August 2024 PAIR Newsletter

The whole team of TRANSFORM TRAUMA is pleased to welcome you to the PAIR Newsletters! 

PAIR (Patient/Public Advisors for Injury Research) is our main PPI (Patient and Public Involvement) group for informing our led research. We established PAIR in 2014.

TRANSFORM TRAUMA is funded by Barts Charity and aims at exploring ways to increase our understanding of blood and bleeding using technologies to direct treatments and support patients in the immediate aftermath of injury.

Wishing you an enjoyable reading!

The whole team of TRANSFORM TRAUMA is pleased to welcome you to the PAIR Newsletters! 

PAIR (Patient/Public Advisors for Injury Research) is our main PPI (Patient and Public Involvement) group for informing our led research. We established PAIR in 2014.

TRANSFORM TRAUMA is funded by Barts Charity and aims at exploring ways to increase our understanding of blood and bleeding using technologies to direct treatments and support patients in the immediate aftermath of injury.

Wishing you an enjoyable reading!

February PAIR Newsletter

The whole team of TRANSFORM TRAUMA is pleased to welcome you to the PAIR Newsletters! 

PAIR (Patient/Public Advisors for Injury Research) is our main PPI (Patient and Public Involvement) group for informing our led research. We established PAIR in 2014.

TRANSFORM TRAUMA is funded by Barts Charity and aims at exploring ways to increase our understanding of blood and bleeding using technologies to direct treatments and support patients in the immediate aftermath of injury.

Wishing you an enjoyable reading!

To our surprise, overall, there was no difference in mortality between those patients who got high dose cryoprecipitate and those who received standard of care. However, these results do fit with our current thinking that one-size fits all does not work for trauma patients, and we need to bring early diagnostic tests close to the patient to allow more precision approaches to treating severe bleeding. The findings can be found here and via the Cryostat-2 website here.

PAIR (Patient/Public Advisors for Injury Research) is our main PPI (Patient and Public Involvement) group for informing our led research. We established PAIR in 2014.

TRANSFORM TRAUMA is funded by Barts Charity and aims at exploring ways to increase our understanding of blood and bleeding using technologies to direct treatments and support patients in the immediate aftermath of injury.

Wishing you an enjoyable reading!

REF 2021 is a UK-wide assessment of university research carried out by the four UK higher education funding bodies. Its aim is to secure the continuation of a world-class, dynamic and responsive research base across the full academic spectrum within UK higher education.

The case studies put forward for assessment in the REF are truly outstanding results and it is especially rewarding to see that our work has been featured as REF 2021 impact case study (Focused, rapid interventions for injured patients with major bleeding saves thousands of lives)

We are incredible proud of being part of C4TS (Centre for Trauma Sciences) and we thank everyone of our staff for their contribution, particularly in light of the difficulties caused by the pandemic in recent years.

Planning preclinical animal studies in trauma research, https://vimeo.com/640531016 

Planning preclinical animal studies in trauma research can be daunting and offers several challenges. There are plenty of rules and regulations to follow. In this video We present how to plan preclinical animal studies in trauma research. The 3R’s and the 5 Step processes, presented here, can be used to ensure that your research meets the highest and most stringent of standards for good science and animal welfare.

Gaining informed consent in trauma research, https://vimeo.com/640532393 

Gaining informed consent in emergency trauma situations presents some unique challenges but is essential for good medical practice. In this video, we present how to gain informed consent in emergency trauma research studies. By following the five key principles of informed consent, you can ensure your research is conducted appropriately; in a way that is both ethical and legal.

How to establish a biobank to store biospecimens when conducting trauma research, https://vimeo.com/640531839 

In this video we present how to establish a biobank to store biospecimens when conducting trauma research. We also highlight the important steps involved in the collection of trauma research samples.

How to create and maintain a database for a research study, https://vimeo.com/640533103 

In this video we present how to create and maintain a database for a research study. We also highlight the key steps involved in creating a database.

Apply here: https://webapps2.is.qmul.ac.uk/jobs/job.action?jobID=6241

Apply here, https://webapps2.is.qmul.ac.uk/jobs/job.action?jobID=6240

They are looking for ex-patient volunteers who would be happy to share some materials to be included in an exhibition held by Queen Mary University of London that will take place during summer 2021.

