• Aerodynamic Drag Reduction of Emergency Response Vehicles

      Taherkhani, A.R.; deBoer, G.N.; Gaskell, P.H.; Gilkeson, C.A.; Hewson, R.W.; Keech, A.; Thompson, H.M.; Toropov, V.V. (2015-09-30)
    • Ambulance over-conveyance to the emergency department: a large data analysis of ambulance journeys

      Miles, J.; O'Keeffe, C.; Jacques, Richard; Stone, Tony; Mason, Suzanne (2018-04)
      Aim Over-conveyance by the ambulance service is a compounding factor of emergency department (ED) crowding. Previous solutions have focused on specific patient groups which have a limited impact when compared to the whole urgent and emergency care system. This study aims to analyse nonurgent conveyances by the ambulance service that could be suitable for discharge on-scene. Results We analysed a dataset of 1,312,539 patient episodes which linked all pre-hospital emergency and urgent calls to subsequent ED attendance in 2014. The study was set in a large region in England (total population 5.3 million). As well as proportion of avoidable conveyances we also examined the association with patient age, time of arrival, re-attendance and initial triage code from ambulance dispatch. Results There were 4 04 348 (30.8%) patients transported to ED by ambulance and of these 66 220 (16.4%) were considered potentially avoidable. There were significantly increased odds of a non-urgent conveyance out of hours (OR 1.44, 95% CI: 1.41 to 1.46). Patients aged 16–34 had the largest proportion of avoidable conveyances with 24 500 (37%). There were 13 625 (21%) episodes that were received from another healthcare professional or urgent telephone number. When analysing ED diagnosis, the highest proportion were attending with minor injury and illness, and alcohol intoxication. Abstracts A22 BMJ Open 2018;8(Suppl 1):A1–A34 Trust (NHS). Protected by copyright. on 14 August 2019 at Manchester University NHS Foundation http://bmjopen.bmj.com/ BMJ Open: first published as 10.1136/bmjopen-2018-EMS.59 on 16 April 2018. Downloaded from Conclusion One in six ambulance conveyances to ED were deemed non-urgent. The younger population had the largest amount of preventable conveyance by ambulance with diagnoses which could be treated and discharged on-scene. Pathways and interventions would provide a larger patient benefit if they were designed around patient populations as opposed to disease specific https://bmjopen.bmj.com/content/8/Suppl_1/A22.3 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/bmjopen-2018-EMS.59
    • Describing and predicting frequent callers to an ambulance service: analysis of 1 year call data

      Scott, Jason; Strickland, Annette Patricia; Warner, Karen; Dawson, Pamela (2014-05)
      Aims Ambulance services in England receive around 8 million calls a year, and no known studies have explored characteristics of frequent callers. This study aimed to identify the characteristics of the most frequent callers to Yorkshire Ambulance Service (YAS) between April 2010 and March 2011. Methods Top 100 frequent callers to YAS were analysed using population comparison, case control and multiple regression methods. 7808 calls were made by the frequent callers, and data were analysed to predict total number of calls made, and explore characteristics of frequent callers. Results Six call codes were associated with a higher number of calls. Frequent callers were assigned slower response levels, or often no call code. Calls increased during the times of 4:00–9:00, 16:00–20:00 and 22:00–2:00, and in the months of December, January and February. Men and patients with all but the very highest conveyance rates had a higher number of different reasons for calling. Patients with a medical diagnosis were more likely to be conveyed, while patients with a psychiatric classification had a higher number of different reasons for calling, were older and were more likely to call for ‘assault/sexual assault’ or ‘haemorrhage/laceration’. Conclusions Frequent callers to YAS were a heterogeneous group that differed from the overall population served, resulting in numerous implications for the delivery of services for this group of patients. Further research is required to determine if and how frequent callers differ from frequent attenders at emergency departments. https://emj.bmj.com/content/emermed/31/5/408.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-2012-202146
    • Elderly falls: a national survey of UK ambulance services

      Darnell, Gareth; Mason, Suzanne; Snooks, Helen (2012-12-29)
      Objective To provide a detailed description of the current UK ambulance service provision for older people who fall. Method National survey of UK ambulance services. Results 11/13 Ambulance services (84.6%) participated in this national survey. Conclusion This survey has highlighted the need for robust evidence to inform policy, service and practice development to improve the care of this vulnerable population. https://emj.bmj.com/content/29/12/1009 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: 10.1136/bmj.h535
    • Frequent callers to and users of emergency medical systems: a systematic review

