Pioneering CPR service launched by Harefield Hospital and Thames Valley Air Ambulance

A new service that will see patients who have had an out-of-hospital cardiac arrest receive advanced treatment, has been launched by Harefield Hospital and Thames Valley Air Ambulance.

The partnership, the first of its kind in the UK, will see eligible patients who don’t respond to standard CPR (cardiopulmonary resuscitation) transported to Harefield Hospital by Thames Valley Air Ambulance to receive E-CPR.

E-CPR is a resuscitation method combining placing patients on ECMO (extracorporeal membrane oxygenation), a machine which pumps blood through an artificial lung outside the body when a patient’s own circulatory system is unable to function properly, and delivering CPR.

This technique has been found to improve survival rates of patients with cardiac arrests, including in a 2020 study which found survival rates reached 43% compared to 7% in patients who received standard CPR interventions.

The technique is currently administered to selected patients who experience a cardiac arrest while at Harefield Hospital, a specialist heart and lung hospital in north London. The team at Harefield has now partnered with charity Thames Valley Air Ambulance to identify and transport patients with cardiac arrests, which do not respond to typical interventions, in the community to Harefield for this time critical intervention.

Dr Waqas Akhtar, registrar in cardiology and intensive care at Harefield Hospital and one of the developers of the service, said: “A cardiac arrest is a medical emergency where a person’s heart has suddenly stopped pumping blood around the body. They are caused by a dangerous abnormal heart rhythm commonly due to blocked arteries causing a heart attack.

“When someone goes into cardiac arrest, it is critical to restore circulation to ensure organs are not starved of oxygen. This is done by delivering CPR. Delivering effective CPR, whether in hospital by medical professionals, or in the community by members of the public, is important to treat patients with cardiac arrests, however, survival rates tend to be low.

“An ECMO machine takes over the function of a patient’s heart and lungs by taking deoxygenated blood out of the patient and inserting oxygenated blood back into them.

“This new service, combining CPR with placing patients on ECMO, has the potential to save more lives than we are able to do with CPR alone.”

From the moment of cardiac arrest, the team will aim to have collected the patient from the community, transferred them to hospital, and placed them on ECMO within 60 minutes. The rapid deployment of critical care paramedics, doctors and resources, which Thames Valley Air Ambulance is capable of, will give eligible people who have gone into cardiac arrest within in the ambulance’s territory the best chances of survival.

Dr James Raitt, Research Lead at Thames Valley Air Ambulance, said: “Patient care is at the heart of all we do at Thames Valley Air Ambulance, so we are proud to be working with Harefield Hospital as part of this new life-saving service. Our critical care crews have been trained to quickly identify the patients who will benefit the most from E-CPR and then enact our procedures for ensuring the patient arrives as quickly as possible for the treatment.”

The launch of this new service will cover eligible patients who have gone into cardiac arrest within the community which Thames Valley Air Ambulance serves. Harefield Hospital is one of fewer than ten centres in the UK to provide ECMO treatment to patients whose circulatory systems are compromised.

Dr Mark Mason, consultant cardiologist at Harefield Hospital and medical director at Royal Brompton and Harefield hospitals, said: “The launch of this new service at Harefield Hospital is part of the hospital’s long history of performing highly specialised procedures and providing innovative cardiac care to people with the most serious cardiac conditions.

“We are proud to be delivering this service in partnership with the Thames Valley Air Ambulance and to be providing such pioneering care to the most critically ill patients in the community.”

Amanda McLean, Chief Executive Officer at Thames Valley Air Ambulance, said: “Here at Thames Valley Air Ambulance we strive for excellence in patient care, pushing the boundaries with new treatments and equipment to ensure better outcomes for the critically ill patients we are called to. Together, working with partners like Harefield Hospital, we will do everything in our power to protect, save and revive lives with the best critical care at the scene and beyond.”