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Emergency Ambulance Re-design Working Group
Journal titleAcademic Emergency Medicine
MetadataShow full item record
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Stay on the ambulance long enough and you’ll go full circle: an evaluation of the clinical safety and effectiveness of non-emergency and multi-occupancy ambulance conveyance in non-emergency percutaneous coronary intervention patientsScholes, Steven; Tunn, Eddie; Newton, Mark; Ratcliffe, David (2016-12)Abstract published with permission. Mechanisms to facilitate rapid ambulance transport of diagnosed STEMI patients from the community and emergency departments (ED) settings directly to primary percutaneous coronary intervention (PPCI) facilities are well established within NHS Ambulance Services. Direct challenge of inter-hospital transfer requests for non-emergency percutaneous coronary intervention (PCI) patients by a regional NHS Ambulance Service identified disagreement between peripheral feeder hospitals and the NHS Ambulance Service on what level of ambulance transport is most appropriate. To reduce unnecessary peripheral feeder hospital requests for paramedic emergency service transfer and resource utilisation in non-emergency PCI patients and to assess the clinical safety of both non-emergency transport and multi-occupancy conveyance for this patient group. A process was established with a regional cardiothoracic centre to support pre-screening of non-emergency PCI patients for conveyance via non-emergency ambulance resources and multi-occupancy. This included centralisation of all non-emergency PCI ambulance transport booking practices and dissemination of learning materials on the process to all stakeholders. During the three-year period 3172 patients were identified as suitable for conveyance by both non-emergency ambulance transports. Of this, 36% (n=1767) were conveyed as part of a multi-occupancy journey and 56% (n=782) were conveyed by non-emergency resources. Overall, 69% (n=782) of all multi-occupancy conveyances were undertaken by non-emergency resources. Two clinical incidents were noted during this period, both of which were managed via clinical telephone advice. Non-emergency ambulances can be safely used to transport non-emergency PCI patients via multi-occupancy, following appropriate pre-screening by the receiving PCI unit. Further work is needed to understand the feasibility of this across other patient groups in the inter-hospital transfer scenario and its transferability to other NHS Ambulance Services.
A survey-based evaluation of the impact of menopause transition on female ambulance staff in one UK ambulance serviceFoster, Theresa; Prothero, Larissa; Winterson, Debra (2020-10)Menopausal symptoms can have a significant impact on workplace attendance and performance, yet limited evidence regarding the menopause transition in the emergency services exists. The aim of this study was to explore work and personal impacts of the menopause on female staff in the ambulance setting. https://emj.bmj.com/content/37/10/e6.3 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2020-999abs.12
A critical reassessment of ambulance service airway management in prehospital care: Joint Royal Colleges Ambulance Liaison Committee Airway Working Group, June 2008Deakin, Charles D.; Clarke, Tom; Nolan, Jerry P.; Zideman, David; Gwinnutt, Carl; Moore, Fionna; Keeble, Carl; Blancke, Wim (2010-03)Paramedic tracheal intubation has been practised in the UK for more than 20 years and is currently a core skill for paramedics. Growing evidence suggests that tracheal intubation is not the optimal method of airway management by paramedics and may be detrimental to patient outcomes. There is also evidence that the current initial training of 25 intubations performed in-hospital is inadequate, and that the lack of ongoing intubation practice may compound this further. Supraglottic airway devices (eg, laryngeal mask airway), which were not available when extended training and paramedic intubation was first introduced, are now in use in many ambulance services and are a suitable alternative prehospital airway device for paramedics. https://emj.bmj.com/content/27/3/226.long. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2009.082115