A Comparative Taxonomy of Australasian Paramedic Clinical Practice Guidelines

Marc Colbeck, Sonja Maria



There are 10 state-run ambulance services in Australia and New Zealand, all of which are members of the Council of Ambulance Authorities (CAA). These CAA services use nine unique sets of clinical practice guidelines (CPGs) to direct the care that their paramedics deliver to patients. Although there are many similarities in these guidelines there are also notable differences in both structure and content. This paper is a comparative analysis of these CAA CPGs that contrasts the differences in organisation and also discusses the similarities and differences between the various CPGs themselves. This comparison was done as a preparatory exercise for the creation of a set of national CPGs by Paramedics Australasia.


The complete set of CPGs were obtained and analysed. All CPGs intended for operational road paramedics were examined. These included extended care paramedic, retrieval and intensive/critical care paramedic CPGs, and first responders. The 10 tables of contents were synthesised into one document and then restructured into a unique taxonomy determined by consensus of the authors. The authors reviewed the taxonomy to ensure the organisation was consistent and logical. Each CPG was then reviewed to ensure that it was appropriately placed in the new taxonomy. The CAA CPGs were further examined for similarities and differences independently by each author according to a predefined list of characteristics.


A new taxonomy for Australasian CPGs is presented with a discussion of various issues of interest that became apparent during the development of the taxonomy. This taxonomy can provide guidance in the creation of a unified set of CPGs that can be used as a reference for developers, educators, clinicians, researchers, managers and industry representatives interested in consulting and developing a clear statement of the scope and standards of Australasian paramedics. The comparative analysis could be of interest to developers of CAA CPGs, and others.


This paper presents a novel taxonomy, or scheme of classification, that incorporates all CAA CPGs in preparation for the development of a uniform set of Australasian CPGs, which will be of use to various individuals and organisations.


Paramedic, Australasia, CPG, Clinical Practice Guideline

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Paramedics Australasia. Paramedicine role descriptors 2012. Available at: https://paramedics.org/wp-content/uploads/2016/09/PRD_211212_WEBONLY.pdf

Blacker N, Pearson L, Walker T, editors. Redesigning paramedic models of care to meet rural and remote community needs. 10th National Rural Health Conference; 2009.

O’Meara PF, Tourle V, Stirling C, Walker J, Pedler D. Extending the paramedic role in rural Australia: a story of flexibility and innovation. Rural Remote Health 2012;12:1–12.

Stirling C, O’Meara P, Pedler D, Tourle V, Walker JH. Engaging rural communities in health care through a paramedic expanded scope of practice. ibid. 2007;7:1–9.

Bigham BL, Kennedy SM, Drennan I, Morrison LJ. Expanding paramedic scope of practice in the community: a systematic review of the literature. Prehosp Emerg Care 2013;17:361–72.

Council of Ambulance Authorities. About the CAA 2017. Available at: www.caa.net.au/about-us [Accessed 8 March 2018].

Paramedics Australasia. About Paramedics Australasia 2017. Available at: www.paramedics.org/about/ [Accessed 8 March 2018].

ACT Ambulance Service. Clinical management guidelines 2017. Available at: http://esa.act.gov.au/actas/about-us/clinical-management-guidelines/ [Accessed 8 March 2018].

NSW Ambulance. Ambulance protocols and pharmacology 2016. Available at: http://ciap.hcn.com.au/www.ciap.health.nsw.gov.au/specialties/cda.html [Accessed 8 March 2018].

Ambulance Victoria. Clinical practice guidelines for MICA and ambulance paramedics. Melbourne, Victoria; 2017. Available at: http://s3-ap-southeast-2.amazonaws.com/prod.assets.ambulance.vic.gov.au/wp-content/uploads/2016/07/CPG-2016-Edition-Vs.1.1web-reducedsize-flattened-secure.pdf [Accessed 8 March 2018].

Ambulance Tasmania. Clinical practice guidelines for Ambulance Tasmania 2015. Available at: www.dhhs.tas.gov.au/ambulance/clinical_services/medical_protocols/paramedic_protocols [Accessed 9 March 2018].

Queensland Ambulance Service. QAS clinical practice manual. Kedron Park, Brisbane: Queensland Government; 2017. Available at: www.ambulance.qld.gov.au/CPGtable.html [Accessed 8 March 2018].

St John Ambulance NT. Clinical practice manual version 2.3, 2013. Available at: www.stjohnnt.org.au/img/documents/clinical-manuals/CPG-HV23June2013.pdf [Accessed 8 March 2018].

St John. Clinical procedures and guidelines: comprehensive edition 2016-2018. Available at: www.rgpn.org.nz/Network/media/documents/St%20John%20CPGs%202016-18/St-John-CPGs,-comprehensive-edition,-2016-2018.pdf [Accessed 8 March 2018].

Wellington Free Ambulance. Clinical procedures and guidelines: comprehensive edition 2016-2018. Available at: www.wfa.org.nz/file/931/WFACPG_Comprehensive_LQ170228.pdf [Accessed 8 March 2018].

Burgers JS, Grol RPTM, Zaat JOM, Spies TH, Van Der Bij AK, Mokkink HGA. Characteristics of effective clinical guidelines for general practice. Br J Gen Pract 2003;53:15–9.

Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Potential benefits, limitations, and harms of clinical guidelines. BMJ 1999;318:527–30.

Agree Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE Project. Qual Saf Health Care 2003;12:18–23.


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The Official Journal of Paramedics Australasia © 2018                           ISSN: 2202-7270