• Mapping midwifery and obstetric units in England

      Walsh, Denis; Spiby, Helen; Grigg, Celia P.; Dodwell, Miranda; McCourt, Christine; Culley, Lorraine; Bishop, Simon; Wilkinson, Jane; Coleby, Dawn; Pacanowski, Lynne; et al. (2018-01)
    • A survey of paramedic advanced airway practice in the UK

      Younger, Paul; Pilbery, Richard; Lethbridge, Kris (2016-12)
      Abstract published with permission. Introduction ‐ Although there are published studies examining UK paramedic airway management in the out-of-hospital setting, there has been no sizeable survey of practicing UK paramedics that examines their advanced airway management practice, training and confidence. Therefore, the Airway Management Group of the College of Paramedics commissioned a survey to gain an up to date snapshot of advanced airway management practice across the UK among paramedics. Methods ‐ An online questionnaire was created, and a convenience sample of Health and Care Professions Council (HCPC) registered paramedics was invited to participate in the survey. Invitations were made using the College of Paramedics e-mail mailing list, the College website, as well as social media services such as Twitter and Facebook. The survey ran online for 28 days from 21 October to 18 November 2014 to allow as many paramedics to participate as possible. The survey questions considered a range of topics including which supraglottic airway devices are most commonly available in practice and whether or not tracheal intubation also formed a part of individual skillsets. In relation to intubation, respondents were asked a range of questions including which education programmes had been used for original skill acquisition, how skills were maintained, what techniques and equipment were available for intubation attempts, individual practitioner confidence in intubation and how intubation attempts were documented. Results ‐ A total of 1658 responses to the survey were received. Following data cleansing, 152 respondents were removed from the survey, leaving a total of 1506. This represented 7.3% of paramedics registered with the HCPC (20,565) at the time the survey was conducted. The majority of respondents were employed within NHS ambulance services. Summary ‐ This is the largest survey of UK paramedics conducted to date, in relation to advanced airway management. It provides an overview of advanced airway management, with a particular focus on intubation, being conducted by UK paramedics.
    • A survey of UK paramedics' views about their stroke training, current practice and the identification of stroke mimics

      McClelland, Graham; Flynn, Darren; Rodgers, Helen; Price, Christopher (2017-06)
      Abstract published with permission. Aims ‐ Paramedics play a crucial role in identifying patients with suspected stroke and transporting them to appropriate acute care. Between 25% and 50% of suspected stroke patients are later diagnosed with a condition other than stroke known as a ‘stroke mimic’. If stroke mimics could be identified in the pre-hospital setting, unnecessary admissions to stroke units could potentially be avoided. This survey describes UK paramedics’ stroke training and practice, their knowledge about stroke mimic conditions and their thoughts about pre-hospital identification of these patients. Methods ‐ An online survey invitation was circulated to members within the UK College of Paramedics and promoted through social media (8 September 2016 and 23 October 2016). Topics included: stroke training; assessment of patients with suspected stroke; local practice; and knowledge about and identification of stroke mimics. Results ‐ There were 271 responses. Blank responses (39) and non-paramedic (1) responses were removed, leaving 231 responses from paramedics which equates to 2% of College of Paramedics membership and 1% of Health and Care Professions Council registered paramedics. The majority of respondents (78%) thought that they would benefit from more training on pre-hospital stroke care. Narrative comments focused on a desire to improve the assessment of suspected stroke patients and increase respondents’ knowledge about atypical stroke presentations and current stroke research. The Face Arm Speech Test was used by 97% of respondents to assess suspected stroke patients, although other tools such as Recognition of Stroke in the Emergency Room (17%) and Miami Emergency Neurological Deficit (11%) were also used. According to those responding, 50% of stroke patients were taken to emergency departments, 35% went straight to a stroke ward and 8% were taken directly to CT scan. Most respondents (65%) were aware of the term ‘stroke mimic’. Two-thirds of respondents (65%) thought a tool that predicted the likelihood of a suspected stroke being a stroke mimic would be useful in pre-hospital care. Conclusion ‐ This study reports a survey of UK paramedics’ views about the stroke care they provide. Conclusions are limited by the low number of responses. Assessment of suspected stroke patients was recognised as an important skill by paramedics and an area where many would like further training. Respondents’ current practice varied in terms of the stroke assessment tools used and whether suspected stroke patients were taken to the emergency department or direct to a stroke ward. A stroke mimic identification tool would be useful if it allowed stroke mimic patients to be directed to appropriate care, but it would need to have a high level of specificity and not adversely impact on time to treatment for true stroke patients.