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Browsing by Person "Fisher, Ruth"

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    Fingermark recovery from riot debris: Bricks and stones
    (Elsevier, 2015-02-13) Davis, Lisa; Fisher, Ruth
    During the UK riots in August 2011, large volumes of bricks and stones were used as weapons or projectiles in acts of violence or to gain illegal entry to properties. As a result, it has been emphasised that it is necessary to determine suitable chemical treatment(s) that will enable the development of fingermarks on such items in order to identify those involved. This study has undertaken the task of attempting to develop latent fingermarks on common house bricks, limestone and sandstone using current techniques including ninhydrin and fluorescence. Results produced have shown that, with fluorescent fingerprint powder, silver nitrate and superglue providing the best results, it is now possible to enhance fingermarks that were previously left undeveloped. In addition, Isomark T-1 Rapid Grey High Resolution Forensic Impression Material has proved extremely effective as an alternative method of recovering fingermarks developed with fluorescent fingerprint powder.
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    Improving post-resuscitation care after out-of-hospital cardiac arrest
    (MA Healthcare, 2020-01-02) Fisher, Ruth
    The average rate of survival following an out-of-hospital cardiac arrest (OHCA) in the UK was 7–8% at the start of 2019. An estimated 60 000 OHCAs are attended by UK ambulance services annually and, despite developments in prehospital and post-resuscitation care, there are significant variations in survival between regions and countries. Aims: This study aims to identify the potential for care pathways, evaluate UK practices and review the evidence for direct referral of OHCA patients to dedicated cardiac arrest centres. Methods: Evidence was gathered from 20 articles identified through a systematic search of articles related to OHCA and post-resuscitation care, as well as from NHS England in relation to performance and outcomes. Results: Between April 2018 and January 2019, 30.6% of patients experiencing an OHCA had a recorded ROSC (return of spontaneous circulation), and 10.2% survived. However, the 58.7% compliance with the post-ROSC care bundle by ambulance services suggests variations in the delivery of post-resuscitation care. At present, UK ambulance services stabilise and transfer OHCA patients with ROSC to the nearest emergency department, which may not provide specialist services. Holland and Norway report survival rates of 21% and 25% respectively, and operate a centralised approach to post-resuscitation care through designated cardiac arrest centres, which provide specialist care that helps to improve the likelihood of survival. While no randomised controlled trials have been carried out in relation to cardiac arrest centres, it is recognised that the quality of care in the post-resuscitation phase is important, as this is when the highest proportion of deaths occur. Conclusion: Further research into specific care pathways and centralised care should be carried out, and an OHCA post-resuscitation care pathway should be developed to improve the delivery of care and survival.
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    Pharmacist Review of Medicines Following Ambulance-Attended Falls—A Multi-Methods Evaluation of a Quality Improvement Initiative
    (MDPI AG, 2025-10-18) Mulrooney, William; Wilson, Caitlin; Pilbery, Richard; Fisher, Ruth; Whiterod, Sarah; Smith, Heather; Turner, Emily; Edmonds, Heather; Webster, Peter; Prestwich, Graham; Bell, Fiona; McLaren, Rebecca
    Background: Falls in older adults are a leading cause of morbidity, particularly when compounded by polypharmacy. There is mixed evidence of the efficacy of medicine reviews, but there is little work exploring this in the ambulance setting. A new referral pathway enabling ambulance staff to connect patients to primary care pharmacists aimed to address this. This study explored staff and patient experiences with the pathway and its potential to improve medication safety after a fall. Methods: A mixed-method service evaluation was conducted to assess the implementation and impact of this pathway. Routine data from an ambulance trust and pharmacist proformas were used to address objectives relating to referral rates, clinical appropriateness, and fall recurrence. Patient and staff stakeholder perspectives were gathered through two cross-sectional surveys designed to explore emotional, behavioral, and practical responses to the intervention. Quantitative data were analyzed descriptively and using ordinal logistic regression where appropriate. Free-text responses were analyzed thematically. Results: Between May 2019 and March 2020, referrals were initiated for 775 older adults after ambulance attendance for a fall, with pharmacists completing medicine reviews on 340 patients. Survey data revealed improvements in patients’ emotional responses to their medicines. Ambulance clinicians identified patient disclosure, stockpiling, and the presence of expired medicines as key indicators of poor medicines management and valued the ability to refer patients. Conclusions: Overall, referral to the pathway demonstrates a marginal improvement in recontact rates in the short-term but does not necessarily represent an improvement in overall patient safety. The cost of such an intervention and patient expectations need further exploration to prove efficacy and patient satisfaction.
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