Research

We are proud to be a research-active organisation, which means we develop and host research studies which contribute to and improve emergency medical care and patient outcomes in the UK and worldwide.

As London has such a diverse population with a variety of health conditions and needs, we have a wide-ranging research portfolio to work with and can investigate a number of different topics. And not just in clinical areas; as we’re a large organisation we can also explore organisational and workforce issues too.

Take a look at some of our published research in the drop down box below, or find out about our current research projects by clicking on the boxes at the bottom of the page.

  • How can I start a research project with you?

    To carry out research involving our patients, staff or our data, please get in touch with our research team as soon as possible. They can discuss the feasibility of carrying out the research and, if possible, grant approval. If you have any questions or concerns, please get in touch with us.

    [email protected]
    020 7783 2504

     

  • Completed research projects

    PARAMEDIC2

    This trial, funded by the NIHR Health Technology Assessment, aimed to understand whether using adrenaline is helpful or harmful when treating someone experiencing a cardiac arrest outside of a hospital. The study ran between 2014 and 2017. PARAMEDIC-2 is officially the largest cardiac arrest drug trial in Europe, involving 8,014 patients (2,102 recruited by the LAS) and the largest randomised placebo-controlled trial examining the role of adrenaline in cardiac arrest.

    Background

    Adrenaline has been an integral component of advanced life support for over 50 years, but it had not previously been fully tested to see if it is beneficial for patients who have a cardiac arrest outside of hospital. This randomised controlled trial compared the clinical and cost effectiveness of adrenaline versus a saline placebo for the treatment of out-of-hospital cardiac arrest. Drugs were blinded so that paramedics were unaware of which drug they were administering. All other aspects of resuscitation practices remained unchanged.

    Four other ambulance trusts also participated in the trial (South Central, North East, West Midlands and Wales). The trial was supported by the International Liaison Committee on Resuscitation, Resuscitation Council (UK), College of Paramedics and the Joint Royal College Ambulance Liaison Committee.

    Results

    The trial found that, after 30 days, adrenaline resulted in a slight increase in survival but much greater likelihood of severe disability.

    The results were published in August 2018 in the New England Journal of Medicine. Further details can be found on the trial website.

    PARAMEDIC-2 was listed in the top 100 papers for 2018 (#27) in terms of the Altmetric score.


    RIGHT-2

    This trial, funded by the British Heart Foundation, aimed to understand whether glyceryl trinitrate (GTN) improves outcomes for patients who experience a stroke. The study ran between 2016 and 2018.

    Background

    High blood pressure (BP) is common in stroke patients and generally associated with poor outcomes. This trial aimed to understand if using GTN as soon as possible after the onset of a stroke improved patients’ neurological outcome. This randomised controlled trial involved paramedics administering either GTN or placebo patches to patients within four hours of them experiencing symptoms.

    Six other ambulance trusts (East Midlands, West Midlands, East of England, South West, South East Coast and Wales) also participated in the trial.

    Results

    The trial found that pre-hospital treatment with GTN for patients with presumed stroke does not appear to improve functional outcome.

    The results were published in February 2019 in The Lancet.

  • Our published research

    Here are some publications from  our most recent research that either feature our staff or some of our data. Names of our staff involved in each project are highlighted in bold.

    2019

    Rationale and protocol for the assessment of impact of real time continuous glucose monitoring on people presenting with severe Hypoglycaemia (AIR-CGM) study
    Authors: Parizad Avari; Rozana Ramli; Monika Reddy; Nick Oliver; Rachael Fothergill
    Journal: BMC Endocrine Disorders
    Status: In press

     

    Using deterministic record linkage to link ambulance and emergency department data: is it possible without patient identifiers?
    Authors: Sophie Clark, Mary Halter, Alison Porter, Holly Christina Smith, Martin Brand, Rachael Fothergill, Jaqualine Lindridge, Martin McTigue, Helen Snooks
    Journal: International Journal of Population Data Science
    Status: Published August 2019
    Read the study here.

