Steven Short and Gareth Clegg met with a group of staff from the Scottish Ambulance Service, Chest Heart and Stroke Scotland and Red Cross met at the Beardmore Conference Centre today for an initial scoping meeting at the ‘soft launch’ of the 3RU Glasgow project.
Proceedings were opened by the Chairman of the SAS board, David Garbutt followed by an introduction from Medical Director Jim Ward. Gareth Clegg laid out the journey that RRG has travelled in reaching current levels of performance in the South East of the country, and outlined the shape of the challenge ahead. Daniel Rankin – SAS General Manager for West Central – then gave some local perspective. Small groups discussed approaches to moving the project forward.
This meeting marks the beginning of a long anticipated conversation between stakeholders aimed at producing a local solution to the problem of OHCA in Glasgow.
The Glasgow 3RU may have a different skin and bones to the Edinburgh model (it will certainly have a different accent) – but there will be a strong family resemblance – the DNA will be the same.
Dr Kirsty Mitchell has been auditing the defibrillator downloads from OHCA in Edinburgh to look at compliance with ALS guidelines for time between defibrillation attempts. Out of the 70 cases she analysed, the mean time between shocks was over 3 min with only 26% of intervals between shocks compliant with ALS guidelines, the rest were shorter or longer than recommended. Getting everything done right at the right time during prehospital resuscitation requires high level team performance, skilled leadership and keen situational awareness. If this finding is a symptom that these elements need optimisation, what is the solution..?
Kirsty’s abstract was one of the top scoring submissions to the College of Emergency Medicine Annual Scientific Conference 2104 and she presented her findings in Exeter today.
Dr Elise Hindle, ICU registrar at the Royal Infirmary of Edinburgh has completed an 18 month in depth audit of outcomes after admission to the Unit following OHCA. The work has examined many different aspects of patient management (e.g. treatment of seizures and infection), methods and timing of neuro-prognostication employed and timing and mode of death.
The findings are fascinating and are currently being prepared for submission. In the meantime, som e of the material is being presented in poster form at the College of Emergency Medicine Conference in Exeter University 9th-11th September 2014.
View a pdf of the poster here: https://www.dropbox.com/s/bgors1ucahtpoku/Elise%20CEM%20poster.pdf?dl=0
During his recent clinical attachment with the Emergency Medicine Research Group in Edinburgh (EMeRGE), Adam developed an interest in how team performance can affect the outcome of resuscitative care. The skill-set needed for successful performance has been thoroughly studied in specialities such as surgery and critical care (anaesthetists), however there is a real lack of research into the nursing skills and attributes that are needed for optimal patient outcomes. In particular the role of the senior nurse in resuscitation team leadership, and how this changes dynamically.
A testimony to his enthusiasm and ability, Adam has been awarded the Gardner Scholarship at the University of Edinburgh. This award will afford him the opportunity to undertake a full‐time PhD over 3 years to look into this area in detail while based in the Resuscitation Research Group and the Emergency Department at RIE.
Welcome to the team Adam!
Photo: Ola Gruszczynska
Pre-hospital Resuscitation – Video Enhanced Nontechnical skills Training
There is an increasing emphasis on the importance of nontechnical skills (NTS) for high acuity resuscitation teams, although little direct evidence exists to demonstrate the relationship between NTS and the quality of technical performance. NTS include situational awareness, decision making, teamworking and leadership.
Dr Alistair Dewar is currently in a two-year out-of-programme post as a clinical teaching fellow in Emergency Medicine. He has embarked on an MD program of work examining NTS in the prehospital resuscitation team, in order to develop novel interventions to augment NTS and improve clinical outcomes.
Alistair summarised his project this way: “We aim to demonstrate a link between improved NTS, technical performance and patient outcomes in OHCA and investigate the most effective tools for optimising team NTS.”
This project is carried out in conjunction with the NHS Lothian Directorate of Medical Education, and will be co-supervised by Dr Gareth Clegg (RRG) and Dr Simon Edgar (Director of Medical Education, NHS Lothian).
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The unique health data architecture in Scotland allows data from a range of discrete sources to be linked, enabling a powerful perspective on OHCA.
Minister for Public Health, Aileen Campbell, launched the first year OHCA review on a visit to Beeslack High School in Penicuik.
Dr Nynke Halbesma is an expert in epidemiology, who is joining RRG to analyse linked data pertaining to OHCA in Scotland.
Exploring the knowledge, attitudes, and behaviour of the general public to responding to out-of-hospital cardiac arrest
RRG have tea with the Permanent Secretary at Scottish Government in recognition of their OHCA Policy Award success
Paul Gowens, Karen MacNee and David Cline collected the Scottish Government’s Policy Development Award on 7th December for Scotland’s Strategy for OHCA.
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A squad of 12 paramedics from the Scottish Ambulance Service make up 3RU.
What can we do to make the diagnosis of OHCA as fast and accurate as possible, and how do we get to CPR quickly?
Postgrad linguistics Ernisa Marzuki is studying communication as a make or break factor in resuscitation by high performance teams
A project to investigate the association between non-technical skills performance and technical performance during OHCA resuscitation