Archive for month: March, 2020

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Inhaled Analgesic Increases Speed Of Discharge Time Per Patient By 71 Minutes On Average Compared To Conventional Therapy

A recent study has revealed that Penthrox▼(methoxyflurane) can save more than one hour per procedure in hospital emergency departments on average — allowing more patients to be seen and potentially saving money for the NHS.¹

Penthrox has been widely used in Australia and New Zealand for many years. However, it is used in fewer than half of UK emergency departments, mainly due to unfamiliarity with the treatment amongst staff.

Now researchers from St Mary’s Hospital, part of Imperial College Healthcare NHS Trust, have found that the non-opioid medicine, which is self-administered under the supervision of a person trained in its administration, can save 71 minutes on average in treating appropriate emergency department (ED) patients, compared to usual pain-killing techniques, with the added benefit of saving up to 50% on the cost of treatment per patient depending on the type of trauma injury.¹

The results echo recent findings from other hospitals which show that patients treated with methoxyflurane spend significantly less time in ED compared to those treated with standard care.^2,3

These results come at a time when the NHS is facing exceptional pressure and demonstrate how the use of Penthrox as a first-line analgesic for appropriate patients can free up resources including staff and equipment required to treat patients compared with standard treatments

Over the course of six months, the researchers, supported by A&E Consultant Dr George Bailey, looked at the length of stay in the Emergency Department for patients with moderate or severe trauma pain who received methoxyflurane compared with those who received standard care.¹

Adult patients with moderate to severe trauma pain and Glasgow Coma Score of 15 were included in the evaluation.

Patients in both the methoxyflurane and standard care cohorts were matched for analytical purposes based on patient characteristics, including age group, gender and injury type, and previous medical history, in order to limit any potential for bias.

There were particular gains for patients suffering from a dislocated shoulder, where methoxyflurane patients saved over three hours in treatment time._¹

The study, published today in the journal Advances in Therapy, also examined the different treatment costs and concluded that methoxyflurane may save up to 50% on the cost of treatment per patient, depending on the type of trauma injury.¹

The researchers explained that Penthrox can negate the need for procedural sedation, which requires an intravenous line into the arm, a resus bed — which are often not immediately free — and also requires the time of three staff to carry out the procedure.

By contrast, Penthrox could be administered in a chair or on a trolley and only required one — two staff members depending on the procedure, as Penthrox is self-administered by the patient.

The researchers commented: “Long waiting times, slow discharge times and overcrowding are affecting almost every ED in the UK, and the situation does not show any signs of significant improvement at present.”

They concluded: “This evaluation demonstrated that the early use of methoxyflurane can positively impact length of stay within EDs and provide effective pain relief for patients.”

Commenting on the findings, Dr George Bailey said: “During our evaluation the use of Penthrox was well received by our staff and patients.’

“Being able to offer early fast-acting pain relief is essential and we were pleased to find the additional benefit of reducing time patients spent in the ED compared to standard care.”

Dr Dennise Broderick, Managing Director and President of Galen (who market Penthrox in the UK) added: “We all know the immense pressures facing trauma services in the UK, exacerbated in these exceptional circumstances.’

“We welcome these latest findings, which reinforce what has already been long accepted in other parts of the world — that Penthrox can help improve the throughput of patients in A&E departments by offering an effective means of pain control for patients that is simple to use and fast-acting.’

“We’re committed to providing education to help hospital teams make use of this particular innovation in the coming weeks and months.”

Penthrox consists of a green-coloured tube containing a fixed measure of methoxyflurane and can be self-administered by patients.

It can provide up to 60 minutes of pain relief per treatment.⁴

As a single-use product that requires no canisters, additional breathing masks or tubes and is disposed of after patient use via a sealable plastic bag, it greatly minimises the potential of inadvertently spreading infection across a department or between buildings.

