Emerg Med J 20:90-96 doi:10.1136/emj.20.1.90
  • Abstracts

Abstracts selected through 999 EMS Research Forum peer review process, and presented orally or by poster at Ambex 2002

Oral presentations


Winner of the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) award for Research Most Likely to Affect Practice

H. Snooks1, N. Kearsley2, M. Halter3, J. Redhead4, J Dale2. 1Clinical School, University of Wales Swansea, Singleton Park, Swansea;2University of Warwick;3London Ambulance Service NHS Trust;4Ealing Hospitals NHS Trust

Background: The number of 999 calls is rising, and some callers have been shown to have non-urgent needs. Evidence concerning the effectiveness of alternatives to the standard 999 service is lacking, although previous studies have highlighted clinical risk for some non-conveyed patients.

Objective: To evaluate the safety of ‘Treat and Refer’ (T&R) protocols for ambulance crews, allowing them to leave patients on scene, with advice or onward referral.

Methods: Treatment protocols were developed by a clinical panel and implemented in one station May - August 2000. Outcomes of care for patients within defined illness codes and attended by trained crews were compared with similar patients attended by crews from a neighbouring station. Pre-hospital, A&E and GP records were collected.

Results: 23 protocols were developed. 260 patients were included in the intervention arm and 537 in the control arm of the study. There were no age / sex differences between groups although intervention patients were more likely to have been attended during the week (χ2 = 4.28, p = .05) and daytime (χ2 = 6.75, p = .01). After follow up at A&E and GPs there were 62 patients for whom no information was retrieved.

Seventeen of the protocols were recorded as used for 110 patients, by all 8 trained crew members. Three patients in each group were admitted to hospital within 14 days of their call, and were judged by clinical reviewers to have been …

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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