Ambulance Research Repository (AMBER)

Houghton Budd, Silas

Alexander-Elborough, Eleanor

Brandon, Richard

Fudge, Chris

Hardy, Scott

Hopkins, Laura

Paul, Ben

Phillips, Sloane

Thatcher, Sarah

Winsor, Paul

Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation

Murphy-Jones, Georgina

Laverty, Diane

Stonehouse, Joanne

Infusing the palliative into paramedicine: inter-professional collaboration to improve the end of life care response of UK ambulance services

Phillips, D.

Mudge, N.

Walter, S.

Fassbender, K.

Stroke identification in ambulance emergency operations centres - a reason for time loss in stroke management?

Cochrane, Alice

Taking the holistic route

Jackson, Craig

amber - ambulance research repository
CPR Induced Consciousness: Insights from ambulance staff
Authors Jackson, Craig
Citation Jackson, C., 2025. CPR Induced Consciousness: Insights from
ambulance staff. [Poster presentation]. 999 EMS Research Forum
Annual Conference 2025. http://hdl.handle.net/20.500.12417/2147
Download date 2026-01-24 00:55:59
Link to Item https://hdl.handle.net/20.500.12417/2147
Repository Link https://amber.openrepository.com
CPR Induced Consciousness: Insights from ambulance staff 
Craig G Jackson, Helen Pocock, Andrew Claxton, Charles D Deakin
● CPR induced consciousness (CPR-IC) describes 
witnessed consciousness during CPR without 
having return of spontaneous circulation1 
● Increasing discussion in literature around the 
incidence but not routinely reported by EMS1 
● Being unable to quantify incidence makes it 
difficult to understand trends and determine if it is 
a prognostic indicator2 
● ePR search identified only a few cases (n=3)
● 87 survey responses
● 62 (71%) responses qualified more than 3 
years
● 70 (84%) respondents witnessed CPR-IC and 
31 (37%) witnessed more than once 
● Manual CPR (67%) was reported to be in 
progress more than mechanical CPR
● 47 respondents (56%) reported lack of 
confidence in dealing with CPR-IC
● Free text ePR search in one English 
ambulance service over a 10-year period. Terms 
associated with CPR
● Internal anonymous questionnaire shared 
internally. 13 multiple choice questions. Multi-
response was offered in some questions to  
enable report on multiple patients
● Data collection: Presentation, frequency, 
presenting rhythm, impact on patient care and 
condition at hospital handover
● Ambulance staff do not often report on ePR 
CPR-IC 
● Data is limited due to reliance on staff recall 
and cyber attack
● Suggestion for implementation of data 
collection feature on ePR for CPR-IC could 
enhance understanding of the significance
Conclusion
 Howard, J. et al. (2022) ‘Pre-hospital guidelines for CPR-induced consciousness (CPRIC): A 
scoping review’, Resuscitation Plus, 12, p. 100335. doi:10.1016/j.resplu.2022.100335. 
Olaussen, A. et al. (2017) ‘Consciousness induced during cardiopulmonary resuscitation: An 
observational study’, Resuscitation, 113, pp. 44–50. doi:10.1016/j.resuscitation.2017.01.018. 
Background Methods
Results
References


