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Papers and Articles

Magpas continues to lead the way in research into the causes of and treatment of major trauma. Through our research Magpas hopes to learn lessons and develop ways to improve treatment and reduce the number of trauma cases in the future.

"Trauma kills or seriously injures over 3,500 children and young people each year. If it were a disease it would be called an epidemic. We are determined to learn as much as we can so we can improve treatment and prevention." Dr James French Magpas Research Fellow

Magpas Helimedix produce a number of articles and papers every year, many go on to be published or displayed at Pre-Hospital Emergency Medicine conferences nationally and internationally. Here is a selection of our most recent publications.
Surgical Airway Frequency

Rapid Sequence Induction of anaesthesia in a pre-hospital setting is indicated in a small but significant number of critically ill patients. Rapid Sequence Induction (RSI) of anaesthesia is associated with improved outcomes in certain patients, but it may also lead to harm. A surgical airway may need to be performed if a conventional airway cannot be established using oral endotracheal intubation or supraglottic airways.

In this document Magpas Consultants Dr Jürgen Klein and Dr Rod Mackenzie, Dr Simon Lewis and Magpas Dr Anne Booth and Dr Alistair Steel investigate the incidence of surgical airway use in the pre-hospital setting.

Rapid Sequence Induction of Anaesthesia

Rapid Sequence Induction of anaesthesia in a Pre-Hospital setting is associated with improved outcomes in certain patients. Difficult airways are frequently encountered. The UK's Difficult Airway Society (DAS) provide guidance for managing patients in whom direct laryngoscopy is unsuccessful. However, DAS guidance is designed for in-hospital use and does not account for the time, distance and equipment challenges associated with pre-hospital anaesthesia.

In this document Magpas Anaesthetists Dr Anne Booth, Dr Alistair Steel and Magpas Consultants Dr Jürgen Klein and Dr Rod Mackenzie detail an application of DAS guidelines to the pre-hospital setting when undertaking Rapid Sequence Induction of anaesthesia.
Simulation Improves the Safety of Pre-Hospital Emergency Rapid Sequence Induction Anaesthesia

Magpas provides a number of Simulation based training courses throughout the year with state of the art 3G Laerdal SimMan. Places for the 2011 course are still available, further details of Magpas courses are available at Helimedix Training.

In this document Magpas Consultant Dr Rod Mackenzie, Dr Alistair Steel, London HEMS Consultant Anaesthetist Dr Anil Hormis, Research Fellow Dr A Batchelder and Critical Care Paramedics Mr Tim Daniel and Mr Nat Holding investigate if Magpas simulation-based training can improve the safety of pre-hospital anaesthesia by reducing the number of critical incidents which may occur and by improving crew resource management (CRM) Thumbnail of Berlin poster (click to jump to full PDF of poster)

There are a number of external publications available on Magpas articles, predominately regarding the provision of Pre-Hospital Critical Care and retrieval. A constant resource is the Emergency Medical Journal a selection of some key Magpas published articles can be found below:

In addition to the research detailed below, an ongoing research project known as CTARP (Cambridge Trauma Audit Research Project) involves one of the most detailed snapshots of trauma epidemiology in the world. The project will give healthcare providers a much better understanding of the needs of patients and will allow us to better understand the impact of using pre-hospital medical teams such as Helimedix.

Further information regarding CTARP can be found here

Magpas works closely with Local authorities, University of Cambridge NHS Foundation Trust, the University of Leicester, the Faculty of Pre Hospital Care, the Royal college of Surgeons Edinburgh and the East of England Deanery to produce these insightful papers and articles. Magpas produces its research through its charitable undertakings. If you would like to help fund future Magpas research projects or would like to request further information on our ground breaking research please contact: This email address is being protected from spambots. You need JavaScript enabled to view it.

Original Magpas research suggests that simulation can be used to increase the safety of Pre-Hospital anaesthesia, particularly by improving "human factors" and crew resource management (CRM)

View the research

Exploring the views of the country's leading stakeholders with regard to pre-hospital care delivery and aspirations. Although there appears to be broad agreement among opinion leaders regarding the concepts underpinning existing pre-hospital critical care services, areas of contention are highlighted that may help explain the current lack of consensus.

View the research

Exploring views regarding the provision of Pre-Hospital critical care in the UK

View the article

Arguments for and against the use of cuffed tubes in children in Pre-Hospital Critical Care View the article

Provision of on scene medical support to ambulance services in the UK is fragmented, disorganised, and largely unregulated.

View this paper

A comprehensive debate on 'A license to practise Pre-Hospital and retrieval medicine' in the UK

View the paper

Exploring concepts of competence, defining terminology, and describing the role of a competence framework in education and training.

View the Article

Competence in Pre-Hospital care: Evolving concepts

View the paper

Magpas has developed a world class Pre-Hospital Emergency Anaesthesia pre-procedure checklist.

View the checklist

Pre-Hospital Care. Commentaries are appended to the PDF of this article.

View the paper

Letter outlining the arguments for using ketamine for the induction of anaesthesia in brain injured patients.

View the letter

Letter challenging the findings of an article that declared that all Pre-Hospital intubations to be harmful.

View the Letter

Further reading:

RSI checklist poster
Difficult Airway Society
Guidance for the ABCD approach to managing airways

presented at:
Retrieval 2010 conference (prize winning)
Forum for Quality & Safety in Healthcare, Berlin 2009 -
National Association of Medical Simulators, London 2008 -

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