Allan MacRaild
Stroke Lead Research Nurse
Stroke, Emergency Medicine, Global Health, Medicine of the Elderly, Patient Experience and Action Research Qualifications:
Masters of Nursing in Clinical Research, BSc (Hons) Nursing Studies, Bachelor of Nursing (Adult), BA Acting Studies Twitter:
@emerge_research
Allan has worked been part of the EMERGE team for three years. He arrived following a Masters of Nursing in Clinical Research and with a clinical background in general surgery.
During his time with the team he has co-ordinated a range of different studies (4AT, PATCH-ED, RAMPP, No PAC, POP) and collaborated with RRG on The PRIOR Study. He has recently taken up the role of Stroke Lead Research Nurse leading a small team and a growing portfolio of acute stroke studies. The Stroke Research Group has a reputation for pioneering work in haemorrhagic strokes (RESTART, SoSTART), imaging studies, and multi-site trials (FOCUS, CLOTS) and collaborates widely with the international Stroke research community.
He has also been fortunate to work with the Global Emergency Medicine team and travelled to Zambia in Spring 2018 to volunteer on the Sachibondu project – providing education and support to aremote rural clinic transitioning to a small local hospital.
Allan is passionate about people and bridging the gap between research and clinical practice and continues to thrive and enjoy the diversity of projects and experiences available in his role
In a previous life, Allan trained as an actor and is always ready for his close-up…
Trials
Early diagnosis is central to improving outcomes for patients with cancer. For cancers without specific risk factors, or with no screening programs are difficult to diagnose and patients often present with non-specific symptoms. Unfortunately this means that these patients are often diagnosed late on in the development of the disease and treatment options are reduced.
INFERENCE
ETNA: Edinburgh Transient and Neurological attack: A Cohort Study
Patients frequently present with minor neurological symptoms where a diagnosis of transient ischaemic attack (TIA) or minor stroke is difficult to make positively or to exclude reasonably. For these patients, clinicians are uncertain whether they should: (a) reassure most patients that their symptoms are benign; (b) treat most patients with antiplatelet or other vascular prevention; or (c) stratify stroke risk further using clinical features or brain imaging.
This is important because clinical diagnosis is difficult. Mis-diagnosis is not infrequent and leads to harm from preventable recurrent stroke and costs to health systems from extra care and legal liabilities.
All ETNA participants will receive an MRI scan and the study aims to establish the feasibility and methods for a larger study of diagnostic utility of MR brain imaging and estimate the effects of MRI on clinician decision making.
This study has been recruiting in the Emergency Dept, inpatient wards and TIA clinics since August 2018. We aim to recruit 270 participants and have almost reached our target!
ETNA
DASH Trial
DASH is a randomised clinical trial investigating a treatment to reverse the effects of blood-thinning medications.
Minimal Unit Pricing Study (MUP)
Assessing the impact of the Minimum Unit Pricing
Strokes caused by a clot are described as ischaemic. When patients experience ischaemic strokes they may be eligible for “clot busting” therapy (thrombolysis). Currently thrombolysis has been shown to improve patient outcome after a stroke if administered within the first 4.5 hours after stroke onset. Up to 25% of patients wake up with symptoms of a stroke. This means they have an unknown onset time for their stroke (so called ‘wake up strokes’). With no known onset time, they are ineligible for thrombolysis. This study will investigate how we might determine stroke onset time.
MRI in Acute Stroke
BRAINED Study
Molecular and cellular analysis of intracranial tumours
This study will investigate how we can help treat patients suffering from shock by the targeted use of specific fluids and medications. Shock is an acute medical condition in which the organs and tissues of the body are not receiving an adequate flow of blood. It is associated with a fall in blood pressure, a build-up in waste products and can result in serious organ damage and even death. We hope to improve our ability to treat shock by evaluating fluid management from the blood samples of a group of healthy volunteers.
The Prior Study
Calculating Osmotic Pressure in Healthy Patients
ATTEST2 Trial
Alteplase-Tenecteplase Trial Evaluation for Stroke Thrombolysis (ATTEST 2)
HighSTEACS Bioresource
Patients commonly present to the Emergency Department with epistaxsis (nose bleed). Standard first aid measures such as applying pressure can often stem bleeding however in more severe cases of epistaxsis further treatment is required.
NoPac Trial
Novel Use of Tranexamic Acid to Reduce the Need for Nasal Packing
Intervention
1. Ambulatory Device, Rocket Pleural vent insertion
2. Standard Treatment, Aspiration +/- chest drain
Primary Outcome Measures
To assess whether use of an ambulatory device (Rocket Pleural Vent) and treatment strategy reduces hospital stay. Total length of stay in hospital up to 30 days post randomisation. Up to 30 days post randomisation.
RAMPP trial
RAMPP trial - Randomised Controlled Trial: Pleural vent (rocket) V standard care in Primary Spontaneous Pnuemothorax
This study contributes to the work of Dr Frank Prior who is developing a tool to be used in the treatment of shock.
It is known that shock creates a set of internal conditions that affect vasculature and that these conditions can vary over time and are dependent on the type of shock. This tool reveals the condition of the vasculature and therefore informs which fluid and drugs are best advised for that patient at that time.
COPS
Calculating Osmotic Pressure in Healthy Patients (COPs)
Determining the diagnostic accuracy of the 4AT for delirium versus the reference standard of a DSM-IV diagnosis
4AT Study
The 4AT as a triage test for delirium: a validation study in acutely hospitalised older patients
Related news
The Prior Study
19 Jul 2017 | Allan MacRaild
EMERGE and RRG are undertaking a preliminary study into the principles of fluid exchange within the body.
Read more
The Beats That My Heart Skipped
23 Jan 2017 | Allan MacRaild
Heartbeats provide the rhythm of life. Interruptions to this rhythm are more likely to lead to a loss of consciousness than just a loss of spark. Rob Hannigan (pictured with Senior Research Nurse Allan MacRaild) took part in the PATCH-ED trial in 2016 following a number of unexplained blackouts. The results of his PATCH highlighted some dangerous arrhythmias including 24 seconds when his heart stopped beating entirely. Six months after his participation in the PATCH-ED trial, Rob met up with Allan to share his experiences.
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4AT team attends British Geriatric Society conference
5 Nov 2015 | Allan MacRaild
Emerge sent two research nurses to the British Geriatric Society (BGS) conference. Jill Steven and Allan MacRaild are recruiting to a study entitled The 4AT as a triage test for delirium: a validation study in acutely hospitalised older patients. This study is a first collaboration between Emerge and Medicine of the Elderly with this study being led by Professor Alasdair MacLullich.
Read more