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  • α1-adrenoceptor antagonists and 5α-reductase inhibitors for urinary tract symptoms in benign prostatic hyperplasia

    Dight, Jack (2024-02-02)
    Benign prostatic hyperplasia is a condition that develops in the majority of men and is by some estimates is the most prevalent of all minor ailments. A healthily functioning prostate is important for the workings of the male reproductive and urinary systems. The most frequently prescribed first-line pharmacological treatments for lower urinary tract symptoms attributed to benign prostatic hyperplasia are α1-adrenoceptor antagonists and 5α-reductase inhibitors; surgery can also be carried out. Expert consensus and a strong body of evidence show these drugs are safe and effective. However, they come with a variety of side-effects so patients' priorities and lifestyles will influence pharmacological management. Abstract published with permission.
  • The influence of biological age and sex on long-term outcome after percutaneous coronary intervention for ST-elevation myocardial infarction

    Jones, Daniel A.; Jain, Ajay K.; Lim, Pitt; MacCarthy, Philip A.; Rakhit, Roby; Lockie, Tim; Kalra, Sandeep; Dalby, Miles C.; Iqbal, S. Malik; Whitbread, Mark; et al. (2021-10-25)
  • Advance care planning virtually during a pandemic

    MacInnes, Lynne; Canning, Deebs; Hutchinson, Wendy; Akinbami, Adenike; Ashaye, Esther; Radcliffe, Caroline; Smith, Bibi; Bonnar, Kim; Ripley, Debbie (BMJ, 2022-02-04)
    Introduction The Marie Curie Virtual Advance Care Planning service was set up in response to the vulnerability of Care Home Residents during the Covid-19 crisis. Aims To evidence that Advance Care Planning can be effective and produce high quality plans even when not done face to face. Method Qualitative interviews with Nurses working on the service. Quantaitive data of numbers of plans created and views by London Ambulance Service. Results It is possible to have meaningful Advance Care Planning conversations virtually and record them electronically to be shared with multiple providers. Conclusion Marie Curie had existing experience of working with Care home staff and GPs to create CMC records. This experience was used to initiate and provide this virtual service across several areas in London involving Care Home residents. and the service has expanded to receive referrals from Hospital Consultants for their out-patients who they believe would benefit from advance care planning and the creation of a CMC record. Impact During the pandemic Marie Curie supported 1,361 new care plans and reviewed 313 existing care plans. The service has returned face to face in Ealing and is still going strong in North East London virtually. We are now looking at supporting Domiciliary Care agencies as well as Care Homes. 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:
  • There are many ways to be a midwife: career pathways in midwifery

    Sarwar, Zainab; Pendleton, John; heys, Stephanie; Mansfield, Amanda; Kerslake, Dawn (2022-01)
  • The United Kingdom and the Netherlands maternity care responses to COVID-19: A comparative study

    van den Berg, Lauri M.M.; Balaam, Marie-Clare; Nowland, Rebecca; Moncrieff, Gill; Topalidou, Anastasia; Thompson, Suzanne; Thomson, Gill; de Jonge, Ank; Downe, Soo; Aspire-Covid19 Collaborative Group (2022-04-05)
  • Safety and efficacy of paramedic treatment of regular supraveentricular tachycardia

