Publications from the East Midlands Ambulance Service. To find out more about EMAS visit their website at https://www.emas.nhs.uk

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  • Novel moving, handling and extraction simulation for students in a soft play area

    McKenzie, John W. B.; Horne, Emma; Smith, Benjamin; Tapson, Ella R.; Whitley, Gregory (2023)
    Background: Emergency medical services often have to extricate patients from their location and take them to an ambulance. High-quality training is required to ensure patient and staff safety during moving, handling and extrication manoeuvres. This study aimed to determine student satisfaction and self-confidence regarding what they had learnt after a novel moving, handling and extrication simulation exercise in a children's soft play area. Methods: A mixed-methods cross-sectional survey was adopted, using the validated Student Satisfaction and Self-Confidence in Learning survey tool. Qualitative data were collected from an open question for additional comments. Student paramedics and student emergency medical technicians from one higher education institution completed four time-limited scenarios, each of which involved moving an immobile patient away from their environment. Descriptive statistics were determined for the participant characteristics and survey responses. Thematic analysis was performed on the qualitative data. Results: The student participants were aged 18–47 years and the majority were women. They were satisfied with both their learning and their self-confidence in what they had learnt after the simulation event, and felt their communication and teamwork skills had improved. They enjoyed the event more than classroom-based simulation. While they felt the simulation was realistic, suggestions were made to make it more so. Conclusion: Use of a children's soft play area for a moving, handling and extrication simulation provided student satisfaction and self-confidence in learning. Abstract published with permission.
  • Factors that influence child conveyance decisions made by prehospital clinicians

    Blake-Barnard, Alex; Whitley, Gregory (2024-02-02)
    Abstract Introduction: The decision to convey children to emergency departments is complex. This study aimed to identify barriers and enablers to making appropriate decisions, along with areas of disparity in this decision-making process by ambulance clinicians. Methods: A rapid evidence review was conducted. MEDLINE, CINAHL and PubMed were searched from 2012 to July 2023. Critical appraisal and thematic synthesis were performed. Results: Three studies were identified, which highlights the lack of research in this area. Five themes were identified: provision of care; equipment and protocols; exposure, experience and confidence; emotional and social circumstances; and education or skill set. Findings: Enhanced paediatric education is required before and after registration to ensure appropriate conveyance and address clinicians' lack of exposure, experience and confidence. Protocols and guidelines should be drawn up to support decision-making for lower-acuity child patients. Specialist paediatric roles are required in ambulance services to support clinicians and provide advanced patient-centred care. Conclusions: The findings of this review provide a basis for discussion and clinical practice improvement. Research to determine the clinical and cost effectiveness of implementing prehospital specialist paediatric roles is required. 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)
  • A Systematic review of ambulance service based randomised controlled trials in stroke

    Dixon, Mark; Appleton, Jason P.; Siriwardena, A. Niroshan; Williams, Julia; Bath, Philip M. (2023-07-05)
  • Characteristics and costs of individuals experiencing severe hypoglycaemia requiring emergency ambulance assistance in the community

    Khunti, Kamlesh; Fisher, Harriet; Paul, S; Mohammad, Iqbal; Davies, Melanie J.; Siriwardena, Aloysius N. (Springer, 2012-10)
  • Patient, family member, and ambulance staff experiences of prehospital acute pain management in adults: A systematic review and meta-synthesis

    Whitley, Gregory; Wijegoonewardene, Nimali; Nelson, David; Curtis, Ffion; Ortega, Marishona; Siriwardena, Aloysius
  • Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review

    Pogson, Rachel; Henderson, Helen; Holland, Matt; Sumera, Agnieszka; Sumera, Kacper; Webster, Carl (2023-10-05)
  • The Impact of specialist practitioners within an English ambulance service

    Spaight, Robert; Clarke, R; England, L; Fryer, C
    Background Specialist Practitioners were introduced to East Midlands Ambulance Service in September 2020. Three Cohorts of SP's have been introduced who have undertaken additional training and education in order to assess minor illness and injuries which may reduce the need for a visit to accident and emergency department. Method Analysis of the clinical analytics data suite matched to the Call data sets and compared with wider cohorts of paramedics to understand the impact of each of the three cohorts since their introduction to the Trust. Results Specialist Practitioner(SP) n=37 have attended (n=16,557) conveyed 36.73% (n=6082) EMAS 44.41% SP variance -7.68%, cohort 1 (CH1) commencement date 28/ 09/20 n=12 (n=7731) conveyed 33.07% CH1 variance - 11.34%, Category 1 calls 48.93% (EMAS 56.88% Variance -7.95%) Category 2 calls 38.66% (EMAS 57.95 Variance - 19.29) Category 3 calls 22.41% (EMAS 32.31% Variance - 9.90) Cohort 2(CH2) commencement date 19/10/20 n=12 have attended (n=6103) conveyed 42.08% (n=2568) SP variance -2.33, Category 1 calls 57.22% (Variance +0.32) Category 2 calls 50.16% (EMAS 57.95 variance -7.79) Category 3 calls 30.12% (EMAS 32.31 variance -2.19). Cohort 3(CH3) commencement date 20/07/21 n=13 have attended (n=2716) conveyed 35.20% (EMAS 44.41 variance -9.21) Category 1 calls 52.97% (Variance -3.91) Category 2 calls 39.51% (Variance -18.44) Category 3 calls 22.99% (variance -9.32). SP Cohort all category variance (33.07 - 42.08). Conclusion The initial three cohorts have all provided significant impact on the conveyance rate of the patient's seen. As this role becomes more embedded the true benefits will be seen through reduced conveyance and support for other crews on the front line. https://bmjopen.bmj.com/content/12/Suppl_1/A15.2 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
  • Community first responders’ contribution to emergency medical service provision in the United Kingdom

