Publications by authors named "Martin Beed"

9 Publications

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A 6-Year Thematic Review of Reported Incidents Associated With Cardiopulmonary Resuscitation Calls in a United Kingdom Hospital.

J Patient Saf 2022 Jan 12. Epub 2022 Jan 12.

From the University of Nottingham Nottingham University Hospitals, Nottingham, United Kingdom University of Alberta Hospital, Edmonton, Canada.

Background: Critical incident reporting can be applied to cardiopulmonary resuscitation (CPR) events as a means of reducing further occurrences. We hypothesized that local CPR-related events might follow patterns only seen after a long period of analysis.

Design: We reviewed 6 years of local incidents associated with cardiac arrest calls. The following search terms were used to identify actual or potential resuscitation events: "resuscitation," "cardio-pulmonary," "CPR," "arrest," "heart attack," "DNR," "DNAR," "DNACPR," "Crash," "2222." All identified incidents were independently reviewed and categorized, looking for identifiable patterns.

Setting: Nottingham University Hospitals is a large UK tertiary referral teaching hospital.

Results: A total of 1017 reports were identified, relating to 1069 categorizable incidents. During the same time, there were approximately 1350 cardiac arrest calls, although it should be noted that many arrest-related incidents were not associated with cardiac arrest call (e.g., failure to have the correct equipment available in the event of a cardiac arrest). Incidents could be broadly classified into 10 thematic areas: no identifiable incident (n = 189; 18%), failure to rescue (n = 133; 12%), staffing concerns (n = 134; 13%), equipment/drug concerns (n = 133; 12%), communication issues (n = 122; 10%), do-not-attempt-CPR decisions (n = 101; 9%), appropriateness of patient location or transfer (n = 96; 9%), concerns that the arrest may have been iatrogenic (n = 76; 7%), patient or staff injury (n = 43; 4%), and miscellaneous (n = 52; 5%). Specific patterns of events were seen within each category.

Conclusions: By reviewing incidents, we were able to identify patterns only noticeable over a long time frame, which may be amenable to intervention. Our findings may be generalizable to other centers or encourage others to undertake this exercise themselves.
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http://dx.doi.org/10.1097/PTS.0000000000000912DOI Listing
January 2022

Co-infection in critically ill patients with COVID-19: an observational cohort study from England.

J Med Microbiol 2021 Apr;70(4)

Department of Critical Care, Nottingham University Hospital NHS Trust, Nottingham NG5 1PB, UK.

During previous viral pandemics, reported co-infection rates and implicated pathogens have varied. In the 1918 influenza pandemic, a large proportion of severe illness and death was complicated by bacterial co-infection, predominantly and . A better understanding of the incidence of co-infection in patients with COVID-19 infection and the pathogens involved is necessary for effective antimicrobial stewardship. To describe the incidence and nature of co-infection in critically ill adults with COVID-19 infection in England. A retrospective cohort study of adults with COVID-19 admitted to seven intensive care units (ICUs) in England up to 18 May 2020, was performed. Patients with completed ICU stays were included. The proportion and type of organisms were determined at <48 and >48 h following hospital admission, corresponding to community and hospital-acquired co-infections. Of 254 patients studied (median age 59 years (IQR 49-69); 64.6 % male), 139 clinically significant organisms were identified from 83 (32.7 %) patients. Bacterial co-infections/ co-colonisation were identified within 48 h of admission in 14 (5.5 %) patients; the commonest pathogens were (four patients) and (two patients). The proportion of pathogens detected increased with duration of ICU stay, consisting largely of Gram-negative bacteria, particularly and . The co-infection/ co-colonisation rate >48 h after admission was 27/1000 person-days (95 % CI 21.3-34.1). Patients with co-infections/ co-colonisation were more likely to die in ICU (crude OR 1.78,95 % CI 1.03-3.08, =0.04) compared to those without co-infections/ co-colonisation. We found limited evidence for community-acquired bacterial co-infection in hospitalised adults with COVID-19, but a high rate of Gram-negative infection acquired during ICU stay.
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http://dx.doi.org/10.1099/jmm.0.001350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289210PMC
April 2021

Does psychological trauma affect resuscitation providers?

Resuscitation 2019 09 27;142:188-189. Epub 2019 Jul 27.

ST5 Specialist Registrar in Forensic Psychiatry, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham NG3 6AA, UK. Electronic address:

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http://dx.doi.org/10.1016/j.resuscitation.2019.07.022DOI Listing
September 2019

Comparing the socioeconomic status of critical care doctors and patients.

Can J Anaesth 2018 03 27;65(3):333-334. Epub 2017 Nov 27.

Division of Pediatric Critical Care, Stollery Children's Hospital, Edmonton, AB, Canada.

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http://dx.doi.org/10.1007/s12630-017-1025-7DOI Listing
March 2018

Airway management outside the operating room: how to better prepare.

Can J Anaesth 2017 May 6;64(5):530-539. Epub 2017 Feb 6.

University of British Columbia, Vancouver, BC, Canada.

