Cambridgeshire-based Magpas Air Ambulance has recently worked with the Trauma Intensive Care Unit (ICU) at Addenbrooke’s Hospital to improve survival and recovery times of intubated patients across the east of England.
Clinicians at Magpas Air Ambulance are trained in Pre-Hospital Emergency Medicine (PHEM), allowing them to provide patients with treatments and procedures at the incident scene that are usually only available in a hospital emergency department. One of the most common of these procedures is the intubation of a patient.
Intubations are needed when a patient can’t breathe for themselves and it involves placing a tube down their throat and attaching it to oxygen, which goes directly into their lungs to keep them inflated. Through this procedure, their brain is protected, and their other organs keep functioning by circulating oxygenated blood. The patient will remain intubated while the air ambulance takes them to hospital.
The tubes currently used in the PHEM setting are intended for short-term use, whereas in the ICU, endotracheal tubes with subglottic secretion drainages are used, which allow ICU staff to drain built-up fluid that could cause an infection.
Over the course of 2021, Magpas Air Ambulance Doctor Adriana Cordier, who is also an intensive care and emergency medicine doctor at Addenbrooke’s Hospital, and other ICU doctors found that the majority of trauma patients in the east of England who are intubated by pre-hospital critical care teams remained intubated for an average of eight days and required their tube to be changed to a subglottic secretion drainage tube.
Therefore, patient care could be enhanced if critical care teams could use the endotracheal tubes with subglottic secretion drainages in their pre-hospital practice. The aim is that once the patient is intubated by Magpas Air Ambulance, the tube will not be changed again, which will reduce risk to the patient as it’s a dangerous procedure, and help prevent infection.
The decision was made to change the tubes they use to those already used in ICU and Magpas Air Ambulance doctors and paramedics commenced use of these tubes this week for the use with all adult patients.
Dr Cordier said: “Changing these tubes will be more expensive for the charity. However, when looking at our patients’ overall journey to recovery, we recognise that by upgrading this piece of equipment, we may well improve their outcome in the long run. We do this job to give the sickest of the sick patients the best chance of survival, so even if it means we have to raise more money each year, it’s a small price to pay to ensure we’re giving our patients the best chance of survival and potentially keeping more families together.
“We will continue to work closely with the Neuro-Trauma Intensive Care Unit to discover innovative ways to improve the overall outcome of our patients.”