A service evaluation of a dedicated pre-hospital cardiac arrest response unit in the North East of England

2016 ◽  
Vol 1 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Graham McClelland ◽  
Paul Younger ◽  
Daniel Haworth ◽  
Amy Gospel ◽  
Paul Aitken-Fell
Keyword(s):  
Cardiac Arrest ◽  
Service Evaluation ◽  
Response Unit ◽  
North East ◽  
The North ◽  
Hospital Cardiac Arrest

Hangings attended by ambulance clinicians in the North East of England

2021 ◽  
Vol 6 (3) ◽  
pp. 49-57
Author(s):  
Gary Shaw ◽  
Lee Thompson ◽  
Graham McClelland
Keyword(s):  
Mental Health ◽  
Cardiac Arrest ◽  
Suicide Attempts ◽  
Service Evaluation ◽  
Health Issues ◽  
Hospital Data ◽  
North East ◽  
The North ◽  
Acute Hospitals ◽  
Future Work

Introduction: Suicide rates have risen in England over the last decade and hanging, a highly lethal method of suicide, has been the most common method. Previous work in this area identified a lack of literature discussing emergency medical services (EMS) attendance at hangings. This article aims to describe hangings attended by EMS in the North East of England in order to inform future work in this area.Methods: A retrospective service evaluation was conducted using existing data from a comprehensive pre-hospital trauma audit database to describe patients with hanging documented in their records who were attended by ambulance clinicians between 1 December 2018 and 31 November 2020.Results: Hanging was recorded in 604 incidents. Most cases (n = 579/604) involved adults (aged 18 years or older) with a median age of 35 years (IQR 27‐45 years), who were male (n = 410/579, 71%). Just over half (n = 341/579, 59%) of adult hangings resulted in cardiac arrest and of these, 10% (n = 33/341) were resuscitated and survived to hospital admission. Threatened and non-fatal hangings appear to have increased dramatically in the latter half of 2020. Previous suicide attempts and mental health issues were frequently reported across this population.Conclusion: Hangings are a method of suicide which frequently result in a cardiac arrest. In the North East of England the ambulance service attends approximately one hanging per day and one fatal hanging every two days. When fatal hangings were resuscitated, pre-hospital outcomes were similar to other causes of cardiac arrest, highlighting that despite the traumatic nature of these cases resuscitation is not futile. In order to better understand this patient group and improve care, pre-hospital data need to be linked to data from other services such as mental health services and acute hospitals.

scholarly journals Awareness of the cost of psychotropic medication among doctors: a service evaluation

2010 ◽  
Vol 34 (9) ◽  
pp. 364-366 ◽  
Author(s):  
Dhananjay Kumar Singh ◽  
Shakil Khawaja ◽  
Ishaq Pala ◽  
Jaleel Khaja ◽  
Ray Krishnanu ◽  
...  
Keyword(s):  
Cost Effective ◽  
Service Evaluation ◽  
Financial Resources ◽  
Clinical Implications ◽  
North East ◽  
The North ◽  
Old Age Psychiatry ◽  
Level Of Knowledge ◽  
The Cost ◽  
Structured Questionnaire

Aims and methodCost-effective prescribing is an increasingly important aspect of our practice. A service evaluation was carried out to assess the level of awareness and knowledge of different aspects of cost-effective prescribing among doctors working in the North East London Foundation Trust. A semi-structured questionnaire was used to benchmark knowledge against six standards.ResultsThe survey was completed by 71% of doctors working in adult or old age psychiatry. A total of 2% of doctors stated that they should always take into consideration the price of the drug when prescribing and only 5% of doctors claimed to know the price of medications they prescribe most frequently.Clinical implicationsStrategies to improve the poor level of knowledge and awareness in this area of clinical practice would be of benefit in making the best use of limited financial resources without any detriment to patient care.

Testing for pharyngeal gonorrhoea in heterosexual men: should we revisit national guidelines?

2020 ◽  
pp. 095646242091344
Author(s):  
Melissa Dresser ◽  
Jane Hussey
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Persistent Infection ◽  
Service Evaluation ◽  
Heterosexual Men ◽  
National Guidelines ◽  
North East ◽  
The North ◽  
Current Guidelines

Pharyngeal testing for Neisseria gonorrhoeae (gonorrhoea) in heterosexual men is not currently recommended in UK guidelines; however, it was being undertaken in a service in the North East of England for those presenting with urethral infection or as contacts of gonorrhoea. This service evaluation was performed to see if this practice should continue, or cease in line with national recommendations. The results revealed that 10% of contacts were positive in the pharynx only. Had this test not been performed, it would have left these patients without any treatment, as the current guidelines now discourage epidemiological treatment of contacts. Twenty-seven per cent of all heterosexual men diagnosed with urethral infection also had oropharyngeal gonorrhoea, with implications for persistent infection, had testing not been performed followed by a test of cure.

scholarly journals The first 6 weeks – setting up a UK urgent dental care centre during the COVID-19 pandemic

