Professor Tom Quinn
Associate Dean for Health & Medical Strategy
Qualifications: MPhil; RN; FESC; FRCN; FAHA
Email: t.quinn@surrey.ac.uk
Phone: Work: 01483 68 4553
Room no: 23 DK 04
Office hours
Monday - Thursday 9.00 - 5.30 by appointment only.Fridays are reserved for the National Institute for Health and Clinical Excellence (NICE).
Please contact Stephanie Fuller s.fuller@surrey.ac.uk or Telephone: 01483 689319
Further information
Biography
Tom Quinn was appointed Associate Dean in May 2012 to co-ordinate the creation of a new Faculty Health and Medical Strategy and work with the University Executive Board and Faculty Deans to create a new University Health and Medical Strategy, representing the University with DH and NHS on training and research matters, and acting as a University link with local NHS Chief Executives and Medical Directors.
Trained as a nurse in Bath, Stoke Mandeville Hospital, the National Heart Hospital and as an NHS Executive Regional research training Fellow, Tom had a 30-year NHS career from the bedside to the Department of Health (DH), including as Section Head of the DH Heart Team, responsible for the CHD National Service Framework, programme lead in an SHA, and in an Ambulance Trust , leading region-wide strategies for primary angioplasty and hyperacute stroke care.
Tom is seconded one day/week as Clinical Lead for NHS Evidence (www.evidence.nhs.uk), part of the National Institute for Health and Clinical Excellence. His research interest is emergency cardiac and stroke care, and he is involved in several major clinical trials and the Birmingham and Black Country NIHR CLAHRC, and a member of the MINAP steering group. A Fellow of the Royal College of Nursing, European Society of Cardiology, and American Heart Association, Tom was a member of the previous Government's Heart Disease Task Force and the DH Emergency Cardiac Care Board, and participated in the Prime Minister's Delivery Unit review of heart attack care which resulted in the National Primary Angioplasty Project (NIAP). He chaired the steering group for development of primary angioplasty for the NHS in Surrey. He is Honorary Clinical and Research Adviser to South East Coast Ambulance Service NHS Foundation Trust, a Board member of Surrey and Sussex Comprehensive Local Research Network, and member of the Steering Group overseeing development of the KSS Partners AHSN.
In August 2012 Tom was elected to the Board of the Acute Cardiovascular Care Association of the European Society of Cardiology, http://www.escardio.org/communities/acca/Pages/welcome.aspx?hit+highlight-on and is a member of the Editorial Board, European Heart Journal - Acute Cardiovascular Care.
Research Interests
Emergency cardiovascular and stroke care
Pre-hospital care
Evidence based healthcare
Research Collaborations
NHS Executive Northern and Yorkshire, regional research training fellowship 1995) Quinn T ‘Assessment of patients with chest pain of presumed cardiac origin admitted to a coronary care unit’ £60,222
British Heart Foundation 2003 Quinn T, Dickson R, Jayram R Evaluating the impact of British Heart Foundation ‘Acute Coronary Syndrome’ nurses £27,800
NHS National Knowledge Service for Health & Social Care 2004 Quinn T Development of a knowledge mobilisation resource for congestive heart failure. £40,000
Department of Health: National Library for Health 2002-2008 Prior P, Quinn T and others Cardiovascular diseases specialist library project £289,191
Knowledge Transfer Enterprise grant Coventry and Warwickshire Cardiac Network 2006 Middleton A, Oldroyd C, Godfrey S, Quinn T. Baseline assessment of cardiac equipment in primary care across Coventry and Warwickshire £6,000
Centre for Interprofessional e-Learning (CIPEL) 2007 Quinn T, Oldroyd C, Day A, Godfrey S 2007 Development and evaluation of online teaching resource for electrocardiography. £30,000
Knowledge Transfer Enterprise grant Coventry (matched by University of West of England) ) Cox H, Moyle S, Hoskins R, Albarran J, Gray A, Quinn T A comparison of Emergency Nurses (EN), Emergency Nurse Practitioners (ENP) and Emergency Care Practitioners (ECP) use of heuristics in assessing patients presenting with chest pain: pilot study. £3,000
National Institute for Health Research (NIHR) 2007 Watkins G, Ford G, Cooke M, Durham S, Fairhurst R, Quinn T, Rose M, Mitchell D, Leathley M, Morris S, Jones S, Mackway-Jones K. Emergency Stroke Calls: Obtaining Rapid Telephone Triage (ESCORTT) £1m
NHS Institute 2008 Quinn T, Low B, Edwards C. Cardiovascular, stroke and vascular specialist libraries projects, National Library for Health (Now NHS Evidence) £507,008
NIHR Health Technology Assessment Programme 2008 Gates S, Perkins G, Woollard M, Quinn T, Lamb S, Cooke M, Deakin C, McCabe C, Mason W, Slowther A, Wyse M, Crooks G. Prehospital Randomised Assessment of Mechanical compression Device In Cardiac arrest Cluster randomised controlled trial of the LUCAS™ mechanical chest compression device for out of hospital cardiac arrest ISRCTN08233942 £2,176,422
http://www.sjtrem.com/content/pdf/1757-7241-18-58.pdf
Use and impact of the pre-hospital electrocardiogram in acute coronary syndrome – insights from the Myocardial Ischaemia National Audit Project (MINAP) registry database.Funder: British Heart Foundation Project Grant PG/11/54/28996
Evaluation of the ABCD2 Score in pre-hospital assessment of Patients with suspected Transient Ischaemic Attack: pilot study. (Joint project with South East Coast Ambulance NHS Foundation Trust)
Funder: South East Coast Strategic Health Authority (with Dr Wendy Knibb)
Decision making and safety in emergency care transitions http://www.sdo.nihr.ac.uk/projdetails.php?ref=10-1007-53 Funder: NIHR SDO - 10/1007/53. (Lead: Sheffield University)
Other projects
Comparison of the efficacy and safety of a strategy of pre-hospital fibrinolytic treatment with tenecteplase and additional antiplatelet and antithrombin therapy followed by catheterisation within 6-24 hours or rescue coronary intervention versus a strategy of standard primary PCI in patients with acute myocardial infarction within 3 hours of onset of symptoms. Strategic Reperfusion Early in Acute Myocardial Infarction (STREAM) trial: Steering Committee, co-chair of UK ambulance committee.
