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Biomedical subjects

Simon Carley

Publications and source records attributed to Simon Carley.

18 recordsLinked to original sources
PubMed2006

A Delphi-based consensus study into planning for biological incidents.

OBJECTIVE: Biological incidents present a significant threat to health services in the UK. The objective of this study was to achieve consensus in all phases of biological incident planning and response. METHODS: A three-round Delphi study was conducted using a panel of 23 experts from specialities involved in the management of biological incidents. The consensus and non-consensus outcomes from the Delphi study were subsequently presented for discussion in four syndicate groups at a one-day consensus conference funded by the Health Protection Agency. RESULTS: The results of each syndicate group discussion were presented at a subsequent plenary session at the end of the conference. Further iteration of both the consensus and the non-consensus outcomes of the Delphi study resulted in the endorsement, modification, integration or rejection of individual statements. 125 consensus statements were produced. CONCLUSIONS: The 125 synopsis consensus statements that all phases of biological incident planning and response. These can be used to inform policy decisions and translated into practical guidance for emergency planners and first responders at local, regional and national levels.

Accidents, Occupational↗
PubMed2006

Emergency departments (EDs) in the United Kingdom (UK) are not prepared for emerging biological threats and bioterrorism.

OBJECTIVE: To assess the preparedness of emergency departments (EDs) in the United Kingdom (UK) for the management of potential biological incidents. METHODS: We telephoned all hospitals in the UK listed as having a major ED. We surveyed their ED facilities and procedures for managing patients with infectious diseases. We determined how many of the EDs had an isolation room available and, if present, whether this had an independent ventilation system and separate access from outside the ED. In addition, we determined how many of the EDs would isolate patients with suspected cases of chickenpox, tuberculosis (TB), severe acute respiratory syndrome (SARS) and other suspicious infections. RESULTS: We obtained complete data from 203 (79%) of the 257 hospitals approached. Only 49 (24%) of these hospitals had isolation facilities available in the ED. Of these 49 EDs, 30 (61%) reported an independent ventilation system and 18 (37%) reported a separate access from outside the ED. The majority of EDs would isolate patients with potential infectious diseases, however, 47 (23%) would not isolate patients with suspected chickenpox, 37 (18%) EDS would not isolate patients with suspected TB, 12 (6%) EDS would not isolate patients with suspected SARS and 55 (27%) EDS would not isolate patients with other suspicious infections. CONCLUSION: EDs in the UK are not prepared for emerging biological threats and bioterrorism. With current facilities and procedures it is highly likely that an infectious agent will spread to staff and other patients in any future biological incident.

Bioterrorism↗
PubMed2005

Best evidence topic report. Timing of lumbar puncture in suspected subarachnoid haemorrhage.

A short cut review was carried out to establish how long after onset of headache a lumbar puncture should be carried out to rule out subarachnoid haemorrhage. Altogether 142 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Evidence-Based Medicine↗
PubMed2005

Best evidence topic report. Antifibrinolytics for the initial management of sub arachnoid haemorrhage.

A short cut review was carried out to gather the evidence for and against the use of tranexamic acid to patients who have suffered subarachnoid bleeding. 267 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2005

Best evidence topic report. Intranasal midazolam in patients with fits.

A short cut review was carried out to establish whether intranasal midazolam was effective for stopping fits. Altogether 36 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Administration, Intranasal↗
PubMed2004

A novel method for the detection of transient myocardial ischaemia using body surface electrocardiac mapping.

