Research Development

Staff Publications

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Find out what your colleagues have been writing. This section features articles published by staff working for St Helens and Knowsley Teaching Hospitals and Halton, Knowsley and St Helens community staff.

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All publications by 'Nee PA'



Mersey and West Lancashire Teaching Hospitals NHS Trust – St Helens & Knowsley Staff

Review: Could this be measles?

​Infection with the measles virus causes an unpleasant disease with many potentially serious complications. It is predominantly a childhood illness but can affect any age. Measles is extraordinarily contagious, but immunisation with measles containing vaccine provides comprehensive protection. An international programme of universal immunisation from the mid-1980s has been..

Published: 08/04/2019
Authors: Nee PA, Vardhan M

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An audit of the use of prothrombin complex concentration

Background Prothrombin complex concentrate (PCC) is licensed for emergency reversal of anticoagulation in severe and life-threatening bleeding, intracranial haemorrhage and prior to emergency surgery. It is an expensive resource costing approximately Eur2000 per adult dose. There is evidence of inappropriate use of PCC leading to delays to treatment, inappropriate dosing..

Published: 20/02/2019
Authors: Bonney S, Nee PA, Schofield J

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Could this be whooping cough?

Whooping cough is a notifiable bacterial respiratory infection caused by Bordetella pertussis . It may produce serious disease, especially in immunocompromised individuals and very young children. The number of reported cases increases in the winter months and the incidence peaks every 4–5 years. However, this periodicity is variable and is inconsistent between..

Published: 24/08/2018
Authors: Nee PA, Vaidya A, Vardhan M

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Critical care in the Emergency Department: organ donation

​ Abstract: Organ transplantation is associated with improved outcomes for some patients with end-stage organ failure; however, the number of patients awaiting a transplant exceeds the available organs. Recently, an extended role has been proposed for EDs in the recognition and management of potential donors. The present review presents an illustrative..

Published: 17/02/2017
Authors: Bonney S, Nee PA, Andrews FJ

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Platelet function analysis utilising the PFA-100

​ Introduction Sepsis is known to be associated with impaired platelet function (1). The PFA-100 (Siemens Healthcare, Dade International, Miami, Fla., USA) is a device in which a citrated whole blood sample is aspirated through an aperture coated with agonists inducing platelet activation. Platelet aggregation leads to occlusion of the aperture and..

Published: 16/08/2016
Authors: Bolton N, , Bonney S, Tridente A, Nee PA

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Critical care in the emergency department: acute kidney injury

​ Abstract Acute kidney injury (AKI) is common among emergency department patients admitted to hospital. There is evidence of inadequate management of the condition leading to adverse outcomes. We present an illustrative case of AKI complicating a gastrointestinal disorder in an older adult. We discuss the clinical presentation, assessment and management..

Published: 19/07/2016
Authors: Bailey DJ, Nee PA, , Todd V

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Vasopressin, steroids and epinephrine

​ The use of vasopressin and steroids in addition to epinephrine during the resuscitation of patients suffering an in-hospital cardiac arrest is associated with an improved neurological outcome. Rehnberg, J.V.; Nee, P. (2015). Vasopressin, steroids and epinephrine and neurologically favourable survival after in-hospital cardiac arrest​ . Journal of the Intensive Care Society. 16 (1), 77..

Published: 19/07/2016
Authors: Nee PA

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The implementation of a blood conservation strategy

​ I​ntroduction Patients admitted to intensive care units (ICUs) are commonly affected by anaemia, which is contributed to by iatrogenic blood loss from diagnostic testing, with potential risks of increasing transfusion requirements and negative effect on outcomes. Recently published guidelines make several recommendations for the management of anaemia and red..

Published: 19/07/2016
Authors: Tridente A, Bonney S, Nee PA

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Neutrophil to lymphocyte count ratio

​ Objectives  Early identification of patients with blood stream infection (BSI), especially bacteraemia, is important as prompt treatment improves outcome. The initial stages of severe infection may be characterised by increased numbers of neutrophils in the peripheral blood and depression of the lymphocyte count (LC). The neutrophil to LC ratio (NLCR)..

Published: 19/07/2016
Authors: Nee PA, Vardhan M

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Lymphopenia as a predictor of bacteremia

​ Introduction  Bloodstream infection (BSI) is associated with a reduction in circulating lymphocytes. Lymphopenia has been proposed as an early marker of BSI in pyrexial adults in the emergency department (ED) setting [1]. The aim of this study was to compare lymphocyte count with conventional markers in patients presenting to the ED..

Published: 19/07/2016
Authors: Nee PA

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Sedation in mechanically ventilated adults

​ Abstract The use of sedative and analgesic dugs is essential in intensive care. The lowest effective doses should be used for the shortest period of time in order to limit the risk of serious complications. Daily interruption of sedation (DIS) is one strategy that has been shown to reduce overall..

Published: 19/07/2016
Authors: Nee PA

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Mechanically Ventilated Adult Patients

​ Abstract The combined use of daily interruption of sedation and a nursing-implemented sedation protocol targetting light sedation does not reduce duration of mechanical ventilation in adult ICU patients. Keough, J; Nee, P. (2013).  Daily interruption of sedation and nursing-implemented sedation protocol in mechanically ventilated adult patients . Journal of the Intensive Care..

Published: 19/07/2016
Authors: , Nee PA

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Critical Care

​ Abstract Inadequate resuscitation of major haemorrhage is an important cause of avoidable death in severely injured patients. Early recognition of blood loss, control of bleeding and restoration of circulating volume are critical to the management of trauma shock, and transfusion of blood components is a key intervention. Vital signs may..

Published: 19/07/2016
Authors: Bonney S, Mahambrey T, Nee PA

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St Helens Community Staff

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Knowsley Community Staff

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Halton Community Staff

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North West Boroughs Community Health Staff

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