European Ambulance acute Coronary Syndrome Angiox Trial: EUROMAX. International Steering Committee.
Optimisation of the management of stroke and Transient Ischaemic Attack (TIA). NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Birmingham & Black Country (member of Theme Management Group).
http://bmjopen.bmj.com/content/2/3/e001430.full.pdf+html
National Institute for Cardiovascular Outcomes Research (NICOR), University College London. Myocardial Ischaemia National Audit Project (MINAP). Steering Group.
Echocardiography in cardiac arrest. Focused Echocardiography in Emergency Life Support. Steering Group.
30 Day Study to Evaluate Efficacy and Safety of Pre-hospital vs. In-hospital Initiation of Ticagrelor Therapy in STEMI Patients Planned for Percutaneous Coronary Intervention (PCI) ATLANTIC trial – Local Collaborator/Principal Investigator, South East Coast Ambulance NHS Foundation Trust (Sponsor – Astra Zeneca)
MRC/NIHR EME REFER (REFer for EchocaRdiogram) Study: A Prospective Validation of a Clinical Decision Rule, NT-proBNP, or their combination, in the Diagnosis of Heart Failure in Primary Care. ISRCTN17635379 (Trial Steering Committee)
NIHR RfPB REVIVE-Airways: Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of pre-hospital cardiac arrest: a feasibility study (Data Montoring and Ethics Committee)
Publications
Highlights
- .
(2012) 'Protocol for an observation and implementation study investigating optimisation of the management of stroke and transient ischaemic attack (TIA).'. BMJ Publishing Group BMJ Open, 2 (pii: e001430)Full text is available at: http://epubs.surrey.ac.uk/738894/
Abstract
Introduction Patients benefit from early and intensive treatment in both acute ischaemic stroke and transient ischaemic attack. Recent audits of acute stroke/transient ischaemic attack care suggest that although standards have improved, current services still fall short of optimal care. The aim of this study is to establish a database of patients accessing stroke services. Data will be collected and analysed to provide individualised feedback to healthcare professionals who can then use these findings to develop strategies for service improvement. Methods and analysis This longitudinal observational study will evolve with the ongoing findings from the research output. The project will consist of three phases: assessment of current practice, feedback of findings and evaluation of service change. Consecutive patients will be recruited from participating hospitals, and identifiable data will be collected to link records from the Primary Care, Secondary Care and Emergency Services. As this study focuses on observation of current practice, a sample size calculation is not deemed appropriate. Patients will be sent follow-up questionnaires examining quality of life at 3 and 12 months post-event. Qualitative interviews will examine the care pathway through the experiences of patients, their carers, healthcare personnel and commissioners. Collected data will be used in economic analyses, which will evaluate the impact of current care and service redesign on the NHS costs and patient outcomes (death and quality of life). Ethics and dissemination Ethical approval for this study has been obtained from the National Research Ethics Committee (reference; 09/H0716/71), and site-specific R&D approval has been acquired from the relevant NHS trusts. All findings will be presented at relevant healthcare/academic conferences and written up for publication in peer-reviewed journals. Results will be fed back to patients and participating trusts through a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation.
- . (2012) ''Is he awake?': dialogues between callers and call handlers about consciousness during emergency calls for suspected acute stroke.'. Emerg Med J,
- .