Airway management outside the operating room is associated with increased risks compared with airway management inside the operating room. Moreover, airway management-whether in the intensive care unit, emergency department, interventional radiology suite, or general wards-often requires mastery of not only the anatomically difficult airway but also the physiologically and situationally difficult airway. The 2015 Difficult Airway Society Guidelines encourage the airway team to "stop and think". This article provides a practical review of how that evidence applies during emergency airway management outside of the operating room. To counter the challenges of airway management outside the operating room, we offer a mnemonic that combines both technical and non-technical insights summarized using the seven letters of the word PREPARE (P: pre-oxygenate/position; R: reset/resist; E: examine/explicit; P: plan A/B; A: adjust/attention; R: remain/review; E: exit/explore). We hope it can unite potentially disparate personnel with a structure that allows them to make acute decisions, coordinate action, and communicate unequivocally. This multidisciplinary publication also hopes to encourage common understanding and language between anesthesiologists and non-anesthesiologists about the perils of airway management outside the operating room and the importance of airway teamwork.
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http://dx.doi.org/10.1007/s12630-017-0834-zDOI Listing
May 2017

Updating our approach to the difficult and failed airway: time to "stop and think".

Can J Anaesth 2016 Apr 11;63(4):373-81. Epub 2016 Feb 11.

Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, T6G 2B7, Canada.

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http://dx.doi.org/10.1007/s12630-016-0594-1DOI Listing
April 2016

Code Blues.

Chest 2015 Oct 22;148(4):1121. Epub 2015 Dec 22.

Edmonton, Alberta, Canada.

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http://dx.doi.org/10.1378/chest.15-0989DOI Listing
October 2015

Two decades of British newspaper coverage regarding do not attempt cardiopulmonary resuscitation decisions: Lessons for clinicians.

Resuscitation 2015 Jan 29;86:31-7. Epub 2014 Oct 29.

Critical Care Medicine, Dosseter Ethics Centre, Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada, T6G2B7. Electronic address:

Objective: To review UK newspaper reports relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in order to identify common themes and encourage dialogue.

Methods: An online media database (LexisNexis(®)) was searched for UK Newspaper articles between 1993 and 2013 that referenced DNACPR decisions. Legal cases, concerning resuscitation decisions, were identified using two case law databases (Lexis Law(®) and Westlaw(®)), and referenced back to newspaper publications. All articles were fully reviewed.

Results: Three hundred and thirty one articles were identified, resulting from 77 identifiable incidents. The periods 2000-01 and 2011-13 encompassed the majority of articles. There were 16 high-profile legal cases, nine of which resulted in newspaper articles. Approximately 35 percent of newspaper reports referred to DNACPR decisions apparently made without adequate patient and/or family consultation. "Ageism" was referred to in 9 percent of articles (mostly printed 2000-02); and "discrimination against the disabled" in 8 percent (mostly from 2010-12). Only five newspaper articles (2 percent) discussed patients receiving CPR against their wishes. Eighteen newspaper reports (5 percent) associated DNACPR decisions with active euthanasia.

Conclusions: Regarding DNACPR decision-making, the predominant theme was perceived lack of patient involvement, and, more recently, lack of surrogate involvement. Negative language was common, especially when decisions were presumed unilateral. Increased dialogue, and shared decision-making, is recommended.
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http://dx.doi.org/10.1016/j.resuscitation.2014.10.002DOI Listing
January 2015

Impact of critical care reconfiguration and track-and-trigger outreach team intervention on outcomes of haematology patients requiring intensive care admission.

Ann Hematol 2010 May 30;89(5):505-12. Epub 2009 Oct 30.

Department of Clinical Haematology, Nottingham University Hospitals-City Campus, Nottingham, UK.

Patients with haematological disorders have previously been considered to have poor outcomes following admission to intensive care units. Although a number of haematology centres from outside the UK have now demonstrated improved outcomes, the continuing perception of poor outcomes in this patient group continues to adversely affect their chances of being admitted to some intensive care units (ICUs). Over the past 10 years, there have been many advances within the disciplines of both haematology and intensive care medicine. This study was done to assess outcomes and the impact of an early warning scoring system (EWS) and early involvement of ICU outreach teams. One hundred five haematology patients (haematopoietic stem cell transplant (HSCT) or non-HSCT) had 114 admissions to ICU between April 2006 and August 2008 which coincided with hospital-wide implementation of EWS. The survival to ICU discharge was 56 (53%). Thirty-three (33%) patients were alive at 6 months giving a 1-year survival of 31%. Of the 39 HSCT patients, nine were post-autologous and 30 post-allogeneic transplant. The survival to ICU discharge was 22 (56%) with 14 (36%) patients alive at 6 months. One year survival was 36%. Prior to the introduction of EWS and critical care outreach team (2004), survival to ICU discharge was 44% which has increased to 53% (2006-2008). This is despite an increase in mechanical ventilation in 2006-2008 (50%) as compared to 2004 (32%).The improvement in ICU survivorship was even more prominent in HSCT patients (37% in 2004 versus 56% in 2006-2008). There was a trend towards decreasing Acute Physiology and Chronic Health Evaluation scores with time, suggesting appropriate patients being identified earlier and having timely escalation of their treatment.
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http://dx.doi.org/10.1007/s00277-009-0853-0DOI Listing
May 2010
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