Fife Medical Group Ltd

Fife Medical Group Ltd Fife Medical Group are a company set up to specialise in

1. first aid and medical event cover

2. medical and first aid training

3. Think about physical health.
(524)

mental health first aid and wellbeing training

1. First aid and medical event cover

professional and friendly service A company is only as strong as the staff that drives it so from the bottom of our hearts we would like to say a massive thanks to all connected with our business, our staff, customers and suppliers. It goes without saying that no company, small or large can win over the long run without energized staff who believe in the mission and understand how to achieve it

Fife medical group is a company set up to specialize in

1 Event first aid and emergency medical cover

Are you looking to get your event covered Fife Medical Group are a dynamic and professional medical events company supplying professional and highly competent fully insured medical personnel to cover your medical events. Whatever your requirement is, we can supply basic first aiders, advanced first aiders, medics or event nurses, technicians, paramedics and doctors. We also have a fleet of ambulances and medical treatments tents and larger treatment facilities. We also have designated staff trained with additional skills such as mental health first aiders, safeguarding, fire marshal, infection control, manual handling and many more giving our customers great value for money. All our medical teams are fully kitted with kit to fit their clinical scope of practice and all of their patient treatment is fully electronic on a tablet with each tablet having access to electronic - Joint Royal College Ambulance Liaison Committee (JRCALC) and JRCALC plus clinical guidelines. Fife medical group has the responsibility to render first aid and medical care to the sick or injured at any public event in collaboration with the event organizers’ and also the local emergency services. Fife medical group are responsible for providing the top level of care within the clinicians individual scope of practice within the event area
your objective is simple; to run an event which is enjoyed by all who attend it, and which is remembered for all the right reasons. At the back of your mind though you know that there is the ever-present risk of accident or sudden illness, which can affect either your staff or visitors. Naturally you want to ensure that you have medical cover in place to deal with such problems calmly, professionally and with minimal disruption to your event. You also want the reassurance of knowing that the medical cover you have organised is the best available, and meets the ever-increasing number of guidelines and regulations in place. This is where Fife Medical Group comes to your aid; we pride ourselves on providing a comprehensive and professional service to event organizers’. We tailor our services to the specific needs of your event, leaving you secure in the knowledge that, should the worst happen, you have the support of a highly trained team ready to come to the aid of your staff and visitors. With us having our own training company within the group we can develop our staff to a very high Standard and also give them ongoing higher level training as part of our continual personal and professional development plan and policy.

2. professional training services

As a well-established training company we offer fun and friendly professional training which is nationally accredited. Our professional training ensures that everybody who attends leaves with the necessary skills and knowledge to deal with emergency situations. Experienced and skilled instructors make learning these valuable skills easy and affordable in a relaxed environment. By selecting Fife Medical Group as your training provider we have covered all of the due diligence you as an employer need to consider, by not only meeting but exceeding the standards of the training provider set by the HSE (Health and Safety Executive).by having in place

• Correct and in-date qualifications expected of Trainers and Assessors
• Monitoring and Quality Assurance systems in place
• Teaching and Standards of First-aid Practice
• Compliance with the Assessment Principles for First Aid Qualifications
• Syllabus content; information included on a certificate
• Sufficient quantity of well-maintained equipment that permits students to complete their training and assessment within the appropriate number of contact hours
• Course evaluation procedure that includes feedback from students
• Nationally recognised and Regulated Qualifications, regulated by the qualification regulators – FAA though Ofqual, delivering qualifications for Scotland (SCQF) England (QCF) Wales (CQFW) Northern Ireland (CCEA)
• Courses taught under current Guidelines published by the Resuscitation Council (UK)
• All Instructors up to date with any changes in Guidelines and attend yearly CPD Training


3. Mental health and wellbeing training

What is mental health? Sometimes people are not sure what mental health is and feel a bit afraid of it. That doesn’t have the same negative impact does it? Our physical health can be good or poor and can vary from day to day. When our physical health is good we can live life to the full. At other times we can be unwell and this can last weeks or months. Or we might be unwell just for a couple of days then we are back to normal. Sometimes our physical is poor because we haven’t taken good care of ourselves or because we were born with a tendency to certain illnesses. When we are unwell we are likely to have less energy and motivation and find taking part in work or play mode difficult. All of these things are true of mental health. The main difference between physical and mental health is that our emotions, our ability to work and our relationships are the main things to be influenced by our mental health. When our mental health is positive we can cope with life’s ups and downs. Our mood is stable and we feel optimistic. When we are mentally unwell we may experience mental or emotional pain. Our mood maybe low and we might lose confidence in our ability to cope with life’s challenges. Sometimes we can have long term mental health problems, just as we can get longer lasting physical illnesses and we can recover in much the same way. Of course the other big difference is that you can’t get a mental health problem from someone else, it isn’t like catching the flu. Physical and mental health have an effect on each other. If your physical health is poor then your mental health is likely to be low. If your mental health is poor then you are more likely to get physically ill. The good news is you can make a massive difference and be aware of your own mental health. By taking a Fife Medical Group mental health course and becoming a mental health first aider is one of the ways that helps you make a difference to your own and other peoples mental health. please get in touch to discuss any requirements

info@fifemedicalgroup.co.uk
07500772643

19/11/2025
It might feel like –2°C isn’t exactly the warmest place to be today, but our medical team are out there regardless. What...
19/11/2025