References

1. Young L, Bailey G, McKinley J. Service evaluation of methoxyflurane versus standard care for overall management of patients with pain due to injury. Adv Ther 2020.
2. Umana E, et al.Inhaled methoxyflurane for the reduction of acute anterior shoulder dislocation in the emergency department. CJEM2019:21(4): 468-472
3. Gangadharan L. Penthrox in the ED –is it worth the hype? Presented at The Royal College of Emergency Medicine Spring CPD meeting. April 2019
4. Penthrox (methoxyflurane) Inhalation Product Information. December 2018 https://www.medicines.org.uk/emc/product/1939/smpc.
5. Coffey F, Wright J, Hartshorn S et al. STOP!: a randomised, double-blind, placebo-controlled study of the efficacy and safety of methoxyflurane for the treatment of acute pain. Emerg Med J2014; 31(8):613–618. https://doi.org/10.1136/emermed-2013-202909.
6. Mercadante S, Voza A, Serra S, et al. Analgesic Efficacy, Practicality and Safety of Inhaled Methoxyflurane Versus Standard Analgesic Treatment for Acute Trauma Pain in the Emergency Setting: A Randomised, Open-Label, Active-Controlled, Multicentre Trial in Italy (MEDITA). Adv Ther 2019; 36(11):3030-3046.

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At a time when the country is pulling together to tackle the Corona Virus outbreak, West Midlands Ambulance Service is putting out an appeal to registered paramedics who live in the region to re-join the Service in order to help treat the increasing numbers of patients.

WMAS has already significantly increased its capacity to deal with COVID-19 patients, but we want to go further still to ensure we can provide care to patients in their hour of need and save as many lives as possible.

As a result, we are looking for any paramedics who retired within the last two years or are working in the private sector for the likes of events medical companies who would like to come back into the NHS family to get in touch.

We have also had former members of staff contact us who went on a career break to look after children, offering to come back, which we welcome.

Trust Chief Executive, Anthony Marsh, said: “Over the last couple of years, we know that several hundred staff have retired from our service after giving many years of outstanding care to the public.’

“We would like those paramedics to consider returning to WMAS so that we can increase the quality and amount of care that we can provide the public in these challenging times.’

“Equally, we have already had a number of paramedics who normally provide medical cover at events such as horse racing come to us to offer their services, for which we are very grateful.’

“We want to boost the number of paramedics we have available as much as possible, so re-employing former paramedics and those who work in the private sector who would like to join us makes sense.’

“Across our country we have seen how much we are all pulling together, from the astonishing scene last Thursday during ‘The Big Clap’ through to the amazing generosity of companies and individuals towards our staff; now we want to go one step further by increasing the number of paramedics to boost our ability to care for patients even further.’

“For those who have retired; I know how much the time you spent with us meant to you; many of you have told me that when we have spoken.’

“I wouldn’t ask you to re-join if I didn’t think it was the right thing for the public of the West Midlands and our country.”

Those who would like to join the Service either on a short term or long term basis are invited to apply via NHS Jobs (www.jobs.nhs.uk) and look out for Job Reference: 217-VN488-19-20

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The Israel Association of Community Centers and Lev Echad have partnered with United Hatzalah of Israel and launched a new national dispatch center managing 30,000 volunteers who will provide assistance to humanitarian emergencies across Israel.

The new partnership has given birth to the largest humanitarian aid group currently operating in Israel.

The mission of the new dispatch center and resulting conglomerate, which launched on Wednesday evening, will be to send volunteers to help the elderly, people with disabilities, or those stuck in home isolation as quickly as possible.

The initiative, which is being dubbed, “1221 Assistance for All”, will be using technology developed by United Hatzalah to locate the closest volunteers based on the GPS on their phones and alert them to the humanitarian emergency in their proximity.

The initiative, which was made possible by financial assistance from the Marius and Inbar Necht Foundation, has received approval and praise from the Minister of Defence Naftali Bennett who promised support from his ministry.

The Ministry for Social Equality will also be forwarding requests for help which it receives.

The emergency number for the new dispatch centre is the same as United Hatzalah’s regular number of 1221.

