PIONEERING CARDIAC ARREST INTERVENTION ACCESSIBLE TO ALL IN THE NORTH WEST
A life-saving medical project between the North West Air Ambulance Charity (NWAA) and Wythenshawe Hospital, part of Manchester University NHS Foundation Trust, has been recognised for Innovation at the National Air Ambulance Awards of Excellence.
As a result of the year-long collaboration, NWAA and Wythenshawe Hospital has been able to streamline potentially life-saving interventions for cardiac arrests for the first time. In one case, it saved the life of a patient whose heart had stopped for 54 minutes.
Approximately 90 per cent of heart attacks which occur outside of a hospital in the UK are fatal. Immediate, uninterrupted CPR, rapid transport to a specialist cardiac centre, and diagnosis and treatment of the underlying cause are vital in increasing the chances of survival. Until recently, these interventions would often be delivered in isolation.
When activated for a cardiac arrest call, NWAA crews can rapidly deploy to the patient by road or by air. There they will carry out an assessment, provide emergency anaesthesia if required, and initiate advanced life support measures. If appropriate for the patient, the Wythenshawe team is activated and the patient transported direct to the cardiac specialists at Wythenshawe Hospital – all in under an hour from call time.
Dr Ian Tyrrell-Marsh, NWAA consultant lead for the project, commented: “In a cardiac arrest situation, it’s all about time and access to specialist services – Every second counts, from the moment the call comes in it’s a race to get to the patient and then stabilise and transfer them to a centre capable of dealing with the underlying problem. Sometimes we are unable to get the heart to start again which previously would mean the patient would unfortunately die. Thanks to this project, we now have the option to transfer the patient, still in cardiac arrest, direct to the specialist facility at Wythenshawe Hospital where they can be immediately placed on a form of heart lung bypass to support the vital organs. This buys the patient vital time for the cardiologists to investigate the underlying cause of their cardiac arrest.”
Access to specialist equipment, not available elsewhere in the North West, has been key to the success of the project. NWAA, a charity which does not receive government funding or National Lottery support, was able to purchase a LUCAS Chest Compression system last year following a generous donation. LUCAS administers automated CPR, allowing NWAA medics to deliver uninterrupted, constant high quality CPR even whilst transporting a patient in the aircraft.
Wythenshawe is the only hospital in the North West offering the highly specialist ECMO (extracorporeal membrane oxygenation) service, which involves placing the patient on a machine to circulate oxygenated blood,essentially acting as an artificial heart and lungs. Wythenshawe Hospital has specially trained the charity’s Medical Teams to assess cardiac arrest patients at the scene for their suitability for ECMO.
The charity and hospital believe this chain of interventions, and how they are now delivered, has the potential to transform cardiac arrest treatment UK-wide. Dr Tyrrell-Marsh continued: “When a person suffers a cardiac arrest outside of hospital, access to in hospital specialist care can be challenging. You can imagine that for people out in rural areas, further away from hospitals, helicopter emergency medical teams are critical in offering stabilisation at scene and rapid transport to hospital, increasing the chance of patient survival.
“It has been an absolute honour for the charity, and Wythenshawe Hospital, to be recognised for our work. In just over a year, we’ve introduced a clinical practice which is saving lives in the North West. We hope the hard work and research we’re completing will assist other air ambulance services in joining up with their local ECMO-equipped centres to allow access to this potentially lifesaving treatment for the benefit of other patients, all across the country.”
To date, NWAA has transferred eight patients to Wythenshawe Hospital as part of the new pathway, five of which received ECMO in the Emergency Department. Two patients were transferred from over 100km away, which would not have been possible without the helicopter emergency medical services to bring the skills and equipment of an Emergency Department directly to the scene.