(2012) 'THE IDENTIFICATION OF ACUTE STROKE: AN ANALYSIS OF EMERGENCY CALLS'. Wiley International Journal of Stroke, volume forthcomingFull text is available at: http://epubs.surrey.ac.uk/7280/
Abstract
Background Accurate dispatch of emergency medical services at the onset of acute stroke is vital in expediting assessment and treatment. We examined the relationship between callers’ description of potential stroke symptoms to the emergency medical dispatcher and the subsequent classification and prioritisation of emergency medical services response. Aim To identify key ‘indicator’ words used by people making emergency calls for suspected stroke, comparing these with the subsequent category of response given by the emergency medical dispatcher. Method A retrospective chart review (hospital and emergency medical services) in North West England (October 1, 2006 to September 30, 2007) identified digitally recorded emergency medical services calls, which related to patients who had a diagnosis of suspected stroke at some point on the stroke pathway (from the emergency medical services call taker through to final medical diagnosis). Using content analysis, words used to describe stroke by the caller were recorded. A second researcher independently followed the same procedure in order to produce a list of ‘indicator’ words. Description of stroke-specific and nonstroke-specific problems reported by the caller was compared with subsequent emergency medical services dispatch coding and demographic features. Results Six hundred forty-three calls were made to emergency medical services of which 592 (92%) had complete emergency medical services and hospital data. The majority of callers were female (67%) and family members (55%). The most frequently reported problems first said by callers to the emergency medical dispatcher were collapse or fall (26%) and stroke (25%). Callers who identified that the patient was having a stroke were correct in 89% of cases. Calls were dispatched as stroke in 45% of cases, of which 83% had confirmed stroke. Of the first reported problems, Face Arm Speech Test stroke symptoms were mentioned in less than 5% of calls, with speech problems being the most common symptom. No callers mentioned all three Face Arm Speech Test symptoms. Conclusion Callers who contacted emergency medical services for suspected stroke and said stroke as the first reported problem were often correct. Calls categorised as stroke by the emergency medical dispatcher were commonly confirmed as stroke in the hospital. Speech problems were the most commonly reported element of the Face Arm Speech Test test to be reported by callers. Recognition of possi
- .
(2011) 'Oxygen therapy for acute myocardial infarction: A systematic review and meta-analysis'. BMJ Group Emergency Medicine Journal, 28 (11), pp. 917-923.Full text is available at: http://epubs.surrey.ac.uk/7273/
Abstract
Oxygen (O2) is widely recommended in international guidelines for treatment of acute myocardial infarction (AMI), but there is uncertainty about its safety and benefits. A systematic review and meta-analysis were performed to determine whether inhaled O2 in AMI improves pain or the risk of death. Cochrane CENTRAL Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE, CINAHL, LILACS and PASCAL were searched from start date to February 2010. Other sources included British Library ZETOC, Web of Science, ISI Proceedings, relevant conferences, expert contacts. Randomised controlled trials of inhaled O2 versus air in patients with suspected or proven AMI of < 24 h onset were included. Two authors independently reviewed studies to confirm inclusion criteria met, and undertook data abstraction. Quality of studies and risk of bias was assessed according to Cochrane Collaboration guidance. Main outcomes were death, pain, and complications. Measure of effect used was the RR. Three trials (n=387 patients) were included. Pooled RR of death on O2 compared to air was 2.88 (95%CI 0.88 to 9.39) on ITT analysis and 3.03 (95%CI 0.93 to 9.83) in confirmed AMI. While suggestive of harm, this could be a chance occurrence. Pain was measured by analgesic use. Pooled RR for the use of analgesics was 0.97 (95%CI 0.78 to 1.20). Evidence for O2 in AMI is sparse, of poor quality and pre-dates advances in reperfusion and trial methods. Evidence is suggestive of harm but lacks power and excess deaths in the O2 group could be due to chance. More research is required.
- . (2010) 'Oxygen therapy for acute myocardial infarction'. JOHN WILEY & SONS LTD COCHRANE DB SYST REV, (6) Article number CD007160
- . (2010) 'Echocardiography in cardiac arrest'. LIPPINCOTT WILLIAMS & WILKINS CURRENT OPINION IN CRITICAL CARE, 16 (3), pp. 211-215.
- .
(2010) 'Oxygen use in acute myocardial infarction: an online survey of health professionals' practice and beliefs'. B M J PUBLISHING GROUP EMERG MED J, 27 (4), pp. 283-286.Full text is available at: http://epubs.surrey.ac.uk/7276/
Abstract
Introduction There is growing interest in the safety of oxygen therapy in emergency patients. A Cochrane review of oxygen versus air for patients with acute myocardial infarction (AMI) showed a potentially important, but statistically non-significant, increase in mortality (RR 3.03 (95% CI 0.93 to 9.83)) and concluded a definitive randomised controlled trial (RCT) was needed.Objective To explore the feasibility of conducting an RCT of oxygen versus air in AMI, by exploring the beliefs of UK professionals who treat patients with AMI about oxygen's benefits, and to establish a baseline of reported practice by asking about their use of oxygen.Method A cross-sectional online survey of UK emergency department, cardiology and ambulance staff.Result 524 responses were received. All specialities had over 100 respondents. 98.3% said they always or usually use oxygen. 80% reported having local guidelines that recommended the routine use of oxygen. 55% believed oxygen definitely or probably significantly reduces the risk of death, while only 1.3% reported that they thought 'it may even increase the risk of death.' There were only minor differences across specialities and grades.Conclusion Widespread belief in the benefit of oxygen in AMI may make it difficult to persuade funders of the importance of this issue and health professionals to participate in enrolling patients into a trial in which oxygen would be withheld from half their patients.