It might feel like –2°C isn’t exactly the warmest place to be today, but our medical team are out there regardless. Whatever the weather, whatever the conditions — Fife Medical Group show up. Reliability isn’t seasonal.

19/11/2025

FINAL SCORE: MKM Dundee Stars 5 Cardiff Devils 4

WHAT A WIN!!!! 🙌

🚨 Jonathan McBean
🚨 Spencer Naas
🚨🚨🚨 Matt Berry

19/11/2025

𝐓𝐢𝐜𝐤𝐞𝐭𝐬 𝐎𝐧 𝐒𝐚𝐥𝐞

Tickets and Hospitality are on sale for this weekend’s fixture, as we welcome Raith Rovers to Gayfield Park.

🎟️ 𝐓𝐢𝐜𝐤𝐞𝐭𝐬: https://arbroathfc.co.uk/ticketing/home-tickets/?ftredirect=1

⭐️ 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐢𝐭𝐲: https://shop.arbroathfc.co.uk/product-category/hospitality-events/

🎫 𝐇𝐚𝐥𝐟 𝐒𝐞𝐚𝐬𝐨𝐧 𝐓𝐢𝐜𝐤𝐞𝐭𝐬: https://arbroathfc.co.uk/ticketing/season-tickets/?ftredirect=1

WE'RE GOING TO THE WORLD CUP!!!!!!!! 🏴󠁧󠁢󠁳󠁣󠁴󠁿🏴󠁧󠁢󠁳󠁣󠁴󠁿🏴󠁧󠁢󠁳󠁣󠁴󠁿🇺🇲🇲🇽🇨🇦HISTORY MADE — SCOTLAND ARE GOING TO THE WORLD CUP! 🏆Fro...
19/11/2025

WE'RE GOING TO THE WORLD CUP!!!!!!!! 🏴󠁧󠁢󠁳󠁣󠁴󠁿🏴󠁧󠁢󠁳󠁣󠁴󠁿🏴󠁧󠁢󠁳󠁣󠁴󠁿

🇺🇲🇲🇽🇨🇦HISTORY MADE — SCOTLAND ARE GOING TO THE WORLD CUP! 🏆
From all of us at Fife Medical Group… CONGRATULATIONS!

For the first time since 1998, Scotland have officially qualified for the World Cup — and what an incredible achievement this is. Years of dedication, passion, and belief have paid off, and the entire nation feels it.

As a medical organisation heavily involved in sport across Scotland, we see first-hand the commitment, sacrifice, and resilience that goes into competing at the highest level. This Scotland squad has shown exactly what it means to work together, stay disciplined, and give everything for the badge.

👏 A massive well done to the players, coaching staff, medical teams, and everyone working behind the scenes.
👏 And of course, to the Tartan Army — unmatched passion and support.

This is a proud day for Scottish football, and for Scotland as a whole.
The journey to the World Cup begins… and Scotland is back where it belongs.

Fife Medical Group proudly congratulates our national team. 💙🏴

🫀 MYOCARDIAL INFARCTION — A CLINICAL OVERVIEW FROM FIFE MEDICAL GROUPMyocardial Infarction (MI) remains one of the most ...
19/11/2025

🫀 MYOCARDIAL INFARCTION — A CLINICAL OVERVIEW FROM FIFE MEDICAL GROUP

Myocardial Infarction (MI) remains one of the most time-critical medical emergencies encountered in both pre-hospital and in-event environments. For Fife Medical Group’s paramedic-led teams, early recognition, rapid intervention, and decisive clinical management are essential to improving outcomes and limiting cardiac damage.

This post breaks down what an MI actually is, how it develops, the key ECG findings, clinical presentations, and the urgent management priorities that guide modern paramedic practice.

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🔍 WHAT IS A MYOCARDIAL INFARCTION?

A myocardial infarction occurs when blood flow to a portion of the heart is suddenly reduced or completely blocked, depriving the cardiac muscle of oxygen. Without oxygen, myocardial cells begin to die — a process known as necrosis.

The most common cause is coronary artery disease:

• Rupture of an atherosclerotic plaque
• Formation of a thrombus (blood clot)
• Acute occlusion of a coronary artery

Within minutes, the affected area becomes ischaemic. Within hours, irreversible myocardial damage progresses.

