Tag Archives: Emergency Medical Services

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CaHRU team attends 999 EMS Research Forum conference in Bristol

EMS999_spaceSix members of the CaHRU team recently attended the 999 EMS Research Forum conference on Wednesday 29th March 2017 at the Bristol Science Centre. The team members attending were Professor Niro Siriwardena, Dr Zahid Asghar, Dr Stephanie Armstrong, Mr Viet-Hai Phung, Laura Simpson and Joseph Akanuwe.

Chiral_logoThe 999 EMS Research Forum is an international partnership bringing together academics and health-care providers with interest in emergency care research. The forum aims to encourage, promote and disseminate research and evidence-based policy and practice in prehospital healthcare. The conference, which was hosted by the South Western Ambulance Service NHS Foundation Trust, included keynote presentations, peer-reviewed presentations, moderated poster presentation sessions and the presentation of prizes and closing remarks.

999EMS_BengerThe conference theme was, “The way forward for Emergency care Research: Inclusion; Collaboration; Sustainability”. The morning was chaired by Professor Jonathan Benger. Keynote speakers included: Professor Ann John of Swansea University Medical School who discussed the emergency care of people who self-harm; Dr Sarah Voss of the University of the West of England, who discussed the social and cultural influences on the design and delivery of collaborative research in emergency care. Other keynote speakers were: Janette Turner of the University of Sheffield, who spoke on the “Ambulance Response Programme”; and Dr Andrew Appelboam with Alex Sharp who presented the, “REVERT to the future: Dissemination and Implementation” study. Last but not the least was Professor Steve Goodacre, Chair of the NIHR Health Technology Assessment Clinical Evaluation and Trials Board, who talked about the way forward with Health Technology Assessment and the HTA programme.

999EMS_CosterThere followed five interesting oral presentations of the highest rated peer-reviewed abstracts submitted. First, Jonathan Chippendale from the East Midlands Ambulance Service NHS Trust, presented a pilot study to assess the feasibility of paramedics delivering antibiotics to ‘red flag’ sepsis patients. Next, Joanne Coster from the University of Sheffield talked about the multi-method consensus development of new ambulance service quality and performance measures. Dr Mathew Booker of the University of Bristol drew on early findings from their prehospital ethnographic study and discussed why primary care problems end up receiving ambulance treatment.

WP_20170328_17_49_05_RichThe moderated poster sessions involved a five minute presentation with two minutes for questions and answers per poster. Members of the CaHRU team presented high quality posters. Professor Niro Siriwardena led the poster presentation on: a reliability and validity of an Ambulance Patient Reported Experience Measure (A-PREM) pilot study. Dr Zahid Asghar presented the poster on a cross section study which explores factors increasing paramedics’ likelihood of administering analgesia in prehospital pain (EXPLAIN). Dr Stephanie Armstrong presented the poster on: consent as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.

The conference proved interesting and worthwhile with opportunities to learn and meet potential research collaborators. The presentation of prizes to deserving winners and closing remarks brought the conference to a close.

By Joseph Akanuwe

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CaHRU seminar – Incorporating ethical considerations in research – Dr Stephanie Armstrong

CaHRU_logotypeThe latest CaHRU Implementation Science and Research Methods seminar was given on November 22nd 2016 by CaHRU’s very own Dr Stephanie Armstrong. Stephanie, currently a Lecturer in Healthcare Quality Improvement at the University of Lincoln, comes from a diverse background, starting in the fields of Zoology (Trinity College Dublin) and Equine Studies (University of Coventry), moving on to studying Forensic Anthropology (University of Lincoln) and working on ethics and human rights. She is now researching the ethics of ambulance trials through a grant funded by the Wellcome Trust: Network exploring Ethics of Ambulance Trials (NEAT).

Stephanie’s talk focused on research ethics. She started the seminar by asking the participants to think about ethics Steph750 11.16and what their definition of ethics was. After a quick discussion around the participants’ thoughts, Stephanie gave an overall definition of research ethics and discussed issues around both the philosophical and legal aspects of ethics. The majority of the seminar was around the four basic constructs of research ethics: autonomy, non-maleficence, beneficence, and justice. Stephanie discussed the most relevant and important laws concerning research, such as the Mental Capacity Act (2005) and the Medicines for Human Use (Clinical Trials) Regulations (2004) – for Clinical Trials Involving Medicinal Products (CTIMPs), before reviewing the different types of participant consent used in research studies. At the end of the seminar, Stephanie reminded the attendees of the importance of ethics in animal research and discussed issues around its governance by the Animals (Scientific Procedures) Act 1986.

NThe seminar was very well presented and raised some very important issues around research ethics. The next Implementation Science and Research Methods seminar will be presented by Professor Chris Bridle, Director of the Institute for Health at the University of Lincoln, on Tuesday December 6th 2016. His topic will be “Accumulative Evidence Synthesis: fast track through the implementation pipeline”.

