A5053458364- Emergency and Acute Care Studies
- Cardiac Arrest and Resuscitation
- Trauma and Emergency Care Studies
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Disaster Response and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Telemedicine and Telehealth Implementation
- Trauma Management and Diagnosis
- Pediatric Pain Management Techniques
- Nursing Roles and Practices
- Family and Patient Care in Intensive Care Units
- Anesthesia and Pain Management
- Healthcare Systems and Technology
- Palliative Care and End-of-Life Issues
- Acute Myocardial Infarction Research
- Healthcare Decision-Making and Restraints
- Asthma and respiratory diseases
- Sepsis Diagnosis and Treatment
- Hip and Femur Fractures
- Geriatric Care and Nursing Homes
- Spinal Fractures and Fixation Techniques
- Radiology practices and education
At Bristol
2025
University of the West of England
2016-2025
University Hospitals Bristol NHS Foundation Trust
2015-2024
University Hospitals Bristol and Weston NHS Foundation Trust
2021-2024
NHS Digital
2013-2023
Imperial College London
2023
NHS England
2013-2023
Lung Institute
2023
Bristol Royal Infirmary
2006-2022
Bristol Clinical Commissioning Group
2021
To derive and validate a risk prediction algorithm to estimate hospital admission mortality outcomes from coronavirus disease 2019 (covid-19) in adults.Population based cohort study.QResearch database, comprising 1205 general practices England with linkage covid-19 test results, Hospital Episode Statistics, death registry data. 6.08 million adults aged 19-100 years were included the derivation dataset 2.17 validation dataset. The first period was 24 January 2020 30 April 2020. second...
<h3>Importance</h3> The optimal approach to airway management during out-of-hospital cardiac arrest is unknown. <h3>Objective</h3> To determine whether a supraglottic device (SGA) superior tracheal intubation (TI) as the initial advanced strategy in adults with nontraumatic arrest. <h3>Design, Setting, and Participants</h3> Multicenter, cluster randomized clinical trial of paramedics from 4 ambulance services England responding emergencies for approximately 21 million people. Patients aged...
The Valsalva manoeuvre is an internationally recommended treatment for supraventricular tachycardia, but cardioversion rare in practice (5-20%), necessitating the use of other treatments including adenosine, which patients often find unpleasant. We assessed whether a postural modification to could improve its effectiveness.We did randomised controlled, parallel-group trial at emergency departments England. randomly allocated adults presenting with tachycardia (excluding atrial fibrillation...
Importance Critical bleeding is associated with a high mortality rate in patients trauma. Hemorrhage exacerbated by complex derangement of coagulation, including an acute fibrinogen deficiency. Management replacement cryoprecipitate transfusions or concentrate, usually administered relatively late during hemorrhage. Objective To assess whether survival could be improved administering early and empirical dose to all trauma that required activation major hemorrhage protocol. Design, Setting,...
<h3>Objective</h3> To compare the clinical effectiveness of intravenous paracetamol with morphine in patients moderate to severe traumatic limb pain. <h3>Methods</h3> This randomised, double-blind pilot study was conducted an urban UK emergency department. Patients between 16 and 65 years old isolated trauma pain (pain score 7 or more) received either 1 g 10 mg sulphate over 15 min. The primary outcome measure measured on a visual analogue scale at 0, 5, 15, 30 60 min after commencing drug...
The Covid-19 mortality rate varies between countries and over time but the extent to which this is explained by underlying risk in those infected unclear. Using data on all adults England with a positive test 1st October 2020 30th April 2021 linked clinical records, we examined trends factors for hospital admission mortality. Of 2,311,282 people included study, 164,046 (7.1%) were admitted 53,156 (2.3%) died within 28 days of test. We found significant variation case hospitalisation time,...
<b>Objective</b> To determine whether full elbow extension as assessed by the test can be used in routine clinical practice to rule out bony injury patients presenting with injury. <b>Design</b> Adults: multicentre prospective interventional validation study secondary care. Children: observational <b>Setting</b> Five emergency departments southwest England. <b>Participants</b> 2127 adults and children department acute <b>Intervention</b> Elbow during care staff need for radiography guide...
In recent years there have been many developments in post-resuscitation care. We investigated trends patient characteristics and outcome following admission to UK critical care units cardiopulmonary resuscitation (CPR) for the period 2004–2014. Our hypothesis is that has a reduction risk-adjusted mortality during this period. undertook prospectively defined, retrospective analysis of Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme Database (CMPD) 1 January 2004 31...
