• Transportation of patients with specialist palliative care needs by a local ambulance provider-policy shaping

      Swann, d.; Whitmore, David; Suggs, L.; Edmonds, P.; Waight, C.; Jones, E.; Crook, T.; Rudgyard, K. (2006-03)
    • An investigation into the introduction and implementation of fitness tests within UK ambulance services

      Clarke, V. (2006-04)
      Front line ambulance work can involve a significant amount of physical activity and manual handling, which is often sporadic and varied in nature. Although training in lifting and handling techniques is delivered to all staff, studies suggest that an above average level of physical fitness can further reduce the incidence of sickness and injury at work. https://emj.bmj.com/content/23/4/e31 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/ http://dx.doi.org/10.1136/emj.2005.032946
    • The impact of shift work on emergency medical dispatching

      Roshanzamir, S.; Heward, Andy; Glucksman, Ed. (2006-04)
      Healthcare professionals are required to work to consistently high standards 24 hours a day, 365 days a year necessitating shift work to be employed. Shift work is often perceived to result in disruption to the worker, manifesting itself in terms of sleep, health, and social disruption, as well as job performance, standards, and safety, with substantial differences in fatigue identified between day and night shift workers. https://emj.bmj.com/content/23/4/321 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/ http://dx.doi.org/10.1136/emj.2005.032938
    • Emergency care practitioners: impact of the new role

      Halter, Mary; Marlow, T.; Jackson, D. (2006-04)
      The emergency care practitioners (ECP) role is one requiring a new model of education: the Department of Health promoting a 16 week course. In London, ECPs undertake a two year interdisciplinary healthcare diploma, practising after completion of modules in “the nature of physical assessment” and “clinical decision making”, then covering pharmacology, paediatrics, minor illness, minor injury, chronic conditions, and mental health. Clinical placements and self management are central. https://emj.bmj.com/content/23/4/e31 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/ http://dx.doi.org/10.1136/emj.2005.032946
    • Older fallers: the risk and opportunity of ambulance non conveyance

      Halter, Mary; Snooks, Helen; Close, Jacqueline; Cheung, Wai Yee; Moore, Fionna (2006-04)
      Large numbers of older people fall every year. Interdisciplinary intervention can reduce the risk of falling, and the use of integrated falls services for ambulance attended patients has been promoted. Non conveyance of fallers by ambulance staff is high but the triage system is informal. This study tested whether the introduction of an assessment tool would enable emergency ambulance staff to leave older fallers at home safely. https://emj.bmj.com/content/23/4/e31 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/ http://dx.doi.org/10.1136/emj.2005.032946
    • Should emergency medical technicians be considered for the role of the emergency care practitioner?

      Halter, Mary; Marlow, T.; Jackson, D.; Moore, Fionna; Postance, B. (2006-11)
      We enjoyed a recent discussion in this journal about the evaluation of the role of the emergency care practitioner (ECP).1,2 In the UK, 77% of ECPs are paramedics and most of the remainder are nurses,2 although studies report them as a homogeneous group. We also find differences within ECPs interesting, particularly as ECPs in London have also been recruited from emergency medical technicians (EMTs). https://emj.bmj.com/content/23/11/888.1 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/ http://dx.doi.org/10.1136/emj.2006.038968
    • An investigation to determine whether evidence exists to support the introduction of paralysis agents into the prehospital environment, to assist endotracheal intubation for patients who sustain head injuries

      Dady, S. (2006-11-27)
      Head injuries are associated with 50% of all deaths due to trauma, about 5000 deaths annually. In traumatic injury, the brain is exposed to two insults: the initial trauma and the second insult during the body’s response. Prevention of this secondary cerebral insult may improve outcome. Intubation facilitated by rapid sequence induction (RSI) ensures appropriate ventilation, reducing the secondary insult by managing arterial CO2 levels. The existing literature indicates that prehospital RSI does not influence the outcome in patients with multiple trauma, yet fails to examine the effect of RSI and intubation on patient recovery from isolated head injury (IHI). https://emj.bmj.com/content/23/12/e68. 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/emj.2006.041574
    • The unanticipated cost of the London congestion charge.

      Hartley-Sharp, Christopher; Munro, M. (2006-12)
      When the London congestion charge was introduced in 2003, operational ambulance personnel were among a group of ‘‘key workers’’ who were refused an exemption. With the charge at £8 per day and public transport options that do not meet the needs of shift workers, many staff have sought alternatives such as motorcycling, which carries an increased risk of involvement in a road traffic collision (RTC) and a greater risk of injury when this happens. https://emj.bmj.com/content/23/12/e68 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/ http://dx.doi.org/10.1136/emj.2006.041574
    • Impact of the terrorist atrocities of 7 July 2005 on the London Ambulance Services incident volume

      Yates, C.; Heward, Andy; Glucksman, E. (2006-12)
      During the past 20 years, there have been numerous terrorist atrocities and other major incidents within the boundaries covered by the London Ambulance Service (LAS) NHS Trust. Historic LAS records and anecdotal feelings suggest that the demands placed on the LAS during these incidents were significantly reduced, with fewer 999 calls received, but no work had previously been undertaken to evidence this suggestion. https://emj.bmj.com/content/23/12/e68 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/ http://dx.doi.org/10.1136/emj.2006.041574
    • Can the provision of alternative transport arrangements increase the availability of emergency ambulances?

