Happy New Year and a TERN update.

Happy new year to all our colleagues in the emergency care community. We hope this finds you well and coping with current working conditions. Although work is challenging at the moment, we feel there is still plenty to be optimistic about in the world of emergency care research and hope the activities of TERN, amongst others, can help to keep you inspired. This a long(ish) but overdue update on TERN activities. Grab a drink, take a breather, and have read about what we’ve been up to and what plans are brewing.

There are a couple of new faces to introduce you to at this end of the TERN email addresses. I (Fraser) have taken over from Rob as TERN Fellow. I am an ST6 trainee in the Severn Deanery who has long had an interest in research alongside full-time clinical training. I see TERN as a network aimed at people just like me until recently - interested and keen to contribute, but needing to make significant effort to fit involvement around the other demands of our work. TERN is here to help, and would love to involve all of you in an accessible way. The introduction of EDT and the emphasis on research and critical appraisal under SLO 10 in the 2021 curriculum will hopefully make this easier for the trainees amongst us.

The network is now also supported by our fantastic administrator, Alice. Alice has an academic background in Translation Studies and in 2020 she left her academic role to pursue a career in research management and administration. She also has roles with the NIHR Emergency Care Incubator and the UWE Emergency Care Research Team so is fast becoming an expert in the field! Please include her in any email communication about study setup and delivery, and in fact just about anything. Alice can be reached at tern.administrator@rcem.ac.uk

TERN has gone from strength to strength since its inception in 2018 thanks to the efforts of its  members, the dedication  of previous TERN fellows Tom and Rob, and the college professors, who continue to offer invaluable guidance and support. Our challenge is to keep the network delivering important research, engage yet more trainees and emergency care staff in research activity, and build a sustainable structure to support a growing range of activities.

Research

ACS:ED - Acute Coronary Syndrome in the Emergency Department.

ACS:ED will run in March 2023. It’s TERN’s next big study looking at chest pain presentations to the Emergency Department. The methodology will be similar to that of SHED with an observational opt out consent model. The recruitment period is short and sweet, only one week long, but we are hoping for big numbers given the frequency of chest pain presentations to every emergency department across the UK. We have received expressions of interest from over 70 sites so far and there is still time to get involved - get in touch ASAP if you want to know more or are interested in running the study at your site. It’s another perfect opportunity for someone without much research experience to run a study so we welcome contact from all staff groups.

The ACS:ED protocol can be found here.

SHED - Sudden onset Headache in the Emergency Department

SHED is in its final few months of recruitment and will stop in February 2023. Recruitment is at over 3500 patients and continuing at a healthy pace. SHED is TERN’s first patient facing study and aimed at one of the 2017 James Lind Alliance emergency medicine research priorities. We’re delighted with progress so far and we’d like to offer a heartfelt thanks to everyone involved and encouragement to keep recruitment going over the winter months until the study ends. Every data point counts! The new NICE guidelines for the diagnosis and management of aneurysmal SAH were published this week including some research recommendations to which the results of SHED will be directly relevant. We’re very excited to start analysing the results and communicating them to our collaborators and beyond.

SEED- UK - An observational Study of E-scooter impacts upon Emergency Departments in the UK.

SEED-UK ran in the Autumn of 2021 and the results have now been written up and submitted for publication. You may have seen Tom and Rob talking about them at the RCEM ASC and EUSEM. SEED-UK is a great example of the power of TERN as a network - an idea that went from design to delivery in a short timeframe, captured useful data about a relatively new clinical area, and has already attracted interest from important decision makers. Congratulations to all involved.

TERN Delphi

The results of the TERN Delphi were published in the EMJ at the end of September. They can be found here. They give a great insight in to the research priorities of members of the TERN network. Have a read, along with the refreshed James Lind Alliance priorities, and get in touch if it sparks some inspiration for a future TERN project.

Next……?

We’d love to hear from you. We see the TERN network as a collaborative community of clinicians and researchers and would be delighted if the idea for TERN’s next big project came from someone reading this email. However small or well-formed your idea might be, whatever your previous experience in research, don’t hesitate to get in touch.

TERN Education

The TERN Education team, tirelessly led by Raj Chatha, continue to work on content for RCEM Learning, the TERN section of which can be found here. We have read with interest and some dismay the results of the EMTA survey which show a clear issue with access to research involvement and critical appraisal activity. We’re currently working on plans to create some regular TERN Education content to help remove barriers to journal club provision at local and regional levels. For this to be a reliable and sustainable process, we will be regularly involving the TERN regional reps in content production, and are also looking to recruit more members to the TERN Education central team. If you are interested in getting involved, please  contact us at  both tern@rcem.ac.uk and tern.education@rcem.ac.uk

TERN Committee

We will be looking to recruit members to a central TERN committee in the near future, so watch out for an email with more details. We’d love to hear any and all suggestions about how the TERN committee could be structured to best serve it’s members.

Regional Reps

Thank you very much to our regional reps who have worked so hard to make the network a success over the past few years. We have refreshed our list of who is in post across the UK and the time has come to appoint some new people in the regions listed below. This is a great opportunity to help with the network’s activities on a regional level, have some input into how TERN research is delivered, and coordinate regional contributions to the TERN Education output. Although responsibilities are not too onerous, there’s plenty of opportunity to make a meaningful contribution.

• Kent Surrey and Sussex
• London North Central and East
• London North West
• London South
• North West
• Northern Ireland
• Scotland North
• Scotland West
• South West - Peninsula
• Wessex
• West Midlands
• Yorkshire and Humber North and East
• Yorkshire and Humber West

Please get in touch if you’d like to be involved or have any questions!

by Fraser Birse