CASE STUDY

Anonymised Case Studies

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Case Study 1

EMRTS Cymru attended a ten year old child involved in a North Wales road accident as the occupant of a family car. He had a significant head injury and received an emergency anaesthetic before being transferred directly to specialist care at Alder Hay Hospital, Liverpool. He has since been discharged with a favourable neurological outcome.

 

Before EMRTS Cymru:

Had EMRTS Cymru not been in attendance there would have been a significant delay prior to an emergency anaesthetic being administered and a transfer to definitive neurocritical care, potentially compromising outcome. 

 

Case Study 2

 

One of the unexpected survivors treated by the Service in Mid-Wales was a gentleman in his sixties involved in a serious industrial accident. He lost a significant amount of blood and suffered a cardiac arrest. This required the full range of critical care interventions including tourniquets (a mechanical device used for the temporary control of the circulation of blood), blood and plasma transfusions, surgery to his chest, anaesthesia and advanced drugs. He was stabilised and flown to specialist care at the Royal Stoke Hospital. He is now doing well.

 

Before EMRTS Cymru:

This kind of resuscitation for patients and survival from traumatic cardiac arrest was unheard of in Wales before the introduction of EMRTS Cymru. It is highly likely that this patient would have died at scene without the care received above.

Case Study 3

 

EMRTS Cymru was called to a South Wales District General Hospital to reports of an unconscious male who had presented to the minor injury unit. The critical care team were taken to the hospital by air and, following a rapid assessment, a decision to anaesthetise and secure the airway was made, along with point-of-care blood tests and monitoring. The patient was then transferred, by road, to a specialist centre for further tests and intensive care. This case illustrates the role of the Service providing an emergency response to health care facilities without resident anaesthetic and intensive care.

 

Before EMRTS Cymru:

 

Staff in the healthcare facility would not have been able to manage the patient’s airways adequately and there would have been a delay to definitive airway control.

Case Study 4

 

A neonate was born pre-term in a residential address in South East Wales. Identification of the case by a Critical Care Practitioner on the Air Support Desk allowed the team to attend the scene by air, carrying specialist equipment, within 30 minutes. On arrival the neonate had been delivered and advanced interventions were instigated in liaison with CHANTS (Cymru Inter Hospital Acute Neonatal Transfer Service). A decision was made to bypass the nearest maternity unit and take the neonate to the appropriate Neonatal Intensive Care Unit. This prevented a secondary transfer and the consequent delay to definitive care. There has been a favourable clinical outcome in this case.

 

Before EMRTS Cymru:

 

The neonate would have been in a worse clinical condition without the above interventions, which would have impacted on hospital length of stay and outcome.

 

 

 

Case Study 5

 

EMRTS Cymru is able to provide additional support to health boards in order to facilitate complex time-critical transfers. Amongst the transfers undertaken was a young lady who, following a heart attack, was in profound cardiogenic shock (where the heart has been damaged to the point where it is unable to supply enough blood to the organs of the body). She had an aortic balloon pump in situ, in a South Wales hospital, and required urgent transfer for further surgery in a specialist centre in England. The transfer was carried out by road in a Welsh Ambulance Service vehicle with an EMRTS Cymru consultant and a perfusionist (a specialised healthcare professional who uses a heart-lung machine during cardiac surgery) from the hospital. This patient’s family have since raised funds for the Wales Air Ambulance Charity. 

 

Before EMRTS Cymru:

 

The in-hospital team would have had to undertake this transfer, which would have depleted the hospital of anaesthetic staff for several hours and therefore significantly impacted on emergency theatre work.

All of the above cases demonstrate the equity and health gain that EMRTS Cymru is striving to provide

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