• Early intervention in psychiatry

      Armitage, Ewan (2015-03)
    • The effect of airway management on CPR quality in the PARAMEDIC2 randomised controlled trial

      Deakin, Charles; Nolan, Jerry P.; Ji, Chen; Fothergill, Rachael; Quinn, Tom; Rosser, Andy; Lall, Ranjit; Perkins`, Gavin (2020-11-12)
    • Effect of listening to Nellie the Elephant during CPR training on performance of chest compressions by lay people: randomised crossover trial

      Rawlins, Lettie; Woollard, Malcolm; Williams, Julia; Hallam, Phil (2009-12-14)
      Objectives To determine whether listening to music during cardiopulmonary resuscitation (CPR) training increases the proportion of lay people delivering chest compressions of 100 per minute. Design Prospective randomised crossover trial. Setting Large UK university. Participants 130 volunteers (81 men) recruited on an opportunistic basis. Exclusion criteria included age under 18, trained health professionals, and cardiopulmonary resuscitation (CPR) training within the past three months. Interventions Volunteers performed three sequences of one minute of continuous chest compressions on a skill meter resuscitation manikin accompanied by no music, repeated choruses of Nellie the Elephant (Nellie), and That’s the Way (I like it) (TTW) according to a pre-randomised order. Main outcome measures Rate of chest compressions delivered (primary outcome), depth of compressions, proportion of incorrect compressions, and type of error. Results Median (interquartile range) compression rates were 110 (93-119) with no music, 105 (98-107) with Nellie, and 109 (103-110) with TTW. There were significant differences within groups between Nellie v no music and Nellie v TTW (P<0.001) but not no music v TTW (P=0.055). A compression rate of between 95 and 105 was achieved with no music, Nellie, and TTW for 15/130 (12%), 42/130 (32%), and 12/130 (9%) attempts, respectively. Differences in proportions were significant for Nellie v no music and Nellie v TTW (P<0.001) but not for no music v TTW (P=0.55). Relative risk for a compression rate between 95 and 105 was 2.8 (95% confidence interval 1.66 to 4.80) for Nellie v no music, 0.8 (0.40 to 1.62) for TTW v no music, and 3.5 (1.97 to 6.33) for Nellie v TTW. The number needed to treat for listening to Nellie v no music was 5 (4 to 10)—that is, the number of cardiac arrests required during which lay responders listen to Nellie to facilitate one patient receiving compressions at the correct rate (v no music) would be between four and 10. A greater proportion of compressions were too shallow when participants listened to Nellie v no music (56% v 47%, P=0.022). Conclusions Listening to Nellie the Elephant significantly increased the proportion of lay people delivering compression rates at close to 100 per minute. Unfortunately it also increased the proportion of compressions delivered at an inadequate depth. As current resuscitation guidelines give equal emphasis to correct rate and depth, listening to Nellie the Elephant as a learning aid during CPR training should be discontinued. Further research is required to identify music that, when played during CPR training, increases the proportion of lay responders providing chest compressions at both the correct rate and depth. https://www.bmj.com/content/339/bmj.b4707. 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/ DOI http://dx.doi.org/10.1136/bmj.b4707
    • The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: Findings from the PACA and PARAMEDIC-2 randomised controlled trials

      Perkins, Gavin D.; Kenna, Claire; Ji, Chen; Deakin, Charles D.; Nolan, Jerry P.; Quinn, Tom; Fothergill, Rachael; Gunson, Imogen; Pocock, Helen; Rees, Nigel; et al. (2019-07)
    • Emergencies in critical care

      Armitage, Ewan (2013-11)
    • Emergency ambulance services for heart attack and stroke during UK's COVID-19 lockdown

      Lumley-Holmes, Jenny; Brake, Simon; Docherty, Mark; Lilford, Richard; Watson, Sam (2020-05-23)
    • Emergency care in the streets

      Armitage, Ewan (2013-08)
    • Emergency surgery

      Armitage, Ewan (2011-02)
    • EMS pocket drug guide

      Armitage, Ewan (2013-07)
    • Enhanced care team response to incidents involving major trauma at night: are helicopters the answer?

      McQueen, Carl; Nutbeam, Tim; Crombie, Nicholas; Lecky, Fiona; Lawrence, Thomas; Hathaway, Karen; Wheaton, Steve (2015-07)
    • European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation

      Perkins, Gavin D.; Handley, Anthony J.; Koster, Rudolph W.; Castren, Maaret; Smyth, Michael A.; Olasveengen, Theresa; Monsieurs, Koenraad G.; Raffay, Violetta; Grasner, Jan-Thorsten; Wenzel, Volker; et al. (2015-10)
    • Evaluation of the use of portfolios in paramedic practice: part 1

      Armitage, Ewan (2011-05)
      Abstract published with permission. 2009 saw the first audit of paramedic portfolios by the Health Professions Council (HPC) and later this year, the second national audit will take place. In the first of a two-part evaluation of the use of portfolios in paramedic practice, the history of professional portfolios is chartered including their current position within the paramedic profession. A number of contemporary issues with portfolios are identified, including format and how they relate to a paramedic's continuing professional development. The impact of the Knowledge and Skills Framework on portfolio use is also discussed.
    • Evaluation of the use of portfolios in paramedic practice: part 2

      Armitage, Ewan (2011-06)
      Abstract published with permission. This second of a two-part evaluation on the use of portfolios in paramedic practice, focuses on what constitutes evidence of a paramedic's competence and ultimate fitness to practice. A variety of evaluation models are identified to help in this process and this is developed further with reference to some educational theories. In the final part of the evaluation, the author proposes a number of recommendations concerning the use of portfolios within the paramedic profession and draws on the issues identified in the first part of the evaluation to summarize the current position of paramedic portfolios.
    • Evolution of triage systems

      Robertson-Steel, Iain (2006-01-26)
      The French word "trier", the origin of the word "triage", was originally applied to a process of sorting, probably around 1792, by Baron Dominique Jean Larrey, Surgeon in Chief to Napoleon's Imperial Guard. Larrey was credited with designing a flying ambulance: the Ambulance Volante. Baron Francois Percy also contributed to the organisation of a care system for the ongoing management of casualties. Out of the French Service de Santé, not only emerged the concept of triage, but the organisational structure necessary to handle the growing number of casualties in modern warfare. http://dx.doi.org/10.1136/emj.2005.030270 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/ DOI http://dx.doi.org/10.1136/openhrt-2015-000281
    • Experiences of paramedics in managing patients with advanced chronic obstructive pulmonary disease (COPD) and advanced cancer

      Munday, D.; Clerici, J.; Karasouli, E.; Bailey, C.; Cole, R.; Hewison, A.; Lovick, R.; Griffiths, F. (2014-06)
    • Family members, ambulance clinicians and attempting CPR in the community: the ethical and legal imperative to reach collaborative consensus at speed

      Cole, Robert; Stone, Mike; Ruck Keene, Alexander; Fritz, Zoe (2020-10-15)
      Here we present the personal perspectives of two authors on the important and unfortunately frequent scenario of ambulance clinicians facing a deceased individual and family members who do not wish them to attempt cardiopulmonary resuscitation. We examine the professional guidance and the protection provided to clinicians, which is not matched by guidance to protect family members. We look at the legal framework in which these scenarios are taking place, and the ethical issues which are presented. We consider the interaction between ethics, clinical practice and the law, and offer suggested changes to policy and guidance which we believe will protect ambulance clinicians, relatives and the patient. https://jme.bmj.com/content/early/2020/12/02/medethics-2020-106490 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/medethics-2020-106490