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🫀 PATHOPHYSIOLOGY – WHAT’S HAPPENING INSIDE THE HEART?

1. Plaque rupture in a coronary artery exposes the underlying lipid core.

2. Clot formation occurs rapidly as platelets activate.

3. The coronary artery becomes partially or fully occluded.

4. Blood flow to downstream myocardium stops → ischaemia.

5. If untreated, cells die → infarction.

6. The affected area becomes electrically unstable → arrhythmias, including VT/VF.

Time is muscle.
Every minute of untreated occlusion leads to larger infarct size and worse long-term heart function.

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📈 TYPES OF MYOCARDIAL INFARCTION

1️⃣ STEMI (ST-Elevation Myocardial Infarction)

• Caused by complete occlusion of a coronary artery
• ECG shows ST-segment elevation in localised leads
• Immediate reperfusion required (PCI or thrombolysis)

2️⃣ NSTEMI (Non–ST Elevation Myocardial Infarction)

• Partial occlusion
• ECG may show ST depression or T-wave inversion
• Troponin elevated
• Urgent cardiology management required

3️⃣ Silent MI

• Typical in diabetics, elderly, patients with neuropathy
• Presents with atypical symptoms or none at all

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📌 CLINICAL PRESENTATION

The classic symptoms include:

• Central chest pain or tightness
• Radiation to arm, jaw, neck, or back
• Sweating, nausea, vomiting
• Shortness of breath
• Feeling of impending doom
• Pale, clammy skin
• Collapse or syncope

However, not all MI patients present with textbook symptoms, especially women, the elderly, and diabetics.

Atypical presentations:

• Epigastric pain
• Indigestion-like discomfort
• Unexplained fatigue or weakness
• Breathlessness without chest pain

This is why rapid assessment and ECG acquisition are critical.

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📈 ECG CHANGES IN MI

1️⃣ STEMI Findings

• ST elevation in contiguous leads
• Reciprocal changes in opposite regions
• Pathological Q waves appear later
• Hyperacute T waves early in the process

Lead patterns correspond to artery involvement:

Region ECG Leads Likely Artery

Anterior V1–V4 LAD
Lateral I, aVL, V5–V6 Circumflex
Inferior II, III, aVF RCA
Posterior V7–V9 RCA/Circumflex

2️⃣ NSTEMI Findings

• ST depression
• T wave inversion
• No ST elevation
• Normal ECG does not exclude MI

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🩺 PRE-HOSPITAL MANAGEMENT PRIORITIES (FIFE MEDICAL GROUP)

At the point of first medical contact — whether on an event field, sports venue, remote setting, or emergency response — our responsibilities are:

1️⃣ Early Recognition

• 12-lead ECG within minutes
• Identify red flags
• Recognise atypical presentations

2️⃣ Immediate Interventions

ABCDE approach
• Oxygen only if hypoxic
• Pain relief where appropriate
• Aspirin administration if indicated
• Monitoring, cannulation if needed
• Treat arrhythmias early (VT, VF, bradyarrhythmias)

3️⃣ Rapid Escalation

• STEMI → direct PCI centre activation
• NSTEMI → urgent referral pathways
• Time-critical handover

4️⃣ Manage Life-Threatening Complications

• Cardiogenic shock
• Pulmonary oedema
• Ventricular arrhythmias
• Complete heart block
• Cardiac arrest (shock promptly)

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🫀 WHY FAST ACTION MATTERS

Every minute of delayed treatment increases myocardial death.

Within 20–30 minutes: cells begin irreversible damage
Within 2–3 hours: major muscle loss
Beyond 6 hours: large infarct with reduced ejection fraction and long-term heart failure risk

Fast recognition, fast ECG, fast escalation — this is where pre-hospital care saves lives.

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⚕️ FIFE MEDICAL GROUP – OUR ROLE

At Fife Medical Group, our clinicians operate at the highest standard of pre-hospital care:

• Paramedic-led assessment and ECG interpretation
• Immediate triage of chest pain and collapse
• Advanced cardiac life support
• Direct liaison with acute cardiology services
• Event cover with rapid response capabilities
• Evidence-based, guideline-driven management

Heart attacks are unpredictable, fast-moving, and unforgiving — but with skilled clinicians, structured pathways, and decisive management, outcomes improve dramatically.

📈 ECG CHANGES IN ELECTROLYTE DISTURBANCES — FIFE MEDICAL GROUPElectrolyte abnormalities can produce profound and sometim...
19/11/2025

📈 ECG CHANGES IN ELECTROLYTE DISTURBANCES — FIFE MEDICAL GROUP

Electrolyte abnormalities can produce profound and sometimes life-threatening ECG changes. For pre-hospital and event medicine, early recognition is critical — particularly in patients presenting with collapse, weakness, arrhythmias, renal disease, dehydration, or drug toxicity.

