EMERGENCY DEPARTMENT RESEARCH NEWS
http://www.sheffield.ac.uk/scharr/sections/hsr/emris
DECEMBER 2014
We are approaching a busy time for research in the ED with several major research projects commencing early next
year.
Research nurses in emergency medicine
Rachel Walker will be starting work as a research nurse in the ED in December. Craig Jones and Zoe Dutton will be
joining her from January.
Researchers observing in the department
Researchers are observing practice in the ED. Fiona Sampson will be observing pain management for her PhD, Mary
Godfrey and Liz Lavender will be observing how we identify and manage patients with acute delirium, and Maxine
Kuczawski and Vicky Brown will be observing senior doctor triage.
Current recruiting studies
Please check the poster in resus and the list of recruiting doctors if you have a patient who might be eligible for
either of the following trials:
 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.
 HALT-IT: A randomised controlled trial of tranexamic acid for gastro-intestinal bleeding. Patients with
potentially life-threatening bleeding (i.e. needing blood cross matching) must be considered for recruitment.
Forthcoming studies
 DiPEP: A case-control study of diagnosis of PE in pregnancy. Recruitment of women with suspected PE in
pregnancy or postpartum will commence in 2015.
 Lab2Go: A cohort study to develop a point-of-care troponin assay using fingerprick blood samples.
Recruitment of patients with suspected ACS will start in 2015.
 CLAHRC2 is a multi-million pound collaboration between research and NHS organisations and 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. Susan Croft will be the local lead for the CLAHRC at STH.
 RAPID-CTCA: A multicentre trial comparing ACS management with CT coronary angiography to management
without. Recruitment of patients with intermediate risk ACS will commence in 2015
 Frequent attenders to the ED: a study undertaking routine data analysis and interviews with patients and
staff about the optimum ways to manage them will commence shortly.
 Evaluation of the role of Senior Doctor Triage and its impact on ED performance, patient outcomes and staff
satisfaction.
 Triage tools for acute delirium: A cohort study to evaluate the 4AT and CAM triage tools. Researchers from
Leeds and Bradford will be undertaking initial qualitative research in the department in autumn 2014 and
then we will start recruiting to the cohort study in 2015.
 SPRAINED: A cohort study to validate a clinical prediction rule for ankles sprains. Researchers from the
Universities of Oxford and Warwick are developing a rule from the CAST dataset. This will be validated in
patients presenting to our department in 2015-16.
Recent studies
 Evidence synthesis of prehospital non-invasive ventilation for acute respiratory failure. This project has just
completed and has shown that prehospital CPAP may reduce mortality and intubation rates in acute
respiratory failure but cost-effectiveness is uncertain and dependent on the incidence of suitable patients.
 The AHEAD Study (Managing anticoagulated patients who suffer head injury). This study has just completed
patient recruitment and is currently completing analysis. It aims to describe the risks of serious intracranial
consequences of patients who have a head injury whilst on warfarin.
PhD students
 Fiona Sampson is undertaking IMPEDE, a study of analgesia use in the emergency department. She will be
piloting qualitative methods (observation and interviews) in the department in 2014-15.
 Kirsty Challen has submitted her PhD, which involved developing a clinical prediction tool for predicting lifethreatening illness in the ED.
 Rajiv Singh is looking at the long term consequences of head injury
 Maysam Abdulwahid is evaluating the role of Senior Doctor Triage in EDs
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 and Lucy
Beales will be joining them shortly.
BMedSci students
 Joseph Buckley has completed 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 have all completed BMedSci studies on various
EM topics ranging from the investigation of abdominal pain to how we recruit patient to EM research.
 Rowena Johnson has presented on her BMedSci topic at our recent CEM Annual Scientific Meeting and
submitted a paper for publication
 Tom Bidmead’s BMedSci project has resulted in publication of a paper in the Emergency Medicine Journal
 Erin Whyte’s BMedSCi project has resulted in a paper being accepted by the European Journal of Emergency
Medicine
 Amy Hewitt has written two papers for publication following her BMedSci
 Toby Morris has commenced his BMedSci comparing performance across 12 EDs nationally.
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
Selected recent publications
1. Webster R, Norman P, Goodacre S et al. Illness representations, psychological distress and non-cardiac chest
pain in patients attending an emergency department. Psychology & health 2014;29(11):1265-1282.
2. Goodacre S, Stevens JW, Pandor A et al. Pre-hospital Non-invasive Ventilation for Acute Respiratory Failure:
Systematic Review, Network Meta-Analysis and Individual Patient Data Meta-Analysis. Acad Emerg Med
2014;21:949-959
3. Bidmead T, Goodacre S, Maheswaran R, O’Cathain A. Factors influencing unspecified chest pain admission
rates in England. Emerg Med J 2014; online first
4. Sampson FC, Goodacre SW and O’Cathain A. Interventions to improve the management of pain in
Emergency Departments: systematic review and narrative synthesis. Emerg Med J 2014;31:e9–e18.
5. Boyle A, Mason S. What has the 4-hour access standard achieved? British Journal of Hospital Medicine 2014,
75(11):620-622.
6. Mason S, Mountain G, Turner J, Arain M, Revue E, Weber E. Innovations to reduce demand and crowding in
emergency care; a review study. Scand J Trauma Resusc Emerg Med 2014, 22:55
7. HA Snooks, B Carter, J Dale, T Foster, I Humphreys, PA Logan, RA Lyons. Support and Assessment for Fall
Emergency Referrals (SAFER 1): Cluster Randomised Trial of Computerised Clinical Decision Support for
Paramedics. PloS one 9 (9), e106436
Research Contacts
Clinical Research Coordinator: Erica Wallis, 0114 2265931 or erica.wallis@sth.nhs.uk
Research Nurse Support: Rachel Walker, 15375 and 07791 380717 or Rachel.Walker@sth.nhs.uk
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)