Prehospital critical care dispatch: a scoping review (PHASE).

Introduction: Prehospital critical care (PHCC) dispatch is a vital component of emergency medical services, aiming to allocate specialised resources for critically ill or injured patients in out-of-hospital settings. This scoping review examines the existing evidence on optimising PHCC dispatch, identifies research gaps, and highlights priorities for future investigation.

Methods: A systematic search of databases including CINAHL, PubMed, EMBASE, and CENTRAL from January 2004 to October 2024.

Behavioral Economic Assessment of Contraceptive Use and Abortion Access Among College Cis Women in the U.S.

College students are at increased risk of sexually transmitted infections and unwanted pregnancies, complicated by changes in abortion access across the United States. The current study utilized a behavioral economic framework to examine how sex-related behavior, knowledge, and attitudes as well as access to abortion impacted valuation of condoms and an emergency contraceptive (i.e.

Streaming and redirection of lower acuity adult patients attending the ED: patient and staff experience.

Background: Streaming and redirection in the ED involves the assessment, triage and prioritisation of patients. Lower acuity patients can be streamed to alternative services within the hospital or redirected to off-site services with the aim of alleviating ED clinical pressures. This study aimed to understand staff, patient, family members and carers' experiences of streaming and redirection, including patients and staff who used an NHS web-based application.

Emergency department interventions and their effect on subsequent healthcare resource use after discharge: an overview of systematic reviews.

Background: Due to the worldwide pressures on Emergency Departments (EDs), there is a focus on ED interventions to alleviate pressure. Ensuring interventions do not inadvertently impact upon other healthcare sectors is an important outcome. This overview of systematic reviews aimed to evaluate the impact of ED based interventions on subsequent healthcare resource use after ED discharge.

Clinical and cost-effectiveness of paramedics working in general practice: a mixed-methods realist evaluation.

Background: General practice services are under pressure due increased demand. Alongside substantial national recruitment challenges, there exists a shortage of general practitioners to meet current need. Resultingly, allied healthcare professionals, including paramedics, are being utilised in general practice.

Factors influencing paramedic conveyance decisions when attending children with minor head injury: a qualitative study.

Introduction: Children with head injury are commonly transported to the ED by ambulance. However, most of those conveyed are deemed non-serious and are discharged at triage. Research is needed to explore the factors that influence paramedics when deciding to convey children with minor head injury to the ED, and to establish whether a clinical decision tool designed to support them would be beneficial.

Links among maternal antenatal attachment, postnatal depressive symptoms and infant crying: a prospective cohort study.

Purpose: This study investigated whether maternal antenatal attachment (MAA) in the third trimester was associated with self-reported problematic infant crying at eight weeks postnatally and explored links with postnatal depressive symptoms.

Methods: A prospective cohort study was conducted with 1287 pregnant participants in Danish general practice. MAA was measured using the Maternal Antenatal Attachment Scale (MAAS) in the third trimester.

Paramedics providing end-of-life care: an online survey of practice and experiences.

Background: Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics' current practice and experiences providing end-of-life care was undertaken.

Paramedic or GP consultations in primary care: prospective study comparing costs and outcomes.

Background: General practice faces pressures because of increased demand and a shortage of GPs. Paramedics in general practice (PGPs) increasingly contribute to managing minor illnesses, conducting home visits, and providing urgent consultations.

Aim: To explore the impact of paramedic consultations on patient-reported experience, safe management, and NHS costs.

Effects of E-cigarettes on Combustible Cigarette Smoking Among Adults With Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial.

Introduction: People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.

A conversation analytical study of call openings in Emergency Medical Service calls where the patient is at imminent risk of out-of-hospital cardiac arrest.

Background: The Chain of Survival identifies the importance of early recognition of patients who are at imminent risk of out-of-hospital cardiac arrest. This research investigated the interaction between callers and call-takers during calls to the Emergency Medical Service; it specifically focussed on patients who were alive at the initiation of the EMS call, but who subsequently deteriorated into out-of-hospital cardiac arrest during the prehospital phase of care (i.e.

Inequalities in birth before arrival at hospital in South West England: a multimethods study of neonatal hypothermia and emergency medical services call-handler advice.

Objectives: To examine inequalities in birth before arrival (BBA) at hospitals in South West England, understand which groups are most likely to experience BBA and how this relates to hypothermia and outcomes (phase A). To investigate opportunities to improve temperature management advice given by emergency medical services (EMS) call-handlers during emergency calls regarding BBA in the UK (phase B).

Design: A two-phase multimethod study.

Which elements of hospital-based clinical decision support tools for the assessment and management of children with head injury can be adapted for use by paramedics in prehospital care? A systematic mapping review and narrative synthesis.

Objective: Hospital-based clinical decision tools support clinician decision-making when a child presents to the emergency department with a head injury, particularly regarding CT scanning. However, there is no decision tool to support prehospital clinicians in deciding which head-injured children can safely remain at scene. This study aims to identify clinical decision tools, or constituent elements, which may be adapted for use in prehospital care.

