Tag: ITM News

Medical device specialists have joined together to support the supply and deployment of vital medical equipment into the healthcare system.

The aim is to support healthcare providers in ordering new devices such as ventilators, infusion pumps, dialysis and critical care equipment that is fit for purpose and appropriate for use in treating COVID-19 patients.

Activities range from sourcing suitable suppliers and devices and checking devices are compliant, through to commissioning, training, ensuring availability of replacement parts and potential ongoing maintenance. The work will include both domestic suppliers and imported equipment, striking a balance between fast access and due process to make sure vital equipment is supplied in a safe and reliable manner.

The team includes researchers from the Healthcare Technologies Institute based within the Institute of Translational Medicine, as well as staff from Hugo Technology, a medical equipment maintenance and management company and MRA Technology, a medical device consultancy.

Experts in the Healthcare Technologies Institute and at MRA Technology are working on sourcing suppliers and carrying out initial due diligence on machines, while assessment and specialist testing could then be carried out in Birmingham and at Hugo Technology.

Dr Richard Williams, from the Healthcare Technologies Institute, explains: “It’s well known that healthcare providers are in urgent need of basic medical equipment that can be supplied rapidly and in large volumes. It is so important, however, that this vital equipment will perform to the expected standard.

“We are keen to work closely with our NHS partners to find out what they need, because not all the equipment available on the market will be suitable for treating COVID-19 patients. Even in times of national emergency we need to uphold patient safety and make sure processes are in place for staff to be able to have the correct equipment to carry out their duties.”

The team has already been at work verifying ventilators and infusion devices from suppliers across the world prior to their being installed in NHS hospitals and in the new NHS Nightingale Hospital set up in London’s ExCel exhibition centre.

Dr Mark Reeves, from MRA Technology said: “Without having physically met the other team members we gravitated quickly, defined how we could best contribute to the crisis and performed tasks required according to our skills and availability at any time.”

Beyond the current pandemic, the plan is to help set in place systems and processes that are sufficiently robust to enable the NHS to respond to future emergencies.

Dr Reeves further commented: “Multidisciplinary expert teams such as ours must be front and centre when reviewing the response to this crisis and planning how to avoid equipment shortages in the inevitable future pandemics. Next time we need the time and resources to procure, hold in readiness and distribute additional complex medical equipment into whatever medical mass-emergency hits us next.”

A disposable plastic ‘pop-up tent’ which creates a protective barrier between patients and healthcare professionals could be the latest line of defence for frontline NHS workers thanks to a new product developed by a collaborative team effort in Birmingham.

Designed by experts at the University of Birmingham, the Disposable Resuscitation, Intubation and Nebulisation Kit Shield – or DRs INK Shield – is a compact device designed to cover the patient’s head, neck and shoulder area while treatments for COVID-19 are administered.

The transparent plastic shield, which features self-closing access points, protects medical staff from airborne droplets that may put them at risk of contracting the virus while allowing them line-of-sight access to the patients’ airways to perform life-saving procedures such as inserting or removing breathing tubes.

Barrier products like these already exist, however current designs are often hard walled boxes which are not only difficult to store in large numbers, but difficult to manoeuvre in emergency situations. The DRs INK Shield is around five times lighter and one third of the cost of currently available solutions.

Its pop-up design means it can be assembled in seconds as well as easy to store prior to use while the disposable material means that it can be disposed of along with other clinical waste.

The project, which has rapidly moved from conception through product development to launch and taking orders in less than a week, has brought together the expertise of staff from the University’s College of Medical and Dental Sciences and College of Engineering and Physical Sciences.

The prototype was tested at the Royal Orthopaedic Hospital in Birmingham with nursing staff, recovery room technicians and anaesthetists. Medical staff using the equipment reported feeling safer and more comfortable, and that it is easy to assemble and use.

Design lead Matthew Campbell-Hill from the Institute of Clinical Sciences said: “We’re told that COVID-19 is primarily spread through respiratory secretions which transmit the virus via the fine spray of droplets released when infected people talk, cough, sneeze or even yawn.