They look for, first, an image of the ex-patient, or an image of something meaningful to them, possibly related to recovery or life after trauma, and second, a couple of lines about the ex-patient, their experience of trauma and why the image was chosen.   

If you are interested in participating in the project, please get in touch by emailing with them on v.r.nicholson@smd18.qmul.ac.uk

Volunteers will be reimbursed £15 in the form of an Amazon voucher for their time.

In 2015, David suffered a severe head injury following a collision between his bicycle and a car driven at 40mph. A detailed account of his journey from Traumatic Brain Injury (TBI) through Recovery can be found here: www.ineededtobeneeded.com 

This year, David has put together a video to share his story in the hope of spreading a little Christmas cheer, give others some tips to aid recovery after TBI and highlight his positive outcomes. The video can be found here: https://youtu.be/Xf6CTb2PysY 

David also contributed to our sister website, the After Trauma website, and his story can be found here: https://www.aftertrauma.org/survivors-stories/davids-story 

Should you wish to contribute to our PPI group or the AfterTrauma website, get in touch with:

Scarlett Gillespie: scarlett.gillespie@nhs.net or Jack Rappoport: j.rappoport@qmul.ac.uk 

As this was the first online meeting we’d held as a group, we ran through introductions and chatted about our interests in Trauma.

Some of the researchers spoke of what C4TS had been up to during the COVID-19 pandemic and ran through the subsequent work C4TS had done to get the trials back up and running. 

We then discussed all the open trials that C4TS are recruiting to, what they mean for patients and what research questions they aim to answer.  

We also spoke about the recent publication of the iTACTIC trial and the key points raised in the paper.

Moving forward the PAIR group will be looking into ways that these results may be shared with a wider lay audience.  

Our next meeting will take place early in the New Year. We are always looking for more patients and interested members of the public to contribute to the PAIR group 

Please see https://www.c4ts.qmul.ac.uk/get-involved/pair for more information 

If you would like any more information about the group please contact Scarlett Gillespie scarlett.gillespie@nhs.net

For more information about TSCIPP, click Here

Trauma Late 1: An Introduction to Trauma

On the 5th November, we were thrilled to host our first Trauma Late of the academic year 2020/21! With over 160 attendees from all over the world, we were excited and humbled by the enthusiasm for trauma care and trauma sciences! Moreover, we were joined by some fantastic speakers who gave their perspective on key trauma topics.

First, we were honoured to have Dr Elaine Cole (the Director of Research and Innovation for the Pan-London Major Trauma System and Senior Lecturer in Trauma Sciences at the C4TS) talk to us about ‘Trauma and Trauma Systems’. Dr Cole introduced the epidemiology of traumatic injury, how the London Major Trauma System operates in a range of scenarios and much more!

Next, we were thrilled to hear Dr Ross Davenport (the Clinical Lead for Trauma Surgery at the RLH and a Senior Clinical Lecturer at the C4TS) discuss ‘Preventable Deaths in Trauma’. Utilising some poignant case studies, Dr Davenport highlighted how advances in trauma systems and patient care have saved a great number of patients from preventable death.

After the break, we were joined by Major Max Marsden (a Clinical Research Fellow at C4TS, General Surgical Registrar at RLH and Major within the Royal Centre for Defence Medicine). Major Marsden gave a fascinating talk on the surgical technique – REBOA. He discussed the principles, indications and evidence surrounding this fascinating intervention, wrapping it up with a real-life case study to contextualise his talk.

Finally, we were lucky to hear from Dr Scarlett Gillespie (the Clinical Trails Manager and Head of Public Engagement and Patient and Public Involvement) and Inova Lee (a Medical and TSCIPP Student). Dr Gillespie gave us a very helpful overview of the differences between PE and PPI, whilst discussing how they impact trauma care and trauma research. Inova Lee discussed her fantastic PPI project ‘Billy and his Blood Cells’ from her TSCIPP Year 2 project that she completed with Manasi Panshikar, providing paediatric trauma patients with a fun, educational tool during their hospital stay.

We received some great questions and feedback during the evening. The Trauma Late was a real success and we would like to thank our speakers and everyone who attended to make it such a fantastic event!

