Centre for Excellence Research & Scholarship
At the Centre for Excellence in Research & Scholarship, we are committed to advancing clinical practice through a culture of inquiry, innovation, and continuous learning. Our work is grounded in the belief that meaningful research and reflective scholarship are essential to improving patient outcomes and shaping the future of pre-hospital care. Through a diverse range of academic and clinical initiatives, we empower our team to explore, question, and contribute to the growing body of knowledge in emergency medicine. This page outlines the key areas of our scholarly activity, each representing a vital component of our mission to deliver evidence-based, compassionate care.
Pre-hospital Assessment Tools in Traumatic Brain Injury (PHAST-TBI)
What is this study about?
We are looking at new ways to check for brain injury before patients reach hospital. These checks can be done quickly by our air ambulance doctors and paramedics, sometimes even at the roadside.
What tools are being used?
• Pupil check (pupillometry): measures how the eyes react to light
• Blood test: looks for signs of brain injury in the blood
• Eye ultrasound: checks for pressure or swelling behind the eye
These tools may help our teams recognise brain swelling or bleeding earlier, leading to faster decisions about the best treatment.
Who is included?
• Patients aged 16 or over
• Treated by Essex & Herts Air Ambulance
• Taken to Broomfield, Addenbrooke’s, or The Royal London Hospital
The National Data Opt-out service will be respected.
When will it take place?
The data collection period for this research will be approximately 12-months, between November 2025 and October 2026, and will not impact on standard patient care.
What information is used?
We use information already collected during routine care, including:
• Standard monitoring before hospital
• Results from the new tools
• Hospital tests and outcomes
The first CT scan in hospital will confirm if a brain injury is present.
If you do not want this information to be used to match your prehospital with your in-hospital records you can opt out. Please contact research@ehaat.org if you wish to opt out.
Is it safe?
Yes. All the tools are fully approved and safe to use. At Essex & Herts Air Ambulance (EHAAT), we have been looking at new monitoring tools that can help our crews assess brain injury more precisely during emergency care under simulated training conditions. This research showed that they:
• Do not delay treatment or hospital transfer
• Do not change the care patients receive
• Do not add any extra risk
Why is this important?
By comparing roadside results with hospital scans, we hope to find out if these tools can identify brain injuries earlier. This could help improve care for patients in the future.
Our Patient and Public Involvement (PPI) forum has played an important role in shaping this study. Patients told us that being part of research can give a sense of purpose and positivity, which may help in long-term recovery. Some have said that contributing to research which could improve care for themselves and for others feels like a natural and rewarding decision.
Your privacy
• The project has been supported under ‘Section 251’ support by the Health Research Authority (HRA) following advice from the Confidentiality Advice Group (CAG).
• We only use the minimum information needed (name, date of birth) to match prehospital with in-hospital data
• All data is stored securely and once matched is anonymised
• Only approved researchers can access it
Who is running the study?
• Laurie Phillipson, Critical Care Paramedic and Clinical Academic Fellow at EHAAT
• Professor Elaine Cole, Queen Mary University of London
Questions?
If you would like more information, please contact our research team:
Email: research@ehaat.org
Our Lightning Scholarly Activity sphere provides a route by which any member of our team can bring forward ideas or thoughts. Crucial to our ideology is that the best ideas and thoughts are usually derived from the team who spend their time at the ‘coalface’ of activity. Our teams notice areas of patient care that need improvement or further study, and we are proud to facilitate activities that explore their observations in more detail. Many seminal medical discoveries have been largely due to the observational power of clinicians at the patient’s side, and we hope to maximise opportunities for our team.
We’re fortunate to have a team who constantly reflect on the care that we provide. All of the thoughts and ideas are brought together in ‘lightning meetings’, held in our clinical learning suite at our North Weald Airbase.
Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria. However, audit is meaningless without a strategy for quality improvement that arises from the ‘audit cycle’. Clinical audit at EHAAT takes a structured approach to measuring the performance of our clinical practice against gold standards. Gold standards are often set out by national organisations (such as the National Institute for Health and Care Excellence, NICE). Often, we will set our own quality improvement targets for specific groups of patients.
