Working with international pre-hospital care professionals to develop and improve patient care

Some of our medics recently joined forces with HEMS operators from the Norwegian Air Ambulance Foundation and Wales’ Emergency Medical Retrieval and Transfer Service to share knowledge and advance patient care.

Procedures and critical care training around premature babies, victims of stabbing and hearts that have stopped beating were just some of the topics included on the agenda.

The experience exchange was arranged by the Norwegian Air Ambulance Foundation and took place at Torpomoen, Norway near the Ål HEMS Base and saw 14 physicians and critical care practitioners come together, discussing their approaches and relevant training.

Dr Marius Rehn, HEMS Physician and Senior Researcher at the Norwegian Air Ambulance, and Professor at the University of Oslo, led a workshop on medical cardiac arrest and the training on inserting a tiny balloon into the aorta. The balloon concentrates the patient’s blood flow to the heart and brain to increase the chance of resuscitation, which is a method used in London to stop severe bleeding. The medics on the day got to practice threading the balloon through blood vessels to the right place on a dummy.

Dr Marius Rehn said: “Collaboration is vital to avoid wasting time and resources while working towards the common goal: to help pre-hospital patients in the best way possible.

“HEMS crews don’t have the luxury of a sterile operating theatre. Our procedures are carried out in someone’s bathroom, outdoors or in the back of an ambulance or helicopter, and some of our equipment is made for in-hospital use.”

Unfortunately with penetrating trauma being the mechanism of injury for 30-35 per cent of London’s Air Ambulance patients, our medics on the day were the experts when it came to patients at risk of bleeding out.

Our Medical Director, Dr Tom Hurst, who attended the collaboration day, said: “The most severe patients, the ones whose hearts have stopped, need a surgical procedure where we open their chest to address their injuries. On the other end, we have patients who only need pain relief and oxygen while we take them to the hospital. In the middle we have patients who are bleeding severely, who we treat with blood transfusions and other interventions to try to stabilise them.” 

These other interventions were a focal point of one of the training sessions.

In rural areas (the 3.2 million people of Wales live across an area 13-times bigger than London, comprising of mountains, shorelines and cities, and Norway has 5.5 million inhabitants scattered across 324,000 square kilometres) complicated and premature births may happen far from the nearest hospitals. 

In recent years the Welsh HEMS crews have flown out on an increasing number of such critical cases and chose to share their experience with their international colleagues on this day.

“There are several reasons behind the increase, like the centralisation of hospitals or women giving birth at a later age than previously possible. It seems our colleagues elsewhere face similar circumstances,” said Dr Laura Owen, HEMS Physician with Wales’ Emergency Medical Retrieval and Transfer Service. “When you go to these jobs, you already know you’ve got two patients: the mother and the baby. If it’s twins, you’ve suddenly got three. That’s something we have experience with and based our training on.”

Our medics thoroughly enjoyed the opportunity to share learnings and hear about the work and research the international HEMS peers are focusing on. Close collaboration with national and international health services, HEMS operators, research communities and industry partners is vital to the Norwegian Air Ambulance Foundation’s work and we’re thankful to have been invited.

Dr Laura Owen said: “Sometimes, at work in your own health care system, you get told that some things can’t be done. Then you meet colleagues from another service who do that exact thing and you understand that you could absolutely do that! It makes me really enthused and inspired. I think there’s no end to the possibilities if we work together and have the right people driving it forward.”