The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration

Fevang, Espen; Lockey, David; Thompson, Julian; Lossius, Hans Morten

doi:10.1186/1757-7241-19-57

Cited by 126 publications

(126 citation statements)

References 73 publications

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

“…The need to substantiate clinical care by evidence and to use clinically relevant performance measures was echoed by studies from Europe and the USA, including both adult and child populations. [7][8][9] There have been substantial international debates regarding the scope of prehospital care, and it is clear that the issue has not been resolved. The SA emergency medical services system has adopted the Anglo-American system, which minimises on-scene time (as opposed to the FrancoGerman model, which includes prehospital physicians with an extensive scope of practice and very advanced technology).…”

Section: Prehospital Emergency Carementioning

confidence: 99%

Emergency care research priorities in South Africap

2015

View full text Add to dashboard Cite

Background. Emergency care research is rarely undertaken in low-and middle-income countries. A manageable 'road map' for research in South African (SA) emergency care is needed to address research gaps. Objective. To identify, collate and prioritise research topics from identified knowledge gaps in emergency care in SA. Methods. Seventy-six individuals were invited to participate in a modified Delphi study. Participants were requested to suggest important research topics before rating them. Consensus was achieved when >75% of participants strongly agreed or disagreed. Participants then ranked the agreed statements before selecting the most appropriate methodology relating to study design, funding and collaboration. Results. Three hundred and fifty topics were suggested by 31 participants. Topics were collated into 123 statements before participants rated them. Consensus was achieved for 39 statements. The highest-ranked priority in the prehospital group was to determine which prehospital interventions improve outcomes in critically ill patients. The competence of emergency care providers in performing common lifesaving skills was deemed the most important in clinical emergency care. Implementing and reviewing quality improvement systems scored the highest under general systems and safety management. Only 22 statements achieved consensus regarding study design. The National Department of Health was the preferred funding source, while private organisations and emergency care societies were identified as possible collaborative partners. Conclusion. This study provides expert consensus on priority research areas in emergency care in SA as a guide for emergency care providers to ensure evidence-based care that is relevant to the SA population.

show abstract

Section: Prehospital Emergency Carementioning

confidence: 99%

Emergency care research priorities in South Africap

2015

View full text Add to dashboard Cite

show abstract

“…The issue of optimising helicopterbased CCT dispatch is well recognised, and a priority for further pre-hospital research. 28 The next stage at which pre-hospital critical care might improve outcomes from OHCA follows the initial resuscitation phase. If the standard ALS algorithm has not resulted in a return of spontaneous circulation (ROSC) by the time the CCT reaches the scene, the CCT can provide additional therapies in special circumstances such as drug overdose, electrolyte disturbances or traumatic cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

2015

View full text Add to dashboard Cite

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest. Resuscitation, 96. pp. 290-295. ISSN 0300-9572 Available from: http://eprints.uwe.ac.uk/29457We recommend you cite the published version. The publisher's URL is: http://dx.doi.org/10.1016/j.resuscitation.2015.08.020Refereed: Yes (no note) Disclaimer UWE has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material. UWE makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited. UWE makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights. UWE accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 1 THE IMPACT OF A PRE-HOSPITAL CRITICAL CARE TEAM ON SURVIVAL FROM OUT-OF- WORD COUNT, REFERENCES, FIGURES AND TABLES Abstract: 233Manuscript: 3045 ABSTRACT AimTo assess the impact of a pre-hospital critical care team (CCT) on survival from out-ofhospital cardiac arrest (OHCA). MethodsWe undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups. The primary outcome was survival to hospital discharge. All data were collected independently of the research. Results1851 cases of OHCA were included in the analysis, of which 1686 received ALS paramedic treatment and 165 were attended by both ALS paramedics and a CCT. Unadjusted rates of survival to hospital discharge were significantly higher in the CCT group, compared to the ALS paramedic group (15.8% and 6.5%, respectively, p < 0.001). After adjustment using multiple logistic regression, the effect of CCT treatment was no longer statistically significant (OR 1.54, 95% CI 0.89 to 2.67, p = 0.13). Subgroup analysis of OHCA with first monitored rhythm of ventricular fibrillation or pulseless ventricular tachycardia showed similar results. ConclusionPre-hospital critical care for OHCA was not associated with significantly improved rates of survival to hospital discharge. These results are in keeping with previously published studies.Further research with a larger sample size is required to determine whether CCTs can improve outcome in OHCA.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 3

show abstract

“…Sonographic cardiac activity was associated with survival, and cardiac standstill was associated with positive predictive value of 97.1% for death at the scene [37]. The feasibility of cardiac ultrasound in the field has been studied in physician and nonphysician providers, and a recent pre-hospital care consensus conference determined that the role of pre-hospital ultrasound should be among the top 5 research priorities in this growing field [38].…”

Section: Out-of-hospital Environmentsmentioning

confidence: 98%

Point-of-Care Cardiac Ultrasound: Feasibility of Performance by Noncardiologists

Nelson

Sanghvi

2013

View full text Add to dashboard Cite

Cardiac ultrasound has been used for decades to assess a wide variety of structural and functional pathology, as well as to monitor response to therapy. It offers the advantages of noninvasive, real-time dynamic functional assessment without the risk of radiation. Cardiologists have traditionally employed this modality and have established robust guidelines on the use of echocardiography. However, other specialties such as emergency medicine and critical care have realized the benefit of cardiac ultrasound and have established specialty guidelines in its use. There is growing evidence for the benefit of cardiac ultrasound at the point of care on hospital wards, clinics, and even pre-hospital environments as well. The pervasive use of focused ultrasound is perhaps most evident in the advent of ultrasound training in undergraduate medical curricula. This paper reviews some of the key literature on the use of focused, point-of-care ultrasound by noncardiologists. Feasibility, clinical utility, and emerging trends are reviewed.

show abstract

The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration

Cited by 126 publications

References 73 publications

Emergency care research priorities in South Africap

Emergency care research priorities in South Africap

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

Point-of-Care Cardiac Ultrasound: Feasibility of Performance by Noncardiologists

Contact Info

Product

Resources

About