Humanitarian calls will be immediately routed to dispatchers who received specialised training from all three organisations that focused on catering to the needs of the people who may be calling in.

In addition to regular phone calls, dispatchers will be handling calls in sign-language via video chat. The dispatch centre will be open between the hours of 8:00 a.m. until 10:00 p.m.six days a week.

All of the volunteers who registered to participate in the initiative have been outfitted with a specialised phone application that will allow the dispatch system to immediately notify the five closest responders to a humanitarian emergency.

Dispatchers will also be contacting those closest to the emergency and ask that they respond and provide the assistance needed.

The assistance will include medical aid provided by trained United Hatzalah EMS personnel for those who are injured or sick, prior to the arrival of an ambulance.

Logistical assistance in picking up and dropping off medicine, medical supplies, food, and immediate arrival of a volunteer to all those requesting aid.

Emotional support for the elderly and those stuck due to Covid-19 regulations including phone support for those stuck in home isolation or quarantine. Lastly, the combined force of volunteers will provide assistance to those with disabilities.

Vice President of Operations of United Hatzalah Dov Maisel explained what prompted the initiative: “During the current crisis taking place in Israel, United Hatzalah volunteers are still responding to medical emergencies across Israel.’

“As an organisation that serves the public, we were unable to stay complacent in the face of what we recognised as a rising humanitarian crisis of national proportions.’

“Numerous segments of the population are suffering as a result of the current crisis due to the dramatic shift of lifestyle now being forced upon us all.’

“We decided to mobilise together with our partners and provide a country-wide network of volunteers that will provide aid to the elderly, people with disabilities and others in need of assistance due to isolation.’

“We have revamped our dispatch centre in order to use it for the new initiative and opened a completely new centre of operations as well as adapting our specialised phone application to incorporate the rest of the volunteers who will be participating in the program.”

General Manager of the Israel Association of Community Centres, Raz Frohlich said: “The Israel Association of Community Centres of Israel, in conjunction with the local and regional councils, manages the largest volunteer system in Israel that numbers close to 30,000 pensioners, adults, and teenagers from all segments of Israeli society.’

“There are more than 1,000 locations that make up the heart of our association that are active both on a regular basis and during emergencies.’

“Together with United Hatzalah and Lev Echad, we will now be providing emergency humanitarian response while strengthening the resiliency of each of these communities during this time of emergency.’

“In addition, we will be focusing on building the community resources necessary for when this situation finally comes to an end.”

Chairman of Lev Echad, Erez Eschel added: “Lev Echad has in the past assisted leading organisations during times of emergency, including Ayalim, HaShomer HaChadash, Pre-Military Academies, to create community coordinators and bridge the gap between the needs of a community and the organisations that are providing assistance.’

“In partnering together with United Hatzalah and the Israel Association of Community Centres, we will work towards providing an emergency humanitarian response to the majority of the needs of the Israeli populace and we will plant the seeds of the foundations needed for after this situation subsides.”

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The Glasgow online travel retailer, Trtl, have donated 5,000 pairs of compression socks to help Scots nurses combat Covid-19, despite having seen sales drop by 95 per cent within the past two weeks.

The generous donation is worth a total of £125,000 and the colourful knee-length socks will help 5,000 acute nurses in six hospitals across Scotland fight fatigue in the coming weeks.

In addition to this, the firm has pledged to give away a further 5,000 in the next seven days to nurses in ​London​, bringing the total to 10,000 (£250,000).

Trtl (pronounced ‘turtle’) have donated compression socks each to acute nurses at Glasgow Royal Infirmary, Royal Alexandra Hospital (Paisley)​ and the ​Queen Elizabeth University Hospital in Govan, — each hospital receiving a total of 1,000 pairs to share out.

In addition, nurses at ​The Royal Edinburgh Hospital​ will take a further 1,000 while Trtl has given 500 to nurses at ​Dundee’s​​ Ninewells Hospital​ and 500 to ​Aberdeen Royal Infirmary.

