Sub30: Feasibility study of a pre-hospital extracorporeal membrane oxygenation (ECMO) in patients with refractory out-of-hospital cardiac arrest in London, United Kingdom.

Aim: Sub30 study is an open-label, prospective, single-arm feasibility study with the primary objective of assessing the logistics, feasibility, and safety of ECPR delivery in a pre-hospital setting for refractory out-of-hospital cardiac arrest patients in London, United Kingdom.

Results: Forty-three eligible patients were identified by London Ambulance Service over 27 trial recruitment days during a 13-month study period resulting in the despatch of the pre-hospital ECPR team to 18 patients. Five patients met full criteria and were cannulated for ECPR.

A retrospective cohort study of pre-hospital agitation management by advanced paramedic practitioners in critical care.

Introduction: Pre-hospital clinicians can expect to encounter patients with agitation, including acute behavioural disturbance (ABD). These situations carry significant risk for patients and emergency medical services. Advanced paramedics within the London Ambulance Service (LAS) are frequently tasked to these incidents.

Out-of-hospital resuscitation of a 3 month old boy presenting with recurrent ventricular fibrillation cardiac arrest: a case report.

A 3 month old boy, with no known health conditions, suffered a sudden collapse at home. On first EMS arrival, ventricular fibrillation (VF) cardiac arrest was identified and resuscitation following UK national guidelines was initiated. He remained in cardiac arrest for over 25 min, during which he received 10 defibrillation shocks, each effective, but with VF reoccurring within a few seconds of each of the first 9.

Sub30: Protocol for the Sub30 feasibility study of a pre-hospital Extracorporeal membrane oxygenation (ECMO) capable advanced resuscitation team at achieving blood flow within 30 ​min in patients with refractory out-of-hospital cardiac arrest.

Background: Out-of-hospital cardiac arrest carries a poor prognosis with survival less than 10% in many patient cohorts. Survival is inversely associated with duration of resuscitation as external chest compressions do not provide sufficient blood flow to prevent irreversible organ damage during a prolonged resuscitation. Extracorporeal membrane oxygenation (ECMO) instituted during cardiac arrest can provide normal physiological blood flows and is termed Extracorporeal Cardio-Pulmonary Resuscitation (ECPR).

Temporal and geographic patterns of stab injuries in young people: a retrospective cohort study from a UK major trauma centre.

Objectives: To describe the epidemiology of assaults resulting in stab injuries among young people. We hypothesised that there are specific patterns and risk factors for injury in different age groups.

Design: Eleven-year retrospective cohort study.

Algorithms to guide ambulance clinicians in the management of emergencies in patients with implanted rotary left ventricular assist devices.

Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services.

Targeted response? An exploration of why ambulance services find government targets particularly challenging.

Introduction Or Background: Ambulance services have historically found their targets particularly challenging. This article explores some areas of this multifaceted problem.

Sources Of Data: Research articles, government publications and published audit data.

Predicting early death in patients with traumatic bleeding: development and validation of prognostic model.

Objective: To develop and validate a prognostic model for early death in patients with traumatic bleeding.

Design: Multivariable logistic regression of a large international cohort of trauma patients.

Setting: 274 hospitals in 40 high, medium, and low income countries

Participants: Prognostic model development: 20,127 trauma patients with, or at risk of, significant bleeding, within 8 hours of injury in the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2) trial.

Emergency care and management of patients with stab wounds.

This article discusses the assessment, management and treatment of patients with stab wounds on arrival in the emergency department. It describes the immediate approach to assessment. The assessment of stab wounds to the chest, abdomen and limbs is also examined.

Development of the combined assessment of residential environments (CARE) profiles.

Aim: This paper reports the development and initial testing of the combined assessment of residential environments (CARE) profiles, which identify the frequency of positive events over a specified time based on the perceptions of residents, relatives and staff in care home settings.

Background: Despite the well-known benefits of positive events for subjective well-being, little is known about the nature of positive events experienced by residents, relatives and staff in care homes. There is also a dearth of tools capable of systematically evaluating how frequently these events occur in this context.

Social support in the healthcare setting: the role of volunteers.

The participation of volunteers in the National Health Service (NHS) has been actively promoted during recent years, particularly within community and primary healthcare services (National Health Service 1996, 1998). As a consequence, volunteers currently make a significant contribution to health and social care within the UK. Concerning this contribution, the literature often portrays the volunteers' role as one of providing social support.

Supporting the psychosocial needs of patients in general practice: the role of a voluntary referral service.

This qualitative study describes and analyses the key features of a practice based voluntary referral service called the Patient Support Service (PSS). This involved collecting interview data from 11 service users and 8 service providers, which was analysed using 'Framework,' a qualitative method of applied policy research. The study findings describe the PSS, its perceived effectiveness and barriers to service provision.

Is the hospital sick role a barrier to patient participation?

The sick role is a complex behaviour that allows a person who is ill to depend on carers. This article discusses the parameters of the sick role, explains how it is prompted by admission to hospital and asks whether it can act as a barrier to patients' participation in decisions on their care. It considers why some patients are reluctant to relinquish the sick role and suggests ways for nurses to help these patients to play an active part in their own recovery.