- .
(2010) 'Prehospital randomised assessment of a mechanical compression device in cardiac arrest (PaRAMeDIC) trial protocol'. BIOMED CENTRAL LTD SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, 18 Article number ARTN 58 Full text is available at: http://epubs.surrey.ac.uk/738733/
- .
(2009) 'The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)'. B M J PUBLISHING GROUP HEART, 95 (7), pp. 559-563.Full text is available at: http://epubs.surrey.ac.uk/7281/
Journal articles
- . (2013) 'Something for the weekend?'. JAMA Neurology, 70 (1), pp. 130-130.
- .
(2012) 'Protocol for an observation and implementation study investigating optimisation of the management of stroke and transient ischaemic attack (TIA).'. BMJ Publishing Group BMJ Open, 2 (pii: e001430)Full text is available at: http://epubs.surrey.ac.uk/738894/
Abstract
Introduction Patients benefit from early and intensive treatment in both acute ischaemic stroke and transient ischaemic attack. Recent audits of acute stroke/transient ischaemic attack care suggest that although standards have improved, current services still fall short of optimal care. The aim of this study is to establish a database of patients accessing stroke services. Data will be collected and analysed to provide individualised feedback to healthcare professionals who can then use these findings to develop strategies for service improvement. Methods and analysis This longitudinal observational study will evolve with the ongoing findings from the research output. The project will consist of three phases: assessment of current practice, feedback of findings and evaluation of service change. Consecutive patients will be recruited from participating hospitals, and identifiable data will be collected to link records from the Primary Care, Secondary Care and Emergency Services. As this study focuses on observation of current practice, a sample size calculation is not deemed appropriate. Patients will be sent follow-up questionnaires examining quality of life at 3 and 12 months post-event. Qualitative interviews will examine the care pathway through the experiences of patients, their carers, healthcare personnel and commissioners. Collected data will be used in economic analyses, which will evaluate the impact of current care and service redesign on the NHS costs and patient outcomes (death and quality of life). Ethics and dissemination Ethical approval for this study has been obtained from the National Research Ethics Committee (reference; 09/H0716/71), and site-specific R&D approval has been acquired from the relevant NHS trusts. All findings will be presented at relevant healthcare/academic conferences and written up for publication in peer-reviewed journals. Results will be fed back to patients and participating trusts through a series of reports and presentations. These will be used to facilitate discussions about service redesign and implementation.
- .
(2012) 'Callers' experiences of making emergency calls at the onset of acute stroke: A qualitative study'. BMJ Emergency Medicine Journal, 29 (6), pp. 502-505.Full text is available at: http://epubs.surrey.ac.uk/726753/
Abstract
Background: Rapid access to emergency medical services (EMS) is essential at the onset of acute stroke, but significant delays in contacting EMS often occur. Objective: To explore factors that influence the caller's decision to contact EMS at the onset of stroke, and the caller's experiences of the call. Methods: Participants were identified through a purposive sample of admissions to two hospitals via ambulance with suspected stroke. Participants were interviewed using open-ended questions and content analysis was undertaken. Results: 50 participants were recruited (median age 62 years, 68% female). Only one of the callers (2%) was the patient. Two themes were identified that influenced the initial decision to contact EMS at the onset of stroke: perceived seriousness, and receipt of lay or professional advice. Two themes were identified in relation to the communication between the caller and the call handler: symptom description by the caller, and emotional response to onset of stroke symptoms. Conclusions: Many callers seek lay or professional advice prior to contacting EMS and some believe that the onset of acute stroke symptoms does not warrant an immediate 999 call. More public education is needed to improve awareness of stroke and the need for an urgent response.
- .
(2012) 'STEMI - taking the acute cardiac care to the patient'. SAGE PUBLICATIONS LTD EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, 11 (2), pp. 138-140.Full text is available at: http://epubs.surrey.ac.uk/738743/
- . (2012) ''Is he awake?': dialogues between callers and call handlers about consciousness during emergency calls for suspected acute stroke.'. Emerg Med J,
- .
