EMERGENCY DEPARTMENT RESEARCH NEWS
http://www.sheffield.ac.uk/scharr/sections/hsr/emris
APRIL 2013
Welcome to the STH ED research newsletter – an intermittent update on research involving the ED.
Current recruiting studies
 CRASH3, a randomised controlled trial of tranexamic acid for significant traumatic brain injury. Patients with
significant traumatic brain injury (i.e. intracranial bleeding on CT scan or GCS < 13) must be considered for
recruitment. Please check the poster in resus and the list of recruiting doctors if you have a patient who
might be eligible. We recruiting to target with 19 patients so far.
Forthcoming studies
 HALT-IT: A randomised controlled trial of tranexamic acid for gastro-intestinal bleeding
 Triage tools for acute delirium: A cohort study to evaluate the 4AT and CAM triage tools
 Lab2Go: A cohort study to develop a point-of-care troponin assay using fingerprick blood samples
 CLAHRC2: Is a multi-million pound collaboration between research and NHS organisations commencing in
Jan 2014. As part of this, we will be developing a stream of work aimed at looking at avoiding unnecessary
attendance and admission in patients with long term conditions.
 British Red Cross: We will be undertaking a randomised controlled trial of first aid information for patients
attending the ED in February 2014. This will be led by ACF David Pallot.
Recent studies
 The 3Mg trial was a multicentre double-blind randomised controlled trial comparing IV or nebulised
magnesium sulphate to placebo for acute severe asthma. intravenous nor nebulised magnesium sulphate
had a significant effect upon admission to hospital, patient-reported breathlessness or peak expiratory flow
rate compared to placebo.
 The PAINTED study (Pandemic Influenza in the Emergency Department) is aimed at evaluating triage
methods for patients with pandemic influenza, if and when the next pandemic occurs. We have developed a
standardised clinical assessment form for patients with suspected influenza and piloted it in NGH and five
other pilot sites. All we need now is a pandemic!
 The EDiT Study (Evaluation of doctors in training) evaluated the changes in competence, confidence and
well-being of junior doctors during their F2 year, and especially evaluated the impact of training in the ED. It
found that the ED is a very valuable experience and that it improved the confidence and competence of the
docs more than any other specialty they undertook in their F2 year!
 The AHEAD Study (Managing anticoagulated patients who suffer head injury). This study has just completed
patient recruitment and is currently completing follow up. It aims to describe the risks of serious intracranial
consequences of patients who have a head injury whilst on warfarin.
 SAFER 2 (randomised trial evaluating the impact of protocols for paramedics to leave elderly fallers at
home). This RCT is also just completed and in the analysis phase. It hopes to show that older patients who
fall with minor illness or injury can be safely left at home.
PhD students
 Eliza Mazan is undertaking a study involving observation and qualitative interviews to examine how ED staff
use IT systems
 Kirsty Challen is working alongside the DAVROS project to develop a clinical prediction tool for predicting
life-threatening illness
 Fiona Sampson will be undertaking a PhD studying the provision of analgesia in the emergency department.
 Rajiv Singh is looking at the long term consequences of head injury
Masters students
 Richard Pilbery (MClinRes) won £1000 for the best presentation at the 999 EMS Research Forum for his
project evaluating the effect of computer-generated ECG reports upon paramedic recognition of STEMI.
 Academic Clinical Fellows Anna Bayston and David Pallott are currently doing their Masters courses
BMedSci students



Jospeh Buckley is undertaking a BMedSci involving interviewing patients who have recently suffered a
medical emergency to explore their attitudes towards participation in emergency medicine clinical trials
Chris Hooper, Rowena Johnson and Charlotte Walker-Jones will all be undertaking BMedSci studies on
various EM topics ranging from the investigation of abdominal pain to how we recruit patient to EM
research.
Erin Whyte, Tom Bidmead and Amy Hewitt successfully completed their BMedSci projects
Masters in Advanced Emergency Care
This advanced Masters course is aimed at clinicians with experience in emergency medicine. It is mainly delivered as
a distance learning course, and aims to improve clinical, research and leadership skills in the specialty. For further
information visit: http://www.sheffield.ac.uk/scharr/prospective_students/masters/ace/course
Research Contacts
Clinical Research Coordinator: Martin Collins, 0114 22 68475 or martin.collins@sth.nhs.uk
Research Nurse Support: Rachel Walker, 15375 and 07791 380717 or Rachel.Walker@sth.nhs.uk
Selected recent publications
1. O’Cathain A, Knowles E, Maheswaran R, Pearson T, Turner J, Hirst E, Goodacre S, Nicholl J. A system-wide
approach to explaining variation in potentially avoidable emergency admissions: national ecological study.
BMJ Quality and Safety 2014;23:47-55
2. Than M, Aldous S, Lord SJ, Goodacre S, Frampton CMA, Troughton R et al. A 2-Hour Diagnostic Protocol for
Possible Cardiac Chest Pain in the Emergency Department: A Randomized Clinical Trial. JAMA Intern Med
2014;174(1):51-8.
3. Whiteley J, Goodacre S. Patient expectations of minor injury care: A cross-sectional survey. Emerg Med J
2013; doi:10.1136
4. Hargreaves K, Goodacre S, Mortimer P. Paramedic perceptions of the feasibility and practicalities of
prehospital clinical trials: A questionnaire survey. Emerg Med J 2013; doi:10.1136
5. Mason S, Weber EJ, Coster J, Freeman J, Locker T. Time patients spend in the emergency department:
England's 4-hour rule-a case of hitting the target but missing the point? Ann Emerg Med. 2012
May;59(5):341-9
6. Rogenstein C, Kelly AM, Mason S, Schneider S, Lang E, Clement CM, Stiell IG.An international view of how
recent-onset atrial fibrillation is treated in the
emergency department. Acad Emerg Med. 2012 Nov;19(11):1255-60.
7. Weber EJ, Mason S, Carter A, Hew RL. Emptying the corridors of shame:
organizational lessons from England's 4-hour emergency throughput target. Ann Emerg Med. 2011
Feb;57(2):79-88.
8. Lecky, F. E., Mason, S., Benger, J., Cameron, P., & Walsh, C. (n.d.). IFEM Framework for Quality and Safety in
the Emergency Department.: IFEM Framework for Quality and Safety in the Emergency Department..
International Federation for Emergency Medicine. Retrieved from
http://www.ifem.cc/Resources/PoliciesandGuidelines.aspx
9. Knowles, E., Mason, S. M., & Moriarty, F. (2012). 'I'm going to learn how to run quick': exploring violence
directed towards staff in the Emergency Department. Emerg Med J. doi:10.1136/emermed-2012-201329
10. Nicholl J, Mason S. Return of the ‘corridors of shame’? BMJ. 2013 Jul 8;347:f4343. doi: 10.1136/bmj.f4343.
Apologies to anyone whose research is missing from this newsletter. If you want to add or correct anything please
contact Steve Goodacre (s.goodacre@sheffield.ac.uk) or Jill Bishop (jill.bishop@sth.nhs.uk)