Below is a clinical breakdown of the ECG relevance for potassium, calcium, and magnesium abnormalities.

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🟧 POTASSIUM (K⁺)

Potassium has the strongest and most predictable effect on cardiac conduction. Even small deviations can produce significant ECG changes.

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🔺 HYPERKALAEMIA (High K⁺)

Life threatening. The higher the potassium, the wider the QRS.

ECG Progression (classic sequence):

1. Tall, peaked T waves (narrow base)

2. Flattened P waves → eventually disappear

3. Prolonged PR interval

4. Widening of QRS

5. Sine-wave pattern (merging of QRS + T → pre-arrest)

6. Ventricular fibrillation, PEA, or asystole

Clinical relevance (FMG context):

• Common in renal failure, acidosis, missed dialysis, crush injury
• High suspicion in patients with weakness, bradycardia, or unusual broad complexes
• Broad complexes + bradycardia = assume hyperkalaemia until proven otherwise

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🔻 HYPOKALAEMIA (Low K⁺)

Key ECG Features:

• Flattened T waves
• Prominent U waves (best seen in V2–V3)
• ST depression
• Prolonged QT interval (risk of torsades)
• Ventricular ectopy: PVCs, VT, torsades de pointes

Clinical relevance (FMG context):

• Common in dehydration, vomiting, diuretics
• Any patient with palpitations, cramping, weakness + prolonged QT → consider low potassium
• Hypokalaemia dramatically increases risk of digoxin toxicity

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🔵 CALCIUM (Ca²⁺)

Calcium primarily affects the length of the QT interval, not the T-wave morphology.

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🔺 HYPERCALCAEMIA (High Ca²⁺)

ECG Features:

• Shortened QT interval
• Osborn (J) waves may appear (rare)
• Can cause mild ST elevation that mimics STEMI

Clinical relevance:

• Seen in malignancy, dehydration, endocrine disorders
• Short QT should always prompt calcium assessment
• Severe cases → risk of ventricular arrhythmias

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🔻 HYPOCALCAEMIA (Low Ca²⁺)

ECG Features:

• Prolonged QT interval (without torsades-type notching)
• T wave may appear normal
• Severe: risk of torsades, VF

Clinical relevance:

• Often accompanies severe sepsis, renal failure, pancreatitis
• Any unexplained prolonged QT should trigger consideration of hypocalcaemia
• High-risk in tetany, paraesthesia, laryngospasm presentations

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🟣 MAGNESIUM (Mg²⁺)

Magnesium affects stability of cardiac membranes and directly influences potassium and calcium balance.

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🔺 HYPERMAGNESEMIA (High Mg²⁺)

Usually seen in renal failure or excessive magnesium therapy.

ECG Features:

• Prolonged PR interval
• Prolonged QRS
• Bradycardia
• Severe: atrioventricular block, asystole

Clinical relevance:

• Elevated magnesium suppresses conduction → bradyarrhythmias
• Consider in obstetric patients (magnesium therapy) or renal impairment

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🔻 HYPOMAGNESEMIA (Low Mg²⁺)

Critically important — drives dangerous arrhythmias.

ECG Features:

• Prolonged QT interval
• Risk of Torsades de Pointes
• PVCs, polymorphic VT
• Often coexists with hypokalaemia (and makes it refractory)

Clinical relevance:

• Think magnesium in “unexplained arrhythmias”
• Consider in alcohol dependence, malnutrition, diarrhoea, diuretics
• Torsades at events (rare, but possible) = magnesium until proven otherwise

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📌 SUMMARY TABLE

Electrolyte High Level (↑) ECG Effect Low Level (↓) ECG Effect

Potassium Tall peaked T, wide QRS, sine wave Life-threatening arrhythmias Flat T, U waves, ST depression QT prolongation, torsades
Calcium Short QT Risk of VT Long QT Risk of torsades, VF
Magnesium Prolonged PR/QRS, AV block Bradycardia/asystole Long QT Torsades, polymorphic VT

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⚕️ FIFE MEDICAL GROUP – CLINICAL RELEVANCE

For our paramedic-led teams:

• Electrolytes drive rhythm stability
• ECG changes may be the first sign of severe biochemical disturbance
• Any “unexplained” arrhythmia, prolonged QT, bradycardia, or broad complex rhythm should raise suspicion
• Early recognition = earlier correction = safer patient outcomes
• Especially relevant in:
– Collapse at events
– Athletes with dehydration
– Patients with renal disease
– Vomiting/diarrhoea
– Toxicology presentations
– Heat illness
– Elderly cardiac patients on diuretics

Understanding these patterns strengthens safe triage, clinical escalation, and rapid intervention across all Fife Medical Group environments.

