The Effect of ambient outside temperatures on scoop stretchers

Background: Scoop stretchers are commonly used in the prehospital care of trauma patients. Patients' clothing is often removed early in the care pathway. There may be unidentified risks if scoop stretchers are particularly cold. Aims: The primary aim of this research was to establish if there is a positive correlation between scoop temperatures and outside temperatures when this equipment is stored without access to vehicle heating. Methods: The authors recruited volunteers at ambulance locations across Scotland to measure scoop temperatures using infrared thermometers. These were compared to outside temperatures at that time. Data were subject to bivariate quantitative analysis to assess correlation strength. Findings: Results demonstrated that there was a moderate-to-strong correlation between scoop temperatures and outside temperatures (mean +3.0°C; P<0.001). There was no significant difference for other variables measured. Conclusion: Without active heating, scoop stretchers will be only marginally warmer than the outside temperature, sometimes colder than the outside temperature and sometimes below freezing point. Abstract published with permissio

Learning curves

Katy Sofield describes intense learning curves as she prepares to become operational Abstract published with permissio

Ambulance head injury guidelines: a-head of the game or in need of review?

Older adults with head injury are a challenging group of patients to the ambulance clinician. Older age, clinical frailty, comorbidities, anticoagulant and antiplatelet medications can contribute to these patients suffering a traumatic intracranial haemorrhage (tICH). Abstract published with permissio

Febrile seizure management and effectiveness of prevention with antipyretics

Background: Before reaching the age of 5, 2–5% of children will have had a febrile seizure. Most are categorised as simple but they can be complex and carry the risk of complications. They can be frightening for parents. UK guidelines advise against the use of antipyretic drugs to prevent febrile seizure recurrence while being mindful of parental sensitivities. Aim: This systematised literature review aimed to appraise the global body of evidence in relation to current guidelines on using conventional antipyretics for the prevention of febrile seizures and explore factors that influence their management. Method: A research question was developed using the PICO (population/participant(s); intervention(s); comparison/control; outcome) framework and two databases were searched for primary research, and abstracts were screened for relevance. Results: Thirty-four articles were identified, or which three were relevant to the research aim. These were critically appraised using the Mixed Methods Appraisal Tool and five themes were identified. Conclusion: One study found that paracetamol may prevent recurrent febrile seizures, one found a small reduction in febrile seizure recurrence when treated with an antipyretic and one found antipyretics ineffective at reducing febrile seizure recurrence. Similar contemporary studies conducted in the UK population may help to improve understanding of the factors influencing febrile seizure management and the effectiveness of antipyretics. Abstract published with permissio

Exploring the experiences of community first responders working in a UK ambulance service

Background: Community first responders (CFRs) work voluntarily to support UK ambulance services by responding to emergencies. They are dispatched via the local 999 call centre and details of incidents in their local area are sent to their mobile phone. They have emergency equipment with them, including a defibrillator and oxygen, and attend a range of incidents, including cardiac arrests. Previous research has looked at the impact the CFR role has had on patient survival, but there is no previous research looking at the experiences of the CFRs while working in a UK ambulance service. Method: This study involved 10 semi-structured interviews, which took place in November and December 2018. One researcher interviewed all the CFRs using a pre-defined interview schedule. The findings of the study were analysed using thematic analysis. Results: The main themes from the study are ‘relationships’ and ‘systems’. The sub-themes of relationships are the relationship between CFRs; the relationship between CFRs and ambulance service staff; and the relationship between CFRs and patients. The sub-themes of systems are call allocation; technology; and reflection and support. Conclusions: CFRs support one another and are encouraging with new starting members. Their relationships with ambulance service staff have improved since CFRs first became active, but there is still room for improvement. The calls that CFRs attend are not always within their scope of practice, but the rate of this occurring is unclear. CFRs are frustrated with the level of technology involved in their role and feel it impacts them attending incidents quickly. CFRs reported attending cardiac arrests on a regular basis and the support that they receive afterwards. Further research should use a survey approach to further explore the experiences of the CFRs based on the themes raised in this study. Using this methodology would identify if these themes are unique to the one ambulance service where this was conducted, or if they are relevant to all UK CFRs. Abstract published with permission

Releasing the pressure

In his first NQP Perspective column, Derek Ford reflects on his journey as a mature student. Abstract published with permission