(2012) 'THE IDENTIFICATION OF ACUTE STROKE: AN ANALYSIS OF EMERGENCY CALLS'. Wiley International Journal of Stroke, volume forthcomingFull text is available at: http://epubs.surrey.ac.uk/7280/
Abstract
Background Accurate dispatch of emergency medical services at the onset of acute stroke is vital in expediting assessment and treatment. We examined the relationship between callers’ description of potential stroke symptoms to the emergency medical dispatcher and the subsequent classification and prioritisation of emergency medical services response. Aim To identify key ‘indicator’ words used by people making emergency calls for suspected stroke, comparing these with the subsequent category of response given by the emergency medical dispatcher. Method A retrospective chart review (hospital and emergency medical services) in North West England (October 1, 2006 to September 30, 2007) identified digitally recorded emergency medical services calls, which related to patients who had a diagnosis of suspected stroke at some point on the stroke pathway (from the emergency medical services call taker through to final medical diagnosis). Using content analysis, words used to describe stroke by the caller were recorded. A second researcher independently followed the same procedure in order to produce a list of ‘indicator’ words. Description of stroke-specific and nonstroke-specific problems reported by the caller was compared with subsequent emergency medical services dispatch coding and demographic features. Results Six hundred forty-three calls were made to emergency medical services of which 592 (92%) had complete emergency medical services and hospital data. The majority of callers were female (67%) and family members (55%). The most frequently reported problems first said by callers to the emergency medical dispatcher were collapse or fall (26%) and stroke (25%). Callers who identified that the patient was having a stroke were correct in 89% of cases. Calls were dispatched as stroke in 45% of cases, of which 83% had confirmed stroke. Of the first reported problems, Face Arm Speech Test stroke symptoms were mentioned in less than 5% of calls, with speech problems being the most common symptom. No callers mentioned all three Face Arm Speech Test symptoms. Conclusion Callers who contacted emergency medical services for suspected stroke and said stroke as the first reported problem were often correct. Calls categorised as stroke by the emergency medical dispatcher were commonly confirmed as stroke in the hospital. Speech problems were the most commonly reported element of the Face Arm Speech Test test to be reported by callers. Recognition of possi
- . (2012) 'Pre-hospital treatment of STEMI patients. A scientific statement of the working group acute cardiac care of the European society of cardiology | Tratamiento prehospitalario de los pacientes con IAMCEST. Una declaración científica del Working Group Acute Cardiac Care de la European Society of Cardiology'. Revista Espanola de Cardiologia, 65 (1), pp. 60-70.
- .
(2011) 'Oxygen therapy for acute myocardial infarction: A systematic review and meta-analysis'. BMJ Group Emergency Medicine Journal, 28 (11), pp. 917-923.Full text is available at: http://epubs.surrey.ac.uk/7273/
Abstract
Oxygen (O2) is widely recommended in international guidelines for treatment of acute myocardial infarction (AMI), but there is uncertainty about its safety and benefits. A systematic review and meta-analysis were performed to determine whether inhaled O2 in AMI improves pain or the risk of death. Cochrane CENTRAL Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE, CINAHL, LILACS and PASCAL were searched from start date to February 2010. Other sources included British Library ZETOC, Web of Science, ISI Proceedings, relevant conferences, expert contacts. Randomised controlled trials of inhaled O2 versus air in patients with suspected or proven AMI of < 24 h onset were included. Two authors independently reviewed studies to confirm inclusion criteria met, and undertook data abstraction. Quality of studies and risk of bias was assessed according to Cochrane Collaboration guidance. Main outcomes were death, pain, and complications. Measure of effect used was the RR. Three trials (n=387 patients) were included. Pooled RR of death on O2 compared to air was 2.88 (95%CI 0.88 to 9.39) on ITT analysis and 3.03 (95%CI 0.93 to 9.83) in confirmed AMI. While suggestive of harm, this could be a chance occurrence. Pain was measured by analgesic use. Pooled RR for the use of analgesics was 0.97 (95%CI 0.78 to 1.20). Evidence for O2 in AMI is sparse, of poor quality and pre-dates advances in reperfusion and trial methods. Evidence is suggestive of harm but lacks power and excess deaths in the O2 group could be due to chance. More research is required.
- . (2011) 'Pre-hospital treatment of STEMI patients. A scientific statement of the Working Group Acute Cardiac Care of the European Society of Cardiology'. Acute Cardiac Care, 13 (2), pp. 56-67.
- . (2010) 'Oxygen therapy in acute MI: role uncertainty'. MA Healthcare Journal of Paramedic Practice, 2 (7), pp. 294-295.
- . (2010) 'The Strategic Reperfusion Early After Myocardial Infarction (STREAM) Study'. American Heart Journal, 160 (1), pp. 30-35.e.
- . (2010) 'Oxygen therapy for acute myocardial infarction'. JOHN WILEY & SONS LTD COCHRANE DB SYST REV, (6) Article number CD007160
- . (2010) 'Echocardiography in cardiac arrest'. LIPPINCOTT WILLIAMS & WILKINS CURRENT OPINION IN CRITICAL CARE, 16 (3), pp. 211-215.
- .
