Now showing items 1-20 of 1594

    • A machine learning algorithm to predict a culprit lesion after out of hospital cardiac arrest

      Pareek, Nilesh; Frohmaier, Christopher; Smith, Mathew; Kordis, Peter; Cannata, Antonio; Nevett, Joanne; Fothergill, Rachael; Nichol, Robert; Sullivan, Mark; Sunderland, Nicholas; et al.
    • Modelling NHS 111 demand for primary care services: a discrete event simulation

      Pilbery, Richard; Smith, Madeline; Green, Jonathan; Chalk, Daniel; O'Keeffe, Colin
    • Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries: the BE SURE study protocol

      Baghdadi, Fadi; Evans, Bridie Angela; Goodacre, Steve; John, Paul Anthony; Hettiarachchi, Thanuja; John, Ann; Lyons, Ronan A.; Porter, Alison; Safari, Solmaz; Siriwardena, Aloysius Niroshan; et al.
      INTRODUCTION: Injuries are a major public health problem which can lead to disability or death. However, little is known about the incidence, presentation, management and outcomes of emergency care for patients with injuries among people from ethnic minorities in the UK. The aim of this study is to investigate what may differ for people from ethnic minorities compared with white British people when presenting with injury to ambulance and Emergency Departments (EDs). METHODS AND ANALYSIS: This mixed methods study covers eight services, four ambulance services (three in England and one in Scotland) and four hospital EDs, located within each ambulance service. The study has five Work Packages (WP): (WP1) scoping review comparing mortality by ethnicity of people presenting with injury to emergency services; (WP2) retrospective analysis of linked NHS routine data from patients who present to ambulances or EDs with injury over 5 years (2016-2021); (WP3) postal questionnaire survey of 2000 patients (1000 patients from ethnic minorities and 1000 white British patients) who present with injury to ambulances or EDs including self-reported outcomes (measured by Quality of Care Monitor and Health Related Quality of Life measured by SF-12); (WP4) qualitative interviews with patients from ethnic minorities (n=40) and focus groups-four with asylum seekers and refugees and four with care providers and (WP5) a synthesis of quantitative and qualitative findings. ETHICS AND DISSEMINATION: This study received a favourable opinion by the Wales Research Ethics Committee (305391). The Health Research Authority has approved the study and, on advice from the Confidentiality Advisory Group, has supported the use of confidential patient information without consent for anonymised data. Results will be shared with ambulance and ED services, government bodies and third-sector organisations through direct communications summarising scientific conference proceedings and publications. 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
    • 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
    • The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: study protocol for an interventional feasibility randomised controlled trial

      Ollis, Lucie; Skene, Simon; Williams, Julia; Lyon, Richard; Taylor, Cath; SEE-IT Trial Group
      INTRODUCTION: Accurate and timely dispatch of emergency medical services (EMS) is vital due to limited resources and patients' risk of mortality and morbidity increasing with time. Currently, most UK emergency operations centres (EOCs) rely on audio calls and accurate descriptions of the incident and patients' injuries from lay 999 callers. If dispatchers in the EOCs could see the scene via live video streaming from the caller's smartphone, this may enhance their decision making and enable quicker and more accurate dispatch of EMS. The main aim of this feasibility randomised controlled trial (RCT) is to assess the feasibility of conducting a definitive RCT to assess the clinical and cost effectiveness of using live streaming to improve targeting of EMS. METHODS AND ANALYSIS: The SEE-IT Trial is a feasibility RCT with a nested process evaluation. The study also has two observational substudies: (1) in an EOC that routinely uses live streaming to assess the acceptability and feasibility of live streaming in a diverse inner-city population and (2) in an EOC that does not currently use live streaming to act as a comparator site regarding the psychological well-being of EOC staff using versus not using live streaming. ETHICS AND DISSEMINATION: The study was approved by the Health Research Authority on 23 March 2022 (ref: 21/LO/0912), which included NHS Confidentiality Advisory Group approval received on 22 March 2022 (ref: 22/CAG/0003). This manuscript refers to V.0.8 of the protocol (7 November 2022). The trial is registered with the ISRCTN (ISRCTN11449333). The first participant was recruited on 18 June 2022.The main output of this feasibility trial will be the knowledge gained to help inform the development of a large multicentre RCT to evaluate the clinical and cost effectiveness of the use of live streaming to aid EMS dispatch for trauma incidents. TRIAL REGISTRATION NUMBER: ISRCTN11449333. 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
    • Types and effects of feedback for emergency ambulance staff: a systematic mixed studies review and meta-analysis

