Lt Jeffreys (pictured, 2nd from left) is a Nursing Officer in QARNNS and here, offers some insight into her new role in Trauma Research at King’s College Hospital, London
I arrived in London in May 2017 to start my new post in Critical Care research working alongside Surg Cdr Hutchings (CA ITU for the RN), at King’s College Hospital (KCH), based in Camberwell, London. I didn’t actually start in the team until the end of May due to the PCRF exercise, but from the start I had to hit the ground running, learning on the job and picking up the basics of research.
This is a busy team in a very busy hospital. KCH is one of the 4 trauma centres in London and is situated in an area of high gang crime so if it was trauma I was looking for, I certainly found it. To add to this, I started not long after the Westminster incident, the London Bridge terrorist attacks took place about two weeks later, swiftly followed by Grenfell Tower and Finsbury Park.
I felt like I was back in Afghanistan with almost daily major incidents.
As mentioned, it is a steep learning curve. I had no idea how many databases and spreadsheets were involved; how to approach families for consent; constantly monitoring the units for new patients or those whose physiology has changed which makes them a candidate for a study. To get my knowledge up to speed, I have been assisting on a number of trauma studies run by the research team.
I am also in regular contact with Group Captain Lamb, the Defence Professor of Nursing, who has kindly guided me in the ways of research, as well as ensuring that projects I am involved with adhere to the DMS strategy. Our current military studies fall into both Tier 1 and Tier 2 priorities which are shown as ‘golden’ apples on the research strategy tree.
At present, Cdr Hutchings and I are currently working on a number of military trauma studies, including:
POEM – Point Of carE Microcirculation. As the microcirculation is the anatomical location of oxygen and substrate exchange, its behaviour during shock is of interest. This study involves the use of a hand held non-invasive sublingual video microscope which is placed under the tongue. Videos are then recorded and the data analysed by the bedside. It is hypothesised that the resulting score (calculated using an established algorithm) can be used to guide the patient’s treatment. We have just completed the first round of the study which aimed to show that the equipment could be used efficiently at the bedside; that two doctors can get comparable videos; and that the doctors award similar bedside scores. We are now awaiting an amendment to be approved in order to increase the study sample size.
MICRORESUS. The treatment guided version of POEM (should commence in 2018).
SHARP – Simulated Hypovolaemia to Assess Resuscitation Parameters. A healthy volunteers study which aims to assess the efficacy of non-invasive equipment to assess patient’s core circulation. We currently use a plethora of devices but none have been rigorously validated using an established technique called Lower Body Negative Pressure (LBNP) which involves placing healthy volunteers in a small box encasing their lower legs and pelvis. The application of suction to this box draws blood into the blood vessels of the lower body and away from the heart and brain. We have successfully completed the first study week and aim to conduct another week in May 2018.
If you would like further information on any of these studies then please do get in touch.