      Hayes, B.; Casson, D.; Lawrence, N.; Carroll, K.; Whitter, B.; Hartley-Sharpe, C. (2006-12)
      With increased licensing hours and the rise in the much publicised binge-drinking culture, the London Ambulance Service is finding itself stretched to the point that patients with serious illnesses or injuries are at risk of not receiving the response that they need. https://emj.bmj.com/content/23/12/e68.info. 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/emj.2006.041574
    • Public perceptions and experiences of heart attack, cardiac arrest and cardiopulmonary resuscitation in London

      Donohoe, Rachael T.; Haefeli, Karen; Moore, Fionna (2006-12)
      Coronary heart disease (CHD) is a leading cause of mortality and a common cause of out-of-hospital cardiac arrest in the UK. The London Ambulance Service NHS Trust attends about 9800 cardiac arrests each year. Of the cardiac arrests considered viable for resuscitation during 2004–5, 79% were of presumed cardiac aetiology. The overall rate of survival for this group of patients was 4%. Although bystander cardiopulmonary resuscitation (CPR) can significantly improve chances of surviving out-of-hospital cardiac arrest, it was initiated in only 30% of cases. https://emj.bmj.com/content/23/12/e68 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/ http://dx.doi.org/10.1136/emj.2006.041574
    • Emergency care of older people who fall: a missed opportunity

      Snooks, Helen; Halter, Mary; Close, Jacqueline; Cheung, Wai Yee; Moore, Fionna; Roberts, Stephen E. (2006-12-01)
      A high number of emergency (999) calls are made for older people who fall, with many patients not subsequently conveyed to hospital. Ambulance crews do not generally have protocols or training to leave people at home, and systems for referral are rare. The quality and safety of current practice is explored in this study, in which for the first time, the short-term outcomes of older people left at home by emergency ambulance crews after a fall are described. Results will inform the development of care for this population. https://qualitysafety.bmj.com/content/15/6/390 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 10.1136/qshc.2006.018697
    • Urinary tract infection: diagnosis and management for nurses

      Naish, Wendy; Hallam, Matt (2007-02-14)
      Urinary tract infection (UTI) is a common health problem, so it is important that nurses in all care settings know how to manage patients with this condition effectively. This article defines UTI, identifying patients who are most at risk and the underlying reasons why. Accurate diagnosis is important in the provision of treatment and the prevention of further complications, some of which can have serious consequences for patients. Inappropriate investigations are expensive, and may result in patients being over-treated. UTI is multifaceted, which makes its management difficult. However, a good understanding of prevention, assessment and management can help nurses to ensure the right treatment is offered. https://search.proquest.com/docview/219852637/abstract/858663895F434BA4PQ/1?accountid=48113. 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
    • Effect of a centralised transfer service on characteristics of inter-hospital neonatal transfers

      Kempley, S. T.; Baki, Y.; Hayter, G.; Ratnavel, Nandiran; Cavazzoni, E.; Reyes, T. (2007-05)
      To determine the effect of a centralised neonatal transfer service on numbers of neonatal transfers and the time taken for teams to reach the baby. https://fn.bmj.com/content/92/3/F185 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/adc.2006.106047
    • Ipratropium bromide: a bit of a wheeze?

      Archer, Tom (2007-06)
      Administration of ipratropium bromide has become standard care in UK prehospital practice for acute severe or life-threatening asthma. This retrospective ‘‘before and after’’ USA study examined prehospital and emergency department records 6 months before and after the introduction of prehospital ipratropium. https://emj.bmj.com/content/24/6/439 ] 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/ http://dx.doi.org/10.1136/emj.2007.048835
    • Accuracy of emergency medical dispatchers' subjective ability to identify when higher dispatch levels are warranted over a Medical Priority Dispatch System automated protocol's recommended coding based on paramedic outcome data

      Clawson, Jeff; Olola, Christopher H.O.; Heward, Andy; Scott, Greg; Patterson, Brett (2007-08)
      To establish the accuracy of the emergency medical dispatcher’s (EMD’s) decisions to override the automated Medical Priority Dispatch System (MPDS) logic-based response code recommendations based on at-scene paramedic-applied transport acuity determinations (blue-in) and cardiac arrest (CA) findings. https://emj.bmj.com/content/24/8/560. 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/emj.2007.047928.
    • Interpreting the signs

      Lawrence, Ricky (2007-10)
    • Reflecting on events

      Lawrence, Pat (2008-02)
    • Mobile phones, in combination with a computer locator system, improve the response times of emergency medical services in central London

      Gossage, J.A.; Frith, D.P.; Carrell, T.W.G.; Damiani, Mike; Terris, J.; Burnand, K.G. (2008-03)