'Blue-lighting' seizure-related needs in care homes: a retrospective analysis of ambulance call-outs for seizures in North West England (2014-2021), their management and costs, with community comparisons.

Objectives: With a projected rise in care home residency and the disproportionate impact of epilepsy and seizures on older adults, understanding seizure-related needs in this population is crucial. Data silos and inconsistent recording of residence status make this challenging. We thus leveraged ambulance data to investigate seizure call-out incidence, characteristics, management and costs in care homes compared with the wider community.

Simulation-based assessment in the context of paramedic education: A scoping review.

Objective: Simulation is a widespread modality in the field of medical education. Within the paramedic sphere, simulation is valuable in providing exposure to high-acuity, low occurrence incidents encountered rarely in practice, affording unique educational opportunities. Recognising this importance, this scoping review seeks to establish the contemporaneous evidence base for the use of simulation-based assessment in the context of paramedic education, systematically map the research done in this area and consider the implications for future educational programmes.

A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest.

Background: In patients with out-of-hospital cardiac arrest, the effectiveness of drugs such as epinephrine is highly time-dependent. An intraosseous route of drug administration may enable more rapid drug administration than an intravenous route; however, its effect on clinical outcomes is uncertain.

Methods: We conducted a multicenter, open-label, randomized trial across 11 emergency medical systems in the United Kingdom that involved adults in cardiac arrest for whom vascular access for drug administration was needed.

HTS library plate rejuvenation using a DMSO-rich atmosphere.

Dry DMSO can rapidly pull water vapor out of the air due to its hygroscopic nature. This is a well-documented problem within drug discovery, particularly within high-throughput screening (HTS). This hydration is caused by atmospheric moisture being absorbed each time a compound library is used.

Head Injury Evaluation and Ambulance Diagnosis (HOME) Study protocol: a feasibility study assessing the implementation of the Canadian CT Head Rule in the prehospital setting.

Introduction: Traumatic brain injury (TBI) is a common presentation in the prehospital environment. At present, paramedics do not routinely use tools to identify low-risk patients who could be left at scene or taken to a local hospital rather than a major trauma centre. The Canadian CT Head Rule (CCHR) was developed to guide the use of CT imaging in hospital.

Should video laryngoscopy or direct laryngoscopy be used for adults undergoing endotracheal intubation in the pre-hospital setting? A critical appraisal of a systematic review.

The safety and utility of endotracheal intubation by paramedics in the United Kingdom is a matter of debate. Considering the controversy surrounding the safety of paramedic-performed endotracheal intubation, any interventions that enhance patient safety should be evaluated for implementation based on solid evidence of their effectiveness. A systematic review performed by Hansel and colleagues (2022) sought to assess compare video laryngoscopes against direct laryngoscopes in clinical practice.

Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance.

Objective: The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals.

Design/setting: An international research priority-setting partnership.

Participants: People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma.

Developing an alternative care pathway for emergency ambulance responses for adults with epilepsy: A Discrete Choice Experiment to understand which configuration service users prefer. Part of the COLLABORATE project.

Introduction: To identify service users' preferences for an alternative care pathway for adults with epilepsy presenting to the ambulance service.

Methods: Extensive formative work (qualitative, survey and knowledge exchange) informed the design of a stated preference discrete choice experiment (DCE). This hypothetical survey was hosted online and consisted of 12 binary choices of alternative care pathways described in terms of: the paramedic's access to medical records/ 'care plan', what happens next (described in terms of conveyance), time, availability of epilepsy specialists today, general practitioner (GP) notification and future contact with epilepsy specialists.

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

Aims: The PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with an intravenous first strategy, for drug administration in adults who have sustained an out-of-hospital cardiac arrest.

Methods: PARAMEDIC-3 is a pragmatic, allocation concealed, open-label, multi-centre, superiority randomised controlled trial. It will recruit 15,000 patients across English and Welsh ambulance services.

External validation of the Manchester Acute Coronary Syndromes ECG risk model within a pre-hospital setting.

Objectives: The Manchester Acute Coronary Syndromes ECG (MACS-ECG) prediction model calculates a score based on objective ECG measurements to give the probability of a non-ST elevation myocardial infarction (NSTEMI). The model showed good performance in the emergency department (ED), but its accuracy in the pre-hospital setting is unknown. We aimed to externally validate MACS-ECG in the pre-hospital environment.

Towards exploring current challenges and future opportunities relating to the prehospital triage of patients with traumatic brain injury: a mixed-methods study protocol.