Understanding paramedic work in general practice in the UK: a rapid realist synthesis.

Background: General practice in the UK is under substantial pressure and practices are increasingly including paramedics as part of their workforce. Little is known about how different models of paramedic working may affect successful implementation of the role, as viewed from patient, clinician and system perspectives. This realist synthesis developed theories about 'models of paramedic working in general practice' in different UK contexts to understand their impact.

Challenges and enablers to implementation of the Additional Roles Reimbursement Scheme in primary care: a qualitative study.

Background: The Additional Roles Reimbursement Scheme (ARRS) was set up to recruit 26 000 additional staff into general practice by 2024, with the aim of increasing patient access to appointments. Despite the potential benefits of integrating ARRS practitioners into primary care, their implementation has not always been straightforward.

Aim: To explore the challenges and enablers to implementation of the ARRS including its impact on primary and secondary care systems.

Identifying patients at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical call: The views of call-takers.

Introduction: There is little research on the triage of patients who are not yet in cardiac arrest when the emergency call is initiated, but who deteriorate and suffer a cardiac arrest during the prehospital phase of care. The aim of this study was to investigate Emergency Operation Centre staff views on ways to improve the early identification of patients who are at imminent risk of cardiac arrest, and the barriers to achieving this.

Methods: A qualitative interview and focus group study was conducted in two large Emergency Medical Services in England, United Kingdom.

First-time mothers' experiences with a web-intervention on maternal mentalisation and mental health.

Introduction: Development in infancy and early childhood affects mental and physical health later in life. Maternal mental health and attachment between mother and child are important for a healthy development. This qualitative study explored first-time mothers' experiences with a web-based intervention aimed at improving maternal mentalisation skills and mental health, thereby affecting child development.

How do emergency department staff respond to behaviour that challenges displayed by people living with dementia? A mixed-methods study.

Objectives: To investigate staff experiences of, and approaches to behaviour that challenges displayed by patients with dementia in the emergency department (ED). Behaviour that challenges is defined as 'actions that detract from the well-being of individuals due to the physical or psychological distress they cause within the settings they are performed', and can take many forms including aggressive physical actions, shouting and verbal aggression and non-aggressive behaviour including repetitive questioning, inappropriate exposure and resistance to care.

Design: Mixed-methods study consisting of an online survey and semistructured telephone interviews.

Randomised trial of the clinical and cost effectiveness of a supraglottic airway device compared with tracheal intubation for in-hospital cardiac arrest (AIRWAYS-3): Protocol, design and implementation.

Survival from in-hospital cardiac arrest is approximately 18%, but for patients who require advanced airway management survival is lower. Those who do survive are often left with significant disability. Traditionally, resuscitation of cardiac arrest patients has included tracheal intubation, however insertion of a supraglottic airway has gained popularity as an alternative approach to advanced airway management.

Mechanical insufflation-exsufflation to promote extubation success in critically ill adults on intensive care: protocol for a randomised controlled feasibility trial.

Background: Extubation failure, defined as reintubation within 48 h, is associated with increased intensive care unit (ICU) length of stay and higher mortality risk. One cause of extubation failure is secretion retention, resulting from an inability to cough effectively. Mechanical insufflation-exsufflation (MI-E) simulates a cough aiding secretion clearance.

Factors that influence the administration of tranexamic acid (TXA) to trauma patients in prehospital settings: a systematic review.

Objective: In the UK there are around 5400 deaths annually from injury. Tranexamic acid (TXA) prevents bleeding and has been shown to reduce trauma mortality. However, only 5% of UK major trauma patients who are at risk of haemorrhage receive prehospital TXA.

Clinicians' experiences in signposting an online mental health resource to expectant mothers: a qualitative study.

Background: Poor maternal mental well-being and a lack of secure parent-infant attachment, have been identified as important factors associated with adverse mental health outcomes later in a child's life. Interventions designed to care for maternal mental well-being during pregnancy and early parenthood, are therefore likely to support healthy child development. Mentalization is a skill parents can practice, improving the emotional bond to the child, offering insights into their own and the child's mental states and potentially improving parental mental well-being.

Health promotion in emergency care settings: investigating staff views and experiences.

Background: Emergency departments (EDs) afford 'teachable moments' for health behaviour change, but staff may not see themselves as public health practitioners and it can be challenging to undertake health promotion activities in emergency care settings. Furthermore, the evidence on health promotion in these settings is limited.

Aim: To investigate the views and experiences of emergency nurses and ambulance service paramedics regarding health promotion in emergency care settings.

Cross-cultural adaptation and its impact on research in emergency care.

The perspective of patients is increasingly recognised as important to care improvement and innovation. Patient questionnaires such as patient-reported outcome measures may often require cross-cultural adaptation (CCA) to gather their intended information most effectively when used in cultures and languages different to those in which they were developed. The use of CCA could be seen as a practical step in addressing the known problems of inclusion, diversity and access in medical research.