Background This article forms part of a series that seeks to identify interjurisdictional differences in the scope of paramedic practice and, consequently, differences in patient treatment based on which jurisdiction a patient is geographically located within at the time of their complaint. Method The current Clinical Practice Guidelines of each Australasian domestic jurisdictional ambulance service (JAS) were accessed during June 2020 and updated in August 2021. Content was extracted and verified by 18 paramedics or managers representing all 10 JASs. Results All JASs use intramuscular adrenaline as a first-line agent for adult anaphylaxis. Beyond this, significant differences exist in all treatments: five services provide nebulised adrenaline; 10 services provide adrenaline infusions (one requires doctor approval; one provides repeat boluses); six services provide nebulised salbutamol; two services provide salbutamol infusions (one requires doctor approval; one provides repeat boluses); five services provide nebulised ipratropium bromide; eight services provide corticosteroids (two restricted to intensive care paramedics (ICPs)); five services provide antihistamines for non-anaphylactic or post-anaphylactic reactions; four services provide glucagon (one requires doctor approval); magnesium is infused by ICPs in two services; 10 services allow unassisted intubation in anaphylactic arrest; one service allows ICPs to provide sedation-facilitated intubation or ketamine-only breathing intubation; eight services allow rapid sequence induction (two restricted to specialist roles). Conclusion The JASs in Australasia have each created unique treatment clinical practice guidelines that are heterogeneous in their treatments and scopes of practice. A review of the evidence underlying each intervention is appropriate to determining best practice.

中文翻译：

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PP16 澳大利亚司法管辖区救护车服务的护理人员临床实践指南系列的比较：成人过敏反应

背景 本文是系列文章的一部分，该系列旨在确定护理人员实践范围内的司法管辖区差异，从而确定患者治疗的差异，具体取决于患者在投诉时所在的地理区域。方法 在 2020 年 6 月访问并于 2021 年 8 月更新每个澳大利亚国内司法救护车服务 (JAS) 的当前临床实践指南。内容由代表所有 10 个 JAS 的 18 名护理人员或管理人员提取和验证。结果 所有 JAS 均使用肌肉注射肾上腺素作为成人过敏反应的一线药物。除此之外，所有治疗都存在显着差异：五种服务提供雾化肾上腺素；10 项服务提供肾上腺素输注（一项需要医生批准；一项提供重复推注）；六项服务提供雾化沙丁胺醇；两项服务提供沙丁胺醇输注（一项需要医生批准；一项提供重复推注）；五项服务提供雾化异丙托溴铵；八项服务提供皮质类固醇（两项仅限于重症监护护理人员 (ICPs)）；五项服务为非过敏或过敏后反应提供抗组胺药；四项服务提供胰高血糖素（一项需要医生批准）；ICP 在两项服务中注入镁；10 项服务允许在过敏性停搏时进行独立插管；一项服务允许 ICP 提供镇静促进插管或仅使用氯胺酮的呼吸插管；八项服务允许快速序列归纳（两项仅限于专家角色）。结论 大洋洲的 JAS 各自制定了独特的治疗临床实践指南，这些指南的治疗和实践范围各不相同。审查每项干预措施背后的证据有助于确定最佳实践。