Adam Boulton
@adamboulton17.bsky.social
NIHR Doctoral Research Fellow, undertaking a PhD in resuscitation
Anaesthetics and intensive care registrar in the West Mids
TRIC Network co-chair
Anaesthetics and intensive care registrar in the West Mids
TRIC Network co-chair
Big thank you to all collaborators who made this possible!
And to the #NIHR for funding the Doctoral Research Fellowship
@nihr.bsky.social
And to the #NIHR for funding the Doctoral Research Fellowship
@nihr.bsky.social
June 5, 2025 at 1:46 PM
Big thank you to all collaborators who made this possible!
And to the #NIHR for funding the Doctoral Research Fellowship
@nihr.bsky.social
And to the #NIHR for funding the Doctoral Research Fellowship
@nihr.bsky.social
🧠 Why this matters?
PHCC is associated with improved outcomes for OHCA patients
They offer advanced interventions or can make timely decisions to stop resuscitation when appropriate.
⚠️Unequal access = potential survival and quality-of-care gap
sciencedirect.com/science/arti...
PHCC is associated with improved outcomes for OHCA patients
They offer advanced interventions or can make timely decisions to stop resuscitation when appropriate.
⚠️Unequal access = potential survival and quality-of-care gap
sciencedirect.com/science/arti...
Prehospital critical care beyond advanced life support for out-of-hospital cardiac arrest: A systematic review
To assess the clinical outcomes of patients with out-of-hospital cardiac arrest attended by prehospital critical care teams compared to non-critical c…
sciencedirect.com
June 5, 2025 at 1:46 PM
🧠 Why this matters?
PHCC is associated with improved outcomes for OHCA patients
They offer advanced interventions or can make timely decisions to stop resuscitation when appropriate.
⚠️Unequal access = potential survival and quality-of-care gap
sciencedirect.com/science/arti...
PHCC is associated with improved outcomes for OHCA patients
They offer advanced interventions or can make timely decisions to stop resuscitation when appropriate.
⚠️Unequal access = potential survival and quality-of-care gap
sciencedirect.com/science/arti...
📌 Other findings:
• 🌍 No association with neighbourhood ethnicity
• ⏰ Time of day matters:
– 12–6pm: 36.2% received PHCC ☀️
– 12–6am: only 10.5% 🌙
– Confirmed in adjusted models
• ♀️ Women less likely to get PHCC 🚨
• 🌍 No association with neighbourhood ethnicity
• ⏰ Time of day matters:
– 12–6pm: 36.2% received PHCC ☀️
– 12–6am: only 10.5% 🌙
– Confirmed in adjusted models
• ♀️ Women less likely to get PHCC 🚨
June 5, 2025 at 1:46 PM
📌 Other findings:
• 🌍 No association with neighbourhood ethnicity
• ⏰ Time of day matters:
– 12–6pm: 36.2% received PHCC ☀️
– 12–6am: only 10.5% 🌙
– Confirmed in adjusted models
• ♀️ Women less likely to get PHCC 🚨
• 🌍 No association with neighbourhood ethnicity
• ⏰ Time of day matters:
– 12–6pm: 36.2% received PHCC ☀️
– 12–6am: only 10.5% 🌙
– Confirmed in adjusted models
• ♀️ Women less likely to get PHCC 🚨
📍 Main finding:
Adjusting for above clinical factors (age, aetiology, rhythm, time of day etc):
• PHCC attendance more likely in more affluent neighbourhoods 🏚️🏡
• OR: 1.034 per decile of affluence 📈
• Strongest OR: 👨⚕️Doctor-led teams
• Weakest OR: 🚑Paramedic-led teams
Adjusting for above clinical factors (age, aetiology, rhythm, time of day etc):
• PHCC attendance more likely in more affluent neighbourhoods 🏚️🏡
• OR: 1.034 per decile of affluence 📈
• Strongest OR: 👨⚕️Doctor-led teams
• Weakest OR: 🚑Paramedic-led teams
June 5, 2025 at 1:46 PM
📍 Main finding:
Adjusting for above clinical factors (age, aetiology, rhythm, time of day etc):
• PHCC attendance more likely in more affluent neighbourhoods 🏚️🏡
• OR: 1.034 per decile of affluence 📈
• Strongest OR: 👨⚕️Doctor-led teams
• Weakest OR: 🚑Paramedic-led teams
Adjusting for above clinical factors (age, aetiology, rhythm, time of day etc):
• PHCC attendance more likely in more affluent neighbourhoods 🏚️🏡
• OR: 1.034 per decile of affluence 📈
• Strongest OR: 👨⚕️Doctor-led teams
• Weakest OR: 🚑Paramedic-led teams
📈 Who got prehospital critical care?
