A5048305926- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Cardiac Arrest and Resuscitation
- Sepsis Diagnosis and Treatment
- COVID-19 Clinical Research Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Respiratory Support and Mechanisms
- Airway Management and Intubation Techniques
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Intensive Care Unit Cognitive Disorders
- Hemodynamic Monitoring and Therapy
- Trauma Management and Diagnosis
- SARS-CoV-2 and COVID-19 Research
- Anesthesia and Sedative Agents
- Long-Term Effects of COVID-19
- Hip and Femur Fractures
- Neonatal Respiratory Health Research
- Disaster Response and Management
- Suicide and Self-Harm Studies
- Mechanical Circulatory Support Devices
- Tracheal and airway disorders
- Injury Epidemiology and Prevention
- Ultrasound in Clinical Applications
- Hospital Admissions and Outcomes
- Healthcare Policy and Management
Royal Alexandra Hospital
2014-2024
University of Glasgow
2010-2024
NHS Greater Glasgow and Clyde
2017-2023
National Health Service
2023
Royal Alexandra Children's Hospital
2021
Scottish Health Services
2019
University Hospital Crosshouse
2004-2012
Southern General Hospital
2008-2012
Ninewells Hospital
2012
In-Q-Tel
2004
An important element in improving the care of patients with sepsis is early identification and intervention. Early warning score (EWS) systems allow earlier physiological deterioration. A standardised national EWS (NEWS) has been proposed for use across National Health Service UK.To determine whether a single NEWS on emergency department (ED) arrival predictor outcome, either in-hospital death within 30 days or intensive unit (ICU) admission 2 days, sepsis.Data were collected over 3-month...
People experiencing a mental health crisis receive variable and poorer quality care than those physical crisis. Little is known about the epidemiology, subsequent pathways of self-harm emergencies attended by ambulance services, all-cause mortality, including deaths suicide. This first national epidemiological analysis processes outcomes people an due to or emergency. The study aimed describe patient characteristics, volume, case-mix, following attendance in this population.A linked data...
Background Scotland has three prehospital critical care teams (PHCCTs) providing enhanced support to a usually paramedic-delivered ambulance service. The effect of the PHCCTs on patient survival following trauma in is not currently known nationally. Methods National registry-based retrospective cohort study using 2011–2016 data from Scottish Trauma Audit Group. 30-day mortality was compared between groups after multivariate analysis account for confounding variables. Results Our set...
International guidelines recommend IV crystalloid as the primary fluid for sepsis resuscitation, with 5% human albumin solution (HAS) second line. However, it is unclear which has superior clinical effectiveness. We conducted a trial to assess feasibility of delivering randomized controlled comparing balanced against HAS sole early resuscitation in patients presenting hospital.
Early intervention and response to deranged physiological parameters in the critically ill patient improve outcomes. A National Warning Score (NEWS) based on observations has been developed for use throughout Health Service UK. The quick Sepsis-related Organ Failure Assessment (qSOFA) was as a simple bedside criterion identify adult patients outwith ICU with suspected infection who are likely have prolonged stay or die hospital. We aim compare ability of NEWS qSOFA predict adverse outcomes...
Trauma remains a leading cause of morbidity and mortality in the UK throughout world. Socioeconomic deprivation has been linked with many types ill-health previous studies have shown an association injury other parts The aim this study was to investigate between socioeconomic trauma incidence case-fatality Scotland. included nine thousand two hundred thirty eight patients attending Emergency Departments following across Scotland 2011-12. A retrospective cohort conducted using secondary data...
Socioeconomic inequalities in chronic disease management and outcomes are well-established. Their association with critical illness is less clear. This study aimed to investigate the between socioeconomic status following emergency admission for illness. Three Scotland-wide health databases were linked: Scottish Intensive Care Society Audit Group database (critical care units); Morbidity Record 01 (hospital admissions) death certificates. A retrospective cohort was conducted on adults (⩾16...
Summary Blood pressure measurement is an essential physiological for all critically ill patients. Previous work has shown that non‐invasive blood not accurate reflection of invasive measurement. In a transport environment, the effects motion and vibration may make less accurate. Consecutive patients transported by dedicated aeromedical retrieval critical care transfer service with simultaneous measurements were analysed. Two sets recorded, first in hospital environment before departure...
Poor communication during patient handover is recognised internationally as a root cause of significant proportion preventable deaths. Improving the accuracy and quality may reduce associated mortality morbidity. Although practice between Ambulance Emergency Department clinicians has received some attention over recent years there little evidence to support best within prehospital domain. Further research therefore urgently required understand most appropriate way deliver clinical...
