This page provides information about the previous research studies within West Midlands Ambulance Service.
The Pre-hospital Evaluation of Sensitive Troponin (PRESTO) study is part of the NHS’ ambition to find new ways of delivering healthcare more efficiently without the need for hospital treatment. The trial is testing a blood test, which paramedics could use, to determine whether a patient is having a heart attack on scene. The trial, which began on 7th May 2019, is running in Coventry & Warwickshire by paramedics. The Trust will work with Warwick Hospital and University Hospital Coventry & Warwickshire. You can find out more here. You can also find out the latest about the study via Twitter by following @PRESTOstudy.
The Prehospital Electrocardiogram 2 (PHECG2) study aims to improve how clinicians decide to perform a diagnostic 12-lead ECG (electrocardiogram – how we trace your heart) on patients. When someone has a suspected heart attack, the ambulance service can test the electrical activity of a person’s the heart to determine the best treatment for them. In a previous project, Professor Tom Quinn and colleagues showed that people who had a special type of test – called a prehospital electrocardiogram, or PHECG – had a better chance of survival. This is a study using routine data and does not involve any changes to patient care. You can find out more here.
The RePHILL (Resuscitation with Pre-Hospital Blood Products) trial is testing whether the use of pre-hospital blood products for patients suffering traumatic bleeding improves outcomes. Critical care teams carry study packs which contain either blood products or saline (which is the standard treatment) and, when treating a patient with a traumatic bleed the patient will receive one of these treatments and their outcome measured. You can find out more here. Results will be published in the future.
This study tested a mechanical chest compressor device against the manual chest compressions given by ambulance staff. The study found no patient benefit to routinely using these devices, although they may still be used in certain circumstances. It provided reassurance that ambulance staff already provide high quality CPR. Results are available here.
PARAMEDIC2 tested the long-term patient outcomes of a medicine called adrenaline, which has been commonly used by ambulance services for many years. Patients with cardiac arrest were slightly more likely to survive if given adrenaline, but the drug doubled the risk of brain injury. The study showed that adrenaline is much less important as a treatment than bystanders recognising cardiac arrest, as well as early CPR and defibrillation. Results are here.
Understanding variation in rates of ambulance service non-conveyance (VAN) of patients to an emergency department showed that some ambulance services are better than others at caring for patients without transporting them to an Emergency Department, and suggested ways that trusts can improve the numbers of patients cared for in their own homes, either after telephone advice (“hear and treat”) or a face-to-face visit (“see and treat”). To find out more click here.
This study looked at the impact of closing or downgrading Emergency Departments in England. The researchers found that there was no evidence of either positive or negative impacts to patients, although closures did increase the overall number of incidents attended by ambulance services. Head to Sheffield University website for more information.
This study tested the use of a simple skin patch to improve functional outcomes for stroke patients. Ultimately, RIGHT-2 showed that the patch was neither helpful nor harmful, but it did prove that paramedics are able to research new treatments even in very challenging circumstances. Read more here.
Our first medicine trial that WMAS took part in was a study looking at a drug to help heart attack patients. It showed that ambulance crews could safely administer ticagrelor to these patients, but that this was no better for their outcomes than giving it in hospital. To find out more about the study click here.