Research

Staff wellbeing: a matter for quality indicators or a concern in its own right?

Despite assurance measures being developed alongside expanding scopes of practice, poor NHS ambulance staff wellbeing means high-quality job performance and patient care are not guaranteed. The UK's service is struggling to cope with growing demand and is not fully adapting from its historical emergency response role to meet modern-day urgent care needs. This puts unnecessary pressures and risks of stress from exhausting, intense work on to its most valuable resource: staff. Detrimental...

PaRamEDIc assessment of laCTate in OHCA and survival to hospital (PREDICT protocol)

Background: Studies suggest that blood lactate differs between survivors and non-survivors of out-of-hospital cardiac arrest who are transported to hospital. The prognostic role of lactate taken during out-of-hospital cardiac arrest remains unexplored. Aims: To measure the association between lactate taken during out-of-hospital cardiac arrest, survival to hospital and 30-day mortality. Methods: This is a feasibility, single-centre, prospective cohort study. Eligible for inclusion are...

Prehospital osmotherapy in isolated traumatic brain injury: a systematic review

Background: Isolated traumatic brain injury (TBI) accounts for 30% of injury-related deaths globally, with significant cost to individual health, lifestyle and the economy. Despite advances in prehospital trauma care, frontline paramedics have limited options to manage cerebral oedema and herniation. Prehospital osmotherapy could limit cerebral oedema and subsequent secondary brain injury, but uncertainties remain of its benefit to patient outcomes. Aim: This study aimed to explore whether...

Mechanical chest compressions and survival in the emergency setting

Advances in cardiac arrest management have led to the use of a mechanical chest compression device in an attempt to improve outcomes in cardiopulmonary resuscitation (CPR). This systematic review set out to identify whether the inclusion of the mechanical device improves survival rates in the cardiac arrest patient within the emergency setting, and explored the themes: training, environment and time of device deployment. The systematic review measured the value of mechanical chest compression...

Where to now? Searching beyond Medline

This article looks at the tools available to you to extend your search beyond the major bibliographic sources. The article identifies the type of literature you can find and which tools are suitable to use to find them. It aims to help you to broaden the scope of your search to find more relevant material. There is a warning about predatory journals and the need to take a critical approach to material that has not been peer-reviewed.

Focused cardiac ultrasound in out-of-hospital cardiac arrest: a literature review

Focused cardiac ultrasound (FoCUS) is emerging in emergency medical systems, particularly in the context of prognostication in out-of-hospital cardiac arrest. However, FoCUS has not been formally incorporated into UK guidelines because of a lack of evidence. Furthermore, concerns have been raised that FoCUS can distract people from providing other essential and evidenced elements of care. This broad literature search aims to shed light on the practice of FoCUS in cardiac arrest by reviewing...

Alcohol/substance use and occupational/post-traumatic stress in paramedics

Background: Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this. Methods: A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms...

Health behaviours in ambulance workers

Introduction: Awareness is increasing that health behaviours, which are a part of a person's lifestyle, have significant effects on emotional and physical wellbeing. Ambulance workers are at a higher risk of poorer psychological health outcomes than the general population. This begs the question whether lifestyle could play a role in emotional and physical health outcomes, which is an understudied area in this population. This paper reviews health behaviours in paramedics and assesses the...

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