     

    The effects of adrenaline in out of hospital cardiac arrest with shockable and non-shockable rhythms: Findings from the PACA and PARAMEDIC-2 randomised controlled trials
    Authors: Gavin Perkins, Claire Kenna, Chen Ji, Charles Deakin, Jerry P Nolan, Tom Quinn, Rachael Fothergill, Imogen Gunson, Helen Pocock, Nigel Rees, Karl Charlton, Judith Finn, Simon Gates, Ranjit Lall
    Journal: Resuscitation
    Status: Published July 2019
    Read the study here.

     

    Repeated adrenaline doses and survival from an out-of-hospital cardiac arrest
    Authors: Rachael Fothergill, Amber Emmerson, Rajeshwari Iyer, Johanna Lazarus, Mark Whitbread, Jerry Nolan, Charles Deakin, Gavin Perkins
    Journal: Resuscitation
    Status: Published May 2019
    Read the study here.

     

    Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial.
    Authors: The RIGHT2 investigators, and Rachael Fothergill, Neil Thompson, Johanna Lazarus, Helen Werts
    Journal: The Lancet
    Status: Published February 2019
    Read the study here.

     

    Attitudes to cardiopulmonary resuscitation and defibrillator use: a survey of UK adults in 2017
    Authors: Claire Hawkes, Terry Brown, Scott Booth, Rachael Fothergill, Niroshan Siriwardena, Sana Zakaria, Sara Askew, Julia Williams, Nigel Rees, Chen Ji, Gavin Perkins
    Journal: Journal of the American Heart Association
    Status: Published February 2019
    Read the study here.

     


    2018

    Chapters: ‘Research and evidence-based practice’ and ‘Using clinical audit to improve patient care’.
    Authors: Rachael Fothergill, Joanna Shaw
    Journal: Blaber’s foundations for paramedic practice: A theoretical perspective
    Status: Published November 2018

     

    Temporal and geographic patterns of stab injuries in young people: a retrospective cohort study from a UK major trauma centre
    Authors: Paul Vulliamy, Mark Faulkner, Graham Kirkwood, Anita West, Breda O’Neill, Martin P Griffiths, Fionna Moore, Karim Brohi
    Journal: British Medical Journal
    Status: Published November 2018
    Read the study here.

     

    Rationale and design of: A randomised trial of expedited transfer to a cardiac arrest center for non-ST elevation out-of-hospital cardiac arrest: The ARREST randomised controlled trial.
    Authors: Tiffany Patterson, Alexander Perkins, Gavin Perkins, Tim Clayton, Richard Evans, Hanna Nguyen, Karen Wilson, Mark Whitbread, Johanna Hughes, Rachael Fothergill, Joanne Nevett, Iris Mosweu, Paul McCrone, Miles Dalby, Roby Rakhit, Philip MacCarthy, Divaka Perera, Jerry Nolan, Simon Redwood
    Journal: American Heart Journal
    Status: Published October 2018
    Read the study here.

     

    A randomized trial of Epinephrine in out-of-hospital cardiac arrest (PARAMEDIC2)
    Authors: Gavin Perkins, Chen Ji, Charles Deakin, Tom Quinn, Jerry P. Nolan, Charlotte Scomparin, Scott Regan, John Long, Anne Slowther, Helen Pocock, John Black, Fionna Moore, Rachael Fothergill, Nigel Rees, Lyndsey O’Shea, Mark Docherty, Imogen Gunson, Kyee Han, Karl Charlton, Judith Finn, Stavros Petrou, Nigel Stallard, Simon Gates, and Ranjit Lall, et al.
    Journal: New England Journal of Medicine
    Status: Published August 2018
    Read the study here.

     

    Characteristics of neighborhoods with high incidence of out-of-hospital cardiac arrests and low bystander cardiopulmonary resuscitation rates in England.
    Authors: Terry Brown, Scott Booth, Claire Hawkes, Jasmeet Soar, Julian Mark, James Mapstone, Rachael Fothergill, Sarah Black, Helen Pocock, Anna Bichmann, Imogen Gunson, Gavin Perkins
    Journal: European Heart Journal
    Status: Published June 2018
    Read the study here.

