Now showing items 1-20 of 1078

    • Infrastructure and operating processes of PIONEER, the HDR-UK Data Hub in Acute Care and the workings of the Data Trust Committee: a protocol paper

      Gallier, Suzy; Price, Gary; Pandya, Hina; McCarmack, Gillian; James, Chris; Ruane, Bob; Forty, Laura; Crosby, Benjamin; Atkin, Catherine; Evans, Ralph; et al. (2021-04)
      Health Data Research UK designated seven UK-based Hubs to facilitate health data use for research. PIONEER is the Hub in Acute Care. PIONEER delivered workshops where patients/public citizens agreed key principles to guide access to unconsented, anonymised, routinely collected health data. These were used to inform the protocol. https://informatics.bmj.com/content/28/1/e100294 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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/bmjhci-2020-100294
    • Complete Versus Culprit only Revascularisation in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction: Incidence and Outcomes from the London Heart Attack Group

      Rathod, Krishnaraj S.; Koganti, Sudheer; Jain, Ajay K.; Rakhit, Roby; Dalby, Miles C.; Lockie, Tim; Kalra, Sandeep; Malik, Iqbal S.; Knight, Charles J.; Whitbread, Mark; et al. (2020-03)
    • Severe hypoglycaemia is a frequent reason for 999 calls in Yorkshire

      James, Cathryn; Scott, A. R.; Walker, Alison; Clapham, L. (2010-03)
    • Paramedic research literature 2011–2019. A bibliographic analysis of the contents of Amber, the ambulance research repository

      Holland, Matt; Dutton, Michelle (2020-10)
      The data held by amber presents an opportunity to understand the structure of the published paramedic literature, specifically the output of NHS staff working in English ambulance services 2011–2019. This period is of interest because it represents part of the development phase of paramedic research in England. The authors apply a series of bibliometric measures to generate a profile of the published literature. https://emj.bmj.com/content/emermed/37/10/e9.3.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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2020-999abs.19
    • The influence of paramedic assessment on emergency transportation of stroke patients

      Price, C.I.; Duckett, Jay; Cessford, C.; Ford, Gary A. (2008-09-01)
    • Too much of a good thing? Oxygen alert cards are helpful for chronic obstructive pulmonary disease patients at risk of oxygen toxicity

      Tooley, S.; Ellis, D.; Greggs, D.; Scott, J. (2006-11-17)
      It is well established that optimal oxygen therapy needs to be provided for patients with COPD while they are being transferred to hospital, or assessed in A&E. (Murphy et al 2001, Durrington et al 2005). The objective is to give appropriate oxygen to support their needs while avoiding the risk of CO2 retention and respiratory acidosis. https://thorax.bmj.com/content/61/suppl_2/ii57 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. http://creativecommons.org/licenses/by-nc/4.0/
    • Out-of-hospital resuscitation of a 3 month old boy presenting with recurrent ventricular fibrillation cardiac arrest: a case report

      Kingsley, Peter; Merefield, Jonathan; Walker, Robert G.; Chapman, Fred W.; Faulkner, Mark (2021-04)
    • Why take a peak flow in asthma – a review

      van Wamel, Annelies; Procter, Shaun (2010-02)
      Current asthma protocols advocate the measurement of peak flow expiratory rate (PEFR) by staff in pre-hospital care in their assessment and management of acute asthma. Yet in practice many, if not most, omit to do this. The limited amount of recent research available – which has been conducted by doctors and accident and emergency staff and concerns patients admitted to accident and emergency departments – shows that PEFR is one of the best, if not the best, predictive assessment tool available to ambulance staff. Pulse oximetry and PEFR do not measure the same things and cannot replace each other. Not taking a pre- and post-treatment PEFR is potentially detrimental to patient care and does not comply with Joint Royal Colleges Service Liaison Committee and British Thoracic Society standards. Paramedic-led research on assessment and management of acute asthma in pre-hospital settings is lacking. Abstract published with permission.
    • Can waveform analysis-guided treatment (shock-first versus CPR first) improve survival among patients with low quality VF? Results of an international prospective double-blinded randomised controlled trial

      Freese, John P.; Jorgenson, Dawn B.; Liu, Ping-Yu; Innes, Jennifer; Matallana, Luis; Nammi, Krishnakant; Donohoe, Rachael T.; Whitbread, Mark; Silverman, Robert A.; Kaufman, B. J.; et al. (2010-12-01)
    • Initial ventricular fibrillation waveform characteristics and outcomes among EMS-witnessed cardiac arrests

      Freese, John P.; Jorgenson, Dawn B.; Liu, Ping-Yu; Innes, Jennifer; Matallana, Luis; Nammi, Krishnakant; Donohoe, Rachael T.; Whitbread, Mark; Silverman, Robert A.; Kaufman, B. J.; et al. (2010-12-01)
    • Achieving routine sub 30 minute door-to-balloon times in a high volume 24/7 primary angioplasty center with autonomous ambulance diagnosis and immediate catheter laboratory access

      Dalby, Miles C.; Kharbanda, Rajesh; Ghimire, Gopal; Spiro, Jon; Moore, Phil; Roughton, Michael; Lane, Rebecca; Al-Obaidi, Mohammad; Teoh, Molly; Hutchinson, Elizabeth; et al. (2009-11-01)
    • Simulation as a tool to improve the safety of pre‐hospital anaesthesia – a pilot study

      Batchelder, Andrew; Steel, Alistair; Mackenzie, Roderick; Hormis, Anil; Daniels, T.; Holding, N. (2009-08-03)
    • Prehospital advanced airway management by ambulance technicians and paramedics: is clinical practice sufficient to maintain skills?

