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Showing results for tags 'Emergency medicine'.
Found 375 results
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Content Article
Human factors for emergency response and critical care
Patient Safety Learning posted an article in Techniques
In this blog post, Liv System’s Nigel Scard talks with Courtney Grant, a Senior Human Factors engineer with Transport for London (TfL). Nigel and Courtney worked together for a number of years at TfL on a number of station and line upgrade projects. A few years ago, Courtney applied his Human Factors and research skills with great tenacity, to a serious healthcare related incident which impacted him personally. This resulted in an important, lifesaving change to ambulance service procedures. In this interview, Courtney describes this in detail and also describes his recent work in supporting the Chartered Institute of Ergonomics and Human Factors (CIEHF) in supporting the response to the COVID-19 pandemic. -
Content ArticleImproving and widening access to care for children and adults needing mental health support is a key priority for the NHS, as outlined in the Long Term Plan. Tthe West of England AHSN are working with NHS commissioners and providers, industry partners, other AHSNs, local trusts, Child and Adolescent Mental Health Services (CAMHS) and community providers on a wide range of initiatives to support their work to improve mental healthcare and wellbeing.
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Content ArticleSpotting and acting on the signs of deterioration in a patient or care home resident is vital to ensuring patient safety. The objective of the national Managing Deterioration Safety Improvement Programme (known as ManDetSIP) is to create and embed the conditions for staff across the healthcare system to improve the safety and outcomes of patients by managing deterioration, and provide a high quality healthcare experience across England.
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Content ArticleNational audits, such as the National Emergency Laparotomy Audit (NELA), are a powerful tool. They allow us to see what is happening to our ‘real-life’ patients, to identify gaps in our local services, to see which hospitals are doing best and to share best practice. This learning informs guidelines and pathways such as ‘The High-Risk Surgical Patient’ and the forthcoming international enhanced recovery programmes for emergency laparotomy. The linking of good practice with a financial incentive, the Best Practice Tariff, has also acted as a carrot for hospitals to support funding for new models of care. Previously we have seen how audit, linked with guidelines and associated financial incentives, has improved outcomes in hip fracture and now it is encouraging to observe similar results in emergency laparotomy. In this blog, Dr Jugdeep Dhesi, Consultant Geriatrician and Deputy Director for the Centre of Perioperative Care, discusses NELA and older patients, and how we must deliver patient-centred rather than surgical-speciality based pathways and to ensure the best outcomes for all of our patients.
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Content ArticleOver the past 12 years, the number of emergency hospital admissions in England has increased by 42%, from 4.25 million in 2006/07 to 6.02 million in 2017/18. Over 60% of patients admitted to hospital as an emergency have one or more long-term health conditions such as asthma, diabetes or mental illness. Patients with long-term conditions spend under 1% of their time in contact with health professionals. The majority of their care, such as monitoring their symptoms and administering medication and treatment, comprises tasks they or their carers manage on a daily basis. To find out how able patients currently feel to manage their health conditions, the Health Foundation looked at Patient Activation Measure (PAM) scores, which assess four levels of knowledge, skill and confidence in self-management, for over 9,000 adults with long-term conditions. In this briefing, the Health Foundation assesses the evidence for the effectiveness of a range of approaches the NHS could use more often to support patients to manage their health conditions. These include: health coaching, self-management support through apps, social prescribing initiatives and peer support including via online communities.
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Content Article
COVID-19: managing an obstetric emergency (November 2020)
PatientSafetyLearning Team posted an article in Maternity
The COVID-19 pandemic provides new challenges for the safety of people receiving and providing maternity care. This project, conducted in collaboration with the PROMPT Maternity Foundation and THIS.institute, involved a rapid-response consultation exercise to understand what good looks like for managing obstetric emergencies in women with suspected or confirmed COVID-19. -
Content ArticleThe objective of this US-based study, published in The Joint Commission Journal of Quality and Safety, was to present safety briefings as a method for discovering and addressing safety events in a paediatric emergency room, describe how professionals perceive them, and characterize the classification and evolution of the incidents identified.