📈 CLINICAL OVERVIEW OF ECG RHYTHMS — FIFE MEDICAL GROUPElectrocardiogram interpretation is at the core of safe, effectiv...
19/11/2025

📈 CLINICAL OVERVIEW OF ECG RHYTHMS — FIFE MEDICAL GROUP

Electrocardiogram interpretation is at the core of safe, effective clinical decision-making in pre-hospital and event medicine. For our paramedic-led teams at Fife Medical Group, rapid rhythm recognition allows us to escalate care, initiate appropriate interventions, and prevent avoidable deterioration.

Below is a structured clinical overview of the most common ECG rhythms encountered across emergency, urgent, and routine settings.

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🔵 NORMAL RHYTHMS

✔️ Normal Sinus Rhythm (NSR)

• Regular rhythm, 60–100 bpm
• P wave before every QRS
• Normal PR and QRS intervals
Significance: Stable, normal conduction.

✔️ Sinus Bradycardia

• 100 bpm
• Caused by pain, fever, exertion, shock, anxiety, hypovolaemia.
Key point: Sinus tachycardia is a symptom, not a diagnosis.

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🟧 ATRIAL RHYTHMS

Atrial Fibrillation (AF)

• Irregularly irregular rhythm
• No visible P waves
Risks: Loss of atrial kick, thromboembolism, rapid ventricular response.

Atrial Flutter

• Saw-tooth flutter waves
• Ventricular rate often 2:1 or 3:1
Clinical focus: Control rate, treat underlying cause.

Supraventricular Tachycardia (SVT)

• Narrow complex tachycardia (>150 bpm)
• Usually regular
Management: Vagal manoeuvres, adenosine (where appropriate).

Wandering Atrial Pacemaker

• Variable P waves
• Irregular rhythm
Often benign; assess underlying triggers.

Multifocal Atrial Tachycardia (MAT)

• Irregular, varying P waves, rate >100
• Common in COPD exacerbations.

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🟥 JUNCTIONAL RHYTHMS

Junctional Rhythm

• Rate 40–60 bpm
• P waves inverted or absent
Cause: SA node suppression or AV node dominance.

Accelerated Junctional Rhythm

• Rate 60–100 bpm
Seen in: digitalis toxicity, post-MI.

Junctional Tachycardia

• >100 bpm
Can compromise perfusion if prolonged.

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⚫ VENTRICULAR RHYTHMS

Premature Ventricular Complexes (PVCs)

• Wide, bizarre QRS
• Compensatory pause
Single PVCs common; frequency matters.

Ventricular Tachycardia (VT)

• Wide complex tachycardia
• May be pulsed or pulseless
Clinical priority: Immediate recognition—can deteriorate to VF.

Torsades de Pointes

• Polymorphic VT with twisting QRS
Cause: QT prolongation, electrolytes, medications
Treatment: Magnesium.

Ventricular Fibrillation (VF)

• Chaotic electrical activity
• No pulse
Management: IMMEDIATE defibrillation.

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🟣 HEART BLOCKS

First-Degree AV Block

• PR interval prolonged (>0.20s)
• Often benign.

Second-Degree Type I (Wenckebach)

• PR interval gradually lengthens until a beat drops
Usually not life-threatening.

Second-Degree Type II (Mobitz II)

• Intermittent dropped QRS
• PR interval constant
High risk of progressing to complete block.

Third-Degree (Complete) Heart Block

• No relationship between P waves and QRS
Management priority: Pacing.

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🟡 BUNDLE BRANCH BLOCKS

Right Bundle Branch Block (RBBB)

• M-shaped QRS in V1
• Slurred S wave in V6

Left Bundle Branch Block (LBBB)

• Notched broad QRS in V6
• Deep S wave in V1
New LBBB with chest pain = treat as acute MI.

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🟤 ISCHAEMIC CHANGES

ST-Elevation Myocardial Infarction (STEMI)

• ST elevation in localised leads
• Reciprocal changes
Immediate activation of emergency pathways.

NSTEMI / Unstable Angina

• ST depression, T-wave inversion
• No ST elevation
Requires rapid assessment and onward referral.

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⚪ OTHER RHYTHMS

Idioventricular Rhythm

• Ventricular rhythm, 20–40 bpm
Sign of severe underlying pathology.

Accelerated Idioventricular Rhythm (AIVR)

• 40–100 bpm
Seen post-reperfusion (e.g., after thrombolysis).

Asystole

• Flatline
No electrical activity — non-shockable rhythm.

Pulseless Electrical Activity (PEA)

• Organised rhythm but no pulse
Treat the underlying “H’s & T’s.”

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🔍 CLINICAL RELEVANCE FOR FIFE MEDICAL GROUP

Across events, ambulances, and high-risk environments, rapid rhythm interpretation enables our clinicians to:
• Identify time-critical arrhythmias
• Initiate appropriate ALS interventions
• Distinguish perfusing from non-perfusing rhythms
• Recognise ischaemia early
• Escalate rapidly for definitive care
• Provide safe discharge or onward referral decisions

Whether it’s athletic tachycardia, exertional arrhythmias, collapse, chest pain, or cardiac arrest, our paramedic-led teams remain clinically prepared for every presentation.

