Recent Submissions

  • Reporting standard for describing first responder systems, smartphone alerting systems, and AED networks

    Muller, M.P.; Thies, K.C.; Grief, R; Scquizzato, T; Deakin, Charles; Auricchio, A; Barry, T; Berglund, E; Bottiger, B.W; Burkart, R; et al. (2024-02)
  • Point-of-care blood testing with secondary care decision support for frail patients

    Novak, Alex; Cherry, Joanne; Ali, Nurul; Smith, Ian; Bowen, Jordan; Ray, James; Black, John JM; Cornett, Ross; Taylor, Sally; Hayward, Gail; et al. (MAG Online, 2022-02-02)
    Aim: A service evaluation was conducted to assess the feasibility and impact of a pilot service to facilitate alternatives to hospital admission for frail patients in supportive care settings. Paramedic assessments were enhanced by point-of-care testing and telephone support from senior physicians. Method: A rapid response vehicle, staffed by a specialist paramedic and equipped with the Abbott i-STAT Wireless 1 point-of-care testing platform that could transmit results to hospital electronic patient record (EPR) systems, was dispatched to frail, non-injured patients over a 3-month period. Results were obtained on scene and transmitted to Oxford University Hospitals EPR system. The patient was then discussed over the telephone with a senior acute medical assessment physician at the Trust for advice and decision support and to coordinate referral to secondary care or other services. Results: The analysis included 56 patients, 21 men and 35 women, with a median age of 86 years. Seventeen patients who had significantly deranged blood test results were transferred to hospital, as were another 10 who did not have such results; 27 patients were admitted in total. Twenty-nine patients remained in their usual environment; of these, four presented to hospital within the next 30 days, and no deaths or adverse events were reported. Conclusion: Point-of-care testing by the ambulance services is feasible and, when combined with telephone advice and decision support from secondary care physicians, may be effective in reducing hospital admission for frail patients in supportive care environments. Larger systematic evaluations are warranted to establish the utility and cost-effectiveness of point-of-care testing by ambulance services. Abstract published with permission
  • Feasibility randomised controlled trial of optimal shock energy for defibrillation

    Pocock, Helen; Deakin, Charles; Lall, Ranjit; Perkins, Gavin (2022-06-01)
  • Systematic review of shock strategies for out-of-hospital cardiac arrest

    Pocock, Helen; Deakin, Charles; Lall, Ranjit; Smith, Christopher M.; Perkins, Gavin (2022-06-01)
  • Do we hyperventilate cardiac arrest patients?

    O'Neill, John; Deakin, Charles. D (2006-09-12)
  • Impact of the Airways-2 trial on advanced airway management use in out-of-hospital cardiac arrest in England

    Aljoubi, M; Brown, Terry P.; Booth, Scott; Deakin, Charles; Fothergill, Rachael; Nolan, Jerry; Soar, Jasmeet; Perkins, Gavin; Couper, Keith; On behalf of OHCAO collaborators (2023)
  • Prehospital optimal shock energy for defibrillation (POSED): A cluster randomised controlled feasibility trial

    Peacock, Helen; Deakin, Charles; Lall, Ranjit; Michelet, Felix; Sun, Chu; Smith, Deb; Hill, Catherine; Rai, Jeskran; Starr, Kath; Brown, Martina; et al. (2023-11-22)
  • Prehospital management of sepsis with IV antibiotics: a UK literature review

    Jadzinski, Patryk; Fouch, Sarah; Markham, Chris; Stores, Rebecca (2024-05-02)
    Background: Sepsis mortality rates increase if prompt treatment is not administered. The Sepsis Six care bundle advocates the early administration of broad-spectrum intravenous antibiotics to reduce mortality and morbidity but this is not routinely practised nationally in UK prehospital settings, although UK ambulance services regularly attend septic patients. Aims: A literature review was conducted to investigate knowledge around paramedics' ability to recognise and treat prehospital sepsis with intravenous antibiotics in the UK and the impact of this on patient outcomes. Methods: A search was conducted and the three eligible studies included underwent a structured critical appraisal and thematic analysis. Findings: Three themes emerged: diagnostic accuracy; administration of prehospital antibiotics; and impact on patient outcomes. Conclusion: There is a significant gap in evidence in this field in the UK, and it was difficult to make generalised recommendations from the studies. Paramedics have the potential to be highly accurate in the recognition of sepsis and administer intravenous antibiotics when following a protocol. No major studies measure patient outcomes following prehospital intravenous antibiotics administration by paramedics in the UK and large empirical studies should be conducted to assess the effectiveness of this. Abstract published with permission
  • Trends in use of intraosseous and intravenous access in out-of-hospital cardiac arrest across English ambulance services: a registry-based, cohort study