The award-winning company, which employs 30 people in Glasgow, had stockpiled thousands of the socks in advance of its peak summer season.

But with sales stalling due to the Covid-19 pandemic and little prospect of travel bans being rescinded any time soon, ​CEO Michael Corrigan​ decided to use them to support frontline nurses in his home city, across Scotland and in worst-hit London instead.

He explained: “Although the compression socks have been most popular with airline travellers, at the start of this year we ran a small campaign with nurses around the world and they were really happy with them.’

“Over the past few days, I’ve been thinking about how we can contribute in what is the biggest crisis many of us will face in our lifetimes.’

“When something like this happens it very rapidly puts things into perspective. Nurses across the UK will be tested as never before in the coming weeks and if we can do something to help make the time they spend on their feet more comfortable, we must.’

“I couldn’t just see these socks sitting in a warehouse when they could be helping people saving lives. That’s what’s important, and nurses need all the help they can get just now.”

John Stuart is the chief nurse at Glasgow Royal Infirmary.​ He said: “We are under no illusions about what we are going to face in the weeks to come.’

“Our nurses work incredibly hard and can spend hours and hours on the move during every shift.’

“With these compression socks we can help our staff alleviate some of the discomfort and aches associated with being on your feet for long periods of time and help them better face the challenges that are coming our way with Covid-19.’

“Any gesture like this can help boost morale and hopefully the colourful designs willhelp brighten the days of our nursing staff.”

A ​2015 study​ found that the average NHS worker walks 3.6 miles a day with some recording up to 11 miles.

Nurses regularly work 12-hour shifts and wearing compression socks reduces leg soreness, swollen ankles and varicose veins.

Established in 2013, Trtl is majority-owned-and-run by founder Michael Corrigan (32), who was born on Glasgow’s south side.

He added: “This may be the biggest challenge we will ever face as a generation and how we react as individuals and collectively could define us in the years to come.”

Best known for its ​Trtl Travel Pillow​, which has sold 1.6M worldwide, Trtl sells a range of travel items from compression socks to packing pods.

Most of its products are bought online through ​trtltravel.com​ and retailers such as Amazon. The company, which won Small Exporter of the Year at the Scottish Export Awards in 2018, is expert at using social media and messaging apps to drive sales.

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Magen David Adom announced on Sunday a first-of-its-kind solution that will address medical teams and the ambulance driver, with the goal of preventing them from being exposed to Corona patients.

The first 50 ambulances from all over the country have been outfitted and another 70 will be outfitted in the coming days.

The complete separation of MDA ambulances between the driver’s cabin and the patient’s cabin was carried out in collaboration with IDF unit 81.

The Sealed Separation Ambulance is designed to evacuate mild Corona patients who need to be evacuated to continue treatment in a designated location. Thus, the driver remains isolated from the verified patients and not exposed to the Corona virus.

It should be noted that the separation exists only in designated ambulances for Corona  patients who are in mild condition and who do not need medical treatment during the evacuation.

The separation was carried out by installing metal walls that are bolted from the ceiling to the floor, creating a complete seal and complete isolation between the driver’s compartment and the passenger compartment.

A separate, opaque window is added to the separation wall, allowing the driver to see the passenger compartment and make eye contact with the paramedic in it, if necessary. 

The ambulance driver and medical team located in the back of the separated ambulance will be able to communicate using a microphone.

According to MDA, if the pilot program expands then the separation walls could be installed in up to ten ambulances daily, thus protecting drivers and crews from exposure to Corona patients.

The airflow in the rear of the ambulance will be exterior and different from that of the driver, in the front of the vehicle.

MDA Director General Eli Bin said about the new ambulances: “In these difficult days, when medical staff work days and nights to help patients and care for Corona patients, we must do everything we can to provide safeguards and isolation to teams, to prevent infection and their stoppage.’

“We will review and launch the pilot as soon as possible, to further expand it to additional vehicles, which will enable us to deliver life-saving, fast and dedicated care — while maintaining the health and well being of our providers.”