This recently published paper describes an open label, randomised controlled trial conducted at (n=102) sites in the US and Puerto Rico. The study aimed to answer the question of the optimal systolic blood pressure (SBP) strategy (target) in the prevention of cardiovascular events.
Background:Climate change will impact on emergency services and healthcare practitioners need to be aware of future challenges. The aim of this study was to assess the effectiveness of a scenario-based educational intervention designed to raise awareness and generate discussion among practitioners and students about sustainability and climate change.Methods:Paramedic undergraduate students completed a Sustainability Attitudes Survey before they participated in a health and sustainability session that focused on resources used in clinical practice and the potential impact of climate change and natural materials scarcity on resource availability. The students completed the questionnaire again following the session.Results:Significant differences between the pre- and post-intervention questionnaires were found for 8/9 attitude statements; there was no significant difference for the statement: the segregation of healthcare waste is important. Students were more likely to accurately report the cost of disposing of clinical and domestic waste following the session.Conclusions:Data suggests that participation in a health and sustainability scenario can improve knowledge about the use of natural resources in clinical practice, where resources come from, and the cost of waste management. Attitudes towards including sustainability and climate change in healthcare curricula were more positive following participation in the health and sustainability session.
Background:Craven Cottage has seen plans approved for a new riverside stand to expand capacity within the stadium from 26 000 to over 30 0000.Aims and Method:In order to anticipate any increase in use of medical services during match days, this study aimed to review nine seasons of medical data for Fulham Football Club. We examined the usage of crowd medical services to see if the number of injuries/illnesses requiring medical assistance at each match had any correlation to the crowd numbers in attendance. A retrospective data analysis was done on injury location, type of injury, whether the patient required transporting to hospital or whether follow up was recommended. The aim being to assess whether increased capacity would impact on local emergency services and primary care.Results:Between 2004–2013, there were 830 presentations to medical services, 43 patients were transported to hospital (5.18%) with 32 (3.85%) being advised to see their GP. Of these, 512 were new injuries/trauma and 318 medical presentations. There was one fatal non-traumatic cardiac arrest and 19 assaults. The data showed total crowd attendances of 4 157 597 over the 10-year period, with mean crowd numbers per game of 18 878. From these total crowd attendances there was a consultation rate per 10 000 gate admissions of 1.97. This is comparable to previously published Premiership data. Analysis of the location of accidental injuries showed no statistical differences in injury patterns; however, regarding mechanism of injury, more assaults occurred in areas where fans mix, irrespective of capacity per match.Conclusions:This study has shown no significant differences or trends in trauma, medical cases or consultations per 10 000 gate admission. Plans to increase capacity should not affect provision of medical cover, though will be accounted for in major incident planning in the number of medical staff required to attend matches to cover for extra ticket sales. GP and A&E services should not be stretched by the increased capacity.
Background:Development of new evidence to support pre-hospital emergency care benefits both patients and practitioners. Clinical research must be conducted within a formal governance framework but it is challenging for paramedics to access traditional good clinical practice (GCP) training due to high service demands and some content is of little relevance to the pre-hospital setting.Objective:To establish the content and format of easily accessible research governance awareness training for use by paramedics and other members of the ambulance service as and when appropriate.Methods:A systematic literature review identified descriptions of pre-hospital research training. An online survey sought views about the formal research training undertaken by NHS paramedics and an expert consensus process confirmed the content of training materials.Results:Research governance training was rarely acknowledged in pre-hospital clinical trial literature and was recalled by only one in eight respondents who had assisted with clinical research. A pre-hospital orientated slide set and matching assessment questions were reviewed in two cycles by an expert panel to achieve a consensus on the content and format.Conclusions:Through a structured process of literature review, stakeholder engagement and expert consensus we have developed training and assessment materials which can be used flexibly to prepare paramedics and the wider ambulance workforce for safe hosting of low-risk research activities.
OverviewThis Continuing Professional Development (CPD) module will explore the presentation and management of critically unwell patients suffering from a form of obstructive shock in the out-of-hospital setting. There are a number of self-directed activities to complete as you move through the article together with a list of further resources that are used to reference this article and to expand your research. This article requires the reader to have an appreciation of basic anatomy and physiology and an awareness of the general approach to assessing and managing patients in the out-of-hospital, emergency setting before completion.Learning OutcomesAfter completing this module you should be able to:Define cardiogenic shock and explore the prevalence and impact on a populationExplore causes of cardiogenic shockIdentify key pathophysiological principles involved in obstructive shockOutline management approaches for these patients.
In October 2012, yours truly wrote the editorial for this fine publication, in which I called for a new way of thinking about leadership in the ambulance service. Fast forward to 2015 and yet another publication is set to hit the market, with a proverbial galacticos of contributors having been assembled from the ambulance service world.
An increasing range of clinicians find themselves working remotely in various ways, requiring remote clinical decision-making (RCDM) skills. However, despite the increasing use of RCDM in managing demand for emergency and unscheduled care, Mike Brady argues that there remains paucity in accredited higher education courses for RCDM.
Pain management is a contemporary issue in pre-hospital care. Mark Hodkinson outlines how in recent years, the development of specialist paramedic roles and changes in laws relating to the control of drugs has seen advances in the array of analgesic options available to paramedics.
The Children's Acute Transport Service (CATS) is a specialist paediatric intensive care service operating in the North Thames and East Anglian areas of the UK. Alan Weir provides an overview of the service and the care it provides.
With the NHS facing one of its most challenging periods since its inception almost 68 years ago, Alistair Quaile reports on this year's Ambulance Leadership Forum, which focused on the future look and feel of ambulance service provision.
‘What's in a name? That which we call a rose, by any other name would smell as sweet,’ as Shakespeare wrote in Romeo and Juliet. In the context in which Shakespeare makes this statement the name is artificial and a meaningless convention, in effect what you are called is insignificant.