    Baker, A.; Whitbread, Mark; Richmond, L.; Kirby, C; Robinson, G.; Antoniou, S.; Schilling, R
    Introduction Treatment of supraventricular tachycardia (SVT) with adenosine by paramedics has been investigated and proven to be safe in the USA, but patients (pts) are transferred to hospital. We hypothesised that paramedics can safely treat and discharge pts with regular SVT without transfer to an accident and emergency department and tested this in a randomised controlled trial. Methods Pts presenting with regular narrow complex tachycardia on 12 lead ECG who were heamodynamically stable, with no history of structural or ischaemic heart disease and without contraindication to adenosine were considered for enrolment. Pts were randomised to paramedic treatment (PARA) or admission to hospital (A&E). PARA pts received valsalva manoeuvre at the scene with subsequent administration of 6 mg and 12 mg of adenosine unless the SVT terminated. Pts were taken to A&E if the tachycardia did not terminate, restarted, or the patient (pt) had continuing symptoms, a persistently abnormal ECG (other than Twave inversion) or was heamodynamically unstable. Prior to discharge from the ambulance pts received an information pack and a referral letter for their GP to refer them to an arrhythmia clinic. Pts randomised to A&E were treated as normal and given no information other than that pertaining to the study. Results Of the 60 pts (33=F, age 52+/-19 years) enroled to date, 56% pts had previously attended A&E with palpitations. 2 pts withdrawn as lost to follow up. Results table 1 PARA discharge times were relatively long because 12 pts randomised to PARA were transported to A&E (5 did not terminate arrhythmia, 1 abnormal observations, 4 paramedic felt ECG abnormal (confirmed as minor abnormalitites by expert panel that would not require treatment), 2 abnormal ECG requiring treatment). A panel of 2 arrhythmia experts reviewed records for all PARA pts and confirmed treatment was appropriate for all but would have further assessed 1 pt with lung disease. Conclusions Paramedic treatment and discharge of pts with regular SVT is safe, efficacious and reduces admissions. Cost effectiveness analysis is ongoing. 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. DOI
  • Impact of the Airways-2 trial on advanced airway management use in out-of-hospital cardiac arrest in England

    Aljoubi, M; Brown, Terry P.; Booth, Scott; Deakin, Charles; Fothergill, Rachael; Nolan, Jerry; Soar, Jasmeet; Perkins, Gavin; Couper, Keith; On behalf of OHCAO collaborators (2023)
  • The impact of COVID-19 pandemic on out-of-hospital cardiac arrest: an individual patient data meta-analysis

    Baldi, Enrico; Klersy, Catherine; Chan, Paul; Elmer, Jonathan; Ball, Jocasta; Counts, catherine R.; Ortiz, Fernando Rosell; Fothergill, Rachael; Auricchio, Angelo; Paoli, Andrea; et al. (2024-01)
  • Never struggle alone

    Sofield, Katy (2024-05-02)
    This shift started like every other and after a couple of jobs, we were on our way to hospital for a category 2 interfacility transfer. However, no less than a mile away from our last job, the stand down alert came through as we were changed to a category 1. The sat nav re-routed to the new location as my crew mate read out the words no one wants to hear: 'Katy, it’s a paediatric arrest'. What went through my mind at that moment is not for the printed page, but a gamut of emotions was flowing. Multiple alerts were pinging through, and control was radioing us. Abstract published with permission
  • Baptism of fire

    Sofield, Katy (2024-03-02)
    Having spent 5 weeks on operational placement, Katy Sofield describes her ‘baptism of fire’. Abstract published with permission.
  • Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST): a UK prospective, multicentre, parallel, randomised clinical trial

    Patterson, Tiffany; Perkins, Gavin; Perkins, Alexander; Clayton, Tim; Evans, Richard; Dodd, Matthew; Robertson, Steven; Wilson, Karen; Mellett-Smith, Adam; Fothergill, Rachael; et al. (2023-10-14)
  • 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.
  • Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens

    heys, Stephanie; Main, Camella; Humphreys, Aimee; Torrance, Rachael (2023-09-01)
  • Sudden-onset disaster mass-casualty incident response: a modified delphi study on triage, prehospital life support, and processes

    Cuthbertson, Joe; Weinstein, Eric; Franc, Jeffrey Michael; Jones, Peter; Lamine, Hamdi; Magalini, Sabina; Gui, Daniele; Lennquist, Kristina; Marzi, Federica; Borrello, Alessandro; et al. (2023-09-07)
  • Experiences and views of people who frequently call emergency ambulance services: a qualitative study of UK service users

    Evans, Bridie; Khanom, Ashra; Edwards, Bethan; Foster, Theresa; Fothergill, Rachael; Foster, Theresa; Fothergill, Rachael; Scott, Jason; Gunson, Imogen; Edwards, Adrian; et al. (2023-08-09)
  • How could pre-hospital ‘silver triage' for older people living with frailty be improved? The views of paramedics

    Teranake, W; Jones, H T; Wan, B; Tsui, A; Gross, L; Hunter, P; Conroy, S. (2023-07-21)
  • 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)

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