🫀 A CLINICAL LOOK AT THE HEART: ANATOMY, ELECTRICAL CONDUCTION & HOW THE CARDIAC CYCLE WORKSAt Fife Medical Group, our t...
19/11/2025

🫀 A CLINICAL LOOK AT THE HEART: ANATOMY, ELECTRICAL CONDUCTION & HOW THE CARDIAC CYCLE WORKS

At Fife Medical Group, our teams operate in environments where rapid recognition of cardiac compromise can be the difference between deterioration and survival. A solid understanding of cardiac anatomy and the electrical conduction system is fundamental across all levels of pre-hospital and event medicine.

ANATOMY OF THE HEART
The heart is a four-chambered muscular organ located within the mediastinum. Each chamber has a precise function:

• Right Atrium – receives deoxygenated blood from the systemic circulation via the superior and inferior vena cava.
• Right Ventricle – pumps this blood through the pulmonary valve into the pulmonary artery for oxygenation.
• Left Atrium – receives oxygenated blood from the pulmonary veins.
• Left Ventricle – the thickest and most powerful chamber; responsible for systemic perfusion via the aorta.

Cardiac valves (tricuspid, pulmonary, mitral, aortic) maintain unidirectional flow and prevent regurgitation. The myocardial wall is supported by the coronary arteries, supplying the oxygen and nutrients required for continuous contraction. Any compromise in coronary perfusion can rapidly progress to ischaemia and infarction.

THE ELECTRICAL CONDUCTION SYSTEM
Cardiac function is driven by an intrinsic, highly coordinated conduction system. Understanding this pathway is essential in the assessment and management of arrhythmias, conduction blocks and cardiac arrest.

1. Sinoatrial (SA) Node – located in the right atrium; initiates the electrical impulse. This natural pacemaker sets the baseline heart rate.

2. Atrial Conduction Pathways – the impulse spreads across both atria, causing atrial systole and optimising ventricular filling.

3. Atrioventricular (AV) Node – introduces a brief delay to allow the ventricles to complete diastolic filling before contraction.

4. Bundle of His – a specialised conduction pathway transmitting the impulse from the AV node into the interventricular septum.

5. Right and Left Bundle Branches – distribute the impulse down each side of the septum. Any disruption here can cause bundle branch blocks, visible on ECG.

6. Purkinje Fibres – spread the impulse rapidly through ventricular myocardium, triggering coordinated ventricular systole.

This sequence occurs with incredible precision. A failure at any point – from SA node dysfunction to ventricular conduction delays – can result in clinically significant arrhythmias requiring rapid recognition and intervention.

THE CARDIAC CYCLE
The heart works through a repeating sequence of mechanical and electrical events:

1. Diastole (Ventricular Filling)
The ventricles relax; the AV valves open, allowing blood to flow passively into the chambers. Roughly 70% of ventricular filling occurs before the atria contract.

2. Atrial Systole
The atria contract, delivering the final 20–30% of the ventricular filling volume – crucial in patients with compromised ventricular function.

3. Ventricular Systole
The ventricles contract; the AV valves close, producing the first heart sound. Pressure forces the semilunar valves open, ejecting blood into the pulmonary artery and aorta. Effective systole is vital for perfusion, especially during trauma, shock or acute illness.

4. Relaxation & Reset
The ventricles relax, semilunar valves close (second heart sound), and the myocardium prepares for the next cycle. The conduction system resets, ready for the next impulse.

CLINICAL RELEVANCE FOR PRE-HOSPITAL & EVENT MEDICINE
For Fife Medical Group clinicians, this knowledge underpins critical decision-making:

• Early identification of ECG abnormalities and conduction defects
• Recognition of perfusion failure, arrhythmias and decompensation
• Effective management of cardiac arrest through defibrillation, pacing and advanced life support
• Understanding the impact of trauma, hypoxia, dehydration and exertion on cardiac performance
• Rapid assessment of chest pain, collapse, or unexplained tachy/bradycardia during events

The heart is a powerful, complex and highly coordinated organ. As a paramedic-led medical provider, Fife Medical Group remains committed to delivering evidence-based, clinically robust care rooted in a deep understanding of human physiology.

Did you know that as an event medical supplier you should be registered with the Information Commissioners Office   and ...
19/11/2025

Did you know that as an event medical supplier you should be registered with the Information Commissioners Office and have a designated data protection officer for control of all of the data you hold. Have you done your due diligence?