We examined the effect of advanced preparation and organisation equipment drugs for Pre-hospital Emergency Anaesthesia (PHEA) tracheal intubation on procedural time, error rates, cognitive load. This study was a randomised, controlled experiment with crossover design. Clinical teams (physician paramedic) from Medical Retrieval Service Scottish Air Ambulance Division were randomised to perform standardised pre-hospital clinical simulation using either unprepared (standard practice) or...
To identify the effect on door to needle (DTN) time of moving site thrombolysis delivery from coronary care unit (CCU) emergency department (ED). ascertain if enables appropriate use thrombolysis.Prospective cohort study.CCU and ED a 450 bed Scottish district general hospital without on-site primary angioplasty.Primary for patients presenting with ST elevation MI (STEMI) moved CCU 1 April 2000. Study who had confirmed STEMI and/or received thrombolytic therapy before this date were defined...
Abstract Background As an adjunct to physical examination, ultrasound is a potentially attractive option for diagnosing pneumothoraces in the pre-hospital and retrieval environment – could confer benefit patient safety. However, published evidence supporting non-physicians use of this setting limited. Aim We aimed establish if Advanced Retrieval Practitioners (non-physicians) acquire views lungs interpret them with sufficient quality diagnose pneumothorax when compared expert review. Method...
Abstract Background Prehospital vital sign documentation in paediatric patients is incomplete, especially ≤ 2 years. The aim of the study was to increase registration through specific educational initiatives. Methods Prospective quasi-experimental with interrupted time-series design North Denmark and South regions. consecutively included all children aged < 18 years attended by emergency medical service (EMS) from 1 July 2019 31 December 2021. Specific initiatives were conducted only EMS...
Objective To investigate the incidence and factors associated with desaturation related to emergency intubations within an aeromedical retrieval service pertaining both primary prehospital secondary interhospital missions. Methods A retrospective analysis of all rapid sequence (RSI) was performed by Emergency Medical Retrieval Service over a 4.5-year period (June 2008–November 2012). For each RSI, clinical indication for age, sex, traumatic or medical diagnosis, team leader specialty,...
Abstract Background COVID-19 has overwhelmed health services across the world; its global death toll exceeded 5.3 million and continues to grow. There have been almost 15 cases of in UK. The need for rapid accurate identification, appropriate clinical care decision making, remains a priority UK ambulance service. To support identification conveyance decisions patients presenting with symptoms Scottish Ambulance Service introduced revised Medical Priority Dispatch System Protocol 36, enhanced...
Abstract Background Life-threatening conditions are infrequent in children. Current literature paediatric prehospital research is centred around trauma and out-of-hospital cardiac arrests (POHCA). The aims of this study were to (1) outline the distribution trauma, POHCA or other medical symptoms among survivors non-survivors after emergency calls, (2) investigate these clinical presentations’ association with mortality children without pre-existing comorbidity, respectively. Methods...
In our previous study, a Paediatric Early Warning Score could be calculated for only one-fifth of 102,993 children transported by ambulance to hospital, as components other than supplemental oxygen were not reliably measured: respiratory rate 90,358 (88%); Glasgow Coma 83,648 (81%); heart 83,330 time capillary reperfusion 81,685 (79%); saturation 71,372 (69%); temperature 60,402 (59%); systolic blood pressure 37,088 (36%). We tested 12 abbreviated scores with 3-5 components. The...
Patients presenting with suspected sepsis to secondary care often require fluid resuscitation correct hypovolaemia and/or septic shock. Existing evidence signals, but does not demonstrate, a benefit for regimes including albumin over balanced crystalloid alone. However, interventions may be started too late, missing critical window.ABC Sepsis is currently recruiting randomised controlled feasibility trial comparing 5% human solution (HAS) in patients sepsis. This multicentre adult within 12...
The Emergency Medical Retrieval Service (EMRS) has provided national pre-hospital critical care and aeromedical retrieval in Scotland since 2010. This study investigates trends the service patients attended over last decade; factors associated with clinical deterioration death.A retrospective cohort was conducted of all taskings ten years (2011-2020 inclusive). EMRS electronic database data on location, sociodemographic factors, diagnoses, physiological measurements, management, deaths....
We describe the first year of operation a rural emergency medical retrieval service (EMRS), staffed by medicine and anaesthetic consultants providing air based critically ill injured patients from general practitioner led community hospitals in west Scotland.Data were collected on all referred to service, both those subsequently transported where transport was not indicated, for period 1 October 2004 30 September 2005. Data included information demographics, physiology, interventions....