• 100 Cases in Acute Medicine

      Armitage, Ewan (2016-09)
    • ABC of alcohol

      Armitage, Ewan (2016-02)
    • ABC of anxiety and depression

      Armitage, Ewan (2015-04)
    • ABC of Diabetes

      Armitage, Ewan (2016-06)
    • ABC of hypertension

      Armitage, Ewan (2015-11)
    • ABC of multimorbidity

      Armitage, Ewan (2014-12)
    • ABC of Patient Safety

      Armitage, Ewan (2011-10)
    • ABC of resuscitation

      Armitage, Ewan (2012-08)
    • The ACUTE (Ambulance CPAP: Use, Treatment effect and economics) feasibility study: a pilot randomised controlled trial of prehospital CPAP for acute respiratory failure

      Fuller, Gordon W.; Goodacre, Steve; Keating, Samuel; Perkins, Gavin D.; Ward, Matthew; Rosser, Andy; Gunson, Imogen; Miller, Joshua; Bradburn, Mike; Thokala, Praveen; et al. (2018-06)
    • Ambulance call-outs and response times in Birmingham and the impact of extreme weather and climate change

      Thornes, John Edward; Fisher, Paul Anthony; Rayment-Bishop, Tracy; Smith, Christopher (2014-03)
      Although there has been some research on the impact of extreme weather on the number of ambulance call-out incidents, especially heat waves, there has been very little research on the impact of cold weather on ambulance call-outs and response times. In the UK, there is a target response rate of 75% of life threatening incidents (Category A) that must be responded to within 8 min. This paper compares daily air temperature data with ambulance call-out data for Birmingham over a 5-year period (2007–2011). A significant relationship between extreme weather and increased ambulance callout and response times can clearly be shown. Both hot and cold weather have a negative impact on response times. During the heat wave of August 2003, the number of ambulance call-outs increased by up to a third. In December 2010 (the coldest December for more than 100 years), the response rate fell below 50% for 3 days in a row (18 December–20 December 2010) with a mean response time of 15 min. For every reduction of air temperature by 1°C there was a reduction of 1.3% in performance. Improved weather forecasting and the take up of adaptation measures, such as the use of winter tyres, are suggested for consideration as management tools to improve ambulance response resilience during extreme weather. Also it is suggested that ambulance response times could be used as part of the syndromic surveillance system at the Health Protection Agency. https://emj.bmj.com/content/emermed/31/3/220.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-2012-201817
    • Ambulance care essentials

      Armitage, Ewan (2016-01)
    • The association between prehospital care and in-hospital treatment decisions in acute stroke: a cohort study

      Sheppard, James P.; Mellor, Ruth M.; Greenfield, Sheila; Mant, Jonathan; Quinn, Tom; Sandler, David; Sims, Don; Singh, Satinder; Ward, Matthew; McManus, Richard J.; et al. (2015-02)
      Background Hospital prealerting in acute stroke improves the timeliness of subsequent treatment, but little is known about the impact of prehospital assessments on in-hospital care. Objective Examine the association between prehospital assessments and notification by emergency medical service staff on the subsequent acute stroke care pathway. Methods This was a cohort study of linked patient medical records. Consenting patients with a diagnosis of stroke were recruited from two urban hospitals. Data from patient medical records were extracted and entered into a Cox regression analysis to investigate the association between time to CT request and recording of onset time, stroke recognition (using the Face Arm Speech Test (FAST)) and sending of a prealert message. Results 151 patients (aged 71±15 years) travelled to hospital via ambulance and were eligible for this analysis. Time of symptom onset was recorded in 61 (40%) cases, the FAST test was positive in 114 (75%) and a prealert message was sent in 65 (44%). Following adjustment for confounding, patients who had time of onset recorded (HR 0.73, 95% CI 0.52 to 1.03), were FAST-positive (HR 0.54, 95% CI 0.37 to 0.80) or were prealerted (HR 0.26, 95% CI 0.18 to 0.38), were more likely to receive a timely CT request in hospital. Conclusions This study highlights the importance of hospital prealerting, accurate stroke recognition, and recording of onset time. Those not recognised with stroke in a prehospital setting appear to be excluded from the possibility of rapid treatment in hospital, even before they have been seen by a specialist. https://emj.bmj.com/content/32/2/93.long 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-2013-203026
    • Barriers to paramedic education in black and ethnic minority (BME) groups

      Farquharson, Natalie; Dudley, Robert; Hardwick, Sharon; Zandbeek, Jennifer (2017-01)
      Abstract published with permission. Purpose: To gain an understanding of how Black and Minority Ethnic (BME) groups respond to information about paramedic courses, their experience of the enrolment processes and their experience of paramedic training. Methodology: Telephone interviews were conducted with qualified paramedics and student paramedics from BME groups. Findings: Interviews revealed issues in relation to the accessibility and understanding of information on paramedic education and a lack of information in preparation for paramedic courses, causing unrealistic expectations. A lack of diversity in the student population, incidences of racial offence (unconscious or conscious), and a lack of visibility of BME staff in the ambulance service as well as in the wider community were identified. Practical implications: The results produced from this evaluation may contribute towards a series of recommendations in order to better inform practice to increase the diversity of students entering into paramedic science and in order to avoid issues such as student attrition.
    • Bystander cardiopulmonary resuscitation: Impact of training initiatives

      Brown, Terry P.; Booth, Scott; Lockey, Andrew S.; Askew, Sara; Hawkes, Claire A.; Fothergill, Rachael T.; Black, Sarah; Pocock, Helen; Gunson, Imogen; Soar, Jasmeet; et al. (2018-09)