Fife Medical Group Ltd have all the necessary procedures in place as well as over 120 robust policies and procedures. As a company we are currently going through the ISO9001 (QMS) approval

What is a Quality Management System (QMS)?
ISO 9001

Companies and organisations are now expected to prove competency across an increasing number of disciplines to win contracts in both the private and public sectors. A Quality Management System (QMS) is one of the best ways of reassuring potential clients that you can meet their aims and objectives. Here we take a closer look at what a QMS is and how it could benefit your business.

A QMS is a clearly defined set of business processes. It is a core tenet of the ISO 9001 standard for quality management. Together with the relevant documentation, it defines your organisation’s commitment to creating products and services in accordance with pre-defined quality standards.

A good Quality Management System should include detailed information about processes and responsibilities within an operational environment, such as an office or factory, and align with regulatory legislation. An effective QMS helps your organisation deliver products and services at a consistently high standard and helps to maintain and improve that quality over time.

Core elements of Quality Management Systems
A Quality Management System is a framework designed for consistently meeting client requirements and improving customer satisfaction with high-quality output. It is built on several core principles which are aligned with the ISO 9001 standard for Quality Management:

Customer focus – The primary goal of a QMS is to meet customer needs and exceed their expectations, driving customer loyalty and attracting new business.
Leadership – Clear guidance from leaders who prioritise quality management helps employees feel more involved in achieving the company’s quality goals.
Employee engagement – Encouraging employees to participate in continual improvement activities, such as problem-solving teams or quality circles, can enhance their ownership and commitment to the QMS.
Process approach – Understanding quality activities as processes that link together and function as a system can help efficiently produce consistent, predictable results.
Improvement – Successful businesses strive to continually improve their QMS to consistently provide high-quality output and take advantage of new opportunities.
Evidence-based decision-making – Effective decisions are based on the analysis and evaluation of data, which helps drive continual improvement.
Relationship management – Fostering strong relationships between an organisation and its external providers requires a balanced approach to increase both parties’ ability to create value.

Quality management techniques
There are various quality management techniques that can help organisations improve their processes, products and services by reducing errors and inefficiencies. Here are some commonly implemented techniques:

ISO 9001 is a globally recognised standard for a QMS. It provides a standardised framework for quality management. It follows a process approach focused on improving customer satisfaction through continual improvement.
Total Quality Management (TQM) promotes a customer-focused, process-centred approach. It requires all employees to be involved in continuous improvement efforts to enhance the quality of products or services.
Six Sigma is a data-driven methodology that uses statistical methods to improve process capability and effectiveness while reducing errors in quality management processes.
Lean eliminates waste in all forms (time, effort, resources) to improve efficiency and streamline operations.
Choosing the right quality management techniques would depend on your organisation’s objectives, size, complexity and specific industry requirements.

What are the benefits of using a QMS?
Implementing a Quality Management System (QMS) can bring substantial advantages to your organisation, promoting efficiency, reliability, and customer satisfaction. The benefits can include:

Consistency
Companies that use a QMS have a clearly defined process for manufacturing products or delivering services that allows them to cope with staff changes, breakdowns, and even finding new outsourcing partners.

Because documentation is a key factor in the QMS, the information is readily available to deal with any changes, planned or not – the organisation is not reliant on individual skill and knowledge.

Reducing failures and dissatisfaction
An effective QMS should have an inbuilt reviewing process. Should a problem occur in a process, or if a customer is not satisfied with a service, then the errors that have led to this failure can be swiftly identified and the causes examined.

From the findings, the systems can then be updated and improved to prevent similar issues from occurring.

Regulatory compliance
A QMS may help you comply with product or service regulations that fall within the scope.

Pre-qualification for new business
A QMS such as ISO 9001 demonstrates your competency to new businesses and markets. Many types of organisation, from those that work in the public sector through to international corporations, will take your QMS as a mark of trust. Some industries may require your organisation to have an ISO certification in order for you to work with them.

Ensure you are certified through an appropriate channel, such as a UKAS accredited certification body, to maximise this benefit.

Evidence-based decision making
Without clear results and data, deciding what changes to make in a business would be guesswork.

A QMS can generate a real picture of operational weak points and potential risks, providing the data needed to reflect and inform meaningful change within the business.

Risk management
Implementing a QMS helps your organisation to manage risks by identifying any potential issues before they become problems. A proactive approach can help your business avoid costly errors.

Customer satisfaction
By using a QMS, you are making a statement about your reliability and ability to deliver on your contractual responsibilities to your customer, making your dedication to meeting their needs clear.

Cost reduction
A well-implemented QMS can help your organisation reduce costs by streamlining processes, reducing waste and improving resource use. This can translate to better profitability and competitive advantage.

Attracting customers and investors
Using a QMS can make your company attractive to potential investors. It confirms that the promises made by your sales and marketing materials can be more than adequately fulfilled by your operational capacity – this can be attractive to investors who want to align themselves with organisations that prioritise strict quality management.

