Pete Gregory

Can the British Heart Foundation PocketCPR application improve the performance of chest compressions during bystander resuscitation: A randomised crossover manikin study.

This study aims to determine whether the British Heart Foundation PocketCPR training application can improve the depth and rate of chest compression and therefore be confidently recommended for bystander use. A total of 118 candidates were recruited into a randomised crossover manikin trial. Each candidate performed cardiopulmonary resuscitation for 2 min without instruction or performed chest compressions using the PocketCPR application. Candidates then performed a further 2 min of cardiopulmonary resuscitation within the opposite arm. The number of chest compressions performed improved when PocketCPR was used compared to chest compressions when it was not (44.28% vs 40.57%, p < 0.001). The number of chest compressions performed to the required depth was higher in the PocketCPR group (90.86 vs 66.26). The British Heart Foundation PocketCPR application improved the percentage of chest compressions that were performed to the required depth. Despite this, more work is required in order to develop a feedback device that can improve bystander cardiopulmonary resuscitation without creating delay.

Does the British Heart Foundation PocketCPR training application improve confidence in bystanders performing CPR

Objectives Out-of-hospital cardiac arrest has poor prognosis and patients rarely survive unless they receive immediate cardiopulmonary resuscitation from bystanders. In 2012, the British Heart Foundation launched its PocketCPR training application to simplify bystander cardiopulmonary resuscitation training and overcome barriers to resuscitation. This study investigates whether the British Heart Foundation PocketCPR training application improves the confidence of bystanders who perform cardiopulmonary resuscitation during simulated resuscitation attempts. Methods This is a mixed method study using a randomised crossover trial with questionnaire analysis. One hundred and twenty participants were randomised to either perform two minutes of cardiopulmonary resuscitation on a resuscitation manikin using the British Heart Foundation PocketCPR application or perform cardiopulmonary resuscitation without instruction. Participants completed a questionnaire to capture their confidence before completing the opposite arm of the study. Each participant then completed a second questionnaire to allow for comparison of levels of confidence. Results Participants in this study were more confident in their overall performance of cardio-pulmonary resuscitation using the British Heart Foundation PocketCPR training application compared to performing cardiopulmonary resuscitation without instruction (mean confidence score (0-100): 50.41 with PocketCPR and 43.92 without (p = 0.026)). They were also more confident that the number of chest compressions in this study was correct (mean: 60.39 with PocketCPR vs. 46.10 without (p < 0.001)), and in the delivery of cardiopulmonary resuscitation without having recent cardiopulmonary resuscitation training (mean: 48.67 with PocketCPR vs. 39.79 without (p < 0.002)). Conclusion The British Heart Foundation PocketCPR training application improved the confidence of bystanders performing cardiopulmonary resuscitation during simulated resuscitation attempts.

Considering the implications of changing ambulance response time targets

A document leaked on 21 December outlining proposals to change the response times for some Red 2 patients caused notable sensationalism within the national media. Pete Gregory looks at some of the concerns raised by the document, while Martin Flaherty provides a response on behalf of the Association of Ambulance Chief Executives.

