You can find out more about injuries and emergencies studies in your area through the UK Clinical Trials Gateway.
The NIHR Clinical Research Network Injuries and Emergency has been enormously successful in integrating clinical research into NHS clinical service provision, and both developing and delivering a large practice changing portfolio of clinical trials.
Read our Injuries and Emergencies Specialty Profile to find out more.
As the most integrated clinical research system in the world, the NIHR supports research studies through our funding programmes, training and supporting health researchers, and providing world-class research facilities. We also support dialogue between the life sciences industry and charities to benefit all, and facilitate the involvement of patients and the public to make research more effective.
Last year (2017/2018) the NIHR supported 169 studies on injuries and emergencies. The NIHR supported these studies through our funding programmes and our research schools and units. We also support injuries and emergencies research through our research infrastructure and our training and career development awards for researchers.
Negative Pressure Wound Therapy (NPWT) is an alternative dressing for open fractures, which are at much greater risk of infection due to the broken bone being exposed to contamination from the outside environment. NPWT creates a partial vacuum using suction, and whilst popular with surgeons, there was little information about its effectiveness.
The WOLLF (Wound Management of Open Lower Limb Fractures) trial aimed to compare NPWT with standard dressings for open fractures of the lower limb.
The NIHR Clinical Research Network (CRN) Injuries and Emergencies specialty used their expertise to work with the study team to identify additional sites and consent patients to take part in the trial.
The study was funded by the NIHR Health Technology Assessment (HTA) Programme and supported by the NIHR Oxford Biomedical Research Centre (BRC) and the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford.
Our impact case study outlines how the results are set to change clinical practice and why the trial marks a step change in how major trauma research is delivered in the UK.
The NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC) has taken the lead in supporting the use of tranexamic acid (TXA) by paramedics and others involved in emergency care for trauma patients, saving approximately 400 lives a year in the UK (CRASH-2 trial data).
Previous research had shown that, if used within three hours after trauma, TXA reduces the risk of death from bleeding by as much as 30%. Despite the costs being low and there being virtually no side effects, there had been little implementation within the NHS. After an initial review of the evidence, it was decided that an effective way of delivery would involve the drug being administered by paramedics as well as in A&E, using a protocol that has been agreed upon with emergency departments.
CLAHRC South West Peninsula worked with the South West Ambulance Service NHS Foundation Trust (SWAST) and the acute trusts to support all emergency services in the south west in carrying TXA. As a result of this successful implementation, the use of TXA was incorporated into the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) National Guidelines for use across the UK. All emergency ambulance services across England now carry TXA, saving lives in the most extreme cases of injury.
Read more in the CLAHRCs: Celebrating 10 years of NIHR report.
Chest pain is the most common reason why patients are admitted to hospital in an emergency. However, most admissions could be avoided with better diagnostic tests for acute myocardial infarction; commonly known as a heart attack.
The aim of the TRAPID-AMI study, which was supported by the NIHR Clinical Research Network (CRN) Injuries and Emergencies specialty, was to demonstrate whether use of a high sensitivity test for troponin T would enable an accurate and more rapid diagnosis of a heart attack, in order to safely rule out heart attacks in the Emergency Department at an earlier stage.
Read about the value to the NHS that this study delivered in our impact case study.
Doctors in Southampton are leading a national trial of a treatment approach that could improve survival from emergency bowel surgery by guiding the amount of fluid given to patients during their operations.
The protocol uses a heart monitoring device that tracks the amount of blood being pumped by the heart during and after surgery so that exact amounts of fluid can be given when required to improve blood flow.
Read more in our news story.
The Protocolised Management in Sepsis (ProMISe) trial investigated a new approach to resuscitation in patients with septic shock. The study found that hemodynamic management according to a strict early, goal-directed therapy protocol did not lead to an improvement in outcome in patients who were identified early and received intravenous antibiotics and adequate fluid resuscitation.
This research was funded by the NIHR Health Technology Assessment (HTA) Programme and supported by the NIHR Clinical Research Network.
Read more about this study in the New England Journal of Medicine (NEJM).