Show simple item record

dc.contributor.authorGreen, Jonathan
dc.contributor.authorRobinson, Maria
dc.contributor.authorPilbery, Richard
dc.contributor.authorWhitley, Gregory
dc.contributor.authorHall, Helen
dc.contributor.authorClout, Madeleine
dc.contributor.authorReeves, Barnaby
dc.contributor.authorKirby, Kim
dc.contributor.authorBenger, Jonathan
dc.date.accessioned2020-07-31T13:55:01Z
dc.date.available2020-07-31T13:55:01Z
dc.date.issued2020-06-01
dc.identifier.citationGreen, J. et al, 2020. Research paramedics’ observations regarding the challenges and strategies employed in the implementation of a large-scale out-of-hospital randomised trial. British Paramedic Journal, 5 (1), 26-31.en_US
dc.identifier.issn1478-4726
dc.identifier.doi10.29045/14784726.2020.06.5.1.26
dc.identifier.urihttp://hdl.handle.net/20.500.12417/898
dc.description.abstractIntroduction: AIRWAYS-2 was a cluster randomised controlled trial (RCT) comparing the clinical and cost effectiveness of the i-gel supraglottic airway device with tracheal intubation in the initial airway management of out-of-hospital cardiac arrest (OHCA). In order to successfully conduct this clinical trial, it was necessary for research paramedics to overcome multiple challenges, many of which will be relevant to future emergency medical service (EMS) research. This article aims to describe a number of the challenges that were encountered during the out-of-hospital phase of the AIRWAYS-2 trial and how these were overcome. Methods: The research paramedics responsible for conducting the pre-hospital phase of the trial were asked to reflect on their experience of facilitating the AIRWAYS-2 trial. Responses were then collated by the lead author. A process of iterative revision and review was undertaken by the research paramedics to produce a consensus of opinion. Results: The main challenges identified by the trial research paramedics related to the recruitment and training of paramedics, screening of eligible patients and investigation of protocol deviations / reporting errors. Even though a feasibility study was conducted prior to the commencement of AIRWAYS-2, the scale of these challenges was underestimated. Conclusion: Large-scale pragmatic cluster randomised trials are being successfully undertaken in out-of-hospital care. However, they require intensive engagement with EMS clinicians and local research paramedics, particularly when the intervention is contentious. Feasibility studies are an important part of research but may fail to identify all potential challenges. Therefore, flexibility is required to manage unforeseen difficulties. Abstract published with permission.
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectOut-of-Hospital Cardiac Arrest (OHCA)en_US
dc.subjectCardiac Arresten_US
dc.subjectRandomized Controlled Trials as Topicen_US
dc.subjectResearchen_US
dc.titleResearch paramedics’ observations regarding the challenges and strategies employed in the implementation of a large-scale out-of-hospital randomised trialen_US
dc.typeJournal Article/Review
dc.source.journaltitleBritish Paramedic Journalen_US
dcterms.dateAccepted2020-06-10
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2020-06-10
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2020-06-01
html.description.abstractIntroduction: AIRWAYS-2 was a cluster randomised controlled trial (RCT) comparing the clinical and cost effectiveness of the i-gel supraglottic airway device with tracheal intubation in the initial airway management of out-of-hospital cardiac arrest (OHCA). In order to successfully conduct this clinical trial, it was necessary for research paramedics to overcome multiple challenges, many of which will be relevant to future emergency medical service (EMS) research. This article aims to describe a number of the challenges that were encountered during the out-of-hospital phase of the AIRWAYS-2 trial and how these were overcome. Methods: The research paramedics responsible for conducting the pre-hospital phase of the trial were asked to reflect on their experience of facilitating the AIRWAYS-2 trial. Responses were then collated by the lead author. A process of iterative revision and review was undertaken by the research paramedics to produce a consensus of opinion. Results: The main challenges identified by the trial research paramedics related to the recruitment and training of paramedics, screening of eligible patients and investigation of protocol deviations / reporting errors. Even though a feasibility study was conducted prior to the commencement of AIRWAYS-2, the scale of these challenges was underestimated. Conclusion: Large-scale pragmatic cluster randomised trials are being successfully undertaken in out-of-hospital care. However, they require intensive engagement with EMS clinicians and local research paramedics, particularly when the intervention is contentious. Feasibility studies are an important part of research but may fail to identify all potential challenges. Therefore, flexibility is required to manage unforeseen difficulties. Abstract published with permission.en_US


This item appears in the following Collection(s)

Show simple item record