Hearing the voice of the minority

Tony Bleetman Lead consultant in emergency medicine, North West London Hospitals NHS Trust; HEMS doctor, Great Western Air Ambulance, UK Mark Bloch Consultant anaesthetist and honorary clinical senior lecturer, Royal Aberdeen Children’s Hospital and Aberdeen Royal Infirmary, UK; clinical lead, Bond Offshore Helicopters Patrick M Bourke Director of the Severe Burns Life Support Foundation (SBLS), Member and Former Governor of the NAEMT-USA, Member of the British Burns Association (BBA), Member of NAEMSE-USA, Chair of International Medical and Rescue Association (IMRA), Member of Euro Mediterranean Council for Burns and Fire Disasters (MBC) and the International Society for Burn Injuries (ISBI) Malcolm Boyle Senior lecturer, Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia Mike Brooke Advanced paramedic, North West Ambulance Service NHS Trust, UK Kerry Gaskin (Cook) Senior lecturer in children’s nursing, Institute of Health and Society, Pre-registration Nursing, Midwifery and Paramedic Science, University of Worcester, UK David Davis NHS Pathways clinical lead, South East Coast Ambulance Service NHS Foundation Trust; national clinical lead, Health and Social Care Information Centre; director of communications, College of Paramedics John Donaghy Principal lecturer and professional lead for paramedic science, University of Hertfordshire, UK Georgette Eaton Emergency care practitioner, Berkshire Healthcare NHS Foundation Trust, UK; paramedic, South Central Ambulance Service NHS Foundation Trust, UK Mike Essery Emergency care practitioner and clinical team leader, Great Western Ambulance Service NHS Trust, Chippenham, UK Richard Fairhurst Chairman, Standards and Training Board, Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh, Scotland, UK David Fitzpatrick Paramedic clinical research specialist, Scottish Ambulance Service, NMHAP Research Unit, University of Stirling, Scotland, UK Alison Gallacher Paramedic, Northern Ireland, UK Pete Gregory Senior lecturer in paramedic practice, Birmingham City University, Birmingham, UK Sigurd Haveland Paramedic, Gibraltar Health Authority, Gibraltar Kieran Henry Advanced paramedic, National Ambulance Service, Ireland Grayham Mclean Unscheduled care lead, Welsh Ambulance Service NHS Trust, Swansea, Wales, UK Joanne Mildenhall Paramedic team leader, South Central Ambulance Service NHS Foundation Trust, UK Tom Mallinson Doctor and paramedic, Jersey General Hospital, Jersey Ambulance Service, Jersey, Channel Islands Ian Mursell Consultant paramedic, East Midlands Ambulance Service NHS Trust Andy Newton Consultant paramedic; clinical operations director, South East Coast Ambulance Service NHS Foundation Trust, UK; council chair, College of Paramedics Adrian Noon Primary care doctor in accident and emergency medicine, Heartlands Hospital, Birmingham, UK; medical advisor, West Midlands Ambulance Service NHS Trust, UK Peter O’Meara Professor in rural and regional paramedicine, La Trobe University, Victoria, Australia. Mike Page Emergency care practitioner and critical care paramedic, Great Western Air Ambulance, UK; visiting lecturer, University of the West of England, UK Ian Peate Head of School, School of Health Studies, Gibraltar Nigel Rees Senior research lead, Welsh Ambulance Services NHS Trust, UK Steven Scholes Advanced paramedic, North West Ambulance Service NHS Trust, UK Lynda Sibson Independent nurse consultant; lecturer, FD Paramedic Studies, Coventry University; telemedicine project manager, Addenbrookes Hospital, UK Rachael Snowden Paramedic, East Midlands Ambulance Service NHS Trust, UK Adrian South Deputy clinical director, South Western Ambulance Service NHS Foundation Trust, UK Dan Staines Lecturer in paramedic science, Coventry University; Emergency ambulance paramedic, West Midlands Ambulance Service NHS Trust, UK James Taylor Programme manager, Department of Pre-hospital and Retrieval Medicine, Cambridge University Hospitals NHS Foundation Trust, UK Richard Whitfield Research and development lead, Welsh Ambulance Services NHS Trust, UK Julia Williams Principal lecturer and research lead in paramedic science, University of Hertfordshire, UK Mark Woolcock Training consultant, Tiger Medical, Truro, UK Consultant Editors Lynda Sibson, Ian Peate, Pete Gregory Editor Alistair Quaile alistair.quaile@markallengroup.com Managing Editor Jessica Daniels jessica.daniels@markallengroup.com Commercial Manager Jack Croissant jack.croissant@markallengroup.com Classified Director Rachel McElhinney rachel.mcelhinney@markallengroup.com Production Manager Jon Redmayne Production Assistant Larry Oakes Commercial Director Tom Pollard Publisher and Managing Director Jon Benson Chief Executive Officer Ben Allen

Implementing the JRCALC Guidelines

Malcolm Woollard Professor in pre-hospital care, Charles Sturt University, New South Wales, Australia; Adjunct professor, Edith Cowan University, Western Australia Consultant Editors Lynda Sibson, Ian Peate, Pete Gregory Editor Alistair Quaile alistair.quaile@markallengroup.com Managing Editor Jessica Daniels jessica.daniels@markallengroup.com Commercial Manager Tom Curtiss tom.curtiss@markallengroup.com Classified Director Rachel McElhinney rachel.mcelhinney@markallengroup.com Production Manager Jon Redmayne Production Assistant Larry Oakes Commercial Director Tom Pollard Publisher Peter Black Chief Executive Officer Ben Allen