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Content ArticleThis study from Harris et al. estimated the effect of prompt admission to critical care on mortality for deteriorating ward patients. They found that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.
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Content ArticlePeople with severe food allergies should carry two adrenaline autoinjector pens with them at all times, according to new guidance. Updated advice from The National Institute for Health and Care Excellence (NICE) says healthcare professionals should always offer people with severe allergies a prescription for two adrenaline auto-injectors (AAIs), which deliver potentially life-saving doses of the hormone to treat anaphylaxis, before being discharged from hospital after emergency treatment. They should also advise patients to always carry two devices with them, the guidance states.
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Content ArticleThis cross-sectional survey in the British Journal of General Practice looks at the availability and use of emergency admission risk stratification (EARS) tools across the UK and aims to identify factors that influence their implementation. The authors identified 39 different EARS tools in use. They found that the most important factors in encouraging general practices to use EARS tools were: promotion by NHS commissioners involvement of clinical leaders engagement of practice managers. High workloads and information governance were significant barriers to their use. The authors highlight the need to align policy and practice with research evidence.
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Content ArticleHuman factors affect paramedic practice and training. However, although there are frequent references to human factors in the literature, little evidence on this is available on those that influence student paramedic development. In this article, published by the Journal of Paramedic Practice, looks at a case study which highlighted certain human factors unique to the role, most notably how interactions between students and mentors can affect a student's practice. Following this, the awareness and effect of human factors within the student paramedic role were investigated.
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Content ArticleThis QualityWatch report, ‘Focus on: Emergency hospital care for children and young people’, shows changes in patterns of use over time and provides the basis for discussion about the quality of care for children and young people. The report analyses Hospital Episode Statistics from 2006/07 to 2015/16, giving a picture of how children and young people used emergency care at NHS hospitals over the past 10 years, what conditions they needed care for, and what may be happening to care quality in some areas. It finds that some age groups saw significant rises in emergency admissions, and many children were hospitalised for conditions that could be treated in other settings. The report, therefore, also raises questions about where children and young people can access high quality treatment outside the hospital emergency care setting.
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Content ArticleHealthcare organisations are designed to achieve consistent and reproducible outcomes when faced with planned, predictable or ‘routine’ emergencies. Unfortunately, the more robust the system, the less agile it is when faced with a novel clinical crisis. This is not surprising, as it is impossible to create emergency operating procedures for every new or unforeseen catastrophe. Similarly, many surgeons in positions of leadership have limited exposure to executive decision-making or clinical expertise outside their area of specialist training. It is not unreasonable therefore for surgical leaders and their organisations to feel overwhelmed by complex and evolving crises, such as the recent COVID-19 pandemic. At such times, it is important to reflect on key strategies that can provide pragmatic, timely and cohesive means of restructuring the delivery of surgical care at an organisational level.
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Content ArticleWe all have to deal with pressure. Sometimes it's minor like "do I go left or right at the roundabout?". Sometimes it's the difference between life and death. But how can we manage and work with that pressure, rather than against it? Dr Stephen Hearns is a critical care doctor and search and rescue specialist in Scotland, who has spent his career understanding what pressure is and how he can try to handle it in stressful times. His new book 'Peak performance under pressure' goes into detail about the tools and techniques we can all use to manage stress when the going gets tough. In this podcast, produced by eeast (East of England Ambulance Service) General Broadcast, Stephen talks about why pressure is sometimes good for us, how to recognise stress in other and what to do when you're maxed out.
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Content ArticleThis web page, from the Society for Endocrinology, contains useful information and guidance for patients and clinicians on the management of adrenal crisis. The information includes links to where organisations can order NHS Steroid Emergency cards. There is also a downloadable version for patients to download and print off immediately. Some patients are also uploading the pdf version as the lock screen on their mobile phones, to show health care professionals in a medical emergency. Follow the link below to find out more.
