London’s Air Ambulance, the
Charity which runs London’s Helicopter Emergency
Medical Service, has become the first in the UK to trial a novel device for
directly cooling the brain using evaporative, nasal spray technology, the
RhinoChill® IntraNasal Cooling System in pre-hospital cardiac arrest patients. London’s Air Ambulance
will conduct this study on its Physician Response Unit; also known as the ‘Cool
Car’.
Thousands of people die every year from sudden cardiac
arrest. Cooling the patient following resuscitation (‘therapeutic hypothermia’)
has been shown to improve survival and limit brain damage from out-of-hospital
cardiac arrest. The latest research, however, suggests that cooling the patient
earlier, at the time of resuscitation, will have an even greater benefit.
The Study
The study will take place on the London’s
Air Ambulance Physician Response Unit. RhinoChill has already been trialled
successfully by emergency medical services in other countries, and the aim of
this study will be to assess the feasibility of using this device in the UK pre-hospital
arena. The study will take place over one year and if proven successful the device
could be trialled by London’s
Air Ambulance for use with other conditions, such as head injuries.
RhinoChill is a new portable and easy-to-use system for
inducing therapeutic hypothermia following cardiac arrest. Clinical data has
shown that it rapidly and effectively reduces both brain and core body
temperature, which can lead to improved survival rates after a cardiac arrest
when administered along with standard life support procedures before the
patient reaches hospital, compared with standard life support procedures only.
London’s Air Ambulance
received a prestigious research grant from the College of Emergency
Medicine to undertake this research project. The
team is committed to frontline resuscitation research and evaluating this new
technology which has the potential to save lives.
Commenting on the study, Dr Gareth Davies, Medical Director
and Chair of the Trustees of London’s Air Ambulance, said: “London’s Air Ambulance prides itself on
delivering medical innovation to increase the survival and recovery of its
patients. Our ‘Cool Car’ sits alongside our Helicopter Emergency Medical
Service and provides advanced medical care to medical emergencies, such as
cardiac arrest.
“I would like to thank the College of Emergency
Medicine for their contribution towards this
project and we look forward to sharing our findings on completion of the
study.”
The ‘Cool Car’
London’s Air Ambulance has an international reputation for delivering advanced
medical care to victims of serious trauma, such as road traffic collisions. The
service also provides a Physician Response Unit (PRU) that responds to medical
emergencies, such as cardiac arrests. This service operates in the area around
the Royal London
Hospital, including the City and East London. The PRU delivers a doctor and paramedic team
that can provide advanced medical care to critically ill Londoners.
The ‘Cool Car’ is the nickname used by the local ambulance
crews when the PRU attends victims of cardiac arrest. The Cool Car team
provides additional equipment, expertise and drugs which can improve survival
and recovery rates in victims of cardiac arrest. When the heart has stopped
following cardiac arrest, it is imperative to ensure oxygen is reaching the
brain and that blood is being pumped round the body. To achieve this, the team
carry a machine called the Autopulse, made by Zoll, which delivers mechanical
chest compressions to ensure consistent high quality CPR.
In a bold innovative step, the Cool Car team will be the
first pre-hospital providers in the UK to start the therapeutic
hypothermia process on patients during active resuscitation and before return
of a pulse. By using the RhinoChill device, the brain and heart will already be
cooling when the patient hopefully regains a pulse, which will protect the
brain from damage due to the lack of oxygen and importantly also further damage
caused when the circulation returns to normal; a condition known as reperfusion
injury. The medical teams are also trained to deliver anaesthesia and sedation
thus allowing oxygenation and ventilation to be optimized prior to arrival at
hospital.
Commenting, Dr Richard Lyon, Registrar in Emergency Medicine
& Pre-hospital Care, said: “We are very proud to have received this grant
from the College
of Emergency Medicine.
Undertaking novel resuscitation research is always very challenging but the
Physician Response Unit of London’s Air Ambulance provides the ideal means to
assess new ways of improving survival and patient care from sudden cardiac
arrest. This project will provide us with invaluable pilot data so we can
continue to undertake cutting edge pre-hospital research.”
