Nick Miller
Senior lecturer in Paramedic Science, State registered Paramedic.
Looking for the Constellation of Symptoms: Spotting the Hidden Big Sick
Föreläsningen
This presentation explores how contemporary ambulance work in Northern Europe is increasingly centred on older adults with comorbidities, frailty and complex social needs. Their acute problems often look minor but may hide serious illness. How can ambulance clinicians navigate this complexity, deciding who can safely remain at home and who needs urgent hospital care?
Ambulance clinicians are not just responders to life threatening emergencies. They increasingly need to be risk assessors within an ageing, complex population, using structured medical history taking; thorough examination skills; clinical judgement and collaboration to spot the “hidden big sick”, while avoiding unnecessary conveyance to hospital.
As demand grows, sending everyone to hospital is both unsafe and unsustainable, yet missing deterioration in the community is equally harmful. Participants will gain a practical framework for assessing risk and complexity in adults; Ideas for strengthening safety measures for home manged patients and strategies to build collaborative pathways with community teams and emergency departments. This ensures that decisions made at the patient’s side are shared, defensible and patient centred.
Erfarenhet
Nick Miller is a Senior Lecturer in Paramedic Science at University of the West England (UWE) Bristol, England. Nick enjoyed a long and successful frontline career in his previous role with the Southwestern Ambulance Service NHS Foundation Trust (SWAST). At SWAST, he worked as a Paramedic, Mentor, Clinical Team Leader and Learning and Development officer, developing a strong foundation in both clinical practice and staff development.
At UWE Bristol his teaching interests focus on advanced history taking, physical examination, clinical reasoning and risk management, alongside wider themes in clinical decision-making and pre-hospital care.
He is committed to developing confident, compassionate paramedics by combining evidence-based teaching with realistic, practice-focused learning, and he remains closely connected to ambulance service colleagues to ensure his teaching reflects the realities of modern paramedic work.