Previous studies suggested intravenous or nebulised magnesium sulphate (MgSO(4)) might improve respiratory function in patients with acute asthma. We aimed to determine whether MgSO(4) symptoms of breathlessness and reduce the need for hospital admission adults severe asthma.In our double-blind, placebo-controlled trial, we enrolled (aged ≥16 years) asthma at emergency departments 34 hospitals UK. excluded life-threatening features contraindication study drugs. used a central randomisation...
<h3>Objectives</h3> Data on costs associated with acute upper gastrointestinal bleeding (AUGIB) are scarce. We provide estimates of UK healthcare costs, indirect and health-related quality life (HRQoL) for patients presenting to hospital AUGIB. <h3>Setting</h3> Six university hospitals >20 AUGIB admissions per month, >400 adult beds, 24 h endoscopy, on-site access intensive care surgery. <h3>Participants</h3> 936 aged ≥18 years, admitted AUGIB, enrolled between August 2012 March 2013...
Introduction The clinical effectiveness of a ‘rule-out’ acute coronary syndrome (ACS) strategy for emergency department patients with chest pain, incorporating single undetectable high-sensitivity cardiac troponin (hs-cTn) taken at presentation, together non-ischaemic ECG, remains unknown. Methods A randomised controlled trial, across eight hospitals in the UK, aimed to establish an hs-cTn and ECG (limit detection discharge (LoDED)) strategy. Eligible adult presented pain; treating clinician...
Objectives Quality and safety of emergency care is critical. Patients rely on medicine (EM) for accessible, timely high-quality in addition to providing a ‘safety-net’ function. Demand increasing, creating resource challenges all settings. Where EM well established, this recognised through the implementation quality standards staff training patient safety. In settings where developing, immense system pressures exist, thereby necessitating availability tiered appropriate local context....
Objectives We investigated whether the timing of hospital admission is associated with risk mortality for patients COVID-19 in England, and factors a longer interval between symptom onset admission. Design Retrospective observational cohort study data collected by Hospitalisation England Surveillance System (CHESS). Data were analysed using multivariate regression analysis. Setting Acute trusts that submit to CHESS routinely. Participants Of 14 150 included until 13 May 2020, 401 lacked...
Child abuse is easily overlooked in a busy emergency department.Two stage audit of 1000 children before and after introduction reminder flowchart.An department suburban teaching hospital seeing about 4000 injured preschool year.Number records which intentional injury was adequately documented considered the number referred for further assessment flowchart into notes.Nurses were asked to insert assessing notes all aged 0-5 years attending with any record results checking child protection...
<b>Objective</b> To determine whether patient controlled analgesia (PCA) is better than routine care in patients presenting to emergency departments with moderate severe pain from traumatic injuries. <b>Design</b> Pragmatic, multicentre, parallel group, randomised trial. <b>Setting</b> Five English hospitals. <b>Participants</b> 200 adults (71% (n=142) male), aged 18 75 years, who presented the department requiring intravenous opioid for treatment of injuries and were expected be admitted...
Objectives To evaluate the clinical effectiveness of soft tissue injury management by emergency nurse practitioners (ENPs) and extended scope physiotherapists (ESPs) compared to routine care provided doctors in a UK department (ED). Design Randomised, pragmatic trial equivalence. Setting One adult ED England. Participants 372 patients were randomised; 126 ESP group, 123 ENP group doctor group. adults (older than 16 years) presenting with peripheral eligible for any three professional groups....
Objectives To determine the safety and effectiveness of home oximetry monitoring pathways for patients with COVID-19 in English National Health Service. Design Retrospective, multisite, observational study suspected or proven COVID-19. Setting This analysed patient data from four pilot sites England across primary secondary care settings. Participants A total 1338 participants were enrolled a programme sites. excluded if oxygen saturations at rest enrolment not available. Data 908 included...
Objectives Emergency departments (EDs) in NHS hospitals England have faced considerable increases demand over recent years. Most developed general practitioner services emergency (GPEDs) to treat non-emergency patients, aiming relieve pressure on other staff and improve ED efficiency patient experience. We measured the impact of GPED flows, health outcomes workload. Design Retrospective observational study. Differences service availability across EDs time day were used identify causal effect...
BackgroundOlder people are at the greatest risk of poor outcomes after serious injury. Evidence is limited for benefit assessment by a geriatrician in trauma care. We aimed to determine effect on clinical older admitted hospital with injury.MethodsIn this multicentre observational study (FiTR 2), we extracted prospectively collected data (aged ≥65 years) 23 major centres England over 2·5 year period from Trauma Audit and Research Network (TARN) database. examined within 72 h admission...