Ambulance crews are working with Brighton hospital staff to test a nasal spray that they hope will save the lives of heart attack patients.
The spray directly and quickly cools the brain of the patient before he or she reaches hospital, which is thought to improve their chances of survival.
South East Coast Ambulance Service NHS Foundation Trust said that it was carrying out an evaluation of the spray.
It will be given to some patients before they are taken to the Accident and Emergency (A&E) Department at the Royal Sussex County Hospital in Brighton.
The treatment is known as the RhinoChill IntraNasal Cooling System.
Paramedics spray an evaporating coolant liquid into the patient’s nasal cavity – a large area situated close to the brain which acts as a heat exchanger.
The spray is used from the start of treatment until the patient arrives at hospital.
Brain cooling with the system will then be maintained from when patients arrive at A&E until they are transferred to the Intensive Care Unit.
The cooling spray will be given to 25 cardiac arrest patients as soon as they have been resuscitated and where treatment has been started by a critical care paramedic.
It is widely believed that cooling the brain following cardiac arrest can improve survival chances and also minimise any long-term neurological damage.
A number of ambulance services, including the South East Coast Ambulance Service, have already investigated and currently use various methods of starting the cooling process before the patient reaches hospital. These include cold saline drips and cooling pads.
But these methods do not directly target the brain and instead rely on cooling the whole body and blood to achieve this effect.
Paramedics testing the nasal spray are trying to assess how easy it is to use in an ambulance and how long it takes to reduce the temperature of the patient’s brain.
The tests will also look at how long patients spend in intensive care, the percentage who survive and leave hospital and the neurological status of those who are discharged.
To date, four patients have been involved in the evaluation. It is expected to take about six months to complete.
Andy Newton, a consultant paramedic and the director of clinical operations at the South East Coast Ambulance Service, said: “The results of this evaluation should be extremely useful.”
Professor Newton added: “We are excited to be the first UK ambulance service able to cool a cardiac arrest patient’s brain while still at the scene and know that we have played our part in giving them the best chance possible for a good recovery.”
Rob Galloway, accident and emergency consultant at the Royal Sussex, said: “We will be particularly interested in the results of this evaluation from a hospital perspective.”
Dr Galloway added: “It’s an excellent example of two separate NHS organisations co-operating to streamline a vital process of patient management, thereby improving patient care.”
This brain cooling therapy actually has roots in Brighton and Hove many years ago. From Wikipedia: “ThermaHelm is an impact activated brain cooling motorcycle crash helmet invented in 2005 by Jullian Joshua Preston-Powers. It is being developed in collaboration with Rainbow Medical Engineering in Letchworth Garden City, England.
Ammonium nitrate and water, stored in separate areas of the helmet’s liner, combine when trigger activated by an impact to create an endothermic reaction to prevent brain swelling, and reduce the effects of traumatic brain injury, a major cause of death and disability worldwide. When activated by sudden impact, the helmet performs like an instant ice pack that immediately initiates a cooling effect. This cooling process lasts approximately 30 to 45 minutes and helps to control swelling, extending protection of vital neurological function during the Golden hour prior to hospital arrival.
Dr Henry Wang, a researcher at the University of Illinois College of Medicine at Peoria, “lives in hope for a day when a pre-hospital cooling head cover will be available to those with head injury or stroke”.