McQueen, Carl (2016) Improving outcomes from major trauma. PhD thesis, University of Warwick.

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Abstract

This thesis presents work from six papers written by the late Dr Carl McQueen during his time as a National Institute for Health Research Doctoral Research Fellow working at the University of Warwick. It explores how best to improve the outcomes of patients who sustain major trauma in the UK – something McQueen was passionate about.

Mobile enhanced care teams can bring the specialist skills usually limited to a hospital to the patient’s side at the point of injury. One of the key specialist interventions such teams can provide is prehospital anaesthesia. In a retrospective observational study from a regional enhanced care team, McQueen showed that prehospital anaesthesia was delivered with a high success rate to patient who sustained major trauma and were unconscious, with or without airway compromise.

The decision about when to send an enhanced care team to the scene of an emergency is challenging. Often insufficient information is available about the nature of the victim’s injury or illness to make an informed decision. McQueen showed that it was relatively rare for patients with medical problems or those linked to equestrian incidents to require specialist intervention. McQueen also showed the location of patients requiring enhanced care skills varies by time of day with most incidents at night occurring around cities / large towns. A systematic review of the literature found little evidence to guide decision making for primary dispatch of the enhanced care teams. Despite the paucity of evidence for triage systems to inform dispatch of enhanced care teams, reorganisation of regional trauma services in the West Midlands appears to have improved targeted dispatch of enhanced care teams.

Together these papers show the potential for benefit from better co-ordination of enhanced care teams.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RA Public aspects of medicine
Library of Congress Subject Headings (LCSH):	Traumatology, Emergency medicine -- Decision making, Emergency medical technicians, Helicopter ambulances
Official Date:	September 2016
Dates:	Date Event September 2016 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Perkins, Gavin D. ; Crossman, Richard J. ; Cooke, Matthew (Professor of clinical systems design)
Format of File:	pdf
Extent:	1 volume (various pagings) : illustrations, charts
Language:	eng

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