Thursday 29 November 2012

Major research gaps exist for how emergencies are managed in the UK

A scoping review of the emergency planning literature has found major gaps in the knowledge base. The project was managed by Andrew Lee from ScHARR Public Health and involved Steve Goodacre and Kirsty Challen from EMRiS, along with collaborators from Manchester and the Health Protection Agency. The report is available at:

Each year there are thought to be about 11 major incidents which often require a coordinated multi-agency responses including from the NHS. Interest in this topic has grown considerably in the aftermath of the 7/7 London bombings and the UK today is seen as a world leader in emergency planning, response and recovery.

The study involved examining more than 1,600 publications and interviewing 17 experts in the field of emergencies and disasters. It found that there was a limited knowledge-base from the UK and a considerable proportion of the literature was from North America. Much of the literature was not robust and there were concerns that findings from North American studies could not be easily extrapolated to the UK setting.

Many of the gaps in the literature were operational in nature rather than technical. For example, there was a lack of knowledge as to how individuals and organisations deal with risk and behave in emergencies, as well as how emergency managers make decisions in emergency situations.

The report concluded that there is a need to build a UK knowledge base, as well as find ways to use the evidence base and to learn from emergencies and disasters. Information from this study will enable research to be directed and developed to ensure that the emergency planning field continues to improve. In turn this will help emergency responders deal with emergencies better, and help strengthen and prepare local communities against disasters.

Findings are also published in the following articles:
Challen K, Lee ACK, Booth A, Gardois P, Woods HB, Goodacre SW. Where is the evidence for emergency planning: a scoping review. BMC Public Health 2012, 12:542. Available from: http://www.biomedcentral.com/1471-2458/12/542
Lee ACK, Phillips W, Challen K, Goodacre SW. Emergency Management in Health: Key Issues and Challenges in the UK. BMC Public Health 2012, 12:884. Available from: http://www.biomedcentral.com/1471-2458/12/884/abstract
 Mackway-Jones K, Carley S. An international expert delphi study to determine research needs in major incident management. Prehospital Disaster Medicine 2012 Aug; 27(4): 351-8. http://journals.cambridge.org/download.php?file=%2FPDM%2FPDM27_04%2FS1049023X12000982a.pdf&code=8e98c1e865ed473600828a47df480146

This project was funded by the National Institute for Health Research Health Services & Delivery Research Programme (NIHR HS&DR) (project number 09/1005/03). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.

Friday 9 November 2012

CEM Scientific conference-posters and presentations

Copies of the EMRiS posters and presentations from the CEM annual scientific conference are now available via the EMRiS web site.

If you wish to contact any of the authors their contact details can be found here


EMRiS posters and presentations

EMRisS contact details

Thursday 25 October 2012

EMRiS at the CEM Annual Scientific Conference

The College of Emergency Medicine Annual Scientific Conference is being held in Sheffield on 7th November.
The contributions from members of EMRiS are shown below. Following the conference copies of the posters and presentation will be available to download from the EMRiS website. They will also be available via this blog.

Lightening Poster Session 1 The Edge Foyer 08:45

Kirsty Challen

  • Pandemic Influenza Triage in the Emergency Department
  • Predicting critical illness and death in the ED: not the same thing

Lightening Poster Session 2 High Tor 2 10:15

Robin Chatters

  • Prospective Study to Explore the Link Between the use of First Aid and Patient Outcomes Following Emergency Medical Events

Jack Whitely

  • Patient expectations of minor injury care

Rod Little prize abstract session High Tor 2 11:00

Kirsty Challen

  • Scoping emergency planning: literature and stakeholders

Track 2 High Tor 4 13:30

Alastair Pickering

  • Academic Emergency Medicine: The training years

Four top-scoring abstracts session High Tor 2 14:00

Colin O'Keeffe

  • Confidence and experience of training junior doctors: Assessing the
    impact of the Emergency Department

Suzanne Mason

  • Evaluating well-being in junior doctors: impact of emergency medicine

Lightening oral Session 2 High Tor 2 15:00

Steve Goodacre

  • Systematic review and meta-analysis of the diagnostic and prognostic accuracy of CT coronary angiography in suspected acute coronary syndrome.
  • Systematic review and meta-analysis of the diagnostic and prognostic accuracy of exercise ECG in suspected acute coronary syndrome.

Posters

Steve Goodacre

  • Cost-effectiveness of presentation and delayed troponin testing for acute myocardial infarction 
  • Systematic review and meta-analysis of alternative early biomarkers for myocardial infarction

Thursday 18 October 2012

MSc in Advanced Emergency Care- February intake

Following the popularity of the ScHARR's new MSc in Advanced Emergency Care we can confirm that will be having a second intake of part time students in February in time for semester two.
This is in keeping with our aims to make the course as flexible as possible,  enabling busy clinicians to combine studying with work and family life.

The MSc web pages will be updated soon with details of the semester two admission process.

MSc in Advanced Emergency Care

University of Sheffield postgraduate applications page

Thomas Locker

Friday 5 October 2012

What have medical ward rounds got to do with the ED?


Yesterday the RCP and RCN published a joint statement on the conduct of medical wards rounds. This document details best practice guidance for the conduct of multidisciplinary medical ward rounds. What has this got to do with emergency medicine?
 Access to inpatient beds is well recognised as a key contributor to emergency department crowding. The recently revised College ofEmergency Medicine guideline on crowding states that “The main reason for crowding in almost all EDs is lack of hospital capacity”. Unfortunately today’s publication fails to mention the significant impact that the timing of medical wards rounds has upon the flow of patients through an emergency department.

The RCP/RCN report acknowledges that “Consultant-led ward rounds should be conducted in the morning to facilitate timely completion of tasks during the working day.” However it should also be recognised that the early morning review of patients is vital so that appropriate patients may be discharged and beds made available in time for the predictable rise in the requirement for inpatient beds that occurs from late morning until the evening.


It will be interesting to see if renewed focus upon consultant ward rounds can alleviate the problems of ED crowding in the UK as we approach the most demanding time of year. 


Ward rounds in medicine: Principles for best practice

Thomas Locker