      Wilson, Caitlin; Janes, Gillian; Lawton, Rebecca; Benn, Jonathan
      BACKGROUND: Extensive research has been conducted into the effects of feedback interventions within many areas of healthcare, but prehospital emergency care has been relatively neglected. Exploratory work suggests that enhancing feedback and follow-up to emergency medical service (EMS) staff might provide staff with closure and improve clinical performance. Our aim was to summarise the literature on the types of feedback received by EMS professionals and its effects on the quality and safety of patient care, staff well-being and professional development. METHODS: A systematic review and meta-analysis, including primary research studies of any method published in peer-reviewed journals. Studies were included if they contained information on systematic feedback to emergency ambulance staff regarding their performance. Databases searched from inception were MEDLINE, Embase, AMED, PsycINFO, HMIC, CINAHL and Web of Science, with searches last updated on 2 August 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Data analysis followed a convergent integrated design involving simultaneous narrative synthesis and random effects multilevel meta-analyses. RESULTS: The search strategy yielded 3183 articles, with 48 studies meeting inclusion criteria after title/abstract screening and full-text review. Interventions were categorised as audit and feedback (n=31), peer-to-peer feedback (n=3), postevent debriefing (n=2), incident-prompted feedback (n=1), patient outcome feedback (n=1) or a combination thereof (n=4). Feedback was found to have a moderate positive effect on quality of care and professional development with a pooled effect of d=0.50 (95% CI 0.34, 0.67). Feedback to EMS professionals had large effects in improving documentation (d=0.73 (0.00, 1.45)) and protocol adherence (d=0.68 (0.12, 1.24)), as well as small effects in enhancing cardiac arrest performance (d=0.46 (0.06, 0.86)), clinical decision-making (d=0.47 (0.23, 0.72)), ambulance times (d=0.43 (0.12, 0.74)) and survival rates (d=0.22 (0.11, 0.33)). The between-study heterogeneity variance was estimated at σ(2)=0.32 (95% CI 0.22, 0.50), with an I(2) value of 99% (95% CI 98%, 99%), indicating substantial statistical heterogeneity. CONCLUSION: This review demonstrated that the evidence base currently does not support a clear single point estimate of the pooled effect of feedback to EMS staff as a single intervention type due to study heterogeneity. Further research is needed to provide guidance and frameworks supporting better design and evaluation of feedback interventions within EMS. PROSPERO REGISTRATION NUMBER: CRD42020162600. 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
    • SWAP: Promoting Staff Wellbeing in UK NHS Ambulance Personnel - Final Report - December 2021

      Sanderson, Kristy; Phung, Viet-Hai; Pritchard, Gary; Asghar, Zahid; Wankhade, Paresh; Bell, Fiona; Siriwardena, Aloysius; Hird, Kelly (2021-12)
    • Research and development : a new direction for NEAS

      McClure, Sally; Marley, George; Cessford, Colin; Clarke, Tom; Dorgan, Sharon; Atkinson, Lorraine; Smith, Justine; O'Neill, Seamus (2009)
      The Department of Health has recently introduced a new national strategic direction for research and development (R&D) across the National Health Service (NHS). One of the major developments is the National Institute for Health Research (NIHR) which provides a framework to position, manage and maintain world-class research, staff and infrastructure in the NHS. This national framework is having a substantial effect on driving and shaping the infrastructure of R&D departments within Ambulance NHS Trusts. This article provides an overview of the national development and highlights some of the major consequential developments for the North East Ambulance Service NHS Trust (NEAS). Abstract published with permission.
    • Impact of paramedics carrying just-in-case end-of-life care medication