    Botan, Vanessa; Asghar, Zahid; Rowan, Elise; Smith, Murray D.; Patel, Gupteswar; Phung, Viet-Hai; Trueman, Ian; Spaight, Robert; Brewster, Amanda; Mountain, Pauline; et al. (Elsevier, 2023-02)
  • Improving ambulance care for children suffering acute pain: a qualitative interview study

    Whitley, Gregory; Hemingway, Pippa; Law, Graham; Siriwardena, Aloysius (BMC, 2022-12)
  • A qualitative study of ambulance personnel, care staff and service users’ experiences and perceptions of emergency care in care homes

    Laparidou, Despina; Phung, Viet-Hai; Curtis, Ffion; Whitley, Gregory; Botan, Vanessa; Akanuwe, Joseph; Rowan, Elise; Fothergill, Rachael; McCranor, Tracy; Bowler, Susan; et al.
  • Indicators for avoidable emergency medical service calls: mapping of paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada

    Agarwal, G; Siriwardena, Aloysius; McLeod, B; Spaight, Robert; Whitley, Gregory; Ferron, R; Pirrie, M; Angeles, R; Moore, H; Gussey, M
  • Implementation of electronic patient clinical records in ambulances in the UK: a national survey

    Williams, Victoria; LaFlamme-Williams, Yvette; McNee, Katie; Morgan, Heather; Morrison, Zoe; Potts, Henry; Shaw, Debbie; Siriwardena, Niro; Snook, Helen; Spaight, Rob; et al. (2019-01-14)
    Background The roll-out of electronic Patient Clinical Records (ePCR) across UK ambulance services has been an important aspect of modernisation. Electronic Records in Ambulances (ERA) is a two-year study which aims to describe the opportunities and challenges of implementing ePCR and associated technology in emergency ambulances. Our study includes a baseline survey of progress implementing ePCR in all UK ambulance services providing a snapshot of current usage. Methods We carried out semi-structured telephone interviews with information managers in each ambulance service in the UK. We asked them about the systems in use, the process and current stage of implementation and explored the perceived value of using ePCR. If services did not use ePCR we asked about plans for future introduction. The interviews were transcribed and thematically analysed, by three members of the research team. Results We completed interviews with 22 managers from 13 services. Implementation varied across the UK. Seven services were using electronic records. Four services had adopted electronic records but, at the time of interview, had reverted to paper with the intention of implementing a new ePCR. Two services still used paper but hoped to move to ePCR in the future. Those who had fully implemented ePCR reported mixed success in terms of staff compliance, and in realising the potential benefits offered by ePCR to link with primary and secondary care. Reported benefits of ePCR were largely associated with improved data management for audit and record keeping. Potential improvements to patient care were discussed, but tended to be associated with future planned developments. Implications Implementation of ePCR has proved challenging with wide variation in use between ambulance services. Progress has been erratic, rather than linear, demonstrated by difficulties that services experienced putting ePCR into practice. There is potential for ambulance services in the earlier stages of implementation to learn from the experiences of others. https://emj.bmj.com/content/36/1/e7.3 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/ DOI http://dx.doi.org/10.1136/openhrt-2015-000281
  • Electronic health records in ambulances: the ERA multiple-methods study

    Porter, Alison; Badshah, Anisha; Black, Sarah; Fitzpatrick, David; Harris-Mayes, Robert; Islam, Saiful; Jones, Matthew; Kingston, Mark; LaFlamme-Williams, Yvette; Mason, Suzanne; et al.
  • Model-based economic evaluation of the effectiveness of "'Hypos' can strike twice", a leaflet-based ambulance clinician referral intervention to prevent recurrent hypoglycaemia

    Smith, Murray D.; Ridyard, Colin; Botan, Vanessa; Brewster, Amanda; Dunmore, Sally; James, June; Khunti, Kamlesh; Laparidou, Despina; Law, Graham; Mountain, Pauline; et al. (PloS One, 2023-03-16)
  • On a scale of zero to ten, how would you rate your pain?

    Whitley, Gregory; Gregory, Pete (2023-06-02)
    Prehospital acute pain management research in adults often focuses on analgesic administration: ‘what proportion of patients received an analgesic?’, ‘did a meaningful pain score reduction occur?’, ‘were there any adverse events?’ Pain is best understood using Engel’s biopsychosocial model of health as the underpinning framework, where analgesic administration addresses the biological and, to some extent, the psychological remit of pain. The psychosocial component of pain is often underrepresented in clinical research. Our latest systematic review and meta-synthesis (Whitley et al, 2023) aimed to address this gap in the literature. Abstract published with permission
  • Which patients should be pre-alerted? A review of UK ambulance service guidelines

    Boyd, Aimee; Sampson, Fiona; Pilbury, Richard; Bell, Fiona; Millins, Mark; Coster, Joanne; Rosser, Andy; Spaight, Robert

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