Background: The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care. Objectives: To explore the feasibility of running a RCT to test the hypothesis that, for people with suspected facet joint back pain, adding the option of intra-articular FJIs (local anaesthetic and corticosteroids) to best usual non-invasive care is clinically effective and cost-effective. Design: The trial was a mixed design. The RCT pilot protocol development involved literature reviews and a consensus conference followed by a randomised pilot study with an embedded mixed-methods process evaluation. Setting: Five NHS acute trusts in England. Participants: Participants were patients aged ≥ 18 years with moderately troublesome LBP present (> 6 months), who had failed previous conservative treatment and who had suspected facet joint pain. The study aimed to recruit 150 participants (approximately 30 per site). Participants were randomised sequentially by a remote service to FJIs combined with 'best usual care' (BUC) or BUC alone. Interventions: All participants were to receive six sessions of a bespoke BUC rehabilitation package. Those randomised into the intervention arm were, in addition, given FJIs with local anaesthetic and steroids (at up to six injection sites). Randomisation occurred at the end of the first BUC session. Main Outcome Measures: Process and clinical outcomes. Clinical outcomes included a measurement of level of pain on a scale from 0 to 10, which was collected daily and then weekly via text messaging (or through a written diary). Questionnaire follow-up was at 3 months. Results: Fifty-two stakeholders attended the consensus meeting. Agreement informed several statistical questions and three design considerations: diagnosis, the process of FJI and the BUC package and informing the design for the randomised pilot study. Recruitment started on 26 June 2015 and was terminated by the funder (as a result of poor recruitment) on 11 December 2015. In total, 26 participants were randomised. Process data illuminate some of the reasons for recruitment problems but also show that trial processes after enrolment ran smoothly. No between-group analysis was carried out. All pain-related outcomes show the expected improvement between baseline and follow-up. The mean total cost of the overall treatment package (injection £419.22 and BUC £264.00) was estimated at £683.22 per participant. This is similar to a NHS tariff cost for a course of FJIs of £686.84. Limitations: Poor recruitment was a limiting factor. Conclusions: This feasibility study achieved consensus on the main challenges in a trial of FJIs for people with persistent non-specific low back pain. Future Work: Further work is needed to test recruitment from alternative clinical situations. Trial Registration: EudraCT 2014-000682-50 and Current Controlled Trials ISRCTN93184143. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 30. See the NIHR Journals Library website for further project information.

This e-poster abstract from the European Society of Regional Anesthesia presents results from data on the role of injection procedures in a multi-disciplinary chronic pain clinic.

This European Airway Management Society (EAMS) conference abstract reports the results of a multicentre survey of current trends in the use of supraglottic airway devices.

Abstract from the Trainee Conference 2021, 8‐9 July 2021, Newcastle, UK and hybrid conference discussing a survey of patient experiences with anaesthetists.

Introduction Human factors, such as communication skills, are imperative to good patient care. In post-simulation debriefs we discuss these non-technical skills with medical students regularly, but do we have a good appreciation of what the terms mean to them, or what aspects of behaviour, good or bad, they focus on? Method Six human-factor sheets were developed to guide the students in their analysis of events in simulated scenarios. The sheets focused on one of: communication, teamwork, decision making, task management, situational awareness, or a final overview. A brief introduction to each factor was given as well as examples of good practice. The students were encouraged to record in writing what aspects of the scenario went well, and what could be improved, for a chosen skill. These sheets were then collected at the end of the session, with the students’ consent, for anonymous analysis. Data collection commenced last month and will run until December, with an estimated inclusion of about 100 students from two universities. The data will be analysed using thematic analysis performed by multiple researchers. Discussion If we can understand what aspects of these non-technical skills are considered important to our students early on in their career we can better tailor our teaching, both in simulation and in the clinical environment, to foster better performance throughout their training. By understanding what our students perceive, analyse, and internalise we can also reflect on our own practice and interactions to consider how we project as role models to our future colleagues.

Conference abstract 000758 for ESICM LIVES 2019 investigating whether intensive care units were adhering to current Resuscitation Council (UK) guidelines.

Conference abstract concerning point of care lung ultrasound and focused echocardiography findings in a cohort of patients with severe COVID‑19.