A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest.

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
31 Oct 2024
Historique:
medline: 31 10 2024
pubmed: 31 10 2024
entrez: 31 10 2024
Statut: aheadofprint

Résumé

In patients with out-of-hospital cardiac arrest, the effectiveness of drugs such as epinephrine is highly time-dependent. An intraosseous route of drug administration may enable more rapid drug administration than an intravenous route; however, its effect on clinical outcomes is uncertain. We conducted a multicenter, open-label, randomized trial across 11 emergency medical systems in the United Kingdom that involved adults in cardiac arrest for whom vascular access for drug administration was needed. Patients were randomly assigned to receive treatment from paramedics by means of an intraosseous-first or intravenous-first vascular access strategy. The primary outcome was survival at 30 days. Key secondary outcomes included any return of spontaneous circulation and favorable neurologic function at hospital discharge (defined by a score of 3 or less on the modified Rankin scale, on which scores range from 0 to 6, with higher scores indicating greater disability). No adjustment for multiplicity was made. A total of 6082 patients were assigned to a trial group: 3040 to the intraosseous group and 3042 to the intravenous group. At 30 days, 137 of 3030 patients (4.5%) in the intraosseous group and 155 of 3034 (5.1%) in the intravenous group were alive (adjusted odds ratio, 0.94; 95% confidence interval [CI], 0.68 to 1.32; P = 0.74). At the time of hospital discharge, a favorable neurologic outcome was observed in 80 of 2994 patients (2.7%) in the intraosseous group and in 85 of 2986 (2.8%) in the intravenous group (adjusted odds ratio, 0.91; 95% CI, 0.57 to 1.47); a return of spontaneous circulation at any time occurred in 1092 of 3031 patients (36.0%) and in 1186 of 3035 patients (39.1%), respectively (adjusted odds ratio, 0.86; 95% CI, 0.76 to 0.97). During the trial, one adverse event, which occurred in the intraosseous group, was reported. Among adults with out-of-hospital cardiac arrest requiring drug therapy, the use of an intraosseous-first vascular access strategy did not result in higher 30-day survival than an intravenous-first strategy. (Funded by the National Institute for Health and Care Research; PARAMEDIC-3 ISRCTN Registry number, ISRCTN14223494.).

Sections du résumé

BACKGROUND BACKGROUND
In patients with out-of-hospital cardiac arrest, the effectiveness of drugs such as epinephrine is highly time-dependent. An intraosseous route of drug administration may enable more rapid drug administration than an intravenous route; however, its effect on clinical outcomes is uncertain.
METHODS METHODS
We conducted a multicenter, open-label, randomized trial across 11 emergency medical systems in the United Kingdom that involved adults in cardiac arrest for whom vascular access for drug administration was needed. Patients were randomly assigned to receive treatment from paramedics by means of an intraosseous-first or intravenous-first vascular access strategy. The primary outcome was survival at 30 days. Key secondary outcomes included any return of spontaneous circulation and favorable neurologic function at hospital discharge (defined by a score of 3 or less on the modified Rankin scale, on which scores range from 0 to 6, with higher scores indicating greater disability). No adjustment for multiplicity was made.
RESULTS RESULTS
A total of 6082 patients were assigned to a trial group: 3040 to the intraosseous group and 3042 to the intravenous group. At 30 days, 137 of 3030 patients (4.5%) in the intraosseous group and 155 of 3034 (5.1%) in the intravenous group were alive (adjusted odds ratio, 0.94; 95% confidence interval [CI], 0.68 to 1.32; P = 0.74). At the time of hospital discharge, a favorable neurologic outcome was observed in 80 of 2994 patients (2.7%) in the intraosseous group and in 85 of 2986 (2.8%) in the intravenous group (adjusted odds ratio, 0.91; 95% CI, 0.57 to 1.47); a return of spontaneous circulation at any time occurred in 1092 of 3031 patients (36.0%) and in 1186 of 3035 patients (39.1%), respectively (adjusted odds ratio, 0.86; 95% CI, 0.76 to 0.97). During the trial, one adverse event, which occurred in the intraosseous group, was reported.
CONCLUSIONS CONCLUSIONS
Among adults with out-of-hospital cardiac arrest requiring drug therapy, the use of an intraosseous-first vascular access strategy did not result in higher 30-day survival than an intravenous-first strategy. (Funded by the National Institute for Health and Care Research; PARAMEDIC-3 ISRCTN Registry number, ISRCTN14223494.).

