West Midlands Ambulance Service and the University of Sheffield have launched a trial which could save lives, reduce the time patients spend in hospital and save money.
The ‘ACUTE’ trial is looking at patients who suffer from life threatening acute respiratory failure. The condition often results in patients spending long periods of time in hospital, frequently in intensive care.
The condition happens when heart or lung disease suddenly develops or worsens and leads to patients being unable to maintain oxygen levels in the blood. As many as one in eight patients will die from the condition.
Patients with conditions such as COPD (chronic obstructive pulmonary disease) and particularly serious cases of pneumonia are often victims of the condition, where they struggle to breathe.
Ambulance staff currently provide oxygen delivered at normal pressure through a loose fitting mask. Under the trial, ambulance crews will use a CPAP device (continuous positive airway pressure). It involves delivering oxygen under increased pressure through a close-fitting facemask effectively forcing oxygen into the lungs. This allows the oxygen to be taken into the blood stream and also allows carbon dioxide to be released.
The ACUTE (Ambulance CPAP: Use, Treatment effect and Economics) trial, will involve ambulance crews in Staffordshire and Birmingham. Staffordshire historically has higher rates of respiratory disease. This pilot study will be used to see if a full trial of CPAP (Continuous Positive Airway Pressure) is feasible, acceptable and cost-effective.
WMAS Lead Research Paramedic, Andy Rosser, said: “We know that CPAP is used very effectively in hospitals. Small studies outside of the UK suggest that using CPAP in an ambulance may save more lives, particularly where the patient is in a more rural location and has further to travel to hospital. Where CPAP is used, the patient would start to receive treatment sooner, rather than waiting until they arrive in hospital:
Research paramedic, Josh Miller, said: “What we want to establish is whether using CPAP in a pre-hospital setting will make a difference to a patient’s survival and reduce hospital stays at the same time. It has the potential to save many lives:
Consultant Paramedic, Matt Ward, said: “Patients who are to be recruited into the trial will receive a full briefing from the ambulance staff so that they can make an informed choice. One of the key issues is making sure ambulance staff can explain the trial in simple terms. In many respects you should think of the lungs as being like a balloon:
Research Paramedic, Imogen Gunson, added: “The mask and straps may not be pretty on the eye, but patients report that it can make a big difference as to how they feel and also how easily they can breathe.” Andy Rosser says it will all be explained:
Note to Editors
Ambulance staff will identify adults with acute respiratory failure. In total, 120 will be included in the trial. Half will receive CPAP while the other half will be treated with standard oxygen therapy. All patients ill then undergo normal hospital treatment and will be followed up for a month. The researchers at the university will measure each patient’s quality of life, need for admission to intensive care, length of stay in hospital and health service use. The results will then be used to establish whether it is feasible and affordable to conduct a full-scale trial evaluating CPAP and how such a study could be carried out.
A 45-minute training video is available for all staff and students at www.sheffield.ac.uk/acute or for more information