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  1. Article ; Online: Implementation of advanced vascular access, physiological monitoring and goal-directed resuscitation during OHCA in a helicopter emergency medical service.

    Aziz, Shadman / Lachowycz, Kate / Major, Rob / Rees, Paul / Barratt, Jon

    The journal of vascular access

    2024  , Page(s) 11297298241242157

    Abstract: Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor in the UK. In order to increase the chances of successful resuscitation, international society guidelines on cardiopulmonary resuscitation quality have recommended titration of chest ... ...

    Abstract Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor in the UK. In order to increase the chances of successful resuscitation, international society guidelines on cardiopulmonary resuscitation quality have recommended titration of chest compression parameters and vasopressor administration to arterial diastolic blood pressure if invasive catheters are in situ at the time of cardiac arrest. However, prehospital initiation of arterial and central venous catheterisation is seldom undertaken due to the risks and significant technical challenges in the context of ongoing resuscitation in this environment. In 2019, a dedicated programme was started at East Anglian Air Ambulance (EAAA) to enable the safe introduction of contemporary emergency vascular access devices, in order to improve physiological monitoring intra-arrest and deliver nuanced, goal-directed resuscitation in OHCA patients. This programme was entitled Specialist Percutaneous Emergency Aortic Resuscitation (SPEAR). This article details the EAAA SPEAR technique; and the development, implementation and governance of this novel endovascular strategy in our UK physician-paramedic staffed helicopter emergency medical service.
    Language English
    Publishing date 2024-04-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298241242157
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6414: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Use of Topical Hemostatic Dressings in an Extended Field Care Model.

    Welch, Matthew / Barratt, Jon / Peters, Alethea / Wright, Chris

    Journal of special operations medicine : a peer reviewed journal for SOF medical professionals

    2021  Volume 21, Issue 4, Page(s) 63–65

    Abstract: Background: We sought to test whether Celox topical hemostatic dressing (Medtrade Products) would maintain hemostasis in extended use.: Methods: An anesthetized swine underwent bilateral arteriotomies and treatment with topical hemostatic dressings ... ...

    Abstract Background: We sought to test whether Celox topical hemostatic dressing (Medtrade Products) would maintain hemostasis in extended use.
    Methods: An anesthetized swine underwent bilateral arteriotomies and treatment with topical hemostatic dressings in line with the Kheirabadi method. The dressings were covered with standard field dressings, and these were visually inspected for bleeding every 2 hours until 8 hours, when the swine was euthanized.
    Results: There was no evidence of rebleeding at any point up to and including 8 hours. The Celox dressings maintained hemostasis in extended use.
    Conclusion: Celox topical hemostatic dressing is effective for extended use and maintains hemostasis. It should be considered for use in situations in which evacuation and definitive care may be delayed.
    MeSH term(s) Animals ; Bandages ; Disease Models, Animal ; Hemostasis ; Hemostatic Techniques ; Hemostatics/therapeutic use ; Swine
    Chemical Substances Hemostatics
    Language English
    Publishing date 2021-12-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3006517-3
    ISSN 1553-9768
    ISSN 1553-9768
    DOI 10.55460/WTUP-GEE0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 7196: Show issues Location:
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  3. Article ; Online: Selective aortic arch perfusion: a first-in-human observational cadaveric study.

    Marsden, Max / Barratt, Jon / Donald-Simpson, Helen / Wilkinson, Tracey / Manning, Jim / Rees, Paul

    Scandinavian journal of trauma, resuscitation and emergency medicine

    2023  Volume 31, Issue 1, Page(s) 97

    Abstract: Background: Selective aortic arch perfusion (SAAP) is a novel endovascular technique that combines thoracic aortic occlusion with extracorporeal perfusion of the brain and heart. SAAP may have a role in both haemorrhagic shock and in cardiac arrest due ... ...

    Abstract Background: Selective aortic arch perfusion (SAAP) is a novel endovascular technique that combines thoracic aortic occlusion with extracorporeal perfusion of the brain and heart. SAAP may have a role in both haemorrhagic shock and in cardiac arrest due to coronary ischaemia. Despite promising animal studies, no data is available that describes SAAP in humans. The primary aim of this study was to assess the feasibility of selective aortic arch perfusion in humans. The secondary aim of the study was to assess the feasibility of achieving direct coronary artery access via the SAAP catheter as a potential conduit for salvage percutaneous coronary intervention.
    Methods: Using perfused human cadavers, a prototype SAAP catheter was inserted into the descending aorta under fluoroscopic guidance via a standard femoral percutaneous access device. The catheter balloon was inflated and the aortic arch perfused with radio-opaque contrast. The coronary arteries were cannulated through the SAAP catheter.
    Results: The procedure was conducted four times. During the first two trials the SAAP catheter was passed rapidly and without incident to the intended descending aortic landing zone and aortic arch perfusion was successfully delivered via the device. The SAAP catheter balloon failed on the third trial. On the fourth trial the left coronary system was cannulated using a 5Fr coronary guiding catheter through the central SAAP catheter lumen.
    Conclusions: For the first time using a perfused cadaveric model we have demonstrated that a SAAP catheter can be easily and safely inserted and SAAP can be achieved using conventional endovascular techniques. The SAAP catheter allowed successful access to the proximal aorta and permitted retrograde perfusion of the coronary and cerebral circulation.
    MeSH term(s) Humans ; Aorta ; Aorta, Thoracic/surgery ; Heart Arrest ; Perfusion/methods ; Shock, Hemorrhagic ; Feasibility Studies
    Language English
    Publishing date 2023-12-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2455990-8
    ISSN 1757-7241 ; 1757-7241
    ISSN (online) 1757-7241
    ISSN 1757-7241
    DOI 10.1186/s13049-023-01148-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Re: Reasons for not using intraosseous access in critical illness.

