Ambulance Services across Australia and the world have clinical practice guidelines or protocols which outline the treatment and management of specific patient presentations. These guidelines vary greatly in everything from how they look, to what they include and the treatment they describe. Some ambulance services have guidelines which are well-defined and easier to follow and understand than others. Some include a lot of detail and background information, whereas others simply list treatment options. Also, the management of certain patient conditions may be clearer when expressed in a specific layout (e.g. flow-chart or diagrams).
Whilst there is great variance in the format and detail in guidelines across different ambulance services, each organisation no doubt would defend their documents as being current best practice and the correct way things should be done! The one thing that is in common between most ambulance service guidelines however, is the lack of evidence justifying the content. Usually there are no references supporting the subject matter at all. So are they really based on current best practice?
Your task is to design a clinical practice guideline/treatment pathway for a specific condition which has been allocated to you. You must decide on the layout and format which best suits the condition, and describe the paramedic management in an out-of-hospital context.
You will need to research the condition, to find out what is the current best practice, and provide references which support the treatment you describe. You may review guidelines which already exist for the condition you have been allocated, but these should not be copied or dictate the management you explain (use journal articles instead).
You have free-range over the design of your guideline, but consider it should be 2-3 pages in length.
Include some background information on the condition and issues for paramedics to reflect on. Highlight potential ‘time-critical’ situations and difficulties with patient assessment. You may also want to consider some overall patient safety statements such as “all unconscious patients should be transported to hospital regardless of the cause” etc.
The guideline should also include explicit details around drugs to administer, including the dose and how often. You may suggest the use of drugs which are currently not common place in the prehospital setting, provided there is evidence supporting their use and it would be reasonable to carry these drugs in an ambulance (e.g. does not require a fridge). There is no need to segregate different levels of practitioner (e.g. Intensive Care Paramedic) – your guideline would be used by every paramedic regardless of their skills.
Use the dedicated assignment forum on FLO if you have any questions regarding this assessment.
Enron Scandal: Impact on Accounting Disclaimer: This work has been presented by an understudy. This isn't a case of the work composed by our expert scholastic scholars. You can see tests of our expert work here. Any feelings, discoveries, ends or proposals communicated in this material are those of the writers and don't really mirror the perspectives of UK Essays. Distributed: Tue, 17 Jul 2018 Representing Enron 1. For what reason is bookkeeping being reprimanded for the misfortunes managed by speculators because of the crumple of Enron? Is this feedback reasonable and do budgetary bookkeeping and announcing hones should be transformed? Bookkeeping has been reprimanded for the misfortunes managed by Enron, as it enabled the organization to conceal points of interest of its dealings from its speculators, until the point when the organization's money related circumstance was bad to the point that the firm was compelled to go bankrupt medium-term. Enron's destruction has been described as "over the top enthusiasm by administration in keeping up stock cost or income incline using abnormally forceful bookkeeping rehearses." (Healy, 2003) As a component of this, Enron utilized "'check to-advertise bookkeeping' for the vitality exchanging business in the mid-1990s and utilized it on a remarkable scale for its exchanging exchanges." (Thomas, 2002) Under stamp to-showcase bookkeeping hones, organizations with exceptional subordinate contracts or buys on their monetary records when accounts are being readied must change them to "equitable esteem" (Thomas, 2002) therefore, anticipated long haul increases or misfortunes on these agreement are connected to the organization's benefits promptly, like devaluation, or resource compose downs. The fundamental trouble experienced while doing this for long haul prospects contracts in vitality markets is that "there are frequently no cited costs whereupon to base valuations. Organizations having these sorts of subordinate instruments are allowed to create and utilize optional valuation models in light of their own suppositions and strategies, as Enron did." (Healy, 2003) Another bookkeeping system Enron used to cover up noteworthy obligations was the utilization of exceptional reason elements (SPEs), which Enron took to "new statures of multifaceted nature and advancement, underwriting them with not just an assortment of hard resources and liabilities, yet additionally to a great degree complex subordinate monetary instruments, its own confined stock, rights to get its stock and related liabilities." (Thomas, 2002) Enron likewise utilized these SPEs to shroud points of interest of benefits which were unreasonably declining in esteem, in this way abstaining from having misfortunes from resource record and deterioration charges on the organization books. This training was connected to "certain abroad vitality offices, the broadband task or stock in organizations that had been spun off to people in general." (Thomas, 2002) The bookkeeping medications around SPEs implied that the misfortunes maintained on these benefit compose downs would not show up on Enron's records. Enron guaranteed share issues to the speculators in the SPEs to remunerate them for taking these advantages on be that as it may, as the estimation of the benefits fell significantly further, Enron got itself unfit to meet these duties from offer issues. These innovative bookkeeping strategies started to be suspected by financial specialists in October 2001, when Enron a few new organizations neglected to execute and also anticipated. Enron was trusting these new organizations would cover its misfortunes on the SPEs in any case, in October 2001 the organization was compelled to report a noteworthy arrangement of compose downs of its own advantages, including "after duty charges of $2.87 million for Azurix, the water business gained in 1998, $180 million for broadband ventures and $544 million for