     

    Influence of prehospital airway management on neurological outcome in patients transferred to a heart attack centre following out-of-hospital cardiac arrest
    Authors: Tim Edwards, Julia Williams, Michaela Cottee
    Journal: Emergency Medicine Australasia
    Status: Published May 2018
    Read the study here.


    2017

    London Ambulance Service source data on choking incidence for the calendar year 2016: an observational study
    Authors: Matthew Pavitt, Joanne Nevett, Laura Swanton, Matthew Hind, Michael Polkey, Malcolm Green, Nicholas Hopkinson
    Journal: BMJ Open Respiratory Research
    Status: Published December 2017
    Read the study here.

     

    Epidemiology and outcomes from out-of-hospital cardiac arrests in England
    Authors: C Hawkes, S Booth, C Ji, SJ Brace-McDonnell, A Whittington, J Mapstone, MW Cooke, CD Deakin, CP Gale, R Fothergill, JP Nolan, et al
    Journal: Resuscitation
    Status: Published November 2017
    Read the study here.

     

    Algorithms to guide ambulance clinicians in the management of emergencies in patients with implanted rotary left ventricular assist devices
    Authors: Christopher Bowles, Rachel Hards, Neil Wrightson et al. Mark Faulkner
    Journal: British Medical Journal
    Status: Published November 2017
    Read the study here.

     

    Contemporary trends in cardiogenic shock: Incidence, intra-aortic balloon pump utilisation and outcomes from the London Heart Attack Group
    Authors: KS Rathod, S Koganti, MB Iqbal, AK Jain, SS Kalra, Z Astroulakis, P Lim, R Rakhit, MC Dalby, T Lockie, IS Malik, CJ Knight, M Whitbread, A Mathur, S Redwood, PA MacCarthy, A Sirker, C O’Mahony, A Wragg, DA Jones
    Journal: European Heart Journal Acute Cardiovascular Care
    Status: Published November 2017
    Read the study here.

     

    Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review
    Authors: CM Smith, SN Lim Choi Keung, MO Khan, TN Arvanitis, R Fothergill, Chris Hartley-Sharpe, MH Wilson, Gavin D Perkins
    Journal: European Heart Journal Qual Care Clin Outcomes
    Status: Published October 2017
    Read the study here.

     

    Double sequential defibrillation therapy for out-of-hospital cardiac arrests: The London experience
    Authors: Amber Emmerson, Mark Whitbread, Rachael Fothergill
    Journal: Resuscitation
    Status: Published June 2017
    Read the study here.

     

    Can pre-hospital National Early Warning Scores identify patients most at risk from subsequent deterioration?
    Authors: Joanna Shaw, Rachael Fothergill, Sophie Clark, Fiona P Moore
    Journal: Emergency Medicine Journal
    Status: Published May 2017
    Read the study here.

     

    Support and Assessment for Fall Emergency Referrals (SAFER)2: a cluster randomised trial and systematic review of clinical effectiveness and cost-effectiveness of new protocols for emergency ambulance paramedics to assess older people following a fall with referral to community-based care when appropriate
    Authors: Helen Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze et al
    Journal: Health Technology Assessment
    Status: Published March 2017
    Read the study here.

     

    Paramedic assessment of older adults following falls including community care referral pathway: Cluster randomised trial
    Authors: Helen A. Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill et al
    Journal: Annals of Emergency Medicine
    Status: Published March 2017
    Read the study here.

     

    A randomised trial of expedited transfer to a cardiac arrest centre for non-ST elevation ventricular fibrillation out-of-hospital cardiac arrest: The ARREST pilot randomised trial
    Authors: Tiffany Patterson, Gavin D Perkins, Jubin Joseph, et al Mark Whitbread, Rachael Fothergill, Joanne Nevett
    Journal: Resuscitation
    Study: Published March 2017
    Read the study here.