How consistent are pre-alert guidelines? A review of UK ambulance service guidelines

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dc.contributor.authorBoyd, Aimee
dc.contributor.authorSampson, Fiona C.
dc.contributor.authorBell, Fiona
dc.contributor.authorSpaight, Robert
dc.contributor.authorRosser, Andy
dc.contributor.authorCoster, Jo
dc.contributor.authorMilliins, Mark
dc.contributor.authorPilbery, Richard
dc.date.accessioned2025-05-29T14:50:45Z
dc.date.available2025-05-29T14:50:45Z
dc.date.issued2024-03-01
dc.identifier.citationBoyd, A., et al., 2024. How consistent are pre-alert guidelines? A review of UK ambulance service guidelines. British Paramedic Journal, 8 (4), 30-37.
dc.identifier.doihttps://doi.org/10.29045/14784726.2024.3.8.4.30
dc.identifier.issn1478-4726
dc.identifier.urihttps://hdl.handle.net/20.500.12417/1938
dc.language.isoenen_US
dc.source.journaltitleBritish Paramedic Journalen_US
dc.subjectEmergency Medical Services
dc.subjectGuidelines as Topic
dc.subjectPre-alerts
dc.subjectTime Factors
dc.subjectCritical Pathways
dc.subjectPre-alerts
dc.titleHow consistent are pre-alert guidelines? A review of UK ambulance service guidelinesen_US
dc.typeJournal Article/Review
dcterms.dateAccepted2024-12-16
dspace.entity.typePublication
html.description.abstractAims: Ambulance pre-alerts are used to inform receiving emergency departments (EDs) of the arrival of critically unwell or rapidly deteriorating patients who need time-critical assessment or treatment immediately upon arrival. Inappropriate use of pre-alerts can lead to EDs diverting resources from other critically ill patients. However, there is limited guidance about how pre-alerts should be undertaken, delivered or communicated. We aimed to map existing pre-alert guidance from UK NHS ambulance services to explore consistency and accessibility of existing guidance. Methods: We contacted all UK ambulance services to request documentation containing guidance about pre-alerts. We reviewed and mapped all guidance to understand which conditions were recommended for a pre-alert and alignment with Association of Ambulance Chief Executives (AACE) and Royal College of Emergency Medicine (RCEM) pre-alert guidance. We reviewed the language and accessibility of guidance using the AGREE II tool. Results: We received responses from 15/19 UK ambulance services and 10 stated that they had specific pre-alert guidance. We identified noticeable variations in conditions declared suitable for pre-alerts in each service, with a lack of consistency within each ambulance service’s own guidance, and a lack of alignment with the AACE/RCEM pre-alert guidance. Services listed between four and 45 different conditions suitable for pre-alert. There were differences in physiological thresholds and terminology, even for conditions with established care pathways (e.g. hyperacute stroke, ST segment elevation myocardial infarction). Pre-alert criteria were typically listed in several short sections in lengthy handover procedure policy documents. Documents appraised were of poor quality with low scores below 35% for applicability and overall. Implications: There is a clear need for ambulance services to have both policies and tools that complement each other and incorporate the same list of pre-alertable conditions. Clinicians need a single, easily accessible document to refer to in a time-critical situation to reduce the risk of making an incorrect pre-alert decision. Abstract published with permission.
refterms.dateFirstOnline2024-03-01
refterms.panelUnspecifieden_US
rioxxterms.licenseref.startdate2024-12-16
rioxxterms.typeJournal Article/Reviewen_US
rioxxterms.versionNAen_US
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