“With much of the treatment for the virus focused around the airways, it is imperative that healthcare workers are protected from potential contamination while still being able to deliver the vital treatments that will save people’s lives.

“Our shield offers an additional form of PPE that can be rapidly assembled during emergency situations adding an extra layer of protection for frontline staff. Staff who have used it report increased confidence in their personal safety, as well as the ease of use and lightness. While this design has the potential to be a vital tool during the current pandemic, we envisage its use in a range of care settings beyond hospitals including ambulances, care homes and public areas.”

Dr Richard Williams, Research Fellow in the Healthcare Technologies Institute within the Institute of Translational Medicine added: “Taking the time to fully understand the clinical problem and then move at speed was essential. Even in this national emergency, some basic considerations of placing a product into service still apply. We drew upon our key contacts and worked remotely to provide an appropriate solution in a timely manner with the ability to scale.”

The equipment is designed to reduce exposure to COVID-19 during procedures such as intubation, resuscitation, ventilation by Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP), delivering treatments by nebuliser, and any other intervention that requires medical staff to be close to the patient’s face.

Aerosol Shield is being manufactured by Airquee, a company that makes medical, emergency and decontamination tents for the military, health services, and humanitarian organisations.  The product is being sold at near-cost to healthcare providers (with a small margin to allow for any potential changes in raw material or manufacturing costs).

The next stage of the project will see the team deploy the solution as quickly as possible to the front-line of COVID-19 care. More information about the DRs INK Shield can be found on the Aerosol Shield website.

Aerosol Shield was designed by: Matthew Campbell-Hill; Dr Egidio da Silva, Consultant Anaesthetist at the Royal Orthopaedic Hospital; GP Dr Lydia Campbell-Hill; Dr Mark Reeves, Director at MRA Technology Ltd; and Dr Richard Williams.  Commercial support was delivered by David Juggins from Hugo Technology Ltd, and Design Assistant Richard Baker-Stevens.

The face of trauma and emergency medicine is undeniably changing.

Between 2008 and 2017, there were almost 250,000 major trauma cases in the NHS – and the complexity of cases has increased for a number of reasons:

> Patients are getting older.

In 2008, the median age of trauma patients was 45. By 2017, it was 59. And in addition, the number of patients over the age of 65 had doubled, from 22% to 42%.

> Trauma is trickier to treat.

As a possible result of the above, trauma patients are now more likely to present with co-morbidities – existing health conditions such as diabetes, COPD, asthma or mental health problems – which may make acute trauma and injuries more difficult to treat. In 2008, only 40% of patients fell into this category – by 2017, almost two-thirds of trauma patients had one or more pre-existing health complication.

> More severe incidents are more common.

Although the median severity of injury hasn’t changed significantly, there has been a marked increase in patients with an injury severity score (ISS) of eight or more – up by 260%.

Worldwide, the picture is much the same. With road traffic increasing in developing countries, significant construction projects in countries with less stringent health and safety regulations, and human conflicts becoming more complex, global health practitioners are increasingly interested in trauma research to improve outcomes.

It’s often said that ‘war is good for medicine’ – with weaponry evolving, the types of injuries sustained by servicemen and women may never have been seen before, meaning field medical teams have to quickly develop new interventions and techniques. For example, during military operations in Iraq and Afghanistan (2003-12), survival rates for UK combat casualties improved consistently due to factors including: pre-hospital interventions during rapid transfer; more effective pre-deployment training; and enhanced protocols.

With the right teams and training in place, military medics returning to the UK now bring with them vast experience of critical, multiple injuries which they can use when treating civilian casualties. To maintain these improvements, the NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC) was established in January 2011 at the ITM – with the aims of:

• • Translating lessons learnt from the military to civilian practice
  • Designing clinical trials that can be tested in the NHS and then implemented on the battlefield
  • Developing innovative, holistic academic and clinical training for the leaders of the future
  • Facilitating engagement with industry by developing collaborative research partnerships

In addition, even when people survive trauma, the impacts are felt long after discharge. The life expectancy of trauma survivors is some ten years shorter than the general population, meaning there are potential implications for the study of ageing – and therefore the possibility of benefit for the non-trauma population too.