How trauma-induced coagulopathy (TIC) is treated across Europe 
How much it costs to treat TIC (health and economic burden) 
Why TIC develops 
Review the effectiveness of treatments 
Develop treatment algorithms for personalised care  

The study paper published included 396 patients across six European Major Trauma Centres; the Royal London Hospital (UK), John Radcliffe Hospital (Oxford, UK), Oslo University Hospital (Norway), Kliniken der Stadt (Cologne, Germany), Academic Medical Centre (Amsterdam), Rigshospitalet (Copenhagen University Hospital, Denmark). 

The primary aim of the trial was to investigate whether trauma patients, who had a bleeding abnormality (known as being coagulopathic/having TIC), had better survival at 28 days after their injury if they received personalised blood transfusions guided by: 

Conventional coagulation tests – these are routinely run in the hospital laboratories and give key quantitative measures of key components of blood clotting such as circulating fibrinogen level (the main protein in blood clots), platelet counts (the main cells in blood clots) and the time taken for a blood clot to be made. 

Viscoelastic haemostatic assays – run on machines that can be close by the patient in the emergency department or operating theatre. These tests stimulate a blood sample to generate a blood clot and can give qualitative readouts about how quickly the blood clot is made and how much fibrinogen and platelet are contributing to the size of the blood clot 

The team hypothesized that personalising blood transfusion using VHA technology would improve survival and reduce the need for ten or more units of red blood cells to be transfused in the first 24 h after injury (referred to as a massive transfusion). 

Although this didn’t appear to be the case from the data analysed in the study, when researchers looked at a subgroup of 74 patients who had a severe traumatic brain injury (TBI), it appeared that patients who received VHA guided blood transfusion had improved survival. This is something the group hope to take forward and further investigate. 

Click Here for the study publication

Click Here for an accessible break down of the study

For more information, please visit: https://www.c4ts.qmul.ac.uk/intrn-projects/tactic

TSCIPP is a programme for medical students aimed at providing clinical and research experience by some of the best trauma staff in the country.

Involvement in Public Engagement is a key part of the programme, and gives students a unique insight into the field of trauma beyond the clinical environment.

Students are able to utilise and develop key skills in communication with the public, creativity and the production of educational materials.

This piece aims to highlight trauma injury and treatment, in addition to increasing public understanding of trauma and research. Through this piece, we hoped to introduce children to trauma and the vital role played by C4TS researchers in improving trauma care.

Click the link below for the PDF Resource: 

Billy and His Blood Cells Resource

Are you interested in joining the MSc in Trauma Sciences ? 

With specialisms in Orthopaedics, Military and Humanitarian and Trauma Sciences, there is course content available for students from a variety of professions.

The course is designed for online learning, over a two year period, allowing students from all over the world to come together to study in the field of Trauma. 

The course is open to students who work clinically so if you are a Nurse, Paramedic, Surgeon, GP or Military personnel, this course is for you! 

For more information about entry requirements, funding opportunities or to speak with one of the team, click HERE

C4TS is now looking to appoint two full-time Clinical Research Fellows to our US DoD funded research award. 

C4TS has been awarded a £1M grant from the US Department of Defense to improve the medical care of injured soldiers using new Artificial Intelligence (AI) tools designed for the battlefield and the hospital.

COMBAT-AID (COMputer Battlefield Assistance in Trauma care and injury Decision-support) is aimed at developing and validating a suite of accurate prediction models and Clinical Decision Support (CDS) tools that clinicians can use to treat wounded soldiers on the battlefield, travelling to hospital and in hospital.

Welcoming the grant, study lead and honorary senior lecturer at Queen Mary, Colonel Nigel Tai, consultant trauma and vascular surgeon at Barts Health NHS Trust and UK Defence Medical Service, said:

“War zones are obviously very fraught environments for clinical decision making, and we know military clinicians have to make difficult decisions under time pressure, far away from the kind of sophisticated diagnostic equipment or senior, experienced advisors that are found in the NHS. So, deciding whether to employ particular surgical techniques, or whether to attempt salvage of a mangled limb, or to use precious stocks of blood is ripe for the kind of decision support aids that Artificial Intelligence might help with.”