Identifiants

DOI: 10.1056/NEJMoa2407780 PMID: 39480216
pubmed: 39480216
doi: 10.1056/NEJMoa2407780
doi:

Banques de données

ISRCTN
['ISRCTN14223494']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Health Technology Assessment Programme
ID : NIHR131105

Informations de copyright

Copyright © 2024 Massachusetts Medical Society.

Auteurs

Keith Couper (K)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Chen Ji (C)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Charles D Deakin (CD)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Rachael T Fothergill (RT)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Jerry P Nolan (JP)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

John B Long (JB)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

James M Mason (JM)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Felix Michelet (F)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Chloe Norman (C)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Henry Nwankwo (H)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Tom Quinn (T)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Anne-Marie Slowther (AM)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Michael A Smyth (MA)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Kath R Starr (KR)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Alison Walker (A)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Sara Wood (S)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Steve Bell (S)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Gemma Bradley (G)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Martina Brown (M)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Shona Brown (S)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Emma Burrow (E)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Karl Charlton (K)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Andrew Claxton Dip (A)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Victoria Dra'gon (V)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Christine Evans (C)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Jakob Falloon (J)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Theresa Foster (T)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Justin Kearney (J)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Nigel Lang (N)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Matthew Limmer (M)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Adam Mellett-Smith (A)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.
ORCID: 0000-0002-6157-8979

Joshua Miller (J)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Carla Mills (C)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Ria Osborne (R)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Nigel Rees (N)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Robert E S Spaight (RES)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Gemma L Squires (GL)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Belinda Tibbetts (B)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Michelle Waddington (M)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Gregory A Whitley (GA)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Jason V Wiles (JV)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Julia Williams (J)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Sarah Wiltshire (S)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Adam Wright (A)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Ranjit Lall (R)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Gavin D Perkins (GD)

From the Warwick Medical School, Clinical Trials Unit, University of Warwick (K.C., C.J., J.P.N., J.B.L., J.M.M., F.M., C.N., H.N., A.-M.S., M.A.S., K.R.S., S.W., R.L., G.D.P.), and the Critical Care Unit, University Hospital Coventry and Warwickshire NHS Trust (M.A.S.), Coventry, Devon Air Ambulance (N.L., B.T.) and South Western Ambulance Service NHS Foundation Trust (R.O., S.W.), Exeter, East Midlands Ambulance Service NHS Trust, Nottingham (R.E.S.S., G.L.S., G.A.W.), East of England Ambulance Service NHS Trust, Cambridge (S.B., T.F.), Kingston University (T.Q.) and London Ambulance Service NHS Trust (R.T.F., J.K., J.F., A.M.-S.), London, North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne (K.C., E.B., M.L.), North West Ambulance Service NHS Trust, Bolton (S.B., A. Wright, M.W.), South Central Ambulance Service NHS Foundation Trust, Bicester (C.D.D., M.B., A.C., V.D.), South East Coast Ambulance Service NHS Foundation Trust, Crawley (G.B., J.W.), Welsh Ambulance Services University NHS Trust, Cwmbran (C.M., N.R.), West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill (A. Walker, C.E., J.M., J.V.W.), the Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham (G.D.P., K.C.), the Emergency Department, Harrogate and District NHS Foundation Trust, Harrogate (A. Walker), the Department of Anaesthesia, Royal United Hospitals Bath NHS Foundation Trust, Bath (J.P.N.), University Hospital Southampton NHS Foundation Trust, Southampton (C.D.D.), and the University of Bristol, Bristol (J.P.N.) - all in the United Kingdom.

Classifications MeSH