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MobiMed Smart is in service in SWASFT and SCASFT Access to Summary Care Record in ambulances Smart Smarta triage vårdkedjor Smart Monitoring Smart Documentation For the first time paramedics are able to access SCR in ambulances MobiMed Smart gives paramedics at South Central Ambulance Service NHS Foundation Trust fast and secure electronic access to SCR, giving them essential clinical patient information at the scene. It is expected to give the clinicians an increased ability/effectiveness to make informed decisions and an increased efficiency in delivering appropriate care to patients. MobiMed Smart supports the needs of a modern 21st century ambulance service. We are ISO-certified: ISO 20000 IT Service Management ISO 27001 Information Security Management Systems ISO 13485 Quality Management System for the Design and Manufacture of Medical Devices Features • Summary Care Record (SCR) • Smart-card login • Personal Demographics Service (PDS) • Monitoring with clinical background from cardiac critical care • Easy to configure and adapt to any clinical standard, such as JRCALC, Snomed, etc • Easy to integrate with CAD, Defibrillators, information systems at hospitals, etc Ortivus Ltd | Tel: 0844 8404 999 | E-mail: sales@ortivus.com | www.ortivus.com
Clinical Focus on the use of Penthrox in Pain Management 21st Century First-on-Scene Pain Relief By Paul Cloves, Medicines Management Lead, South East Coast Ambulance Service NHS Foundation Trust The effective treatment of pain is a fundamental component of quality patient care, yet in the pre-hospital setting the management of pain is a complex mix of multiple resources, medicines and techniques, which are often vastly ineffective. Below Paul Cloves reports on SECAmb’s recent introduction of new analgesia Penthrox for their pain management formulary. During 2014/15, 6.5 million patients received treatment from ambulance personnel, of which 63% required transportation to an Emergency Department in England. 1 We all understand that inadequately managed pain can have psychological, physiological and socioeconomic consequences that can worsen patient suffering, clinical outcome, and increase the financial costs of healthcare 2 but in a modern health service, where resources are at a premium, how do you ensure that the right treatment is available at the right time? Until recently, the ability to provide immediate analgesia was limited to morphine sulphate for injection, with this being the most reliable, fast-acting analgesic. However, if you add in the delays for cannulation, removing morphine from secure storage and administration time, the patient still has to wait at least 10 minutes to receive effective analgesia even if we ensure a paramedic arrives on scene first. So what happens when there is no paramedic? Or in the time you wait for a paramedic to arrive? In November 2015 South East Coast Ambulance Service NHS Foundation Trust (SECAmb) introduced Penthrox (methoxyflurane) into the Trust formulary aimed at enabling non-paramedics to provide analgesia prior to paramedic arrival as well as enabling paramedics to administer an immediate analgesia while they prepare the patient for cannulation. The initial review of our first administrations is making interesting reading! On average patients present with a patient score 8.7 Spring 2016 | Ambulancetoday out of 10, all patients were provided with Penthrox for the immediate treatment of their pain whilst further analgesia was prepared, after one minute of Penthrox the average pain score had dropped to 4.5 out of 10. Once a patient started using Penthrox, the majority were then able to receive a further 20 minutes of analgesia before the device ran out by which time the patient was able to receive additional longer acting analgesics. Figure 1 identifies which other analgesics were administered to patients either before or after administration of Penthrox. An important observation was that 20% of patients still required Entonox despite Penthrox; digging deeper into the patient care records, this 20% represents a group of patients who were cared for and transported by non-paramedic staff, where the Penthrox device had run out leaving Entonox as the only available analgesia for the remaining journey time. For the initial introduction, patients were limited to one dose of Penthrox in an episode of trauma. Figure 1. Use of other analgesics. During this study some patients received additional analgesia after administration of Penthrox. The diagram depicts the types of analgesics used and the frequency at which each analgesia was administered. What about side effects? Understanding that the current pre-hospital analgesics all have notable side effects we were expecting to see similar for Penthrox however there were relatively few side effects and certainly none that had any clinical impact. 29 3
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