South East Coast Ambulance Service (SECAmb) Critical Care Paramedics (CCPs) have recently contributed to two important publications to help shape the future of pre-hospital care.
The first study, authored in-house by Interim Head of Critical Care, Alan Cowley and Consultant Paramedic, Dan Cody in collaboration with the Trust’s Medicines and Health Informatics teams, examined the use of clot-busting thrombolysis during out-of-hospital cardiac arrest.
Published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, the study analysed several years of cardiac arrest data, with the team exploring whether giving the drug, Tenecteplase, in the pre-hospital setting, improved patient outcomes when a blood clot was suspected.
The findings showed that thrombolysis did not improve survival and may be associated with poorer outcomes in undifferentiated cardiac arrest, highlighting how difficult it is to accurately diagnose the cause of cardiac arrest in the field.
Alan explained: “Our research reinforces that empiric thrombolysis in cardiac arrest based on suspicion alone may not be prudent, so we have refined our guidance in an attempt to ensure it is only used for patients that raise the index of suspicion of a blood clot to a far higher level.
“As well as adding to the current literature base we hope this helps inform future research to truly identify when these high-risk treatments should be used and define which patients truly benefit from this treatment.”
The full article is available here
Elsewhere, a national consensus statement, jointly authored by SECAmb CCP, Claire Foweraker, in conjunction with the Faculty of Pre-hospital Care, focuses on the care of critically ill or injured pregnant patients.
Pregnancy presents unique challenges during emergencies, particularly in trauma and cardiac arrest. This guidance brings together the best available evidence and expert consensus to support pre-hospital clinicians with assessment, resuscitation, positioning, and time-critical decision-making, always prioritising the mother’s care to give the best chance of survival for both mother and baby.
Acting Chief Medical Officer, Richard Quirk said: “I would like to thank everyone involved in these important pieces of work. They demonstrate the growing role of paramedics as clinical leaders and researchers. By working collaboratively across teams and national organisations, colleagues are continuing to improve patient care while contributing to the wider evidence base for pre-hospital medicine.”