      Scott, Jason; Strickland, Annette Patricia; Warner, Karen; Dawson, Pamela (2014-08)
      Background There appears to be a paucity of studies examining the characteristics and impact of frequent users upon emergency medical services (EMS). Objective To review current primary research on frequent users of EMS and to identify possible gaps in the literature. Methods Ovid, PubMed and CINAHL/Medline were systematically searched for articles that were published in English and either referred to frequent callers to or users of an EMS, or referred to frequent users of other services where admissions were via ambulance. Studies were included regardless of quality. Findings Eighteen studies were included. Ten were emergency department based, seven in EMS and one in a psychiatric emergency service. In emergency department studies, frequent users were more likely to arrive via ambulance than infrequent users. In EMS studies, between 0.2% and 23% of patients using EMS were frequent users accounting for 1.4% to 40% of all ambulance use. No two EMS studies used the same definition of a frequent user. No studies focused on characteristics of callers to EMS. Two studies explored interventions for frequent callers to EMS, with mixed results in reducing ambulance use. Discussion It is unknown to what extent frequent callers impact upon EMS resources. Research should identify predictors and characteristics of frequent users of EMS, and a consistent definition of a frequent caller to or user of EMS would provide greater comparability. The lack of studies identified in this review suggests that further research is needed in order to inform policy and practice. https://emj.bmj.com/content/emermed/31/8/684.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-2013-202545
    • How to turn the blue lights green

      Percival, Alexis (2019-05-22)
    • The impact of an ambulance vehicle preparation service on the presence of bacteria: a service evaluation

      Mackenzie, Mo; Pilbery, Richard (2019-03-01)
      Introduction: Around 300,000 patients a year in England acquire a healthcare-associated infection (HAI) while being cared for by the NHS. The contribution from NHS Ambulance Services is not known, but previous studies have identified the presence of pathogenic bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus, including resistant strains in some cases, inside ambulances. To improve ambulance cleanliness, Yorkshire Ambulance Service NHS Trust (YAS) piloted an Ambulance Vehicle Preparation Service (AVPS) at two ambulance stations, where staff were tasked with ensuring every ambulance at these stations was cleaned every 24 hours. Methods: Adenosine triphosphate (ATP) bioluminescence testing was conducted on 16 ambulances at the two pilot AVPS stations and on 18 ambulances at four ‘business as usual’ (BAU) ambulance stations using a Hygiena SystemSURE luminometer. Swabs were obtained from 10 pre-selected locations inside each ambulance. Results: Between November 2016 and August 2018, a total of 690 swabs were obtained and recorded from 34 ambulances. Overall, median relative light unit (RLU) values for both groups were < 100, with only the BAU group having an upper quartile value > 100. However, when stratified by swabbing area, three areas had a median RLU of > 100 in the BAU group: suction unit handle, steering wheel and airway seat shelf. In addition, the upper quartile RLU values for the grab rail above the stretcher and the passenger seat in the BAU group were also > 100. No swab areas had a median RLU > 100 in the AVPS group. Conclusion: A dedicated AVPS results in better cleaning of ambulance vehicles than the existing cleaning system utilising operational crews. The areas most likely to be contaminated are the suction unit handle, steering wheel, airway seat shelf and grab rails. The position of equipment and the materials that equipment are constructed from should have infection prevention and control (IPC) as a consideration. Abstract published with permission.
    • Temporal changes in bystander cardiopulmonary resuscitation rates in England

      Brown, Terry P.; Hawkes, Claire A.; Booth, Scott; Fothergill, Rachael; Black, Sara; Bichmann, Anna; Pocock, Helen; Soar, Jasmeet; Mark, Julian; Perkins, Gavin D. (2017-09)
    • UK ambulance services: collaborating to provide good end-of-life care

      Stead, Sarah; Datta, Shirmilla; Hill, James; Smith, Richard; Nicell, Claire (2018-05)
    • Understanding variation in ambulance service non-conveyance rates: a mixed methods study

      O'Cathain, Alicia; Knowles, Emma; Bishop-Edwards, Lindsey; Coster, Joanne; Crum, Annabel; Jacques, Richard; james, cathryn; Lawson, Rod; Marsh, Maggie; O'Hara, Rachel; et al. (2018-06)