PHECC Advanced Paramedic common mistakes
PHECC Advanced Paramedic · Understand the traps and how to avoid them.
Assessing the patient and starting treatment before confirming a working diagnosis against the PHECC Clinical Practice Guidelines, then following the algorithm even when the presentation does not match it.
Candidates memorise guideline flowcharts as sequences of steps and treat the first impression as the diagnosis, so they commit early and stop gathering data.
What to do instead
State the working diagnosis explicitly, list the guideline criteria it meets, and name the findings that would make you change course; re-check these after every intervention.
Giving a medication dose or route that differs from the PHECC CPG for that indication (for example an adult dose extrapolated to a paediatric patient or an IM drug given IV).
Candidates learn drugs by class and dose range rather than by indication-specific CPG entry, and rely on recall under time pressure.
What to do instead
For each medication, rehearse a fixed triad: indication, exact CPG dose/route for adult and paediatric, and contraindications; practise stating them aloud before every administration.
Failing to confirm and re-confirm airway placement and ventilation effectiveness with objective findings rather than chest rise alone.
Candidates treat intubation or supraglottic insertion as the endpoint of the airway task and move straight to other priorities.
What to do instead
Treat airway as a continuous loop: confirm with waveform capnography plus auscultation and chest rise, document the reading, and reassess after every move or transfer.
Skipping a structured primary survey or repeating it incompletely, so a time-critical problem is found late.
Candidates jump to the obvious complaint and treat the secondary survey as the 'real' assessment.
What to do instead
Use a fixed verbal structure for the primary survey, treat it as a loop that restarts whenever the patient deteriorates, and only proceed to history when the primary survey is complete and stable.
Not recognising the patient who is peri-arrest or deteriorating, and continuing scene treatment instead of escalating and transporting.
Candidates focus on completing interventions and lose track of trends across repeat observations.
What to do instead
Record and trend a full set of observations at fixed intervals, define in advance the triggers that mandate escalation or immediate transport, and act on the trend rather than the single reading.
Acting outside the scope of practice for the Advanced Paramedic level, or failing to call clinical advice or transport when a skill is not authorised.
Candidates blur the registered practitioner levels and assume that knowing a skill means being permitted to perform it.
What to do instead
Learn the scope boundaries by skill and by level, and practise the script for requesting clinical advice or handing over when a required intervention is outside your authority.
Poor documentation and handover: missing times, doses, observations, consent, and refusals, or giving an unstructured handover.
Candidates treat paperwork as an afterthought after the clinical work, and write retrospectively from memory.
What to do instead
Document contemporaneously using a fixed template, and deliver handover in a consistent structured format covering situation, history, observations, interventions with times and doses, and outstanding concerns.
Managing consent, capacity, and refusal poorly, for example accepting a refusal from a patient without assessing capacity or without exploring the risks.
Candidates see refusal as an endpoint and fear conflict, so they avoid the conversation rather than assess it.
What to do instead
Work through a set sequence for every refusal: assess capacity, ensure information was given, consider reversible causes, involve others appropriately, document the discussion, and escalate per policy.
Unsafe manual handling and scene safety omissions, including moving a patient before assessing and not identifying hazards or the need for additional resources.
Candidates prioritise clinical urgency and skip the scene and mechanism phase of the assessment.
What to do instead
Make a scene and mechanism assessment a mandatory first step with a spoken safety check, and justify any patient movement against spinal and clinical risk before doing it.
Giving oxygen, fluids, or ventilation by habit rather than to a target, and failing to reassess the effect of an intervention.
Candidates associate oxygen and fluids with doing something helpful and do not connect them to specific targets and endpoints.
What to do instead
For every intervention, state the target (for example a saturation range or a clinical endpoint), then reassess and record whether the target was met or the intervention stopped.