BACKGROUND: The limitations of the 12-lead ECG in the detection of myocardial ischaemia are well known. This study sought to test the hypothesis that a Body Surface Mapping (BSM) system can detect and localise the transient regional ischaemia induced by elective percutaneous coronary intervention (PCI) in patients with stable angina. METHODS AND RESULTS: 25 patients undergoing elective single vessel PCI were studied: 11 with RCA lesions, 9 with LAD lesions and 5 with circumflex lesions. Patients had BSM readings every 30 s following the inflation of a dilating balloon in the target vessel for 1 min. BSMs were analysed for ST segment change at 60 ms after the J point (ST60). Peak ST changes were analysed and colour map reconstruction made. Characteristic ST segment changes in each arterial domain were observed following inflation of the balloon. Maximal change occurred in a standard V lead on only 2/46 occasions. Statistically significant rapid rise and fall of ST 60 readings were observed indicating the onset recovery and location of the transient ischaemia. A novel method for the presentation of colour map reconstruction that removes baseline noise has been developed. CONCLUSIONS: These data confirm the hypothesis that this BSM system can detect and display transient myocardial ischaemia. BSM may represent a novel clinical tool for the assessment of clinical ischaemia.

Angioplasty, Balloon, Coronary↗
PubMed2004

Best evidence topic report. Suicide at christmas.

A short cut review was carried out to establish whether the risk of suicide and parasuicide increases at Christmas. Fifteen papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Emergency Medical Services↗
PubMed2004

Best evidence topic reports. Screw tipped needles for intraosseous access.

A short cut review was carried out to establish whether screw tipped intraosseous needles were better than standard intraosseous needles. Altogether 35 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Alcoholism↗
PubMed2003

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Acute myocardial infarction in cocaine induced chest pain presenting as an emergency.

A short cut review was carried out to establish the incidence of acute myocardial infarction in patients presenting as emergencies with post-cocaine chest pain. Altogether 198 papers were found using the reported search, of which eight presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2002

Planning for major burns incidents by implementing an accelerated Delphi technique.

OBJECTIVE: This paper presents a series of practical guides for use in planning and responding to a major incident involving large numbers of burns casualties. METHOD: The guidance is based on the findings of an expert Delphi study published as an accompanying paper. RESULTS: The guidance covers preparation and all aspects of the response from prehospital care and hospital care to resolution recovery. Emphasis is placed on the management of the secondary/tertiary care interface as this is the point at which significant difficulties may arise. The importance of local interpretation of guidelines is emphasised. CONCLUSION: This practical guide for emergency planners will improve the preparation and response to a major incident involving burns.

Burn Units↗
PubMed2002

Planning for major burns incidents in the UK using an accelerated Delphi technique.

BACKGROUND: Major incidents require careful planning if they are to be managed well. Although a generic plan to deal with all major incidents is essential, a number of "special incidents" deserve special consideration because of their potential to impact on specialist services. This paper examines the problems of managing a major incident involving large numbers of burns casualties. METHOD: A three-round Delphi study was conducted using a multidisciplinary panel of experts from prehospital care, emergency medicine, burns surgery, intensive care and emergency planning. RESULTS: A series of consensus statements on the management of burns incidents are presented. An accompanying paper describes the practical implementation of this guidance. CONCLUSION: Specific consideration should be given to the problems of managing a major incident involving burns casualties.

Burn Units↗
PubMed2002

Aspiration of acute traumatic knee haemarthrosis.

A short cut review was carried out to establish whether aspiration of a traumatic knee haemarthrosis improved the patient's symptoms. Altogether 267 papers were found using the reported search, of which none answered the question posed. Further research is needed in this area.

Acute Disease↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Propofol for resistant status epilepticus.

A short cut review was carried out to establish whether propofol is effective at stopping fitting in resistant status epilepticus. Altogether 24 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Tape stripping the stratum corneum and the effectiveness of EMLA.

A short cut review was carried out to establish whether there is any evidence to show that stripping the stratum corneum with adhesive tape reduces time to analgesia after application of EMLA in children undergoing venepuncture. Altogether 43 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.

Anesthetics, Local↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Staples or sutures for repair of scalp laceration in adults.

A short cut review was carried out to establish whether staples are better than sutures for scalp wound repair in adults. Altogether 42 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Aged↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Staples or sutures in children with scalp lacerations.

A short cut review was carried out to establish whether staples are better than sutures for scalp wound repair in children. Eight papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.

Child↗