C4TS will work in collaboration with Queen Mary University of London's Risk and Information Management research group in the School of Electronic Engineering and Computer Science.

The grant builds on joint work between Queen Mary’s Computer Science team – led by Dr William Marsh – and C4TS over more than five years. It has drawn on major advances in computational modelling to develop Bayesian Network (BN) statistical analysis CDS tools for clinicians treating patients in the Royal London Hospital Major Trauma Centre. The tools generate accurate risk assessments of whether a seriously injured patient is likely to experience a major blood clotting problem – Trauma Induced Coagulopathy (TIC) (also known as Acute Traumatic Coagulopathy) - and whether an amputation is necessary for a badly damaged limb. The right treatment can then be matched to individual patients.

The grant will enable the University’s teams to extend this vital research to develop CDS models that improve the effectiveness of damage control surgery and resuscitation, limb salvage and other critical medical interventions in conflict zones.

Colonel Tai concluded: “The grant is an acknowledgement of the world-leading trauma research being undertaken by the C4TS team. The new CDS tools will first be developed and validated using sophisticated statistical models in London and the US. If successful, these AI clinical innovations could potentially be adopted by major trauma centres around the world to save civilian lives.”

The role is to manage and coordinate the activities of the C4TS team, both internally and externally with partners across the University, the UK, and globally. The post also has a strong outward-facing role, maintaining and fostering new partnerships with industry and military contacts, as well as funding and research governance bodies. Essential requirements include theoretical and practical involvement with scientific research; experience of project management/coordination for a diversity of teams; managing and reporting of budgets and resources across a portfolio of research projects; and familiarity with financial management procedures.

The post is full time (although 0.8 FTE will also be considered), and it is a fixed term appointment for 2 years, available from January 2020. Starting salary will be in the range of £47,325 - £52,833 per annum, inclusive of London Allowance. Benefits include 30 days annual leave, pension scheme and interest-free season ticket loan.

Candidates must be able to demonstrate their eligibility to work in the UK in accordance with the Immigration, Asylum and Nationality Act 2006. Where required this may include entry clearance or continued leave to remain under the Points Based Immigration Scheme.

Informal enquiries should be addressed to Karim Brohi at k.brohi@qmul.ac.uk   Closing date for applications is 26 Nov 2019.

To apply, click here.

Professor Brohi is director of the capital’s major trauma network, set up in 2010 in response to the July 7 terror attacks in 2005.

The network has led to a 20 per cent reduction in the capital’s mortality rate from major trauma, and was vital in saving many victims of the Westminster, London Bridge and Finsbury Park terror attacks and the Grenfell Tower fire.  

Commenting on the recognition, Professor Brohi said: “It is a great honour to be named in this list. It reflects the amazing trauma care delivered by all disciplines and specialities at the Royal London Hospital's Major Trauma Centre, the commitment and drive of my research team, and the amazing institutional commitment to trauma care, innovation and research from Queen Mary University of London's School of Medicine and Dentistry, the Blizard Institute and Barts Health.”

You can read the Evening Standard's article here.

The article describes the kinds of injuries, clinical procedures and patient outcomes that Professor Brohi and his team dealt each day over a week.

It shows the variety of severe injuries that clinicians working in London’s major trauma system deal with each day, including servere pelvic injuries and haemorrhage from road traffic collisions, traumatic brain injuries from a variety of causes, and knife crime victims.  The article also explains what happens in a major trauma centre during a Code Red alert.

Regarding the increasing numbers of stabbing injuries and dealths from knife violence, which affect primarily very young patients, Professor Brohi notes:

“"There is no doubt that seeing these cases takes its toll on healthcare staff. But it can be nothing compared to being a teenager who is exposed to, and in fear of, this level of violence on a day-to-day basis.

"The level of stress and anxiety on these kids, and their family, is unfathomable."

"We do our best to save lives. But to really save a life - and make one that's worth living - takes a whole community.

"We need to look again at our society, our culture and our values if we are to live in a world where children can be children, and mothers can be mothers, without ever having to sit in a hospital waiting room."

Read the whole BBC article here.

Read the London Major Trauma System’s public health approach to violence reduction here.