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Content ArticleCoroners have a statutory duty to issue a Prevention of Further Deaths report to any person or organisation where, in the opinion of the coroner, action should be taken to prevent future deaths. This is a coroner's report into the death of 35 year-old Mr Mitica Marin. It was found that the defibrillator was set to manual mode, which meant that staff were not automatically alerted to the fact that Mitica's heart had a shockable rhythm. This caused a delay to Mr Marin receiving CPR treatment.
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Content ArticleCoroners have a statutory duty to issue a Prevention of Further Deaths report to any person or organisation where, in the opinion of the coroner, action should be taken to prevent future deaths. This coroners report relates to the death of 15 year-old Najeeb Katende and the delay in defibrillation due to the equipment being set to manual mode and not detecting his shockable rhythm. The coroner found that the delay in defibrillating Najeeb significantly reduced his chances of survival.
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Content ArticleImplementation of high reliability principles in healthcare delivery is recognized as an effective strategy for reducing harm to patients and healthcare workers. With the coronavirus disease 2019 (COVID-19) pandemic upon us, our emergency departments (EDs) are facing an unprecedented safety threat. How does a high reliability ED function during a pandemic, and what are the most important strategies for keeping ourselves and our patients safe? Thull-Freedman et al. discuss this in a commentary in the Canadian Journal of Emergency Medicine.
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Content Article
This is the US Military Health System
Claire Cox posted an article in Stories from the front line
Army, Navy and Air Force medical personnel care for Soldiers, Sailors, Airmen, Marines, Coast Guardsmen and all who come in harm's way – on and off the battlefield. This video, in less than 4.5 minutes, provides a glimpse of the unique mission and benefits of military medicine. -
Content ArticleThere has never been a wider mix of illnesses and issues seen by the UK ambulance services. There's also never been more different care pathways. It can sometimes be hard to know what the best thing to do is. Choice fatigue, along with patients sometime presenting in the same way as others can lead crews to make some challenging decisions. In this podcast from General Broadcast, some of the patient safety team sit down to talk about what's important when leaving a patient at home and what safety netting needs to be in place. General Broadcast covers the whole of the Ambulance service, from clinical to non-technical skills, from best practice to learning from incidents and more.
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Content ArticleDan Phillips, Clinical Lead from the East of England Ambulance Service, talks to General Broadcast about their aims to reduce time on scene for seriously unwell patients. He looks specifically at a project called 10-10 and how to improve outcomes for stroke patients.
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News ArticleA three-year-old child died after its desperate mother spent more than an hour on hold to the NHS 111 helpline. The ill child suffered a cardiac arrest at its home and died in hospital, according to details of critical incidents affecting children in London amid the coronavirus crisis. Another case saw a six-month-old die from sepsis and liver failure because the parents feared the child could catch Covid-19 in hospital, the Evening Standard reports. Doctors have raised concerns that parents are not seeking treatment for their children amid the outbreak. Read full story Source: 16 April 2020, Mail Online
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Content ArticlePaediatric cardiac arrest is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one, making ventilations crucial to the child’s chances of survival. However, for those not trained in paediatric resuscitation, the most important thing is to act quickly to ensure the child gets the treatment they need in the critical situation. This page contains:an EPALS algorithm for paediatric COVID-19 patients.a flowchart on the resuscitation of paediatric COVID-19 patients in hospital.
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Content Article
COVID-19: guidance for Ambulance Trusts
Claire Cox posted an article in Guidance
This guidance set out by Public Health England is for possible cases of COVID-19 where an emergency ambulance response is required. Content includes: identification of possible cases on-scene clinician precautions personal protective equipment (PPE) patient assessment conveyance and patient handover post conveyance decontamination. -
Content Article
NHS Pathways
Patient Safety Learning posted an article in Care pathways
NHS Pathways is a clinical tool used for assessing, triaging and directing the public to urgent and emergency care services.
