Dr Gregory Whitley

Post-doctoral Fellowship

Dr Gregory Whitley

Paramedic
United Kingdom

East Midlands Ambulance Service NHS Trust & University of Lincoln

Post-doctoral Fellowship Project Title: improving Pain mAnagement for childreN and young people attendeD by Ambulance (PANDA): A realist informed intervention development and feasibility study.

Post-doctoral Fellowship Project Description:
BACKGROUND: Each year in England approximately 86,000 children and young people under 18 years of age are transported by ambulance to emergency departments with acute pain. The pain may have been caused by injuries such as wounds, burns or broken bones, or by illnesses such as tummy pain. Paramedics and other ambulance clinicians aim to reduce the pain at the scene and during hospital transport. Treating pain in children and young people attended by ambulance is very challenging and research studies have shown that around 60% do not have their pain treated effectively. Without effective pain treatment, children and young people may suffer adverse consequences such as post-traumatic stress disorder. 
AIM: The aim of this PANDA study is to explore the experiences of children and young people who have been attended by ambulance for a painful condition, along with their parents/carers and ambulance clinicians and to develop and test a new method to improve pain management.
METHODS: The research will involve three stages. Stage 1 will search for and analyse published research, clinical guidelines and policies to understand how previous methods to improve pain management have worked. Stage 2 will use interviews, diaries and electronic communication to understand the experiences of children, young people, parents/carers and ambulance clinicians, with arts and drawings used for younger children to enable them to better explain their experience. Clinical data will be used to analyse pain reported by children and young people to see which pain treatments work best. Stage 2 will also gather key people, such as children, young people, parents/carers, members of the public and ambulance staff to work together and develop a new method to improve pain management. The new method may, for example, include training for ambulance staff, feedback on the care they provide or pain assessment and treatment prompts. Stage 3 will test the new method and monitor pain levels, sleep disturbance and signs of post-traumatic stress disorder in children and young people for up to 3 months. The experiences of paramedics, children, young people and parents/carers when utilising this new method will also be explored. This programme of research will take 45 months to complete.
PATIENT AND PUBLIC INVOLVEMENT: A Young Persons Advisory Group (YPAG) has contributed to the design of this study. The YPAG consisted of ten members between the age of 16 and 17 years recruited from a local school. The members were eager to help design the study as they felt their views represented the patient population and they wanted to help improve pain management for children and young people in the future. The group contributed to this study by reviewing this plain English summary, providing advice on study advertising and making key decisions regarding participant recruitment and data collection. The YPAG will continue to be involved in key decision making before and after each of the three stages of this study, developing and reviewing recruitment material and interpreting study findings. When established members are unable to participate due to education or employment commitments, new YPAG members will be recruited and will receive training. YPAG members will also be encouraged and supported to participate in research activities where possible.
PLAN TO SHARE FINDINGS: The PANDA study findings will be presented at conferences and published in academic journals. An animated video will be created and shared using social media and a summary of the research will be sent to key ambulance service groups, including the chief executives, medical directors and the research leaders. Once development of the new method to improve pain management is complete, its effectiveness may be tested in a future clinical trial.

Details:

Funding Organisation: Health Education England/National Institute for Health and Care Research
Amount of Funding: £418,824
Start Date: 2023
End Date: 2027
Status: Ongoing

Research Interests

Prehospital and emergency care, pain management.
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