clinicians to tailor resuscitation in real time based on the patient's own physiological response, rather than relying on a fixed protocol alone. Underpinning this shift, however, remains the fundamental requirement for high-quality CPR: adapting care in response to physiology is only possible when that care, and its effect, can first be accurately measured.

This session examines how CPR feedback technology supports that measurement, enabling clinicians to monitor performance, make informed adjustments during resuscitation and move towards a more responsive, data-informed approach to cardiac arrest management. Through a practical, clinically grounded discussion, delegates will gain insight into how combining high-performance CPR with physiology-guided decision-making can enhance the quality and effectiveness of resuscitation in the out-of-hospital setting.

This session explores the shift from protocol-driven cardiac arrest management to physiologically guided resuscitation, where treatment is adapted in real time based on patient response. Focusing on the integration of monitoring, mechanical chest compressions, synchronised ventilation, and point-of-care ultrasound, the discussion will highlight how a connected approach can support more informed decision-making during resuscitation.

Particular attention will be given to the value of coordinating compressions and ventilation, maintaining high-quality CPR, and using imaging to identify reversible causes. Through practical insight and clinical context, the session will examine how combining these elements can reduce interruptions, improve team coordination, and support a more personalised, physiology-led approach to resuscitation.

Stepping onto the road as a newly qualified paramedic is one of the most exciting, and challenging, moments in a clinician’s career. This session, delivered by Paramedic Mentor Harry Vines, explores the transition from Newly Qualified Paramedic through to Band 6, focusing on the practical realities of developing confidence and clinical autonomy on the frontline.

Through a supportive, experience-led approach, the session examines key challenges, expectations, and opportunities encountered during this progression, highlighting how clinicians can consolidate foundational skills, adapt to increasing responsibility, and grow into autonomous practitioners within the out-of-hospital environment.

Delivered by Sam Thompson, this interactive session provides a rare opportunity to experience remote clinical decision-making from the clinician's perspective. Through an unfolding patient story, delegates will discover why the greatest challenge isn't making decisions without seeing the patient, it's knowing which questions still need to be asked. Drawing on the principles explored in Remote Triage and Consultations in Emergency and Primary Care, the session introduces the concept of calibrated curiosity, a practical approach to asking better questions, recognising and excluding red flags, and making confident, proportionate decisions in the face of uncertainty.

Rather than promoting defensive practice or unnecessary escalation, the session explores how structured clinical reasoning helps clinicians identify the patients who genuinely need emergency care while giving them the confidence to safely manage those who do not. Whether you work in ambulance services, urgent care, primary care or remote triage, this practical and thought-provoking session will challenge assumptions, provide a unique insight into the realities of remote clinical decision-making, and offer immediately applicable strategies for delivering safe, effective and patient-centred care.