Independent association with PHCC attendance for:
•👶 Younger age
•♂️ Male sex
•🏙️ Public/non-home locations
•🩸 Aetiologies: asphyxia, drowning, trauma
•⚡️ Shockable rhythms
•❤️ Bystander-witnessed w/ CPR
•🌞 Daytime arrests
Independent association with PHCC attendance for:
•👶 Younger age
•♂️ Male sex
•🏙️ Public/non-home locations
•🩸 Aetiologies: asphyxia, drowning, trauma
•⚡️ Shockable rhythms
•❤️ Bystander-witnessed w/ CPR
•🌞 Daytime arrests
June 5, 2025 at 1:46 PM
📈 Who got prehospital critical care?
Independent association with PHCC attendance for:
•👶 Younger age
•♂️ Male sex
•🏙️ Public/non-home locations
•🩸 Aetiologies: asphyxia, drowning, trauma
•⚡️ Shockable rhythms
•❤️ Bystander-witnessed w/ CPR
•🌞 Daytime arrests
Independent association with PHCC attendance for:
•👶 Younger age
•♂️ Male sex
•🏙️ Public/non-home locations
•🩸 Aetiologies: asphyxia, drowning, trauma
•⚡️ Shockable rhythms
•❤️ Bystander-witnessed w/ CPR
•🌞 Daytime arrests
Breakdown of PHCC assets:
• 🚁 HEMS: 85.5% (53.9% by helicopter)
• 👨⚕️ BASICS: 13.3%
• 🌍 NHS: 5.1%
A HEMS or NHS prehospital doctor attended 50% of PHCC cases 🩺
• 🚁 HEMS: 85.5% (53.9% by helicopter)
• 👨⚕️ BASICS: 13.3%
• 🌍 NHS: 5.1%
A HEMS or NHS prehospital doctor attended 50% of PHCC cases 🩺
June 5, 2025 at 1:46 PM
Breakdown of PHCC assets:
• 🚁 HEMS: 85.5% (53.9% by helicopter)
• 👨⚕️ BASICS: 13.3%
• 🌍 NHS: 5.1%
A HEMS or NHS prehospital doctor attended 50% of PHCC cases 🩺
• 🚁 HEMS: 85.5% (53.9% by helicopter)
• 👨⚕️ BASICS: 13.3%
• 🌍 NHS: 5.1%
A HEMS or NHS prehospital doctor attended 50% of PHCC cases 🩺
📊 Who was studied?
All OHCAs treated by 3 English NHS ambulance services (2018–2023)
Out of 61,011 patients:
👥 26.5% attended by prehospital critical care (varied between services)
🚑 >1 PHCC team in 7.9%
🚨 PHCC first on scene in 3.9%
All OHCAs treated by 3 English NHS ambulance services (2018–2023)
Out of 61,011 patients:
👥 26.5% attended by prehospital critical care (varied between services)
🚑 >1 PHCC team in 7.9%
🚨 PHCC first on scene in 3.9%
June 5, 2025 at 1:46 PM
📊 Who was studied?
All OHCAs treated by 3 English NHS ambulance services (2018–2023)
Out of 61,011 patients:
👥 26.5% attended by prehospital critical care (varied between services)
🚑 >1 PHCC team in 7.9%
🚨 PHCC first on scene in 3.9%
All OHCAs treated by 3 English NHS ambulance services (2018–2023)
Out of 61,011 patients:
👥 26.5% attended by prehospital critical care (varied between services)
🚑 >1 PHCC team in 7.9%
🚨 PHCC first on scene in 3.9%