{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:58:29Z","timestamp":1784887109679,"version":"3.55.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor in the UK. In order to increase the chances of successful resuscitation, international society guidelines on cardiopulmonary resuscitation quality have recommended titration of chest compression parameters and vasopressor administration to arterial diastolic blood pressure if invasive catheters are in situ at the time of cardiac arrest. However, prehospital initiation of arterial and central venous catheterisation is seldom undertaken due to the risks and significant technical challenges in the context of ongoing resuscitation in this environment. In 2019, a dedicated programme was started at East Anglian Air Ambulance (EAAA) to enable the safe introduction of contemporary emergency vascular access devices, in order to improve physiological monitoring intra-arrest and deliver nuanced, goal-directed resuscitation in OHCA patients. This programme was entitled Specialist Percutaneous Emergency Aortic Resuscitation (SPEAR). This article details the EAAA SPEAR technique; and the development, implementation and governance of this novel endovascular strategy in our UK physician-paramedic staffed helicopter emergency medical service.<\/jats:p>","DOI":"10.1177\/11297298241242157","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:33:50Z","timestamp":1712968430000},"page":"982-988","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Implementation of advanced vascular access, physiological monitoring and goal-directed resuscitation during OHCA in a helicopter emergency medical service"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8596-4703","authenticated-orcid":false,"given":"Shadman","family":"Aziz","sequence":"first","affiliation":[{"name":"Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, Norfolk, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Lachowycz","sequence":"additional","affiliation":[{"name":"Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, Norfolk, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Major","sequence":"additional","affiliation":[{"name":"Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, Norfolk, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Rees","sequence":"additional","affiliation":[{"name":"Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, Norfolk, UK"},{"name":"Barts Interventional Group, Barts Heart Centre, St Bartholomew\u2019s Hospital, London, UK"},{"name":"Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research &amp; Clinical Innovation), Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Barratt","sequence":"additional","affiliation":[{"name":"Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Norwich, Norfolk, UK"},{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research &amp; Clinical Innovation), Birmingham, UK"},{"name":"Emergency Department, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"Epidemiology of cardiac arrest guidelines","author":"Perkins GD","year":"2021","unstructured":"Perkins GD, Nolan JP, Soar J, et al. Epidemiology of cardiac arrest guidelines. Resuscitation Council UK, 2021.","journal-title":"Resuscitation Council UK"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2019.12.042"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2004.10.009"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829d8654"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/bean.2000.0109"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440080084029"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0300-9572(88)90111-6"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.69.4.822"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2012.10.023"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2021.02.009"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201407-1343OC"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2011.05.002"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resplu.2021.100159"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199306000-00016"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2021.10.019"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005715"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032270"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2013.06.014"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2019.06.101"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.09.035"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241242157","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241242157","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241242157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:24:28Z","timestamp":1777692268000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241242157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/11297298241242157"],"URL":"https:\/\/doi.org\/10.1177\/11297298241242157","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,12]]}}}