Emergency medical dispatch recognition, clinical intervention and outcome of patients in traumatic cardiac arrest from major trauma : an observational study

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: The aim of this study is to describe the demographics of reported traumatic cardiac arrest (TCA) victims, prehospital resuscitation and survival to hospital rate. SETTING: Helicopter Emergency Medical Service (HEMS) in south-east England, covering a resident population of 4.5 million and a transient population of up to 8 million people. PARTICIPANTS: Patients reported on the initial 999 call to be in suspected traumatic cardiac arrest between 1 July 2016 and 31 December 2016 within the trust's geographical region were identified. The inclusion criteria were all cases of reported TCA on receipt of the initial emergency call. Patients were subsequently excluded if a medical cause of cardiac arrest was suspected. OUTCOME MEASURES: Patient records were analysed for actual presence of cardiac arrest, prehospital resuscitation procedures undertaken and for survival to hospital rates. RESULTS: 112 patients were reported to be in TCA on receipt of the 999/112 call. 51 (46%) were found not to be in TCA on arrival of emergency medical services. Of the 'not in TCA cohort', 34 (67%) received at least one advanced prehospital medical intervention (defined as emergency anaesthesia, thoracostomy, blood product transfusion or resuscitative thoracotomy). Of the 61 patients in actual TCA, 10 (16%) achieved return-of-spontaneous circulation. In 45 (88%) patients, the HEMS team escorted the patient to hospital. CONCLUSION: A significant proportion of patients reported to be in TCA on receipt of the emergency call are not in actual cardiac arrest but are critically unwell requiring advanced prehospital medical intervention. Early activation of an enhanced care team to a reported TCA call allows appropriate advanced resuscitation. Further research is warranted to determine which interventions contribute to improved TCA survival.Peer reviewedFinal Published versio

Increasing Extrinsic Motivation Improves Time-Based Prospective Memory in Adults with Autism: Relations with Executive Functioning and Mentalizing

Time-based prospective memory (PM) is diminished under various task demands in individuals with autism spectrum disorder (ASD). However, it is still unclear what underpins their impairment or how it could be remediated. This study explored whether instructions to prioritise one element of a PM task over another improved performance in adults with ASD (compared to a group of matched neurotypical adults), and how that is related to cognitive abilities. Results indicated that importance instructions significantly improved the PM performance of participants with ASD. Moreover, the extent of the benefit was associated significantly with objectively-measured executive set-shifting ability and self-reported inhibitory control ability (the poorer the set-shifting/inhibitory control, the greater the benefit). Implications for future research and clinical practice are discussed

Integrating Indigenous perspectives in the drama class: Pre-service teachers\u27 perceptions and attitudes

Currently, educational bodies are recognising the importance of integrating Australian Indigenous cultures in education to promote intercultural understanding and improve outcomes for Indigenous students. In drama, learning about Indigenous perspectives can be integrated through sharing cultural stories, with this integration mandated by the Australian curriculum. However, teachers are struggling to achieve this directive due to a lack of knowledge in Indigenous content and concerns surrounding permission and cultural appropriation. This qualitative study used a focus group interview to determine non-Indigenous pre-service drama teachers\u27 perceptions about integrating Indigenous perspectives in their praxis. Inductive analysis of the data revealed participants strongly believed in the importance of embedding Indigenous perspectives yet felt apprehensive due to a range of challenges, including a lack of adequate training. These challenges and the participants\u27 recommendations provide compelling evidence for initial teacher education to specifically embed learning experiences in Indigenous theatre and to provide opportunities for pre-service drama teachers to collaborate with Indigenous communities. The significance of this research points to the importance for pre-service drama teachers to be given tools to ensure that their praxis breaks the generational cycle of insufficient teaching of Indigenous perspectives in Australian schools, a cycle that has disadvantaged Indigenous children since colonisation

A novel method of non-clinical dispatch is associated with a higher rate of critical Helicopter Emergency Medical Service intervention

