{
  "abstract": "Background Chest pain is a common prehospital complaint and a leading cause of emergency department (ED) attendance. Timely blood testing, especially for cardiac biomarkers, is critical for diagnosis and management. Current practice delays initial blood draws until after ED arrival and triage, often leading to prolonged length of stay (LOS). International studies suggest prehospital phlebotomy completed by paramedics for chest pain patients can reduce ED LOS, but this has not been explored in a UK NHS context. This planning-stage pilot study aims to assess the impact of paramedic-conducted prehospital blood draws on ED LOS, and test the feasibility of this project for a larger trial.Methods This project is a single-centre, pilot randomised controlled trial involving 30 adult patients (18+ years old) with non-STEMI chest pain who will be conveyed by the ambulance service to the ED. Eligible patients will be randomised (1:1) to standard care or standard care with prehospital phlebotomy using the sealed envelope method. Paramedics will be trained in phlebotomy and will collect blood samples on-scene for in-hospital analysis.Results The study is currently in the planning and approvals phase. This project aims to output metrics for both groups surrounding ED LOS, ambulance on-scene times, and the time difference between ambulance and hospital blood draws. For the intervention group, the sample complication rate (e.g. haemolysed samples or insufficiently filled blood bottles) will be reported. Moreover, the project will track the patient recruitment rate.Conclusion This pilot study will evaluate whether prehospital phlebotomy is practicable within an NHS ambulance service and ED. Whilst not powered to detect statistically significant differences, findings from this project can be used to inform the design of a larger definitive trial. If successful, prehospital blood draws may represent a cost-effective strategy to reduce ED crowding and improve chest pain pathways.",
  "authors": [
    {
      "affiliations": [
        "North East Ambulance Service NHS Foundation Trust, UK"
      ],
      "name": "Angus Thomas"
    },
    {
      "affiliations": [
        "North East Ambulance Service NHS Foundation Trust, UK"
      ],
      "name": "Karl Charlton"
    }
  ],
  "title": "PP25 Expediting ED length of stay for chest pain patients through paramedic prehospital phlebotomy – a pilot RCT",
  "uid": "0b60267d-21ae-5a62-a8c2-116cb7c2457f"
}