Now showing items 1-20 of 63

    • A survey-based evaluation of ambulance staff awareness of vitamin D and risk of deficiency in a UK ambulance service

      Prothero, Larissa; Foster, Theresa (2021-09)
      Healthcare professions, shift-working and indoor-working are risk factors for vitamin D deficiency. The aim of this survey was to investigate ambulance staff awareness of vitamin D, and the risks associated with deficiency, to inform the need for appropriate well-being resources. Abstract published with permission.
    • Randomised feasibility study of prehospital recognition and antibiotics for emergency patients with sepsis (PhRASe)

      Jones, Jenna; Allen, Susan; Davies, Jan; Driscoll, Timothy; Ellis, Gemma; Fegan, Greg; Foster, Theresa; Francis, Nick; Islam, Saiful; Morgan, Matt; et al. (2021-09-20)
    • Mental health, well-being and support interventions for UK ambulance services staff: an evidence map, 2000 to 2020

      Clark, Lucy V.; Fida, Roberta; Skinner, Jane; Murdoch, Jamie; Rees, Nigel; Williams, Julia; Foster, Theresa; Sanderson, Kristy (2021-03)
      Prior to COVID-19 there had been a renewed policy focus in the National Health Service on the health and well-being of the healthcare workforce, with the ambulance sector identified as a priority area. This focus is more important than ever as the sector deals with the acute and longer-term consequences of a pandemic. Abstract published with permission.
    • Mobile stroke unit in the UK healthcare system: avoidance of unnecessary accident and emergency admissions

      Phillips, Daniel J.; Grunwald, Iris Q.; Walter, Silke; Faßbender, Klaus (2021-03)
      The aim of the study was to explore the benefit of a mobile stroke unit (MSU) in the UK National Health Service (NHS) for reduction of hospital admissions. Abstract published with permission.
    • Ambulance staff awareness of vitamin D and risk of deficiency in a UK ambulance service: a survey-based evaluation

      Prothero, Larissa (2021-03)
      The aim of this service evaluation was to explore staff awareness of vitamin D and the risks associated with deficiency in the ambulance setting, to inform the need for appropriate well-being support and resources. Abstract published with permission.
    • Too much of a good thing? Oxygen alert cards are helpful for chronic obstructive pulmonary disease patients at risk of oxygen toxicity

      Tooley, S.; Ellis, D.; Greggs, D.; Scott, J. (2006-11-17)
      It is well established that optimal oxygen therapy needs to be provided for patients with COPD while they are being transferred to hospital, or assessed in A&E. (Murphy et al 2001, Durrington et al 2005). The objective is to give appropriate oxygen to support their needs while avoiding the risk of CO2 retention and respiratory acidosis. https://thorax.bmj.com/content/61/suppl_2/ii57 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/
    • Simulation as a tool to improve the safety of pre‐hospital anaesthesia – a pilot study

      Batchelder, Andrew; Steel, Alistair; Mackenzie, Roderick; Hormis, Anil; Daniels, T.; Holding, N. (2009-08-03)
    • Mobile Stroke Unit in the UK Healthcare System: Avoidance of Unnecessary Accident and Emergency Admissions

      Grunwald, Iris Q.; Phillips, Daniel J.; Sexby, David; Wagner, Viola; Lesmeister, Martin; Bachhuber, Monika; Mathur, Shrey; Guyler, Paul; Fisher, James; Perera, Saman; et al. (2020-09)
    • A qualitative study on conveyance decision-making during emergency call outs to people with dementia: the HOMEWARD project

      Voss, Sarah; Brandling, Janet; Pollard, Katherine; Taylor, Hazel; Black, Sarah; Buswell, Marina; Cheston, Richard; Cullum, Sarah; Foster, Theresa; Kirby, Kim; et al. (2020-01-29)
    • Paramedic clinical leadership

      Martin, John; Swinburn, Andy (2012-03)
      Developing the paramedic profession is at the heart of the mission for the College of Paramedics. As any profession develops it evolves to take leadership and responsibility for a growing body of knowledge that informs practice. Back in 2008 the College published the second edition of the curriculum framework for paramedics clearly outlining the need for the development of roles at a variety of clinical levels. Having these levels populated creates a clinical framework that will deliver patient benefit and develop future paramedic practice. At its recent Council meeting the College outlined the need to develop education standards, clinical guidelines, and voluntary regulation for these emerging elements on the career framework, and is set to do this over the coming year. In this article Andy Swinburn the College Council representative for NW region outlines how the North West Ambulance Service NHS Trust has put into place a structured career development spanning the professional roles from first registration to consultant practice. https://www.magonlinelibrary.com/doi/full/10.12968/jpar.2012.4.3.181 ] 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/10.12968/jpar.2012.4.3.181
    • A survey-based evaluation of the impact of menopause transition on female ambulance staff in one UK ambulance service

      Foster, 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
    • Effect of blood pressure on stroke severity and outcomes in acute cases

      Kench, Charles Albert (2020-04)
      Stroke results in impairment of cerebral autoregulation. Systemic blood pressure (BP), whether low or high, may affect cerebral blood flow and cause damage to brain tissue, so is important in the context of stroke. Effective management of BP may result in less severe strokes and better outcomes for patients. https://www.magonlinelibrary.com/doi/full/10.12968/jpar.2020.12.4.157#d1614240e1 Abstract published with permission.
    • #BlackLivesMatter (2020)

      Asamoah-Danso, Tanoh; Mistry, Alpesh (2020-07)
      ‘6 foot 9?’ Another guess going wide of the mark from our third conscious and breathing patient of the shift—a guess coming a few minutes after my sigh of relief and stand down of helimed as it had come through as a confirmed choking. The life of a black paramedic in England is slightly difficult to contextualise. It is easy to say ‘my experience is my experience only’, but more often than not, I feel my experience is probably a carbon copy of that of other black staff. https://www.magonlinelibrary.com/doi/full/10.12968/jpar.2020.12.7.290 Abstract published with permission.
    • Surveying young patients