It’s for these reasons that SRMRC exists.

Located centrally in Birmingham, SRMRC is co-located with the Royal Centre for Defence Medicine at the renowned major trauma centre, the Queen Elizabeth Hospital. The ‘QE’ – and its parent trust University Hospitals Birmingham – is the largest teaching hospital trust in England, treating 2.2m people every year.

But more important than the size of the Trust is its depth of expertise: it is a level 1 trauma centre and receives patients from across the Midlands and further afield for emergency treatment, and its trauma team includes medics from across the armed forces.

And as part of the wider Birmingham Health Partners ecosystem, SRMRC researchers are able to collaborate with colleagues from various specialties including genomics, inflammation and ageing, metabolomics, burns research and healthcare technologies – as well as specialist clinical trials units.

The annual cost of trauma to the UK economy is some £3.8bn – but back in 2010, trauma accounted for only one per cent of research expenditure.

Now, however, with SRMRC covering trials in neurotrauma; trauma and orthopaedics; critical care; burns; hand injuries; peripheral nerve damage; and emergency and pre-hospital medicine, there is every chance that survivorship, reenablement and rehabilitation will continue to improve for both civilian and military casualties, here and overseas.

You might also be interested in:

• • Visit the SRMRC website
  • Meet the SRMRC’s 24/7 research nursing team

The Scar Free Foundation – based at the Institute of Translational Medicine – has won one of The Sun’s prestigious Military Awards for pioneering research carried out in partnership with Birmingham Health Partners founder members UoB and UHB, aiming to advance the rehabilitation and recovery of injured servicemen and women.

Prime Minister Boris Johnson helped hand out the awards – affectionately dubbed the Millies – which honour serving personnel and reservists for acts of sacrifice and gallantry during the past year, and pay tribute to the companies and charities that have supported the Armed Forces community.

The Scar Free Foundation received an award for Innovation, in recognition of its unique partnership with The CASEVAC Club and pioneering research underway at The Scar Free Foundation Centre for Conflict Wound Research.  The centre is based within the Healthcare Technologies Institute and is a partnership with the University of Birmingham, the Centre for Appearance Research at the University of the West of England), and the CASEVAC injured veterans club.  It aims to develop new approaches to reduce, and eventually eliminate scarring altogether.

The award ceremony took place at Banqueting House, Whitehall, and was attended by the Secretary of State for Defence, The Rt Hon Ben Wallace, who hosted a reception at Downing Street beforehand.

The Scar Free Foundation has always enjoyed a close relationship with the Armed Forces and veteran community and hopes its work will improve the outcomes for those injured in conflict, both now and in the future.

Marking the 200^th anniversary of Florence Nightingale’s birth, 2020 has been named the ‘Year of the Nurse and Midwife’ by the World Health Organization (WHO). While many of us will think of a hospital ward-based caregiver when asked to picture a nurse, they actually undertake a much wider variety of roles than you may know. In the first of a series of blogs, we meet the professionals working around the clock to support clinical trials – the SRMRC research nurses.

Every patient should have the chance to take part in a research trial. But what happens when illness or injury strikes suddenly, outside of normal working hours?

The NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC) has sought to ensure that trauma and serious illness would no longer be a barrier to research since its nursing team was established in 2012. However, the first year revealed difficulties in recruiting to trauma trials during evenings and weekends. As a result a 7am-7pm on-call service was established, to ensure that even the most critical patients – no matter what their injuries are or when they are admitted – have the opportunity to join a study. Additionally, two critical care nurses work over the weekend so that recruitment can continue – vitally important when we consider the trauma risks of leisure and social activities that occur on Saturdays and Sundays.

The 24/7 research nurse team is a trailblazer – the first nurse-led team in the UK to operate out of a major trauma centre 24 hours a day, every day of the year – with a reputation for recruiting to the trials no-one else could. In 2012 they were lauded as the fastest-recruiting team to the SyNAPSE study, even though the trial was open at hundreds of centres and in 21 countries worldwide.