Introduction: Traumatic brain injury (TBI) is a major global health burden that results in disability and loss of health. Identifying those patients who require specialist neuroscience care can be challenging due to the low accuracy of existing prehospital trauma triage tools. Despite the widespread use of decision aids to 'rule out' TBI in hospitals, they are not widely used in the prehospital environment.

Impact of COVID-19 on out-of-hospital cardiac arrest care processes.

Early bystander cardiopulmonary resuscitation, use of defibrillators (including automated external defibrillators) and timely treatment by emergency medical services are known to increase the chances of survival for a patient experiencing an out-of-hospital cardiac arrest (OHCA); however, the impact of the COVID-19 pandemic on this is unclear from examining previous literature. This commentary critically appraises a recent systematic review and meta-analysis which assesses the effect of the COVID-19 pandemic on pre-hospital care for OHCA.

Prehospital triage tools in major trauma: a critical appraisal of a systematic review.

Effective triage is critical to ensure patients suffering major trauma are identified and access a pathway to definitive major trauma care, typically provided in a major trauma centre as part of an established major trauma system. The pre-hospital triage of trauma patients often relies upon the use of major trauma triage tools; this commentary critically appraises a recent systematic review which sought to evaluate and compare the accuracy of pre-hospital triage tools for major trauma.

The diagnostic accuracy of prehospital triage tools in identifying patients with traumatic brain injury: A systematic review.

Introduction: Prehospital care providers are usually the first responders for patients with traumatic brain injury (TBI). Early identification of patients with TBI enables them to receive trauma centre care, which improves outcomes. Two recent systematic reviews concluded that prehospital triage tools for undifferentiated major trauma have low accuracy.

Detecting cortical responses to continuous running speech using EEG data from only one channel.

Objective: To explore the detection of cortical responses to continuous speech using a single EEG channel. Particularly, to compare detection rates and times using a cross-correlation approach and parameters extracted from the temporal response function (TRF).

Design: EEG from 32-channels were recorded whilst presenting 25-min continuous English speech.

Prehospital Airway Management.

The prehospital emergency airway management is a key moderating factor for patient survival and mortality rates. There has been much debate around the optimum method of prehospital emergency airway management. This commentary critically appraises a recent systematic review which assesses the harms and benefits of three different airway management strategies for a range of emergency clinical scenarios.

Use of a modified Delphi process to develop research priorities in major trauma.

Purpose: The burden of major trauma within the UK is ever increasing. There is a need to establish research priorities within the field. Delphi methodology can be used to develop consensus opinion amongst a group of stakeholders.

PRe-hospital Evaluation of Sensitive TrOponin (PRESTO) Study: multicentre prospective diagnostic accuracy study protocol.

Introduction: Within the UK, chest pain is one of the most common reasons for emergency (999) ambulance calls and the most common reason for emergency hospital admission. Diagnosing acute coronary syndromes (ACS) in a patient with chest pain in the prehospital setting by a paramedic is challenging. The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision rule is a validated tool used in the emergency department (ED) to stratify patients with suspected ACS following a single blood test.

Three generalizability studies of the components of perceived coach support.

Coaches are important providers of social support, but what influences us to perceive our coaches as supportive or unsupportive? We investigated the extent to which perceptions of coach support reflect characteristics of athletes and coaches, as well as relational components. In three studies, athletes judged the actual or hypothetical supportiveness of various coaches. The methods of generalizability theory permitted us to conclude that perceptions of coach support primarily reflected relational components, with characteristics both of athletes and coaches also independently playing (lesser) roles.

Pulmonary vein encircling ablation alters the atrial electrophysiologic response to autonomic stimulation.

Objective: Pulmonary vein encircling ablation is often effective in the treatment of atrial fibrillation (AF). The success of the procedure does not depend upon creation of continuous lines of block. Thus mechanisms by which pulmonary vein encircling can cure AF remain unclear.

The acute effects of different whole body vibration amplitudes on the endocrine system of young healthy men: a preliminary study.

Whole body vibration (WBV) has been suggested as an alternative form of exercise producing adaptive responses similar to that of resistance training. Very limited information is available on the effects of different vibration parameters on anabolic hormones. In this study, we compared the acute effects of different WBV amplitudes on serum testosterone (T) and insulin growth factor-1 (IGF-1).

Evaluation of novel particles as pulmonary delivery systems for insulin in rats.

The purpose of the study was to evaluate the influence of calcium phosphate (CAP) and polyethylene glycol (PEG) particles on the systemic delivery of insulin administered by the pulmonary route. Two methods of pulmonary delivery were employed: intratracheal instillation and spray instillation. Insulin-CAP-PEG particles in suspension (1.