2020 ◽  
Author(s):  
Emily Carter ◽  
Charlotte C Currie ◽  
Abisola Asuni ◽  
Rachel Goldsmith ◽  
Grace Toon ◽  
...  
Keyword(s):  
Dental Care ◽  
Care Service ◽  
Clinical Care ◽  
Service Evaluation ◽  
Urgent Care ◽  
List Type ◽  
Care Centre ◽  
North East ◽  
The North ◽  
Patient Pathways

AbstractIntroductionThe COVID-19 pandemic has posed many challenges, including provision of urgent dental care. This paper presents a prospective service evaluation during establishment of urgent dental care in the North-East of England over a six-week period.AimTo monitor patient volumes, demographics and outcomes at the North-East urgent dental care service and confirm appropriate care pathways.Main Outcome MethodsData were collected on key characteristics of patients accessing urgent care from 23rd March to 3rd May 2020. Analysis was with descriptive statistics.ResultsThere were 1746 patient triages, (1595 telephone and 151 face-to-face) resulting in 1322 clinical consultations. The most common diagnoses were: symptomatic irreversible pulpitis or apical periodontitis. 65% of clinical consultations resulted in extractions, 0.5% an aerosol generating procedure. Patients travelled 25km on average to access care, however this reduced as more urgent care centres were established. The majority of patients were asymptomatic of COVID-19 and to our knowledge no staff acquired infection due to occupational exposure.ConclusionThe urgent dental care centre effectively managed urgent and emergency dental care, with appropriate patient pathways established over the 6-week period. Dental preparedness for future pandemic crisis could be improved and informed by this data.Three In Brief PointsA summary is given of how urgent dental care was established in the North East of England during the COVID-19 pandemic which may help with future preparedness for pandemics.Aerosol generating procedures were almost always avoided in the delivery of urgent dental careA telephone triage system was effectively used to determine who needed clinical care, and to separate symptomatic, asymptomatic and shielding patients, with very few failures in triage noted.

Abstract 19542: A North American Survey of Public Opinion on the Acceptability of Crowdsourcing Basic Life Support for Out-of-hospital Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Katie N Dainty ◽  
Steven Brooks
Keyword(s):  
Cardiac Arrest ◽  
North American ◽  
Basic Life Support ◽  
Life Support ◽  
Public Access ◽  
The North ◽  
The Usa ◽  
Bystander Cpr ◽  
Use Of Social Media ◽  
Hospital Cardiac Arrest

Introduction: Performance of bystander CPR and early defibrillation following out-of-hospital cardiac arrest (OHCA) have been shown to increase the odds of survival to hospital discharge more than 3-fold. The PulsePoint Respond™ Application (App) is a novel system that can be implemented by EMS to crowdsource basic life support for victims of OHCA. The system sends cardiac arrest notifications to a user’s mobile device which includes the location of the emergency and nearby public access defibrillators to facilitate bystander CPR and AED use while EMS personnel are en route. We conducted a North American survey to evaluate public perceptions of such an application, including acceptability and willingness to respond to alerts. Methods: The web-based survey was conducted in Canada and the USA by an established external polling vendor, Ipsos Reid. Sampling was designed to ensure broad representation of gender, age, geography, and spoken language following recent census statistics. Respondents were presented with a short concept description of cardiac arrest and the Pulsepoint app in text format followed by 6 closed-ended and 4 open-ended questions. Results: A random sample of 2,415 total surveys were collected (1106 from Canada and 1309 from the US). 70% of Canadian respondents but only 47% of US respondents had been trained in CPR at some point. On average, 79.5% of respondents agreed that Pulsepoint is something they would like to see in their community and 59.5% said they would download the App. 80% of Canadians and 77% of Americans were comfortable with receiving help in a public setting (street, office, etc) and 72 and 68% respectively, indicated they would be comfortable with receiving help in a private setting (home). Less than 40% of respondents identified concerns; as expected those identified included training concerns and trust issues. An average of 89% of the sample from both countries felt it was important that responders have up-to-date CPR certification. Conclusions: Overall, the North American public find the concept of the Pulsepoint application and crowdsourcing basic life support for OHCA acceptable and would be willing to respond. This is encouraging insight to support the use of social media to increasing bystander CPR rates in North America.