      O'Brian, Edward; Chohan, Andeep; Sewell, Bernadette; Pease, Nikki (2023-11-02)
      Early in the COVID-19 pandemic, it was predicted that frail community patients with symptoms of severe COVID-19 infection may need urgent symptom management—and that unless they had already been identified as being in their last weeks of life, they would be unlikely to have just-in-case (JIC) medications at home. The Welsh Ambulance Services NHS Trust therefore placed JIC medications on emergency ambulances to increase symptom management options for paramedics treating patients with symptoms of severe COVID-19 infection and/or associated with advanced end-stage illness. Abstract published with permission.
    • Carrying out research, critical appraisal, ethics and stakeholder involvement

      Rees, Scott (2023-11-02)
      Research skills are a requirement under the Health and Care Professions Council (HCPC) standards for paramedic registration. Paramedics must ‘recognise the value of research to the critical evaluation of practice’. Research in the medical field is important in order to improve the knowledge of clinicians and inform evidence-based practice. The purpose of this article is to demonstrate the key components of the research process, use of a PICO [population, intervention, comparison, outcome] tool to search relevant databases and explain the critical appraisal of research in order to establish if research is valid before implementing results into paramedic practice. Abstract published with permission.
    • A new adventure

      Sofield, Katy (2023-11-02)
      Third year came around in the blink of an eye. Before I knew it, the Christmas holidays were here and, in the new year, the university had put on a recruitment day for prospective ambulance services to come in to talk to students. Over the two recruitment days, I heard pitches from most ambulance trusts across the UK and Wales. The Trust I carried out my placement with was North West Ambulance Service (NWAS), with other contenders being East Midlands and Yorkshire. Following this, I completed an elective placement with London Ambulance Service (LAS) (Sofield, 2023). While this was with advanced paramedic practitioners in urgent care, it gave me a taste of London Ambulance Service (LAS) as a whole, which sparked an interest in potentially moving and working for them in the future. Abstract published with permission.
    • Hyperventilation in cardiac arrest—a systematic review and narrative synthesis

      Kirk, Benjamin; McClelland, Graham; Hepburn, Sarah (2023-11-02)
      Resuscitation guidelines recommend delivering ventilations at a rate of 10 per minute. However, hyperventilation is commonly reported during out-of-hospital cardiac arrest resuscitation efforts, and the impact of this on patient outcomes is unclear. This review explores the reported rates, causes and patient outcomes of hyperventilation in the management of out-of-hospital cardiac arrest. Abstract published with permission.
    • A significant proportion of patients with acute coronary occlusion lack ST elevation: implications for diagnosis and provision of primary angioplasty services

      Apps, A.; Malhotra, A.; Ali, O.; Smith, R.; Lane, R.; Kabir, Tito; Mason, M.; Whitbread, Mark; Iisley, C.; Dalby, M. (Oxford Academic, 2012-08-28)
    • A response to 'Fighting the fire': fire chiefs' proposal to run England's ambulance service...‘Fighting the fire: a response to fire chiefs’, October, 2010

      Jones, Peter; Woollard, Malcolm (MAG Online, 2011-02-04)
      In October 2010, JPP published a comment by Prof Malcolm Woollard, titled ‘Fighting the fire: a response to fire chiefs’ proposal to run England’s ambulance service’, expressing his view as to why the proposal by the Chief Fire Officers Association (CFOA) is not workable. JPP has received a letter regarding this, which is printed below, along with a response from Prof Woollard that also discusses the latest report published by the CFOA. Abstract published with permission
    • 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)
    • Improving paramedic responses for patients dying at home: a theory of change-based approach

      Simpson, Jane; Remawi, Bader Nael; Potts, Kieran; Blackmore, Tania; French, Maddy; Haydock, Karen; Peters, Richard; Hill, Michael; Tidball, Oliver-Jon; Parker, Georgina; et al. (2023-08-02)
    • Prehospital video triage of potential stroke patients in North Central London and East Kent: rapid mixed-methods service evaluation

      Ramsay, Angus; Ledger, Jean; Tomini, Sonila; Hall, Claire; Hargroves, David; Hunter, Patrick; Payne, Simon; Mehta, Raj; Simister, Robert; Tayo, Fola; et al. (2022-09)