A study of paramedics attitudes to the effects of speed humps on resuscitation of patients en route - PowerPoint PPT Presentation

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A study of paramedics attitudes to the effects of speed humps on resuscitation of patients en route

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London Ambulance Service spokesman says 'It is possible that minute from ... Also sponsored by London Ambulance Service NHS Trust. June 2003. Limitations ... – PowerPoint PPT presentation

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Title: A study of paramedics attitudes to the effects of speed humps on resuscitation of patients en route


1
A study of paramedics attitudes to the effects
of speed humps on resuscitation of patients en
route to hospital, including general patient care
and ambulance response times
  • By Mark Belchamber
  • BSc (Hons), AASI, SR Para
  • (Training Officer/Paramedic, London Ambulance
    Service NHS Trust)

2
Or.
3
How speed humps affect
  • your patients
  • your staff
  • and
  • your response times.

4
Sound familiar?
  • Delays due to road conditions
  • Ill go this way to avoid the humps
  • Humps dont slow the idiots down anyway
  • You cant avoid the humps
  • I hate humps!
  • Cant the driver slow down?
  • Im feeling really sick
  • OUCH!
  • These bumps are awful
  • Cant you go a different route?
  • I hate humps!

5
In the last week.
  • Barnett council (London) propose to remove all
    500 speed humps saying they are Ineffectual and
    cause road deaths and damage to vehicles
  • London Ambulance Service spokesman says It is
    possible that minute from response times
    (service-wide) could equate to 500 more lives
    saved per year.

6
Methodology
  • Literature search/review
  • Scant information (predominantly U.S. based)
  • NO research surrounding attitudes, perceptions,
    responses of Paramedics

7
Methodology (cont.)
  • Questionnaire pre-tested by 10 individuals
  • 100 questionnaires (based on literature reviews)
    sent to a purposive sample
  • Mainly quantitative (but also qualitative
    elements)

8
Methodology (cont.)
  • Data Analysis
  • Closed questions (nominal and ordinal data)
    charted where appropriate
  • Free text analysed for thematic content
  • SPSS, MS Excel and Lotus 1-2-3 used
  • Information graphed and cross-tabulated
  • Qualitative responses categorised to establish
    potential relationships

9
Methodology (cont.)
  • Ethics
  • Approval from University of Hertfordshire
  • Also sponsored by London Ambulance Service NHS
    Trust

10
Limitations
  • Small study (36 out of 100 respondents)
  • Inability to generalise (Polit Hungler 1995)
  • Lack of other (similar) research for comparison
  • Only Paramedics were questioned
  • Possible geographical bias
  • Time limitation

11
Results
12
All respondents drive over humps at least once
per shift.Over half do it more than 4 times per
shift
13
Response to 999 calls
14
67 actively avoid humps
15
Over half said time was a factor
16
30 would add 2 minutes, 55 between 1 and 5
minutes!
17
Humps slow you down, but respondents would add
time to avoid humps
18
There is no published research concerning actual
time delays that humps cause to U.K. ambulances
19
Transportation of medically unstable patients to
a receiving facility
20
59 take a different route
21
31 are concerned with improved care, 25 with
patient condition - 56 in total!
22
19 of 20 people would extend time to hospital.
75 would add up to 5 minutes - but 2 would add
10 minutes!
23
In Paramedics experiences, patient care and/or
conditions suffer significantly over road
humps.Times to receiving facilities and
definitive care are increased.
24
Transportation of patients in cardiac arrest to
AE
25
All respondents had undertaken CPR whilst
travelling over road humps
26
More than 50 would deviate
27
Of 18 people, 12 would add up to 5 minutes to AE.
28
50 gave a poor CPR a reason, 25 crew safety
29
90! Some wont deviate, but most acknowledge a
problem
30
Paramedics are the professionals at CPR. They
know if its poor.
31
43 feel outcome was affected.
32
.due to poor CPR
33
Speed humps definitely affect CPR
adversely..and may affect outcomes in cardiac
arrest.
34
Conditions affected by speed humps
35
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36
More than half of comments concern exacerbation
of condition
37
Paramedics and patients agree speed humps are
not conducive to patient care
38
Intervention and treatment
39
Nearly half!
40
Some said they would stop the vehicle - but not
all.
41
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42
10 of 27 people would neglect to undertake a
procedure they felt was essential solely due to
the presence of speed humps
43
This study found
  • Paramedics are willing to add several minutes to
    a 999 response
  • Paramedics are willing to add several minutes to
    AE with a medically unstable patient
  • Paramedics are willing to add several minutes to
    AE with a patient in cardiac arrest

44
This study found (cont.)
  • Humps affect CPR in the vast majority of cases
  • Humps affect most patient conditions and injuries
    detrimentally
  • Paramedics elect not to undertake essential
    interventions when travelling over humps

45
This is a direct result of speed humps
46
Humps present a potentially huge clinical risk
47
Speed humps affect
  • your patients
  • your staff
  • and
  • your response times.

48
Recommendations
49
  • Large scale study using both qualitative and
    quantitative elements
  • Service/nation wide (national mapping)
  • Include all types of speed hump
  • Involve ALL staff
  • Involve patients
  • Practical CPR investigation
  • Investigate injuries to staff and patients
  • Investigate damage to vehicles (and costs)

50
Dissemination
51
  • Full study available at
  • www.belchamber.org/speedhumps
  • Available personally at posters between 1300 and
    1400 on Sunday 29th June 2003

52
Grateful acknowledgements
  • Julia Williams and Indra Jones (University of
    Hertfordshire)
  • Rachael Donohoe, Rachel Peters and the Clinical
    Audit and Research Unit team (London Ambulance
    Service NHS Trust)

53
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