      Foster, Theresa; Maillardet, Victoria (2010-03)
      The East of England Ambulance Service NHS Trust (the Trust) was keen to engage young patients and to encourage them to give feedback about the service they had received. The standard Trust satisfaction survey was modified for use with young patients, and this had the effect of increasing the response rate from this patient group by 8%, and increasing the percentage of young patients aged 5-10 years completing the survey themselves by 29%. The vast majority of parents/guardians were happy for the Trust to survey their child, but the age of the child affected to whom they would like the survey sent. The Trust subsequently altered patient survey practice to write to parents/guardians of patients aged <12 years and directly to all patients aged > or = 12 years. https://emj.bmj.com/content/27/3/221. 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.2008.065615
    • Research paramedics’ observations regarding the challenges and strategies employed in the implementation of a large-scale out-of-hospital randomised trial

      Green, Jonathan; Robinson, Maria; Pilbery, Richard; Whitley, Gregory; Hall, Helen; Clout, Madeleine; Reeves, Barnaby; Kirby, Kim; Benger, Jonathan (2020-06-01)
      Introduction: AIRWAYS-2 was a cluster randomised controlled trial (RCT) comparing the clinical and cost effectiveness of the i-gel supraglottic airway device with tracheal intubation in the initial airway management of out-of-hospital cardiac arrest (OHCA). In order to successfully conduct this clinical trial, it was necessary for research paramedics to overcome multiple challenges, many of which will be relevant to future emergency medical service (EMS) research. This article aims to describe a number of the challenges that were encountered during the out-of-hospital phase of the AIRWAYS-2 trial and how these were overcome. Methods: The research paramedics responsible for conducting the pre-hospital phase of the trial were asked to reflect on their experience of facilitating the AIRWAYS-2 trial. Responses were then collated by the lead author. A process of iterative revision and review was undertaken by the research paramedics to produce a consensus of opinion. Results: The main challenges identified by the trial research paramedics related to the recruitment and training of paramedics, screening of eligible patients and investigation of protocol deviations / reporting errors. Even though a feasibility study was conducted prior to the commencement of AIRWAYS-2, the scale of these challenges was underestimated. Conclusion: Large-scale pragmatic cluster randomised trials are being successfully undertaken in out-of-hospital care. However, they require intensive engagement with EMS clinicians and local research paramedics, particularly when the intervention is contentious. Feasibility studies are an important part of research but may fail to identify all potential challenges. Therefore, flexibility is required to manage unforeseen difficulties. Abstract published with permission.
    • Views regarding the provision of prehospital critical care in the UK

      Mackenzie, R.; Steel, A.; French, J.; Wharton, R.; Lewis, S.; Bates, A.; Daniels, T.; Rosenfeld, M. (2009-05-22)
      Aims: There is a lack of consensus regarding the role for critical care in the prehospital environment in the UK. It was hypothesised that this related to differences in views and understanding among opinion leaders within influential prehospital care organisations. Methods: A 38-item survey was developed by an established paramedic-physician prehospital critical care service. The survey was distributed to individuals in senior positions within seven organisations that have a major influence on UK prehospital services. Analysis comprised a description of the distribution of results, assessment of the level of agreement with each statement by professional background and current involvement in prehospital critical care and evaluation of the overall consistency of responses. Free-text comments were invited to illustrate the reasoning behind each response. Results: There were 32 respondents. The estimated response rate was 40%. The consistency of the questionnaire responses was very high. Overall, all individuals agreed with most of the statements. Paramedic respondents were more likely to disagree with statements that suggested that critical care involved interventions that exceed the current capability of the NHS ambulance service (p<0.05). Free-text comments revealed wide differences of opinion. Conclusion: Although there appears to be broad agreement among opinion leaders regarding the concepts underpinning existing prehospital critical care services, areas of contention are highlighted that may help explain the current lack of consensus. Cooperative efforts to assess the current demand and clinical evidence would assist in the creation of a joint consensus and allow effective future planning for the provision of prehospital critical care throughout the UK. https://emj.bmj.com/content/26/5/365. 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.2008.062588
    • Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience

      Khan, S. N.; Murray, Paul; McCormick, L.; Sharples, L. S.; Salahshouri, P.; Scott, Jason; Schofield, P. M. (2009-05-22)
      Introduction: Prehospital thrombolysis has been shown to improve patient outcomes in clinical trials and this has been confirmed in the ongoing large national myocardial infarction registry (Myocardial Infarction National Audit Project; MINAP) reports. This paper describes a system to improve the delivery of prehospital thrombolysis and the associated governance requirements to gain maximum patient benefit. Methods: Demographic data were prospectively collected on all patients treated by the East Anglian Ambulance Trust with bolus thrombolytics for a presumed diagnosis of ST elevation myocardial infarction between November 2003 and February 2007. Survival status was determined from the NHS strategic tracing service. Results: 1062 patients (mean age 64.0 years (SD 10.6), 795 men) were treated in this time period. There were 71 deaths in this group, with actuarial survival of 93.9% (SE 0.9%) at 30 days, 91.7% (SE 1.0%) at 6 months and 90.8% (SE 1.1%) at 12 months after treatment. Age and cardiac arrest were most strongly associated with mortality (both p<0.001). Twelve (1.2%) patients received thrombolysis that on review was considered inappropriate. There were no deaths in this subgroup. Conclusions: Prehospital thrombolysis can be administered safely by ambulance staff supported by a Trust clinical support system with excellent clinical outcomes. https://emj.bmj.com/content/26/6/452. 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.2008.062729