(2010) 'Oxygen use in acute myocardial infarction: an online survey of health professionals' practice and beliefs'. B M J PUBLISHING GROUP EMERG MED J, 27 (4), pp. 283-286.Full text is available at: http://epubs.surrey.ac.uk/7276/
Abstract
Introduction There is growing interest in the safety of oxygen therapy in emergency patients. A Cochrane review of oxygen versus air for patients with acute myocardial infarction (AMI) showed a potentially important, but statistically non-significant, increase in mortality (RR 3.03 (95% CI 0.93 to 9.83)) and concluded a definitive randomised controlled trial (RCT) was needed.Objective To explore the feasibility of conducting an RCT of oxygen versus air in AMI, by exploring the beliefs of UK professionals who treat patients with AMI about oxygen's benefits, and to establish a baseline of reported practice by asking about their use of oxygen.Method A cross-sectional online survey of UK emergency department, cardiology and ambulance staff.Result 524 responses were received. All specialities had over 100 respondents. 98.3% said they always or usually use oxygen. 80% reported having local guidelines that recommended the routine use of oxygen. 55% believed oxygen definitely or probably significantly reduces the risk of death, while only 1.3% reported that they thought 'it may even increase the risk of death.' There were only minor differences across specialities and grades.Conclusion Widespread belief in the benefit of oxygen in AMI may make it difficult to persuade funders of the importance of this issue and health professionals to participate in enrolling patients into a trial in which oxygen would be withheld from half their patients.
- .
(2010) 'Prehospital randomised assessment of a mechanical compression device in cardiac arrest (PaRAMeDIC) trial protocol'. BIOMED CENTRAL LTD SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, 18 Article number ARTN 58 Full text is available at: http://epubs.surrey.ac.uk/738733/
- .
(2009) 'The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP)'. B M J PUBLISHING GROUP HEART, 95 (7), pp. 559-563.Full text is available at: http://epubs.surrey.ac.uk/7281/
- . (2009) 'Pre-hospital thrombolysis for acute ST segment elevation myocardial infarction: A survey of paramedics' perceptions of their role.'. Acute Card Care, Sweden: 11 (1), pp. 52-58.
- . (2009) 'A decade of improvement for cardiac patients in England'. Journal of Research in Nursing, 14 (3), pp. 199-202.
- . (2008) 'Coronary artery bypass grafting: Patients' and health professionals' views of recovery after hospital discharge'. ELSEVIER SCIENCE BV EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, 7 (1), pp. 36-42.
- . (2008) 'Other clinicians play a part in expediting reperfusion'. B M J PUBLISHING GROUP EMERG MED J, 25 (2), pp. 122-122.
- . (2008) 'Practice development: What is it and why should we be doing it?'. Nurse Education in Practice, 8 (4), pp. 221-222.
- . (2008) 'Ketamine use in prehospital critical care - Response'. B M J PUBLISHING GROUP EMERGENCY MEDICINE JOURNAL, 25 (9), pp. 619-619.
- . (2008) 'Availability of cardiac equipment in general practice premises in a cardiac network: A survey'. British Journal of Cardiology, 15 (3), pp. 141-144.
- . (2008) 'Bodies at risk. An ethnography of heart disease'. BLACKWELL PUBLISHING SOCIOL HEALTH ILL, 30 (1), pp. 165-165.
- . (2007) 'Recovery after coronary artery bypass grafting: patients' and health professionals' views of the hospital experience.'. Eur J Cardiovasc Nurs, Netherlands: 6 (3), pp. 200-207.
- . (2007) 'Trench entrapment: is ketamine safe to use for sedation in head injury?'. Emergency Medicine Journal, 24, pp. 794-795.
- . (2006) 'Acute coronary syndrome nurses: perceptions of other members of the health care team.'. Accid Emerg Nurs, Scotland: 14 (4), pp. 204-209.
- . (2006) 'Commentary on Nicholson C (2004) A systematic review of the effectiveness of oxygen in reducing acute myocardial ischaemia. Journal of Clinical Nursing 13, 996-1007.'. J Clin Nurs, England: 15 (1), pp. 121-122.
- . (2006) 'Stroke as a clinical emergency'. Emergency Nurse, 14 (3), pp. 15-19.
- . (2006) 'Using simulation to estimate the cost effectiveness of improving ambulance and thrombolysis response times after myocardial infarction'. B M J PUBLISHING GROUP EMERGENCY MEDICINE JOURNAL, 23 (1), pp. 67-72.
- . (2006) 'Paramedics' perceptions of their role in providing pre-hospital thrombolytic treatment: Qualitative study'. Accident and Emergency Nursing, 14 (4), pp. 237-244.
- . (2005) 'The role of nurses in improving emergency cardiac care.'. Nurs Stand, England: 19 (48), pp. 41-48.