CPR Induced Consciousness: Insights from ambulance staff

Self-care – your way

Soiland-Reyes, Claudia

Tang, Sammer

Clayton, Stephen

Bell, Steve

amber - ambulance research repository
Role of the NHS Ambulance Service in identifying
and addressing health inequalities - a service
evaluation of North West Ambulance Service (NWAS)
workforce’ awareness, understanding and practice
Authors Soiland-Reyes, Claudia;Tang, Sammer;Clayton, Stephen;Bell,
Steve
Citation Soland-Reyes, C. et al, 2025. Role of the NHS Ambulance Service
in identifying and addressing health inequalities -A service
evaluation of North West Ambulance Service (NWAS) workforce’
awareness, understanding and practice. [Poster presentation].
999 EMS Research Forum Annual Conference 2025. http://
hdl.handle.net/20.500.12417/2146
Download date 2026-01-24 00:40:00
Link to Item https://hdl.handle.net/20.500.12417/2146
Repository Link https://amber.openrepository.com
Role of the NHS Ambulance Service
in identifying and addressing health inequalities - 
A service evaluation of North West Ambulance Service (NWAS)
workforce’ awareness, understanding and practice  
Claudia Soland-Reyes 1, Sammer Tang 2, Stephen Clayton 3, and Steve Bell 1
1 North West Ambulance Service NHS Trust, 2Cwm Taf Morgannwg University Health Board , 3 University of Liverpool.
Background
The Health Care Act 2022 1 places mandatory duties on NHS 
organisations to reduce health inequalities. To achieve this, staff must 
be equipped with appropriate knowledge and skills. 
To tackle health inequalities, we need to understand the complex 
interaction between contributory factors; worse health outcomes occur 
when people have limited access to health care, experience poorer-
quality care, and practise more risky health-related behaviours, but 
these factors are influenced by the wider determinants of health, such 
as income, housing, environment, transport, education, and work 2, 
which are not spread equally across society 3. 
Make Every Contact Count (MECC) is an approach to behaviour change 
that uses the millions of day-to-day interactions to tackle health 
inequalities by supporting individuals change lifestyle behaviour or
Aims
A service evaluation was 
undertaken across clinical 
and non-clinical staff and 
volunteers at the North 
West Ambulance Service 
(NWAS), a regional NHS 
ambulance service, to 
assess awareness and 
understanding of health 
inequalities and MECC, 
and to inform future 
training design.
Methods
• All NWAS staff and volunteers (approx. 7,415) were invited to respond to an anonymous structured survey, assessing 
their understanding of health inequalities and MECC, and their application in practice. 
• The survey was created in Microsoft Forms, contained 41 closed questions and 4 open open-ended questions to 
capture participants additional insights. Questions were organised into three main sections: 
1. Awareness and understanding of health inequalities, wider determinants of health and prevention; 
2. Previous knowledge and training; and 
3. Awareness and understanding of MECC, practice, barriers or opportunities, with different sections for 
patient-facing and non-patient facing staff. 
• Minimal personal information was collected (area, service line, and role). Recruitment was through self-selection 
sampling. The survey was open for responses between 5th March and 30th April 2024. Descriptive statistical analysis 
was applied to closed responses. Open-ended responses were analysed thematically. 
Results
• After data cleaning, number of valid responses was 393, 5.3% response rate.
• 62.1% responses were from patient-facing staff (staff and volunteers).
• 84% and 33% of respondents indicated they were familiar with the terms ‘health 
inequalities’ and ‘wider determinants of health’ respectively, highlighting a 
knowledge gap on health inequalities’ contributory factors.
• 16.5% of respondents had received MECC or similar training. Amongst patient-
facing staff, 82% agreed that signposting patients to local services would benefit 
patients’ health and wellbeing; only 23% and 10% reported doing this regularly, 
in person and remotely, respectively.
• Overall, 82% of respondents agreed NWAS should play a role in improving 
population and workforce health. 
• Thematic analysis of open-ended responses identified interrelated themes to 
barriers and opportunities, including that a MECC approach is not perceived as 
part of roles, a lack of training and confidence in abilities to do MECC, system 
limitations to do MECC, and improved access to a directory of available services. 
References:
1. Health and Care Act 2022
2. Health inequalities in a nutshell | The King's Fund
3. Health disparities and health inequalities: applying All Our 
Health - GOV.UK
4. Make Every Contact Count (MECC): Consensus statement
5. Helping to reduce Health Inequalities - aace.org.uk
6. Tang, S., 2019. DOI:10.13140/RG.2.2.12544.46082
7. Schofield et al, 2024. doi.org/10.21203/rs.3.rs-5288861/v1
Presenting author: claudia.soiland-reyes@nwas.nhs.uk
Conclusions
This is the first known survey of its kind within NHS ambulance services. Findings show strong 
workforce support for NWAS having a role in improving population health but reveal gaps in 
understanding of health inequalities and implementation of MECC. Findings provide actionable 
findings to inform future training and support, and useful baseline data to assess improvement. 
Amongst the study limitations, there was low response rate across roles, responses are subject to 
self-selection bias; quantitative analysis only uses proportional data, and qualitative analysis is only 
exploratory as data was not specifically collected to provide in-depth responses.
"Design adapted from doi.org/10.7490/f1000research.1120199.1 under CC-BY-4.0 license
referring them to local support services; for instance, to improve diet, 
exercise, or risky behaviours; or to support them managing debt, gaining 
employment or tackling housing issues 4. 
In 2023, the Association of Ambulance Chief Executives (AACE) 
published a national consensus establishing a shared commitment to 
‘Strengthening the role of the ambulance sector in reducing health 
inequalities’ 5.
There is limited evidence regarding the use of MECC in urgent and 
emergency settings. Amongst these, two studies have looked at 
understanding ambulance clinicians’ attitudes towards public health and 
their current practice for health promotion 6, and how health promotion 
is delivered by emergency department nurses and paramedics 7. 
Findings indicated uncertainty on whether health promotion is part of 
paramedics’ standard practice, and gaps in training. 


Role of the NHS Ambulance Service in identifying and addressing health inequalities - a service evaluation of North West Ambulance Service (NWAS) workforce’ awareness, understanding and practice

Heys, Stephanie

Downe, Soo

Thomson, Gill

'I know my place'; a meta-ethnographic synthesis of disadvantaged and vulnerable women's negative experiences of maternity care in high-income countries

Al-Mayhani, T.

Jonsdottir, E.

Hunter, P.

Chandratheva, A.

Hargroves, D.

Haider, S.

Simster, R.

Video triage significantly reduces TIA and stroke-mimics admissions to stroke service

Mortimer, Craig

A preliminary study to identify correlations between blood glucose levels and cardiorespiratory observations in acute asthma patients receiving nebulised salbutamol

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