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2. Emergency front-of-neck access in cardiac arrest: A scoping review

Author

Berg, Katherine M., Böttiger, Bernd W., Chia, Yew Woon, Crowley, Conor, D'Arrigo, Sonia, Deakin, Charles D., Fernando, Shannon M., Garg, Rakesh, Granfeldt, Asger, Grunau, Brian, Hirsch, Karen G., Holmberg, Mathias J., Lavonas, Eric, Leong, Carrie, Kudenchuk, Peter J., Morley, Peter, Moskowitz, Ari, Neumar, Robert, Nicholson, Tonia C., Nikolaou, Nikolaos, Nolan, Jerry P., O'Neil, Brian, Ohshimo, Shinichiro, Parr, Michael, Pocock, Helen, Sandroni, Claudio, Scquizzato, Tommaso, Skrifvars, Markus, Vlok, Neville, Welsford, Michelle, Zelop, Carolyn, Aljanoubi, Mohammed, Almazrua, Abdulkarim A., Johnson, Samantha, Drennan, Ian R, Reynolds, Joshua C., Soar, Jasmeet, and Couper, Keith

Published
2024
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5. Route of drug administration in out-of-hospital cardiac arrest: A protocol for a randomised controlled trial (PARAMEDIC-3)

Author

Couper, Keith, Ji, Chen, Lall, Ranjit, Deakin, Charles D, Fothergill, Rachael, Long, John, Mason, James, Michelet, Felix, Nolan, Jerry P, Nwankwo, Henry, Quinn, Tom, Slowther, Anne-Marie, Smyth, Michael A, Walker, Alison, Chowdhury, Loraine, Norman, Chloe, Sprauve, Laurille, Starr, Kath, Wood, Sara, Bell, Steve, Bradley, Gemma, Brown, Martina, Brown, Shona, Charlton, Karl, Coppola, Alison, Evans, Charlotte, Evans, Christine, Foster, Theresa, Jackson, Michelle, Kearney, Justin, Lang, Nigel, Mellett-Smith, Adam, Osborne, Ria, Pocock, Helen, Rees, Nigel, Spaight, Robert, Tibbetts, Belinda, Whitley, Gregory A., Wiles, Jason, Williams, Julia, Wright, Adam, and Perkins, Gavin D

Published
2024
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7. Introduction of a section for recording dementia improves data capture on the ambulance electronic patient record: evidence from a regional quality improvement project.

Author

King, Phil, Jadzinski, Patryk, Pocock, Helen, Lofthouse-Jones, Chloe, Brown, Martina, and Fogg, Carole

Subjects
AUDITING, COMPUTERS, COMPUTER software, MENTAL health, DATA analysis, RESEARCH funding, STATISTICAL sampling, DESCRIPTIVE statistics, ACQUISITION of data, ELECTRONIC health records, AMBULANCES, GERIATRIC assessment, DEMENTIA, DATA warehousing
Abstract

Introduction: Dementia is a common co-morbidity in older people who require urgent or emergency ambulance attendance and influences clinical decisions and care pathways. Following an initial audit of dementia data and consultation with staff, a specific section (tab) to record dementia was introduced on an ambulance service electronic patient record (ePR). This includes a dementia diagnosis button and a free-text section. We aimed to assess whether and how this improved recording. Methods: To re-audit the proportion of ambulance ePRs where dementia is recorded for patients aged ≥65 years, and to describe the frequency of recording in patients aged <65; to analyse discrepancies in the place of recording dementia on the ePR by comparing data from the new dementia tab and other sections of the ePR. Results: We included 112,193 ePRs of patients aged ≥65 with ambulance attendance from a six-month period. The proportion with dementia recorded in patients aged ≥65 was 16.5%, increasing to 19.9% in patients aged ≥75, as compared to 13.5% (≥65) and 16.5% (≥75) in our previous audit. In this audit, of the 16.5% (n = 18,515) of records with dementia recorded, 69.9% (n = 12,939) used the dementia button and 25.4% (n = 4704) recorded text in the dementia tab. Dementia was recorded in ePR free-text fields (but not the dementia tab) in 29.7% of records. Eighteen other free-text fields were used in addition to, or instead of, the dementia tab, including the patient's social history, previous medical history and mental health. Dementia was present on the ePR of 0.4% (n = 461) of patients aged <65. Conclusions: An ePR dementia tab enabled ambulance clinicians to standardise the location of recording dementia and may have facilitated increased recording. We would recommend other ambulance trusts capture this information in a specific section to improve information sharing and to inform care planning for this patient group. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Classification Schemes: Developments and Survival.