    Vadeyar, Sharvari; Buckle, Alexandra; Hooper, Amy; Booth, Scott; Deakin, Charles; Fothergill, Rachael; Chen, Ji; Nolan, Jerry P; Brown, Martina; Cowley, Alan; et al. (2023-10)
  • Febrile seizure management and effectiveness of prevention with antipyretics

    Dra'gon, Victoria; Jadzinski, Patryk (2024-01-02)
    Background: Before reaching the age of 5, 2–5% of children will have had a febrile seizure. Most are categorised as simple but they can be complex and carry the risk of complications. They can be frightening for parents. UK guidelines advise against the use of antipyretic drugs to prevent febrile seizure recurrence while being mindful of parental sensitivities. Aim: This systematised literature review aimed to appraise the global body of evidence in relation to current guidelines on using conventional antipyretics for the prevention of febrile seizures and explore factors that influence their management. Method: A research question was developed using the PICO (population/participant(s); intervention(s); comparison/control; outcome) framework and two databases were searched for primary research, and abstracts were screened for relevance. Results: Thirty-four articles were identified, or which three were relevant to the research aim. These were critically appraised using the Mixed Methods Appraisal Tool and five themes were identified. Conclusion: One study found that paracetamol may prevent recurrent febrile seizures, one found a small reduction in febrile seizure recurrence when treated with an antipyretic and one found antipyretics ineffective at reducing febrile seizure recurrence. Similar contemporary studies conducted in the UK population may help to improve understanding of the factors influencing febrile seizure management and the effectiveness of antipyretics. Abstract published with permission
  • Remote COVID-19 assessment in primary care (RECAP) risk prediction tool: derivation and real-world validation studies

    Espinosa-Gonzalez, Ana; Prociuk, Derek; Fiorentino, Francesca; Ramtale, Christian; Mi, Ella; Mi, Emma; Glampson, Ben; Neves, Ana Luisa; Okusi, Cecilia; Husain, Laiba; et al. (2022-09)
  • Defibrillator electrode pads – where are we really placing them?

    Brown, Martina; Claxton, A.; Clinton-Parker, K.; Deakin, Charles (2023-10)
  • Consensus on innovations and future change agenda in Community First Responder schemes in England: a national Nominal Group Technique study

    Patel, Gupteswar; Botan, Vanessa; Phung, Viet-Hai; Trueman, Ian; Pattinson, Julie; Hosseini, Seyed Mehrshad Parvin; Orner, Roderick; Asghar, Zahid; Smith, Murray Donald; Rowan, Elise; et al. (2023)
  • Quantifying the impact of environment factors on the risk of medical responders’ stress‐related absenteeism

    Brito, Mario P.; Chen, Zhiyin; Wise, James; Moritmer, Simon (Wiley, 2022-08)
    Medical emergency response staff are exposed to incidents which may involve high-acuity patients or some intractable or traumatic situations. Previous studies on emergency response staff stress-related absence have focused on perceived factors and their impacts on absence leave. To date, analytical models on absenteeism risk prediction use past absenteeism to predict risk of future absenteeism. We show that these approaches ignore environment data, such as stress factors. The increased use of digital systems in emergency services allows us to gather data that were not available in the past and to apply a data-driven approach to quantify the effect of environment variables on the risk of stress-related absenteeism. We propose a two-stage data-driven framework to identify the variables of importance and to quantify their impact on medical staff stress-related risk of absenteeism. First, machine learning techniques are applied to identify the importance of different stressors on staff stress-related risk of absenteeism. Second, the Cox proportional-hazards model is applied to estimate the relative risk of each stressor. Four significant stressors are identified, these are the average night shift, past stress leave, the squared term of death confirmed by the Emergency Services and completion of the safeguarding form. We discuss counterintuitive results and implications to policy
  • A healthy exchange of views

    Darzi, Lord Ara; Neve, Suzanne; Beda, Oliver; Newton, Andy; Venn, Richard; Forni, Lui; Forni, Lui (2007-12-15)
  • Wound closure on scene: ethical analysis and reflection

    Winch, Spencer (2009-05-01)
    This case study involves the critical analysis and reflection of the ethics involved when an emergency care practitioner closed a 16-year-old patient's self-inflicted wounds at scene, rather than transporting to A&E. The article aims to show the challenges faced by ambulance personnel in the pre-hospital setting when faced with issues surrounding patient autonomy, consent and capacity and how these should be considered on a ‘case by case’ basis. Abstract published with permission.
  • Role of ambulance crews

    Berry, Richard (2009-11)

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