How well do children in the North East of England function after a crisis: a service evaluation

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Emily Staite ◽  
Lynne Howey ◽  
Clare Anderson ◽  
Paula Maddison
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Services ◽  
Service Evaluation ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Content Type ◽  
North East ◽  
The North ◽  
The Uk

Purpose Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis. Design/methodology/approach This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019. Findings There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service. Practical implications Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team. Originality/value This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.

scholarly journals How well do children in the North East of England function after a mental health crisis during the COVID-19 pandemic: A service evaluation

2021 ◽  
pp. 135910452110372
Author(s):  
Emily Staite ◽  
Lynne Howey ◽  
Clare Anderson
Keyword(s):  
Mental Health ◽  
Young People ◽  
Rating Scale ◽  
Service Evaluation ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
North East ◽  
The North ◽  
Before And After ◽  
The Uk

The COVID-19 pandemic has affected millions of people, and some researchers postulate that a mental health crisis will follow. The immediate effects of the COVID-19 pandemic on children’s mental health are now starting to be published, and results appear to be mixed. There is no research, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from Child and Adolescent Mental Health Services (CAMHS) Crisis Teams in the UK during the COVID-19 pandemic. This service evaluation aims to do this using data from an NHS trust that supports 1.4 million people in the North East of England. We compared functioning, as measured by the Outcome Rating Scale (ORS), before and after treatment for young people discharged from the CAMHS Crisis Team between December 2019 and December 2020. ORS scores were significantly higher at the end of treatment (t(420) = −57.36, p < 0.001) with a large effect size (d = −1.56). Fifty eight percent of patients exhibited significant and reliable change (i.e. functioning improved to a ‘healthy’ level). No patients significantly deteriorated in functioning after accessing the crisis service.

scholarly journals Babies born in the pre-hospital setting attended by ambulance clinicians in the north east of England

2019 ◽  
Vol 4 (3) ◽  
pp. 43-48
Author(s):  
Graham McClelland ◽  
Emma Burrow ◽  
Helen McAdam
Keyword(s):  
Rare Event ◽  
Hospital Setting ◽  
Service Evaluation ◽  
Mortality And Morbidity ◽  
North East ◽  
The North ◽  
The United Kingdom ◽  
Clinical Observations ◽  
Routinely Collected Data ◽  
One Year

Introduction: The majority of births in the United Kingdom happen in hospital or at stand-alone midwife led centres, or with the support of midwives in a planned fashion outside of hospital. The unplanned birth of a baby in the pre-hospital setting is a rare event which may result in an ambulance being called, so attendance at a birth is a rare event for ambulance clinicians. A service evaluation was conducted to report which clinical observations were recorded on babies born in the pre-hospital setting who were attended by ambulance clinicians from the North East Ambulance Service (NEAS) over a one-year period.Methods: A retrospective service evaluation was conducted using routinely collected data. All electronic patient care records covering a one-year period between 1 October 2017 and 30 September 2018 with a primary impression of ‘childbirth’ were examined.Results: This evaluation identified 168 individual pre-hospital childbirth cases attended by NEAS clinicians during the evaluation timeframe. The majority (85%) of babies were born to multiparous mothers with a median gestation of 39 weeks. Very few clinical observations were recorded on the babies (respiratory rate 23%, heart rate 21%, temperature 10%, APGAR 8%, blood sugar 1%) and no babies had all five of these observations documented. Only 5% of babies had any complications documented.Conclusion: This study showed that NEAS ambulance clinicians rarely attend babies born in the pre-hospital setting and that complications were infrequently recorded. There was a lack of observations recorded on the babies, which is an issue due to the clear link between easily measurable characteristics such as temperature and mortality and morbidity.

scholarly journals Incidence of emergency calls and out-of-hospital cardiac arrest deaths during the COVID-19 pandemic: findings from a cross-sectional study in a UK ambulance service

2021 ◽  
pp. emermed-2020-210291
Author(s):  
Karl Charlton ◽  
Matthew Limmer ◽  
Hayley Moore
Keyword(s):  
Cardiac Arrest ◽  
Cross Sectional Study ◽  
Ambulance Service ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Emergency Calls ◽  
North East ◽  
Hospital Cardiac Arrest

BackgroundIn response to the COVID-19 pandemic, a national lockdown was introduced on 23 March 2020. In the following weeks, emergency departments in the UK reported a reduction in attendances. We aimed to explore the incidence of emergency calls across North East England, as well as the number of out-of-hospital cardiac arrest (OHCA) deaths.MethodsData were collected for all patients who contacted North East Ambulance Service between 4 March 2019–2 June 2019 and 2 March 2020–31 May 2020 suffering stroke, ST elevation myocardial infarction, allergy, asthma, chronic obstructive pulmonary disease, falls, intoxication, seizure, sepsis, acute coronary syndrome and OHCA.ResultsThere were a reduction in incidence of calls, excluding OHCA, resulting in ambulance activation during the pandemic compared with same period in 2019, 16 743 versus 19 639, respectively (−14.74%). The decline in calls was partially reversed by the end of May 2020. Incidence of OHCA at the time of the national lockdown had increased by 13.79% with a peak increase of 73.56% in the second week in April 2020. OHCA deaths peaked in the first 2 weeks in April 2020, 95.65% and 90.07%, respectively, but by the end May 2020, incidence of OHCA and OHCA deaths had returned to prelockdown levels.ConclusionIncidence of emergency calls were reduced during the pandemic compared with 2019. There was a rise in incidence of OHCA and OHCA deaths during the same period; however, these changes appear transient. Further research is required to understand patient behaviour towards seeking help during the pandemic and the long-term consequences of not doing so.

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