Diagnostic yield of an ambulatory patch monitor in Emergency Department syncope patients unexplained after Emergency Department evaluation – a pilot study (PATCH-ED)
EMERGE are excited to announce the PATCH-ED study – aiming to recruit 100 patients, PATCH-ED will involve an ambulatory patch monitor being applied to monitor heart beats for 14 days in eligible patients who present with an episode of syncope that remains unexplained after full ED assessment. A patch report will be provided by iRhythm Technologies, Inc. San Francisco, CA enabling any arrhythmias to be identified and informing appropriate follow-up.
Study Aims: PATCH-ED aims to investigate the diagnostic yield, prevalence of events captured on patch monitor, patient satisfaction of patch monitor, patch compliance and influence on subsequent treatment in ED syncope patients.
Primary: Diagnostic yield of the ambulatory patch monitor for significant symptomatic arrhythmia at 90-day follow-up versus standard care strategies.
Sponsor: This study is sponsored by NHS Lothian.
Funding: Chest, Heart and Stroke Scotland
Setting: This is a single centre study being carried out in a teaching hospital ED, RIE.
Study Population: Patients presenting with an episode of syncope who after full ED assessment have no cause of syncope identified.
Syncope will be defined as a transient loss of consciousness (TLOC) with inability to maintain postural tone and immediate complete spontaneous recovery without medical intervention (to preexisting mental status and neurologic function)
Obvious underlying causes will be defined as:
Dr Matthew Reed
Kirsty Simpson, Research Nurse
Director of EMERGE, Consultant, NRS Career Research Fellow & Honorary Reader in Emergency Medicine
10 Apr 2017 | Megan McGrath
EMERGE will soon begin recruitment to the new SNAP40 trial which will compare the new SNAP40 device with standard monitoring devices in the Emergency Department.Read more
23 Jan 2017 | Allan MacRaild
Heartbeats provide the rhythm of life. Interruptions to this rhythm are more likely to lead to a loss of consciousness than just a loss of spark. Rob Hannigan (pictured with Senior Research Nurse Allan MacRaild) took part in the PATCH-ED trial in 2016 following a number of unexplained blackouts. The results of his PATCH highlighted some dangerous arrhythmias including 24 seconds when his heart stopped beating entirely. Six months after his participation in the PATCH-ED trial, Rob met up with Allan to share his experiences.Read more
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.
Trauma remains a major cause of mortality and morbidity. 10% of blunt force trauma patients admitted to a major trauma centre will have sustained one or more fractured ribs, which may cause significant pain and problems with breathing.
To establish the outcome of rib fractures and their treatments it is important to know what to measure, and how to measure this accurately. A patient reported outcome measure (PROM) is a questionnaire used to measure patient reported outcomes, to show how the patient is doing from their perspective.
Whilst there is ongoing interest in surgery to fix broken ribs, there is no PROM specifically designed for patients with broken ribs following chest trauma. Therefore, it is not clear whether the symptoms that are most important to these patients are being represented by the current outcome measures. This study aims to create a PROM specific to rib fracture patients to give us a better understanding of whether a new treatment actually makes a difference to the patient’s recovery.
The 1st part of the study involves asking patients with rib fractures to help design a new PROM. This will be conducted through focus groups at a site in Nottingham. The 2nd part of the study entails field testing, whereby patients with rib fractures will be asked to test this new PROM. This will be conducted across multiple secondary care settings in the UK, including the Royal Infirmary of Edinburgh. The study is expected to run for approximately 2 years, with recruitment targets of 50 patients for the PROM Creation phase and 250 for the Field Testing phase.