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Publication Urgent Care Centre Eligible Presentations in a Remote Emergency Department(Wiley, 2025-09-09) Johnstone, Jack; Perry, Chris; Rigby, Ellice; Capps, Lisa; Johnson, Richard; Johnstone, Jack; Medical and DentalObjective: This study aimed to identify presentations to the Alice Springs Emergency Department that could be managed in an Urgent Care Centre (UCC). Methods: We reviewed 1 year of ED presentation data at Alice Springs Hospital (ASH) from August 2022 to August 2023 and used a sequence of exclusion criteria to identify patients most likely to be eligible for UCC management. Results: Our model indicated that 35.0% of ED presentations at ASH during this period could have been managed in a UCC. Only 41.5% of these presentations (14.5% of total presentations) occurred during UCC operating hours. Conclusions: According to this model, a significant proportion of ED presentations could potentially be managed in a UCC, although a large proportion of these occurred outside of UCC opening hours. The impact of the introduction of a UCC into a remote community on ED presentations, patient experience, patient outcomes and the broader system requires further study.Publication Defining capabilities in deployed UK military prehospital emergency care(BMJ Publishing Group, 2024-03-21) Thompson, Michael; Jefferson, Oliver; James, Thomas; Waller, Bentley; Reed, Richard; Slade, Harmony; Pynn, Harvey; Thompson, Michael; Medical and DentalThe UK military prehospital emergency care (PHEC) operational clinical capability framework must be updated in order that it retains its use as a valid operational planning tool. Specific requirements include accurately defining the PHEC levels and the ‘Medical Emergency Response Team’ (MERT), while reinforcing PHEC as a specialist area of clinical practice that requires an assured set of competencies at all levels and mandatory clinical currency for vocational providers. A military PHEC review panel was convened by the Defence Consultant Advisor (DCA) for PHEC. Each PHEC level was reviewed and all issues which had, or could have arisen from the existing framework were discussed until agreement between the six members of this panel was established. An updated military PHEC framework has been produced by DCA PHEC, which defines the minimum requirements for each operational PHEC level. These definitions cover all PHEC providers, irrespective of professional background. The mandatory requirement for appropriate clinical exposure for vocational and specialist providers is emphasised. An updated definition of MERT has been agreed. This update provides clarity to the continually evolving domain of UK military PHEC. It sets out the PHEC provider requirements in order to be considered operationally deployable in a PHEC role. There are implications for training, manning and recruitment to meet these requirements, but the processes required to address these are already underway and well described elsewhere.Publication The effects of sleep deprivation and extreme exertion on cognitive performance at the world-record breaking Suffolk Back Yard Ultra-marathon(Public Library of Science, 2024-03-14) Benchetrit, Sandy; Badariotti, Juan; Corbett, Jo; Costello, Joseph; Benchetrit, Sandy; Medical and DentalUsing a prospective observational design, this study investigated the hypothesis that competing in the Suffolk Back Yard Ultra-marathon, would result in impaired cognitive performance and examined whether pre-race sleep patterns could mitigate this. Fifteen runners (1 female) volunteered to undertake this study and eleven males were included in the final analysis. Before the race and after withdrawal participants completed the following cognitive performance tasks: 2 Choice Reaction Time (2CRT), Stroop, and the Tower Puzzle. Pre-race sleep strategies were subjectively recorded with a 7-day sleep diary. Following race withdrawal, reaction time increased (Δ 77±68 ms; p = 0.004) in the 2CRT and executive function was impaired in the Stroop task (Interference score Δ -4.3±5.6 a.u.; p = 0.028). Decision making was not affected in the Tower Puzzle task. There was a significant correlation between the pre-race 7-day average sleep scores and both 2CRT Δ throughput (r = 0.61; p = 0.045) and 2CRT Δ RT (r = -0.64; p = 0.034). This study supports the hypothesis that running an ultra-marathon, which includes at least one night of sleep deprivation, impairs cognitive performance and provides novel evidence suggesting good sleep quality, in the week prior to an ultra-marathon, could minimise these effects.Publication RCEM best practice guideline: suspected cannabinoid hyperemesis syndrome in emergency departments(BMJ Publishing Group, 2024-03-06) Humphries, Christopher; Gillings, Marianne; Gillings, Marianne; Medical and DentalCannabinoid hyperemesis syndrome (CHS) is an episodic syndrome of cyclic vomiting in the context of the prolonged use of cannabis. The Royal College of Emergency Medicine Toxicology Special Interest Group has produced guidance to support emergency medicine clinicians with the recognition and treatment of people experiencing CHS.Considerations regarding recognition, investigation and communication are discussed, and recommendations regarding treatment options (which include haloperidol and capsaicin) are made. There is a focus on making recommendations on the best available evidence.