Author

Pocock, Helen

Abstract

Discusses the growth, survival and future of library classification schemes. Concludes that to survive, a scheme must constantly update its policies, and readily adapt itself to accommodate growing disciplines and changing terminology. (AEF)

Published
1997

33. Adrenaline to improve survival in out-of-hospital cardiac arrest: the PARAMEDIC2 RCT

Author

Perkins, Gavin D, primary, Ji, Chen, additional, Achana, Felix, additional, Black, John JM, additional, Charlton, Karl, additional, Crawford, James, additional, de Paeztron, Adam, additional, Deakin, Charles, additional, Docherty, Mark, additional, Finn, Judith, additional, Fothergill, Rachael T, additional, Gates, Simon, additional, Gunson, Imogen, additional, Han, Kyee, additional, Hennings, Susie, additional, Horton, Jessica, additional, Khan, Kamran, additional, Lamb, Sarah, additional, Long, John, additional, Miller, Joshua, additional, Moore, Fionna, additional, Nolan, Jerry, additional, O’Shea, Lyndsey, additional, Petrou, Stavros, additional, Pocock, Helen, additional, Quinn, Tom, additional, Rees, Nigel, additional, Regan, Scott, additional, Rosser, Andy, additional, Scomparin, Charlotte, additional, Slowther, Anne, additional, and Lall, Ranjit, additional

Published
2021
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34. Additional file 7 of Cost-effectiveness of adrenaline for out-of-hospital cardiac arrest

Author

Achana, Felix, Petrou, Stavros, Madan, Jason, Khan, Kamran, Ji, Chen, Anower Hossain, Lall, Ranjit, Slowther, Anne-Marie, Deakin, Charles D., Quinn, Tom, Nolan, Jerry P., Pocock, Helen, Rees, Nigel, Smyth, Michael, Gates, Simon, Gardiner, Dale, and Perkins, Gavin D.

Abstract

Additional file 7. Cost-effectiveness (£, 2017 prices) of adrenaline based on within-trial economic evaluation; sensitivity analyses and subgroup analyses results. Additional cost-effectiveness results.

Published
2020
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37. OP6 Long term outcomes of participants in the paramedic-2 randomised trial of adrenaline in out of hospital cardiac arrest

Author

Haywood, Kirstie L, primary, Ji, Chen, additional, Quinn, Tom, additional, Nolan, Jerry P, additional, Deakin, Charles D, additional, Scomparin, Charlotte, additional, Lall, Ranjit, additional, Gates, Simon, additional, Long, John, additional, Regan, Scott, additional, Fothergill, Rachael T, additional, Pocock, Helen, additional, Rees, Nigel, additional, O’Shea, Lyndsey, additional, and Perkins, Gavin D, additional

Published
2020
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40. A randomized trial of epinephrine in out-of-hospital cardiac arrest

Author

Perkins, Gavin D., Ji, Chen, Deakin, Charles D., Quinn, Tom, Nolan, Jerry P., Scomparin, Charlotte, Regan, Scott, Long, John, Slowther, Anne, Pocock, Helen, Black, John J. M., Moore, Fionna, Fothergill, Rachael, Rees, Nigel, O’Shea, Lyndsey, Docherty, Mark, Gunson, Imogen, Han, Kyee, Charlton, Karl, Finn, Judith, Petrou, Stavros, Stallard, Nigel, Gates, Simon, Lall, Ranjit, HASH(0x5651c98b1680), and Collaborators, Paramedic2

Subjects
Male, Resuscitation, Emergency Medical Services, Epinephrine, Electric Countershock, alliedhealth, 030204 cardiovascular system & hematology, Placebo, Out of hospital cardiac arrest, law.invention, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Double-Blind Method, law, Modified Rankin Scale, Emergency medical services, Medicine, Humans, Hospital Mortality, Sympathomimetics, Survival rate, Aged, business.industry, 030208 emergency & critical care medicine, health, General Medicine, Odds ratio, Middle Aged, Combined Modality Therapy, QP, Cardiopulmonary Resuscitation, United Kingdom, Survival Rate, Anesthesia, Female, Nervous System Diseases, business, Out-of-Hospital Cardiac Arrest, medicine.drug, RC
Abstract