By Despina Laparidou

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Experts convene for Wellcome funded Network Exploring Ethics in Ambulance Trials (NEAT) project meeting

NOn 4th November 2016, CaHRU played host to an eminent group of researchers, ethicists and patient representatives in a meeting to discuss ethics in ambulance based trials. The group was formed as part of the Network Exploring Ethics in Ambulance Trials (NEAT) project, funded by the Wellcome Trust, which is seeking to understand the issues related to ethics in ambulance trials. The meeting had two main objectives, firstly to update the network on the findings of the NEAT project to date and secondly to discuss potential recommendations and future funding opportunities.

neat_ws1In the morning presentations by Dr Adele Langlois and Dr Stephanie Armstrong, outlined the findings of the project to date. These included a systematic review of published randomised controlled trials, a review of global and national regulations and the preliminary results of interview studies with expert informants, paramedics and patients who have been involved in ambulance trials. The morning sessions generated a lot of lively debate centring on both consent models and regulations, and in fact where there was agreement and conflict between these areas.

NAfter a pleasant lunch the discussion continued with possible recommendations of the project being that more work need to be done to clarify the guidance and regulations ultimately leading to a code of practice for ambulance trials and accompanying common ethics framework. Funding opportunities were discussed and the day ended with an agreement that there should be a commitment to continue the work of the network through collaborative research opportunities.

By Dr Stephanie Armstrong

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Making it Happen – CaHRU attend 999 EMS Research Forum conference in Newcastle

Members of the CaHRU team together with colleagues from East Midlands Ambulance Service NHS Trust attended the 999 EMS Research Forum conference, ‘Making it happen: delivering research in pre-hospital care’ at the Assembly Rooms in Newcastle on 1 March 2016. The event was organised by the 999 EMS Forum in collaboration with North East Ambulance Service NHS Trust and Newcastle University.

IqbalEMS9991.3.16The conference was opened by Yvonne Ormston, Chief Executive of North East Ambulance Service and introduced by Prof Helen Snooks, Professor of Health Services Research at Swansea University and chair of the EMS 999 Research Forum. The opening keynote was given by Dr Simon Woods of Newcastle University on ‘Ethics and consent in pre-hospital research’. This was followed by a number of oral presentations from the highest scoring abstracts submitted to the conference. This included a presentation by Dr Mohammad Iqbal, research associate at East Midlands Ambulance Service NHS Trust and research fellow at CaHRU, who presented his doctoral study, ‘Non randomised control study of the effectiveness of a novel pain assessment tool for use by paramedics’. After the oral presentations there was a further keynote from Dr Chris Price of Newcastle University on ‘Delivering safe pre-hospital research: a stroke perspective’.

FionaEMS9991.3.16Poster sessions included a presentation from Fiona Togher, graduate research assistant at CaHRU on her doctoral research, ‘Refining questionnaire items in a Patient Reported Experience Measure (PREM) designed for users of NHS ambulance services: Question Appraisal Study’. The afternoon session included a workshop given by Prof Niro Siriwardena and Dr Adele Langlois supported by Dr Stephanie Armstrong, on ‘Ethics and consent in pre-hospital research’, which form part of the Network exploring Ethics of Ambulance Trials funded by the Wellcome Trust. The workshop was well attended and generated ideas on consent, confidentiality, and privacy in relation to ambulance trials as well as ideas on future research.

NEAT_team1.3.16The final keynote was given by Dutch researcher, and acute physician, Dr Prabath Nanayakkara on his ‘Research in the pre-hospital management of sepsis: opportunities and challenges’. The conference was closed by Prof Siriwardena, with prizes presented to the best research, best poster, research most likely to affect practice and best use of data, and thanks given to the organisers for an excellent and memorable event.

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CaHRU wins new grant to investigate prehospital pain management

zahidAn international team of researchers led by Prof Niro Siriwardena with statistician Dr Zahid Asghar from CaHRU has been awarded funding from the Falck Foundation to study prehospital pain management. The study involves collaboration between CaHRU at the University of Lincoln, with East Midlands, East of England and South Central Ambulance Service NHS Trusts, together with the Universities of Swansea, Hertfordshire and the Sunshine Coast (Australia).

EMAS - A&E 9The study, ‘Exploring factors increasing Paramedics’ likelihood of administering Analgesia in pre-hospital pain: cross sectional study (ExPLAIN)’ aims to identify how patient factors such as age, gender, ethnicity and the cause of pain together with clinician factors such as sex or role seniority affect pain assessment and use of analgesic drugs by ambulance staff. The study builds on previous research conducted by members of the team in the area of prehospital pain management and the findings will be used to inform recommendations to improve the rate and quality of acute pain relief provided by ambulance staff and to reduce unintended variations in care.

EMAS - A&E 5_750

The study is part of CaHRU’s ongoing research as part of its Prehospital and Emergency Quality and Outcomes (PEQO) workstream which involves collaboration with other ambulance services in England and which has already led to new measures and improvements in the quality of ambulance service care provision.