- . (2005) 'Reduction of treatment delay in patients with ST-elevation myocardial infarction: impact of pre-hospital diagnosis and direct referral to primary percutaneous intervention'. OXFORD UNIV PRESS EUROPEAN HEART JOURNAL, 26 (13), pp. 1343-1343.
- . (2005) 'Management of acute coronary syndromes, a questionnaire survey of the clinical practice of cardiologists and other medical physicians belonging to west midland hospitals'. ELSEVIER SCI IRELAND LTD INTERNATIONAL JOURNAL OF CARDIOLOGY, 99 (1), pp. 71-75.
- . (2005) 'Use of statistical process control to support improved care for patients with acute myocardial infarction eligible for thrombolytic treatment: Experience from 2 hospitals in England during 2002-2003'. Critical Pathways in Cardiology, 4 (1), pp. 21-25.
- . (2005) 'Redefining the coronary care unit: an observational study of patients admitted to hospital in England and Wales in 2003'. Quarterly Journal of Medicine, 98 (11), pp. 797-802.
- . (2005) 'Duncan P, Mackie F, Mackay F, Quinn T (2005) Use of statistical process control to support improvements in care for patients with acute myocardial infarction eligible for thrombolytic treatment: initial experience from two hospitals in England during 2002-03'. Critical Pathways in Cardiology, 4, pp. 21-25.
- . (2004) 'Managing acute myocardial infarction.'. Emerg Nurse, England: 12 (3), pp. 17-19.
- . (2004) 'The cost of national service frameworks'. MARK ALLEN PUBLISHING LTD HOSPITAL MEDICINE, 65 (3), pp. 184-184.
- . (2004) 'Influences upon the diffusion of thrombolysis for acute myocardial infarction in England: case study.'. International Journal of Technology Assessment in Health Care, 20, pp. 537-544.
- . (2003) 'The interdisciplinary interface in managing patients with suspected cardiac pain.'. Emerg Nurse, England: 11 (6), pp. 22-24.
- . (2003) 'Impact of a region-wide approach to improving systems for heart attack care: the West Midlands Thrombolysis Project.'. European Journal of Cardiovascular Nursing, 2, pp. 131-139.
- . (2002) 'Effective nurse-led interventions in heart disease.'. Int J Cardiol, Ireland: 83 (3), pp. 233-237.
- . (2002) 'Task Force on the management of chest pain.'. European Heart Journal, 23, pp. 1153-1176.
- . (2002) 'Implementing paramedic thrombolysis: an overview'. Accident and Emergency Nursing, 10, pp. 189-196.
- . (2002) 'NICE announce audit of secondary prevention guidance'. British Journal of Cardiology, 9 (5), pp. 303-304.
- . (2001) 'Quality of care for coronary heart disease in two countries.'. Health Affairs, 20, pp. 55-67.
- . (2000) 'Determining chest pain patients’ suitability for transfer to a general ward following admission to a cardiac care unit.'. Journal of Advanced Nursing, 32, pp. 310-317.
- . (2000) 'Improving door to needle times with nurse initiated thrombolysis'. Heart, 84 (3), pp. 262-266.
- . (2000) 'Reducing ‘door-to-needle’ time by nurse-initiated thrombolysis.'. Heart, 84, pp. 262-266.
- . (1999) 'History and development of coronary care.'. Intensive Crit Care Nurs, SCOTLAND: 15 (3), pp. 131-141.
- . (1999) 'Thrombolysis in accident and emergency: the exception not the rule. Are we denying patients lifesaving treatment?'. Accid Emerg Nurs, SCOTLAND: 7 (1), pp. 39-41.
- . (1998) 'Determining patients’ suitability for thrombolysis: coronary care nurses’ agreement with an expert cardiological ‘gold standard’ as assessed by clinical and electrocardiographic ‘vignettes’'. Intensive and Critical Care Nursing, 14, pp. 219-224.
- . (1998) 'Early experience of nurse-led elective DC cardioversion.'. Nurs Crit Care, 3, pp. 59-62.
- . (1996) 'Professional deveploment. Cardiopulmonary resuscitation: the role of the nurse (continuing education credit).'. Nurs Times, ENGLAND: 92 (46)
- . (1996) 'Professional development. Cardiopulmonary resuscitation: knowledge for practice (continuing education credit).'. Nurs Times, ENGLAND: 92 (45)
- . (1996) 'Professional deveploment. Cardiopulmonary resuscitation: the role of the nurse (continuing education credit).'. Nursing times, 92 (46)
- . (1996) 'Professional development. Cardiopulmonary resuscitation: knowledge for practice (continuing education credit).'. Nursing times, 92 (45)
- . (1995) 'Can nurses safely assess suitability for thrombolytic therapy? A pilot study.'. Intensive and Critical Care Nursing, 11, pp. 126-129.
- . (1995) 'Administration of thrombolytic therapy to patients with acute myocardial infarction'. Accident and Emergency Nursing, 3 (4), pp. 208-214.