Background\ud \ud Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients.\ud \ud Methods\ud \ud In a randomized, double-blind trial involving 8014 patients with out-of-hospital cardiac arrest in the United Kingdom, paramedics at five National Health Service ambulance services administered either parenteral epinephrine (4015 patients) or saline placebo (3999 patients), along with standard care. The primary outcome was the rate of survival at 30 days. Secondary outcomes included the rate of survival until hospital discharge with a favorable neurologic outcome, as indicated by a score of 3 or less on the modified Rankin scale (which ranges from 0 [no symptoms] to 6 [death]).\ud \ud Results\ud \ud At 30 days, 130 patients (3.2%) in the epinephrine group and 94 (2.4%) in the placebo group were alive (unadjusted odds ratio for survival, 1.39; 95% confidence interval [CI], 1.06 to 1.82; P=0.02). There was no evidence of a significant difference in the proportion of patients who survived until hospital discharge with a favorable neurologic outcome (87 of 4007 patients [2.2%] vs. 74 of 3994 patients [1.9%]; unadjusted odds ratio, 1.18; 95% CI, 0.86 to 1.61). At the time of hospital discharge, severe neurologic impairment (a score of 4 or 5 on the modified Rankin scale) had occurred in more of the survivors in the epinephrine group than in the placebo group (39 of 126 patients [31.0%] vs. 16 of 90 patients [17.8%]).\ud \ud Conclusions\ud \ud In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of a favorable neurologic outcome because more survivors had severe neurologic impairment in the epinephrine group. (Funded by the U.K. National Institute for Health Research and others; Current Controlled Trials number, ISRCTN73485024.)\ud

Published
2018

44. Cost-effectiveness of adrenaline for out-of-hospital cardiac arrest.

Author

Achana, Felix, Petrou, Stavros, Madan, Jason, Khan, Kamran, Ji, Chen, Hossain, Anower, Lall, Ranjit, Slowther, Anne-Marie, Deakin, Charles D., Quinn, Tom, Nolan, Jerry P., Pocock, Helen, Rees, Nigel, Smyth, Michael, Gates, Simon, Gardiner, Dale, Perkins, Gavin D., for the PARAMEDIC2 Collaborators, Cooke, Matthew, and Lamb, Sarah

Abstract

Background: The 'Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration In Cardiac Arrest' (PARAMEDIC2) trial showed that adrenaline improves overall survival, but not neurological outcomes. We sought to determine the within-trial and lifetime health and social care costs and benefits associated with adrenaline, including secondary benefits from organ donation.Methods: We estimated the costs, benefits (quality-adjusted life years (QALYs)) and incremental cost-effectiveness ratios (ICERs) associated with adrenaline during the 6-month trial follow-up. Model-based analyses explored how results altered when the time horizon was extended beyond 6 months and the scope extended to include recipients of donated organs.Results: The within-trial (6 months) and lifetime horizon economic evaluations focussed on the trial population produced ICERs of £1,693,003 (€1,946,953) and £81,070 (€93,231) per QALY gained in 2017 prices, respectively, reflecting significantly higher mean costs and only marginally higher mean QALYs in the adrenaline group. The probability that adrenaline is cost-effective was less than 1% across a range of cost-effectiveness thresholds. Combined direct economic effects over the lifetimes of survivors and indirect economic effects in organ recipients produced an ICER of £16,086 (€18,499) per QALY gained for adrenaline with the probability that adrenaline is cost-effective increasing to 90% at a £30,000 (€34,500) per QALY cost-effectiveness threshold.Conclusions: Adrenaline was not cost-effective when only directly related costs and consequences are considered. However, incorporating the indirect economic effects associated with transplanted organs substantially alters cost-effectiveness, suggesting decision-makers should consider the complexity of direct and indirect economic impacts of adrenaline.Trial Registration: ISRCTN73485024 . Registered on 13 March 2014. [ABSTRACT FROM AUTHOR]

Published
2020
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46. Bystander cardiopulmonary resuscitation: Impact of training initiatives

Author

Brown, Terry, primary, Booth, Scott, additional, Lockey, Andrew, additional, Askew, Sara, additional, Hawkes, Claire, additional, Fothergill, Rachel, additional, Black, Sarah, additional, Pocock, Helen, additional, Gunson, Imogen, additional, Soar, Jasmeet, additional, Mark, Julian, additional, and Perkins, Gavin, additional

Published
2018
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47. Feasibility of data linkage in the PARAMEDIC trial: a cluster randomised trial of mechanical chest compression in out-of-hospital cardiac arrest

Author

Ji, Chen, primary, Quinn, Tom, additional, Gavalova, Lucia, additional, Lall, Ranjit, additional, Scomparin, Charlotte, additional, Horton, Jessica, additional, Deakin, Charles D, additional, Pocock, Helen, additional, Smyth, Michael A, additional, Rees, Nigel, additional, Brace-McDonnell, Samantha J, additional, Gates, Simon, additional, and Perkins, Gavin D, additional

Published
2018
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48. Characteristics of neighbourhoods with high incidence of out-of-hospital cardiac arrest and low bystander cardiopulmonary resuscitation rates in England

Author

Brown, Terry P, primary, Booth, Scott, additional, Hawkes, Claire A, additional, Soar, Jasmeet, additional, Mark, Julian, additional, Mapstone, James, additional, Fothergill, Rachael T, additional, Black, Sarah, additional, Pocock, Helen, additional, Bichmann, Anna, additional, Gunson, Imogen, additional, and Perkins, Gavin D, additional

Published
2018
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