Paramedic case study: Emergency Medicine

Keith Dickinson, a paramedic at the Scottish Ambulance Service, describes how he uses Telephone Advice & Guidance to speak to consultants at Ninewells Hospital at NHS Tayside Health Board.

“Telephone Advice & Guidance is an extremely valuable service which should be utilised for the benefit of patients.”  Keith Dickinson

Paramedic case study: Emergency Medicine

Keith Dickinson, as well as the other members of the Scottish Ambulance Service, has had access to Telephone Advice & Guidance and IG Secure Clinical Photography (PhotoSAF) since September 2018. The service allows paramedics and GPs to speak to local consultants working in Acute Medicine, Emergency Medicine and Stroke Medicine. This enables consultants and paramedics or GPs to work together to decide the best patient pathway.


Keith has been a paramedic for 15 years. Before he had access to Telephone Advice & Guidance, he used to get advice via ambulance control. He would also call the Perth Royal Infirmary A&E department or ask local GPs for advice. He prefers Telehone Advice & Guidance because:


“We can access senior advice from a single source that understands the challenges of our environment, distances from available hospitals, our guidelines, and what skills and drugs we have available.”


It is “through this understanding that [consultants can help paramedics] to apply the most relevant treatment and [to organise] transportation to the most appropriate hospital” – saving time for all concerned, ensuring that the best patient pathway is followed and avoiding unnecessary attendances at A&E.


We asked Keith what he would say to paramedics who are unsure about using the service. He commented that:

“Telephone Advice & Guidance is an extremely valuable service which should be utilised for the benefit of patients.”

We asked Keith to provide a recent clinical issue that prompted him to use Telephone Advice & Guidance when with a patient. He provided the following example.


“Recently, during a weekend shift, I attended an elderly male who was in severe pain due to a large swelling in his groin. Through hearing the patient’s past medical history and my examination, I was concerned that he was suffering from a strangulated hernia. Our current guidelines require us to take all surgical cases with the exception of Abdominal Aortic Aneurysm to Perth Royal Infirmary in the first instance for assessment. I used Telephone Advice & Guidance to raise my concerns that it would be detrimental to my patient to have him taken to Perth Royal Infirmary for assessment only then to be transferred on to Ninewells Hospitals for the immediate attention his condition required.”


How Telephone Advice & Guidance helped:

“Through my immediate discussion with the senior consultant at Ninewells Hospital, we agreed to bypass Perth Royal Infirmary and transfer my patient directly to Ninewells Hospital which helped to speed up his treatment.”

Click here to view and download a PDF version of this case study.

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