• The accuracy of media reports as a mode for communicating information about a waiver of consent trial

      Kaye, Charlotte; Horton, Jessica; Rumble, Sarah; Hennings, Susie; Nolan, Jerry P.; Quinn, Tom; Deakin, Charles D.; Slowther, Anne-Marie; Gates, Simon; Perkins, Gavin D. (2015-11)
    • Advice from the Cheshire cat

      Deakin, Charles D. (2014-05)
    • Algorithms to guide ambulance clinicians in the management of emergencies in patients with implanted rotary left ventricular assist devices

      Bowles, Christopher T.; Hards, Rachel; Wrightson, Neil; Lincoln, Paul; Kore, Shishir; Marley, Laura; Dalzell, Jonathan R.; Raj, Binu; Baker, Tracey A.; Goodwin, Diane; et al. (2017-12)
      Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services. This has resulted in inconsistent availability and content of information with the risks of delayed or inappropriate decision-making. In order to improve patient safety, a consortium of UK healthcare professionals with expertise in LVADs developed universally applicable prehospital emergency algorithms. Guidance was framed as closely as possible on the standard ABCDE approach to the assessment of critically ill patients. https://emj.bmj.com/content/emermed/34/12/842.full.pdf 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/ http://dx.doi.org/10.1136/emermed-2016-206172
    • Ambulance telephone triage using 'NHS Pathways' to identify adult cardiac arrest

      Deakin, Charles D.; England, Simon; Diffey, Debbie (2017-05)
      Background UK ambulance services are called to 30 000 cardiac arrests (CAs) annually where resuscitation is attempted. Correct identification by the ambulance service trebles survival by facilitating bystander-cardiopulmonary resuscitation (CPR) and immediate ambulance dispatch. Identification of CA by telephone is challenging and involves algorithms to identify key features. ‘NHS Pathways’ is now used for triage by six of 12 UK ambulance services, covering a population of 20 million. With the significant improvements in survival when CA is accurately identified, it is vital that ‘NHS Pathways’ is able to identify CA correctly. Methods All ‘999’ emergency calls to South Central Ambulance Service (SCAS) over a 12-month period screened by NHS Pathways v9.04 were identified. All actual or presumed CAs identified by the emergency call taker were cross-referenced with the ambulance crew’s Patient Report Form to identify all confirmed CAs. Results A total of 469 400 emergency (999) calls were received by SCAS. Of the 3119 CA identified by ambulance crew, 753 were not initially classified as CA by NHS Pathways (24.1%). Overall, sensitivity=0.759 (95% CI 0.743 to 0.773); specificity=0.986 (95% CI 0.9858 to 0.98647); and positive predictive value=26.80% (95% CI 25.88 to 27.73%). Conclusions NHS Pathways accurately identifies 75.9% of adult CAs. The remainder represents approximately 7500 treatable CAs in the UK annually where the diagnosis is missed, with significant implications for patient outcome. Further work is required to improve this first link in the chain of survival https://heart.bmj.com/content/heartjnl/103/10/738.2.full.pdf 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/ http://dx.doi.org/10.1136/heartjnl-2016-310651
    • Bacterial tonsillitis: prevalence, prediction and treatment by the ECP

      Winch, Spencer (2010-09)
      Sore throat or tonsillitis is not necessarily considered a life-threatening emergency but such calls are received and attended to by the ambulance service. It is believed that this is because a face-to-face assessment is often required as the symptoms of a high temperature, headache, lethargy, vomiting and a stiff neck are far too similar to those of meningitis. With complex telephone triage now being performed by nurses and emergency care practitioners (ECP) on clinical support desks within most emergency operation centres, it is hoped that this complaint could be narrowed down and a more appropriate ECP response despatched. When presented with tonsillitis in the community, it is difficult for the practitioner to establish whether the infection is of a bacterial or viral origin. Learned behaviour would suggest that white exudates on the tonsils deem a bacterial origin and requires antibiotic treatment, but this can sometimes be a self limiting illness and antibiotic treatment is not indicated and will only assist with resistance. This article looks as the incidence of bacterial tonsillitis, tools to predict bacterial tonsilitis, and the correct antibiotic and length of course once established. It also briefly touches on the Department of Health's current consultation on paramedic prescribing rights and how a delayed prescription treatment plan cannot be achieved working under a patient group directive (PGD) when treating bacterial tonsillitis. Abstract published with permission.
    • Bystander cardiopulmonary resuscitation: Impact of training initiatives

      Brown, Terry P.; Booth, Scott; Lockey, Andrew S.; Askew, Sara; Hawkes, Claire A.; Fothergill, Rachael; Black, Sarah; Pocock, Helen; Gunson, Imogen; Soar, Jasmeet; et al. (2018-09)
    • Can ambulance telephone triage using NHS Pathways accurately identify paediatric cardiac arrest?

      Deakin, Charles D.; England, Simon; Diffey, Debbie; Maconochie, Ian (2017-07)
    • Changing paramedic students' perception of people who self-harm

      Ramluggun, Pras; Freeman-May, Andrew; Barody, Gabby; Groom, Nicholas; Townsend, Chloe (2020-10-07)
      Aim: This study aimed to identify whether paramedic students' perceptions of patients who self-harm changed following an educational intervention. Background: Self-harm is a major public health concern with an increasing number of incidents being reported in England. Paramedics are often the first contact for those who self-harm and antipathy to these patients among caregivers, including paramedics, has been reported. Negative attitudes to patients who self-harm from health professionals is a considerable barrier to their care. Education on self-harm for paramedics has been historically inadequate, even though it can potentially improve attitudes and how these practitioners engage with those who self-harm. Method: A pre- and post-survey analysis was undertaken to examine whether any identified unsympathetic perceptions of paramedic students (n=30) towards patients who self-harm would decrease following an educational intervention, using a validated questionnaire measuring attitudes to self-harm. Results: Perceptions of people who self-harm were generally moderately negative prior to the educational intervention, with a significant drop in negative attitudes after it was completed. A survey showed that this drop was also mostly sustained 10 months later. Conclusion: Educational interventions may help to reduce negative perceptions of patients who self-harm in paramedic students. Abstract published with permission.
    • Characteristics of neighbourhoods with high incidence of out-of-hospital cardiac arrest and low bystander cardiopulmonary resuscitation rates in England

      Brown, Terry P.; Booth, Scott; Hawkes, Claire A.; Soar, Jasmeet; Mark, Julian; Mapstone, James; Fothergill, Rachael; Black, Sarah; Pocock, Helen; Bichmann, Anna; et al. (2019-01-01)