      Deakin, Charles; King, Phil; Thompson, F. (2009-11-24)
      Introduction: Ambulance paramedics are now trained routinely in advanced airway skills, including tracheal intubation. Initial training in this skill requires the insertion of 25 tracheal tubes, and further ongoing training is attained through clinical practice and manikin-based practice. In contrast, training standards for hospital-based practitioners are considerably greater, requiring approximately 200 tracheal intubations before practice is unsupervised. With debate growing regarding the efficacy of paramedic intubation, there is a need to assess current paramedic airway practice in order to review whether initial training and maintenance of skills provide an acceptable level of competence with which to practice advanced airway skills. Methods: All ambulance patient report forms (anonymised) for the period 1 January 2007 to 31 December 2007 were reviewed, and data relating to airway management were collected. Paramedic and technician identification codes were used to determine the number of airway procedures undertaken on an individual basis. Results: Of the 269 paramedics, 128 (47.6%) had undertaken no intubation and 204 (75.8%) had undertaken one or less intubation in the 12-month study period. The median number of intubations per paramedic during the 12-month period was 1.0 (range 0–11). A total of 76 laryngeal mask insertion attempts were recorded by 41 technicians and 30 paramedics. The median number of laryngeal mask insertions per paramedic/technician during the 12-month period was 0 (range 0–2). A survey of ongoing continuing professional development across all ambulance trusts demonstrated no provision for adequate training to compensate for the lack of clinical exposure to advanced airway skills. Conclusion: Paramedics use advanced airway skills infrequently. Continuing professional development programmes within ambulance trusts do not provide the necessary additional practice to maintain tracheal intubation skills at an acceptable level. Advanced airway management delivered by ambulance crews is likely to be inadequate with such infrequent exposure to the skill. https://emj.bmj.com/content/26/12/888. 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/emj.2008.064642
    • Prehospital Transdermal Glyceryl Trinitrate for Ultra-Acute Intracerebral Hemorrhage: Data From the RIGHT-2 Trial

      Dixon, Mark; Bath, Philip M.; Woodhouse, Lisa J.; Krishnan, Kailash; Appleton, Jason P.; Andersona, Craig S.; Berge, Eivind; Cala, Lesley; England, Timothy J.; Godolphin, Peter J.; et al.
    • The Development of Swedish Military Healthcare System: Part II-Re-evaluating the Military and Civilian Healthcare Systems in Crises Through a Dialogue and Study Among Practitioners

      Khorram-Manesh, Amir; Burkle, Frederick M.; Phattharapornjaroen, Phatthranit; Ahmadi Marzaleh, Milad; Al Sultan, Mohammed; Mantysaari, Matti; Carlstrom, Eric; Goniewicz, Krzysztof; Santamaria, Emelia; Comandante, John David; et al. (2020-11-02)
    • Did West Midlands ambulance service paramedics’ usage of adrenaline change after the publication of the paramedic2 results, but prior to any guideline change? A service evaluation

      Gunson, Imogen M. (2020-10)
      This project evaluated whether practice change occurred amongst Paramedics directly after the publication of the PARAMEDIC2 trial, regarding adrenaline administration during out-of-hospital cardiac arrest (OHCA) without a change in guidelines. When Paramedics are exposed to a seminal publication there is anecdotal concern their autonomous practice changes, based on comprehension of findings ahead of potential guideline changes, however little evidence appraises whether this really occurs. https://emj.bmj.com/content/37/10/e4.3 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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2020-999abs.7
    • The theory and application of pulse oximetry

      Mildenhall, Joanne (2008-11)
      Pulse oximetry is widely used in the prehospital environment, yet researchers question whether health professionals fully understand the theory to support the practical application of its use. This article explores the fundamental theory of pulse oximetry to give applied understanding. From a prehospital perspective, it details and examines the advantages and limitations of this observational aid, which must be considered when making clinical decisions regarding a patient’s care. Abstract published with permission.
    • Long term outcomes of participants in the paramedic-2 randomised trial of adrenaline in out of hospital cardiac arrest

      Haywood, K.; Ji, Chen; Quinn, Tom; Nolan, Jerry; Deakin, Charles; Scomparin, Charlotte; Lall, Ranjit; Gates, Simon; Long, John; Regan, Scott; et al. (2020-10)
      We recently reported early outcomes in patients enrolled in a randomised trial of adrenaline in out-of-hospital cardiac arrest: the PARAMEDIC-2 (Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest) trial. The purpose of the present paper is to report long-term survival, quality of life, functional and cognitive outcomes in cardiac arrest patients who survived. https://emj.bmj.com/content/37/10/e4.2 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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2020-999abs.6