Background - Helicopter Emergency Medical Services (HEMS) are a scarce resource that can provide advanced emergency medical care to unwell or injured patients. Accurate tasking of HEMS is required to incidents where advanced pre-hospital clinical care is needed. We sought to evaluate any association between non-clinically trained dispatchers, following a bespoke algorithm, compared with HEMS paramedic dispatchers with respect to incidents requiring a critical HEMS intervention. Methods - Retrospective analysis of prospectively collected data from two 12-month periods was performed (Period one: 1st April 2014 – 1st April 2015; Period two: 1st April 2016 – 1st April 2017). Period 1 was a Paramedic-led dispatch process. Period 2 was a non-clinical HEMS dispatcher assisted by a bespoke algorithm. Kent, Surrey & Sussex HEMS (KSS HEMS) is tasked to approximately 2500 cases annually and operates 24/7 across south-east England. The primary outcome measure was incidence of a HEMS intervention.Results - A total of 4703 incidents were included; 2510 in period one and 2184 in period two. Variation in tasking was reduced by introducing non-clinical dispatchers. There was no difference in median time from 999 call to HEMS activation between period one and two (period one; median 7 min (IQR 4–17) vs period two; median 7 min (IQR 4–18). Non-clinical dispatch improved accuracy of HEMS tasking to a mission where a critical care intervention was required (OR 1.25, 95% CI 1.04–1.51, p = 0.02).Conclusion - The introduction of non-clinical, HEMS-specific dispatch, aided by a bespoke algorithm improved accuracy of HEMS tasking. Further research is warranted to explore where this model could be effective in other HEMS services.Peer reviewedFinal Published versio

Rubagabaga Village : Empowering Villages Center and Agricultural Training Center

By partnering with non-profit organizations such as Journeyman International and Empowering Villages, undergraduate students can engage in senior projects that have far reaching humanitarian impacts. Journeyman International is well known for creating powerful teams of students who tackle design challenges in developing countries. This paper details the work of two architectural engineering students from California Polytechnic State University, San Luis Obispo on a design for the Empowering Villages Center (EVC) and Agricultural Training Facility (ATF) in Rubagabaga Village, Rwanda. The EVC and ATF project was proposed by Empowering Villages, an organization that aims to bring electricity and socioeconomic growth to rural communities in East Africa. The students collaborated on an interdisciplinary team for nine months to produce structural calculations and drawings for the project. In addition to the structural calculations and drawings, this report includes a project overview, challenges, the final impact, team dynamics, and personal reflections

A Rising Tide: Oyster Aquaculture Survey Instrument

This document provides the survey instrument for the oyster aquaculture survey that was conducted throughout August and October of 2021. The purpose of the survey was to gain a food system-wide perspective on gender dynamics in the region’s aquaculture industry, inclusive of different genders and identify potential gender-based barriers and opportunities to participation for men, women, and non-binary/third gender oyster aquaculturists

A Rising Tide: Oyster Aquaculture Survey Results

This document provides the results from a survey conducted August-October 2021 on the Maine and New Hampshire oyster aquaculture industry. The purpose of the survey was to gain a food system-wide perspective on gender dynamics in the region’s aquaculture industry, inclusive of different genders and identify potential gender-based barriers and opportunities to participation for men, women, and non-binary/third gender oyster aquaculturists. The published survey results include qualitative responses and demographic data for a subset of farmers in the oyster aquaculture industry of Maine and New Hampshire

A Rising Tide Photovoice Photobook

This document provides the results of the photographic documentation and written narrative portion of the photovoice case study conducted from November, 2021 to March, 2022 by (n=4) research participants. The goal of the Photobook is to share the data collected by the research participants on their experiences as women owning and operating an oyster farm in Maine and New Hampshire

What do self-efficacy items measure? : Examining the discriminant content validity of self-efficacy items

© 2018 The British Psychological Society.Peer reviewedPostprin