Members of the SRMRC research team on the steps of the ITM. Upper row L-R: Karen – research nurse; Chris – research nurse; Morgan – trial administrator; Tracy – research nurse. Lower row: Elaine – research nurse; Kamal – research fellow;  Tony Belli – Professor of Trauma Neurosurgery; Ronald – senior research nurse

Advancing scientific understanding, improving care and shaping the treatments of the future

Covering trials in neurotrauma; trauma and orthopaedics; critical care; burns; hand injuries; peripheral nerve damage; and emergency and pre-hospital medicine, the SRMRC research nurses see patients and families at their most vulnerable. The incredibly complex studies to which they recruit require the highest level of skill to screen and enrol patients, alongside the empathy and compassion needed to support extremely sick people and their families at a time when clinical research is the least of their concerns.

The team are also master multi-taskers – the 10 nurses are currently recruiting to over 30 clinical trials, and with their expertise held in such high regard, new studies are sent to them on an almost daily basis. Thanks to the high rates of recruitment they achieve around the clock, the exemplary quality of the data that they collect and the dedication of each individual team member, SRMRC is regularly named the top recruiter to complex, multi-centre and even international trials.

As well as working with colleagues in research and clinical care across the BHP members, the research nurse team has developed collaborative partnerships with more than 50 international universities, trial centres and pharmaceutical companies – including global brands such as AstraZeneca and GlaxoSmithKline – as well as the MoD. These collaborations are vital for developing treatments for trauma patients and translating scientific discoveries from the bench to the bedside.

The SRMRC nurses have also set-up a dedicated research Patient and Public Involvement (PPI) group to make sure the patient is at the centre of all its work. The group has provided feedback for studies, co-designed research materials and acted as lay representatives on grant applications – all of which helps to keep the centre’s work focused on the needs of patients.

Vital to the ground-breaking research being carried out both here in Birmingham and around the country, the team’s ability to recruit patients 24/7/365 has enabled the capture of data which truly reflects the general population. Its work is underpinned by a belief that a trauma patient coming into the emergency department at 3am should have the same opportunity to take part in research – and to contribute to scientific discoveries – as someone coming in between 9 and 5. The research nurse team has allowed research in trauma and emergency care to become embedded as part of normal clinical care and a fundamental stage in the patient journey.

As a former research patient summed up: “being able to take part in a trial meant that something positive could come from one of the worst days of my life.”

Medtech is of critical importance to the Midlands economy, a new report has found.

The report focuses upon the nature and scale of the medtech sector, its contribution to the regional economy, what Midlands businesses need in order to achieve growth, and the barriers faced.

Key findings from the Midlands MedTech Sector Analysis include the following:

• Medtech contributes an estimated £1.6bn in GVA for the region annually
• It is a driver of high productivity, with GVA per worker standing 40% higher than the Midlands average
• There are close to 1,000 MedTech businesses operating in the Midlands – the largest number of medtech companies in any region in the UK
• Midlands medtech employs 23,600 people – the second highest UK region for employment

The report, commissioned by MI Health and supported by the Midlands Engine, was produced by the independent consultancy Hatch Regeneris Ltd.

It states the case for supporting the continued need for a large-scale, fully-integrated approach to medtech across the Midlands, developing existing critical infrastructure and opening new close-to-market opportunities.

Sir John Peace, Chairman of Midlands Engine who funded the study, said: “Medical technologies were identified as a strength of the region in our Midlands Engine Science and Innovation Audit. This new study gives us important information about our medtech businesses and highlights the importance of the sector to our region, including the impressive rate of growth being seen in this sector. Significantly, the report also shines a light on the need for a pan-Midlands approach to supporting our medtech clusters.”

Professor Mark Lewis, Convener of MI Health, said: “This report represents a ‘golden thread’ through an ambitious series of activities that will enhance the Midlands’ reputation as a global player in medtech. This ambition builds upon world-leading regional strengths, such as our outstanding medtech companies, a unified group of research-intensive universities and a network of engaged health and medicine professionals within our NHS Trusts. Our national assets include the £300m Defence Military Rehabilitation Centre, which has been the catalyst for the UK government’s commitment to establish a National Rehabilitation Centre on the same site. Marshalling these opportunities will enable the Midlands vision to be realised.”