Examples of clinical audits that help us understand how we can continue to improve are:
- Monitoring the timing and potency of our analgesia so that we can demonstrate our patients are not in pain.
- Evaluating our conversations with patients and families at the accident scene so we have a cycle of constant improvement.
- Understanding the outcomes of interventions such as the delivery of ‘clot busting drugs’ in cases of cardiac arrest.
Our annual clinical audit and quality improvement plan is reviewed each year, so that we maintain a fresh and relevant approach to understanding the care that we deliver.
This term is used to describe the processes by which we learn from every case so that we can understand the true impact of our interventions on outcome.
Often in the ”out-of-hospital” phase of care, our clinicians have a very challenging role to play in making a diagnosis rapidly and intervening to correct the processes that we believe are affecting the patient. In the hospital environment, clinicians now have access to all sorts of diagnostic tools such as CT (Computed Tomography) scans, MRI (Magnetic Resonance Imaging), complex blood tests, and so on. Understandably there is limited access to these tests at the roadside. Much is dependent on our clinicians applying their clinical experience and acumen. Increasingly, we are using tools such as ultrasound to help us, especially in patients who are critically unwell.
We piece together the parts of the medical jigsaw to analyse our cases.
Where a patient dies in our care, our teams care deeply about ensuring that the treatment we gave was correct and accurate. In these cases, we work very closely with our local pathologists, HM Coroner’s, and others. We have included Dr Ben Swift, a forensic pathologist, in our team so that we understand our cases better.
Working with these specialists means that we can strive to make things better for the next patient that we see. Our bi-monthly CPC (Clinico-pathological Correlation) meetings bring together our entire clinical team with Dr Swift, who helps us understand and analyse the findings that we discovered on scene. There is a cycle of learning that is then fed-back to our team.
Years ago, air ambulances focused predominantly on service provision. This was crucial in the early days, where our entire effort, especially our funding, was focused on an individual case. Every hospital-based medical specialty has a very strong academic foundation, with some specialties having undertaken many centuries of research, education and innovation.
At EHAAT we see our academic work as a core element of what we do. This is the way that we will pave the way for future interventions and treatments. True academic centres all support undergraduate and postgraduate academic programmes. We work closely with our university partners to support medical and paramedic students, and then qualified doctors, nurses and paramedics in their advanced studies.
In 2023 we were proud to help enrol our first PhD student, Laurie Phillipson. Laurie is working with our partners at Queen Mary University London, to explore opportunities for the future in head injured patients.
In 2024, and working with Anglia Ruskin University, we were delighted to welcome our second PhD student, Dolly McPherson, who will be studying the quality of bystander interventions in cardiac arrest. More information on Dolly’s work can be found in our ‘clinical community’ section.
Through building our academic infrastructure, we will increasingly be able to study our interventions more formally through a significant programme of research. We are already working closely with many other organisations in our work on blood transfusion through the SWIFT trial.
Many more opportunities lie ahead. Our relationships with universities, the National Health Service (NHS) and others is crucial to undertaking the high-level scholarly work that know will help our patients in the future.
A great deal of work has been carried out during our 25-year evolutionary journey in a number of areas, supporting our teams to deliver the best patient care possible.
In 2022, we worked very closely with other air ambulance providers, universities and others to establish the top research priorities for services such as ours. This has helped to set the scene for the future.
We’ve known for some time, that having exposure to the most serious ill and injured patients can have a significant effect on responders. Supporting many sick patients and their families over an extended period of time is something that might have an impact on the future of our operational team. One of our projects, carried out in 2024, looked closely at the mental health and well-being aspects of caring in this environment, ensuring that our teams in the future will be as best prepared as possible for helping those who need us.
Our team was key in delivering a national document outlining the research priorities for pre-hospital services in the UK.
In addition, it is imperative that we use the resources that we have secured in the most optimal way, so that we channel our clinical expertise to where it is most valuable. We adopted an academic approach to exploring the need for our team to be available during the nighttime. Our study in 2022 demonstrated that there was a pressing need to increase our availability. Now, our team is available in a response car throughout the region, and we are extremely pleased to be able to offer this service.
As we continue to develop our team, we would like more of what we do to be available for our supporters to read, contribute to, and understand. We strongly believe in including patients and their families in our academic work.