    Barratt, Jon William

    Emergency medicine journal : EMJ

    2013  Volume 30, Issue 6, Page(s) 516–517

    MeSH term(s) Attitude of Health Personnel ; Critical Care/methods ; Humans ; Infusions, Intraosseous
    Language English
    Publishing date 2013-06
    Publishing country England
    Document type Comment ; Letter
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2012-202120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1941: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Prehospital invasive arterial blood pressure monitoring in critically ill patients attended by a UK helicopter emergency medical service- a retrospective observational review of practice.

    Butterfield, Emma D / Price, James / Bonsano, Marco / Lachowycz, Kate / Starr, Zachary / Edmunds, Christopher / Barratt, Jon / Major, Rob / Rees, Paul / Barnard, Ed B G

    Scandinavian journal of trauma, resuscitation and emergency medicine

    2024  Volume 32, Issue 1, Page(s) 20

    Abstract: Background: Accurate haemodynamic monitoring in the prehospital setting is essential. Non-invasive blood pressure measurement is susceptible to vibration and motion artefact, especially at extremes of hypotension and hypertension: invasive arterial ... ...

    Abstract Background: Accurate haemodynamic monitoring in the prehospital setting is essential. Non-invasive blood pressure measurement is susceptible to vibration and motion artefact, especially at extremes of hypotension and hypertension: invasive arterial blood pressure (IABP) monitoring is a potential solution. This study describes the largest series to date of cases of IABP monitoring being initiated prehospital.
    Methods: This retrospective observational study was conducted at East Anglian Air Ambulance (EAAA), a UK helicopter emergency medical service (HEMS). It included all patients attended by EAAA who underwent arterial catheterisation and initiation of IABP monitoring between 1st February 2015 and 20th April 2023. The following data were retrieved for all patients: sex; age; aetiology (medical cardiac arrest, other medical emergency, trauma); site of arterial cannulation; operator role (doctor/paramedic); time of insertion and, where applicable, times of pre-hospital emergency anaesthesia, and return of spontaneous circulation following cardiac arrest. Descriptive analyses were performed to characterise the sample.
    Results: 13,556 patients were attended: IABP monitoring was initiated in 1083 (8.0%) cases, with a median age 59 years, of which 70.8% were male. 546 cases were of medical cardiac arrest: in 22.4% of these IABP monitoring was initiated during cardiopulmonary resuscitation. 322 were trauma cases, and the remaining 215 were medical emergencies. The patients were critically unwell: 981 required intubation, of which 789 underwent prehospital emergency anaesthesia; 609 received vasoactive medication. In 424 cases IABP monitoring was instituted en route to hospital.
    Conclusion: This study describes over 1000 cases of prehospital arterial catheterisation and IABP monitoring in a UK HEMS system and has demonstrated feasibility at scale. The high-fidelity of invasive arterial blood pressure monitoring with the additional benefit of arterial blood gas analysis presents an attractive translation of in-hospital critical care to the prehospital setting.
    MeSH term(s) Humans ; Male ; Middle Aged ; Female ; Blood Pressure ; Arterial Pressure ; Hemodynamic Monitoring ; Retrospective Studies ; Critical Illness ; Emergency Medical Services ; Aircraft ; Air Ambulances ; Heart Arrest ; United Kingdom
    Language English
    Publishing date 2024-03-12
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2455990-8
    ISSN 1757-7241 ; 1757-7241
    ISSN (online) 1757-7241
    ISSN 1757-7241
    DOI 10.1186/s13049-024-01193-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Letter to editor: Best estimations of the effects of alcohol on emergency department attendance.

    Welch, Matthew / Waseem, Hunniya / Catton, Andy / Barratt, Jon

    Emergency medicine journal : EMJ

    2017  Volume 34, Issue 6, Page(s) 425

    Language English
    Publishing date 2017-06
    Publishing country England
    Document type Letter
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2016-206400
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1941: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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