- . (1995) 'Safety of thrombolytic therapy in patients with central venous cannulation.'. British Heart Journal, 73, pp. 359-362.
Conference papers
- . (2008) 'A comparison of emergency nurses', emergency nurse practitioners' and emergency care practitioners' use of heuristics in their clinical reasoning and decision making ability to manage/triage patients presenting with chest pain correctly'. B M J PUBLISHING GROUP HEART, Manchester, ENGLAND: Annual Scientific Conference of the British-Cardiovascular-Society 94, pp. A140-A140.
- . (2006) 'Paramedics' perceptions of their role in providing thrombolytic treatment in acute myocardial infarction: Qualitative study'. B M J PUBLISHING GROUP HEART, Glasgow, SCOTLAND: Annual Scientific Conference of the British-Society-Promoting-Cardiovascular-Health 92, pp. A22-A22.
- . (2005) 'Managing knowledge for the emergency care of heart attack patients: paramedics and thrombolytic treatment'. IEEE 2005 27th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Vols 1-7, Shanghai, PEOPLES R CHINA: 27th Annual International Conference of the IEEE-Engineering-in-Medicine-and-Biology-Society, pp. 6965-6968.
Books
- . (2009) Acute Cardiac Care. Wiley-Blackwell
- . (2007) Emergency care of the patient with a heart attack. Elsevier Health Sciences
- . (2006) Cardiac Care. John Wiley & Sons Inc
- . (2004) Caring for the coronary patient. Butterworth-Heinemann Medical
- . (1999) Acute Myocardial Infarction. A core dataset for monitoring standards of care. London : Royal College of Physicians of London
Book chapters
- . (2007) 'Coronary heart disease, healthcare policy and evolution of chest pain assessment and management in the UK'. in Albarran JW, Tagney J (eds.) Chest pain Wiley-Blackwell
Internet publications
- . (2012) Evidence Update 9 – Transient loss of consciousness. Natinal Institute for Health and Clinical Excellence
- . (2012) Venous thromboembolism: reducing the risk. Evidence update February 2012. National Institute for Health and Clinical Excellence
- . (2011) Chronic heart failure: Evidence Update November 2011. National Institute for Health and Clinical Excellence
- . (2010) Evidence Update - atrial fibrillation. NHS Evidence/National Institute for Health and Clinical Excellence
- . (2010) Cochrane Journal Club - oxygen therapy for acute myocardial infarction.
Teaching
Applied Research, for BSc (hons) Paramedic studies
Advanced Research Methods for D Clin Prac programme
Research supervision, D Clin Prac, PhD and Masters students
Lectures on heart attack and stroke
Departmental Duties
Internal:
Associate Dean for Health and Medical Strategy
Member, University Health and Medical Strategy Committee
Chair of University Self Assessment Team for Athena Swan
Member, Doctoral Board of Studies
Member, Programme Management Team, BSc (Hons) Paramedic Practice
External:
Clinical Lead for NHS Evidence – National Institute for Health and Clinical Excellence (seconded one day/week to NICE)
Networking with the NHS locally and nationally
University of Surrey representative, Board of Surrey and Sussex NIHR Comprehensive Local Research Network
Injuries and Emergencies Local Speciality Group, Surrey and Sussex CLRN, NIHR
Member, Cardiovascular Local Specialty Group, NIHR
Member, Critical Care, Anaesthetics and Pain Management Local Specialty Group, NIHR
Member, Research and Development Working Group, South East Coast Ambulance NHS Foundation Trust
Consultancy – e.g. clinical trials in emergency care of heart attack
Affiliations
External appointments/ Membership professional organisations
Fellow of the European Society of Cardiology
Fellow of the Royal College of Nursing
Fellow of the American Heart Association (Council on Quality Care and Outcomes Research)
Board Member Acute Cardiovascular Care of ESRC (2012 - present)
Member, British Cardiovascular Society working group on acute cardiac care (to 2011)
Member, European Resuscitation Council
Member, Resuscitation Council (UK)
Member, American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation
Member, Nucleus ESC Working Group on Acute Cardiac Care (to 2012)
Member, Advisory Committee, ESC Council on Cardiovascular Nursing and Allied Professions
Member of steering group, Myocardial Ischaemia National Audit Project (1999 - present)
Founder Nurse Member, Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh
Member, Health Professions Advisory Group, British Heart Foundation
Faculty Member, NIHR
Inaugural Chair, RCN Cardiovascular Network (to 2009)
Member of Joint Royal Colleges Ambulance Liaison Committee (JRCALC) (to 2012)
Member of acute care steering committee, UK Stroke Research Network (to 2011)
Member of Emergency Cardiac Care Board, Department of Health (2003-2010)
Member of Coronary Heart Disease Taskforce, Department of Health (2002-2006)
Member of expert advisory group for review of CHD NSF implementation, Healthcare Commission (2005)
Chairman, ESC Working Group on Cardiovascular Nursing (1996-1998)