different speculations." (Healy, 2003) These compose downs added up to twenty two percent of the capital spent by Enron on building up its business somewhere in the range of 1998 and 2000. Furthermore, Enron sold Portland General Corp., the electric power plant it had procured in 1997, for $1.9 billion, at lost $1.1 billion over the securing cost. (Healy, 2003) The misfortunes brought about because of this made financial specialists question whether Enron's technique was attainable in the long tem, and in business sectors other than subordinates. In synopsis, while the bookkeeping ideas and methodology hidden the gas subsidiaries exchanging was a sensible endeavor to create an incentive for financial specialists, "augmentations of this thought into different markets and worldwide development were unsuccessful." (Healy, 2003) However, while the stamp to market and SPE bookkeeping strategies utilized by the organization helped conceal this reality from speculators, the securities exchanges in general were blameworthy of "to a great extent overlooked warnings related with Enron's astounding revealed execution" (Thomas, 2002). This supported and, according to the administration at Enron, vindicated the organization's development technique by permitting Enron access to a lot of capital efficiently and effectively. All things considered, bookkeeping can't be completely rebuked for the misfortunes maintained by financial specialists, as the speculators themselves just accepted that the esteem Enron had all the earmarks of being producing "would be managed far into the future, notwithstanding minimal monetary reason for such a projection." (Thomas, 2002) thus, while bookkeeping made it less demanding for Enron to deceive its financial specialists, the actualities demonstrate that speculators themselves were more worried about Enron's accounted for benefits and development, than examining the roots causes and plan of action. 2. Does it make a difference what bookkeeping approaches are received by an organization as long as they are sufficiently uncovered? An "exceptionally confounding reference in Enron's 2000 money related articulations" (Thomas, 2002) portrayed the exchanges being referred to one, anyway as per experts, "a great many people would be unable to comprehend the impacts of these revelations on the budgetary proclamations, giving occasion to feel qualms about both the nature of the organization's income and in addition the business motivation behind the exchange." (Thomas, 2002) By mid 2001, a few market examiners had started to scrutinize the clearness and straightforwardness of Enron's divulgences. One examiner was cited as saying, "The notes simply don't bode well, and we read notes as a profession." (Thomas, 2002) Enron openly condemned and manhandled these investigators notwithstanding, in light of these activities, financial specialists started to see Enron's bookkeeping arrangements, and revelations, with more noteworthy and more prominent doubt. Surely, regardless of the way that Enron's divulgences were sufficient in the administrative structure, they were still not in the soul of administrative duty to investors. In another case of deficient divulgence arrangements, Satava et al (2003) inspected the observed Royal Mail Case and the ramifications of the case for the bookkeeping practice today. Satava's contentions guaranteed that the case was "not about the usage of mystery holds, but rather about the non-revelation of reimbursements by the Inland Revenue of over arrangements for expense, and that resistance advise for the reviewer succeeded in view of the feeble truthful case exhibited by the arraignment." (Satave et al, 2003) In synopsis, the obligation of bookkeepers to sufficiently unveil their bookkeeping approaches can frequently strife with endeavors by similar bookkeepers to utilize these strategies to profit the organization. Thus, these irreconcilable circumstances regularly result in just really satisfactory exposures of substandard bookkeeping strategies. 3. What exactly degree did Enron use wobbly sheet financing in its activities? Were these exchanges suitably treated and sufficiently uncovered in the monetary explanations of the organization? What outcomes did the bookkeeping treatment of these exchanges have for Enron and its speculators? The primary way Enron utilized reeling sheet financing was in its broad utilization of SPEs to give it prepared access to back without announcing any obligations it acquired in its records. The organization contributed resources, and obligation anchored against those advantages, to a SPE in return for control of the SPE, and the SPEs at that point acquired a lot of capital which was utilized to fund Enron, with no obligation or resources appearing in Enron's records. Enron additionally sold advantages for the SPEs at above market esteem, and in this manner detailed benefits on these deals. Enron utilized tremendous quantities of SPEs along these lines, the most understood of which were LJM Cayman LP and LJM2 Co-Investment LP. "From 1999 through July 2001, these elements paid Enron supervisors more than $30 million in administration expenses, much more than their Enron pay rates, apparently with the endorsement of best administration and Enron's governing body." (Healy, 2003) The SPEs thus made that's right more SPEs, known as the Raptor vehicles, which empowered Enron to put intensely in a bankrupt broadband organization, Rhythm NetConnections, amid the dotcom blast. To back this speculation Enron made an offer issue worth $1.2 billion. In any case, so as to finish this arrangement, Enron expanded investors' value to mirror this exchange, which has been professed to damage bookkeeping models and standards. Furthermore, bookkeeping decides really implied that Enron ought to have included data from the LJM and Raptor SPEs in their records, instead of keep on utilizing them as cockeyed sheet financing. (Healy, 2003) Notwithstanding these minor infringement, Enron uncovered in October 2001 that few different SPEs had abused the bookkeeping standard that required no less than 3 percent of the elements to be possessed by different financial specialists, with no enthusiasm for the parent organization. Once more, by disregarding this necessity, Enron kept the financing it acquired from these elements off its monetary record, empowering it to downplay its liabilities and misfortunes on this wellspring of financing. Nonetheless, on October 16, 2001, Enron declared that "repetitions to its monetary explanations for quite a long time 1997 to 2000 to redress these infringement would diminish income for the four-year time frame by $613 million (or 23 percent of revealed benefits dating the period>GET ANSWER