المؤلفون: Vaughan-Huxley, Eyston, Griggs, Joanne, Mohindru, Jasmit, Russell, Malcolm, Lyon, Richard, ter Avest, Ewoud

المصدر: Vaughan-Huxley , E , Griggs , J , Mohindru , J , Russell , M , Lyon , R & ter Avest , E 2023 , ' A data-driven algorithm to support the clinical decision-making of patient extrication following a road traffic collision ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 31 , 90 . https://doi.org/10.1186/s13049-023-01153-2Test

الوصف: Background: Some patients involved in a road traffic collision (RTC) are physically entrapped and extrication is required to provide critical interventions. This can be performed either in an expedited way, or in a more controlled manner. In this study we aimed to derive a data-driven extrication algorithm intended to be used as a decision-support tool by on scene emergency service providers to decide on the optimal method of patient extrication from the vehicle. Methods: A retrospective observational study was performed of all trauma patients trapped after an RTC who were attended by a Helicopter Emergency Medical Service (HEMS) in the United Kingdom between March 2013 and December 2021. Variables were identified that were associated with the need for HEMS interventions (as a surrogate for the need for expedited extrication), based on which a practical extrication algorithm was devised. Results: During the study period 12,931 patients were attended, of which 920 were physically trapped. Patients who scored an “A” on the AVPU score (n = 531) rarely required HEMS interventions (3%). Those who did were characterised by a shorter than average (29 vs. 37 min) 999/112 emergency call to HEMS on-scene arrival interval. A third of all patients responding to voice required HEMS interventions. Absence of a patent airway (OR 6.98 [1.74–28.03] p <.001) and the absence of palpable radial pulses (OR 9.99 [2.48–40.18] p <.001) were independently associated with the need for (one or more) HEMS interventions in this group. Patients only responding to pain and unresponsive patients almost invariably needed HEMS interventions post extrication (90% and 86% respectively). Based on these findings, a practical and easy to remember algorithm “APEX” was derived. Conclusion: A simple, data-driven algorithm, remembered by the acronym “APEX”, may help emergency service providers on scene to determine the preferred method of extrication for patients who are trapped after a road traffic collision. This has the potential to facilitate ...

وصف الملف: application/pdf

العلاقة: https://research.rug.nl/en/publications/479ee42b-4c36-41a3-983d-c4367736cefbTest

الإتاحة: https://doi.org/10.1186/s13049-023-01153-2Test
https://hdl.handle.net/11370/479ee42b-4c36-41a3-983d-c4367736cefbTest
https://research.rug.nl/en/publications/479ee42b-4c36-41a3-983d-c4367736cefbTest
https://pure.rug.nl/ws/files/856550531/s13049-023-01153-2.pdfTest
http://www.scopus.com/inward/record.url?scp=85178389180&partnerID=8YFLogxKTest

المؤلفون: Cheema, Sanjay, Anderson, Jane, Duncan, Callum, Davagnanam, Indran, Armstrong, Paul, Redfern, Nancy, Ordman, Anthony, D'Antona, Linda, Nissen, Justin, Sayal, Parag, Vaughan-Huxley, Eyston, Lagrata, Susie, Iodice, Valeria, Snape-Burns, Jessica, Joy, Clare, Matharu, Manjit

المصدر: essn: 2632-6140 ; nlmid: 101775450

مصطلحات موضوعية: CSF, headache, neuroradiology, neurosurgery, pain

الوصف: OBJECTIVE: To assess the knowledge, attitudes and practices of healthcare professionals regarding the diagnosis and management of spontaneous intracranial hypotension (SIH). METHODS: We performed a cross-sectional, web-based survey of multiple healthcare professional groups in the UK from June to August 2021. There were 227 respondents to the survey, including 62 general practitioners, 39 emergency medicine physicians, 38 neurologists, 35 radiologists, 20 neurosurgeons, 18 anaesthetists and 15 headache nurse specialists. The majority of the respondents were at the consultant level and all worked in the UK National Health Service. RESULTS: Few general practitioners or emergency medicine physicians had ever been involved in the care of a patient with SIH or received teaching about SIH. Only 3 of 62 (4.8%) general practitioners and 1 of 39 (2.5%) emergency medicine physicians were confident in recognising the symptoms of SIH. Most neurologists were confident in recognising SIH and performed MRI of the brain as a first-line investigation, although there was variability in the urgency of the request, whether contrast was given or MRI of the spine organised at the same time. Most said they never or rarely performed lumbar puncture for diagnosis of SIH. Most neuroradiologists, but few general radiologists, were confident in interpreting imaging of patients with suspected SIH. Lack of access to epidural blood patching, personnel able to perform myelography, and established management pathways were identified by many respondents as barriers to the treatment of SIH. CONCLUSIONS: We have identified a lack of awareness of SIH among non-specialists, several barriers to optimal treatment of SIH and a variation in current management pathways. The results highlight the need for education of healthcare professionals about SIH and the development of clinical practice guidelines to enable delivery of optimal and equitable care for patients with SIH.

وصف الملف: application/pdf

العلاقة: https://www.repository.cam.ac.uk/handle/1810/342162Test

الإتاحة: https://doi.org/10.17863/CAM.89581Test
https://www.repository.cam.ac.uk/handle/1810/342162Test

المؤلفون: O'Callaghan, David JP, Jayia, Parveen, Vaughan-Huxley, Eyston, Gribbon, Michael, Templeton, Maie, Skipworth, James RA, Gordon, Anthony C

المصدر: Critical Care ; volume 16, issue 5, page R173 ; ISSN 1364-8535

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الإتاحة: https://doi.org/10.1186/cc11650Test

المؤلفون: Vaughan-Huxley, Eyston

المصدر: BJA: British Journal of Anaesthesia ; volume 113, issue eLetters ; ISSN 0007-0912 1471-6771

مصطلحات موضوعية: Anesthesiology and Pain Medicine

الإتاحة: https://doi.org/10.1093/bja/el_12154Test

المؤلفون: Jaffer, Usman, Vaughan-Huxley, Eyston, Standfield, Nigel, John, Nigel W.

المصدر: Journal of Surgical Education ; volume 70, issue 1, page 121-128 ; ISSN 1931-7204

مصطلحات موضوعية: Education, Surgery

الإتاحة: https://doi.org/10.1016/j.jsurg.2012.06.024Test
https://api.elsevier.com/content/article/PII:S1931720412001778?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1931720412001778?httpAccept=text/plainTest

المؤلفون: Sadri, Amir, Vaughan-Huxley, Eyston, Nott, David

المصدر: Surgical Techniques Development; 2011, Vol. 1 Issue 2, p70-70, 1p