Continual improvement
Going forward, a QMS will provide a business with a framework for implementing change within procedures, complete with a full documentation process that allows businesses to plot the evolution of different approaches.

The continual refinement of the system allows organisations to improve every aspect of their business.

Why you should choose ISO 9001 as your QMS
ISO 9001 is an internationally recognised standard and one of the most popular for quality management. It is possible for a business to implement a QMS and still experience a disconnect between policy and procedure across the operational capacity. This is not the case with ISO 9001.

No other standard has the history of ISO 9001. The roots of the standard can be traced back to the World War II era and it was introduced as a standard in the 1980s. Since then, it has undergone continual revision on the worldwide stage and has become the world’s best-known quality management system.

There are three reasons why the ISO 9001 standard has developed this reputation for delivering real results:

1. Credibility
ISO 9001 certification requires a third party to assess an organisation against the required standards. This ensures that the organisation meets a high level of consistent quality assurance and that the certification itself is unbiased and trustworthy.

2. Universality
Because ISO 9001 is a standard that can be applied across a wide variety of sectors, it can be adopted by vast numbers of companies. With such a wide reach, it has become the simple way for procurement teams to rate companies.

3. Success
When an organisation implements ISO 9001 effectively, it can assist in delivering three things – generating results, improving efficiency and providing a framework for continual improvement. The standard’s reputation is based on a consistently high level of return on investment, making it an extremely attractive proposition for business.

As an accepted framework for a successful QMS, ISO 9001 reduces the workload for business directors and senior management. Rather than having to construct an entire approach from the ground up, this standard allows businesses to make the decision and accelerate towards certification and a better operational structure.

Requirements of an ISO 9001 QMS
The ISO 9001 standard is based on several quality management principles, including a strong customer focus and continual improvement. It’s structured around ten main clauses structured to follow the Plan, Do, Check, Act (PDCA) cycle:

Clause 1: Scope – Defines the purpose and scope of the standard.
Clause 2: Normative References – Provides details of the reference standards or publications relevant to this particular standard.
Clause 3: Terms and Definitions – Explains the terms and definitions applied within the ISO 9001 standard for clear understanding and consistency.
Clause 4: Context of the Organisation – Requires the identification of any internal/external issues, interested parties and their requirements to determine the processes needed for the QMS.
Clause 5: Leadership – Explains the need for senior management to demonstrate leadership and commitment to the QMS, customer focus and quality – and outlines organisational roles and responsibilities.
Clause 6: Planning – Details requirements for addressing risks and opportunities, QMS objectives and plans to achieve them.
Clause 7: Support – Covers resources, competence, awareness, communication and documented information.
Clause 8: Operation – Focuses on operational planning and control, customer communication, design, controlling external provisions, production and service provision, release of products and services and nonconformity controls.
Clause 9: Performance Evaluation – Involves monitoring, measurement, analysis, evaluation, internal auditing and management reviews of the QMS and your products/services.
Clause 10: Improvement – Emphasises the need for improvement by highlighting nonconformity and potential risks and embracing continual improvement.
Other quality management standards
Besides ISO 9001, there are a number of other standards related to quality management. Two examples include:

First, you will need to have a comprehensive understanding of ISO 9001 and the wider role a Quality Management System plays in an organisation. This includes familiarity with the standard’s clauses and core elements.

You will then undergo a Stage 1 assessment. This assessment is primarily a gap analysis to identify what is missing in your existing quality management process. After this analysis, a report is issued to highlight the actions needed for your organisation to acheive ISO 9001 certification.

Based on these findings, you may need to take additional steps to make your QMS ISO 9001 compliant before the Stage 2 assessment.

The Stage 2 assessment is an in-depth review of your Quality Management System. An auditor will conduct a full assessment to determine whether your management systems and processes meet the standard’s requirements. A critical part of your Stage 2 assessment is reviewing real examples of the delivery of your products and services.

Once your organisation has passed the Stage 2 assessment, you will be awarded your ISO 9001 certification.

Your QMS will need an annual reassessment to keep its ISO 9001 certification. These audits verify that the QMS continues to comply with ISO 9001 requirements and demonstrate continual improvement.

Get started on your ISO 9001 certification journey
If you’re ready to start your ISO 9001 certification journey and want to take your organisation to the next level, contact British Assessment Bureau.

Our website provides a comprehensive overview of all the ISO standards your organisation may need, including ISO 9001. We also offer a comprehensive library of ISO resources, including The Ultimate Guide to ISO 9001, a downloadable ISO 9001 checklist and ISO 9001 training courses.

Business is always becoming increasingly competitive. With more than 4.8 million companies currently active in the UK, how can your organisation stand out from competitors in your sector? Implementing a QMS and becoming ISO 9001-certified can give you a competitive edge in a clear, discernible way that your customers can understand.

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Fife Medical Group is a company set up to specialise in

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