Research Suggests HEMS Teams at the Forefront of Evolving Cardiac Arrest Care, but Evidence Gaps Remain
Source: Hampshire and Isle of Wight Air Ambulance
HAMPSHIRE and ISLE OF WIGHT, U.K.—New research from Hampshire and Isle of Wight Air Ambulance, in conjunction with Dorset and Somerset Air Ambulance, Thames Valley Air Ambulance and the Isle of Wight Ambulance Service, published in Resuscitation Plus highlights variation in prehospital management of patients requiring defibrilation, urging the need for a more conclusive, definitive study.
Cardiac cases typically make up around 50% of air ambulance missions across the UK. Helicopter Emergency Medical Services (HEMS) crews are playing an increasingly vital role in managing complex cardiac arrest cases, particularly when patients experience persistent heart rhythms such as ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT). However, a new study reveals that treatment practices among air ambulance teams remain highly varied, largely due to a lack of strong clinical evidence guiding the best approach.
The research found that only around half of HEMS providers in the UK currently follow a formal protocol for these challenging cases. With the management of cardiac arrest evolving rapidly—thanks to new technologies and advanced interventions entering the prehospital space – researchers suggest there’s a need to standardise care.
Dr Jamie Plumb, Hampshire and Isle of Wight Air Ambulance Research Lead, said:
"Persistent shockable rhythms present us with a challenge: we do not yet have an established system for placing these patients onto an emergency heart/lung bypass circuit within Hampshire, so we need to work hard to find out what treatment options are the best for saving the most lives.
“The REVIVE group is a collaboration between ourselves, Thames Valley Air Ambulance, the Isle of Wight Ambulance Service and Dorset and Somerset Air Ambulance, by working together we can hopefully continue to try to answer some of the difficult research questions in this area."
Doctor James Raitt, Research Lead at Thames Valley Air Ambulance, said:
“Cardiac arrests make up around a third of the call outs our crews attend. Collaborating with other air ambulances through this kind of research is a great example of how we can share knowledge and expertise to make sure patients get the absolute gold standard of critical care before they reach hospital.
“As this research found, HEMS crews employ a range of strategies to try to stabilize patients with persistent shockable rhythms. We now have a fantastic opportunity to close the evidence gap on this issue, by building up further data to produce an evidence-based approach. This will give patients the best possible chance when the worst happens.”
In response, the REVIVE group’s study is aiming to deliver a definitive answer. This trial will investigate whether a new treatment approach—such as using short-acting beta blockers in combination with stopping the use of adrenaline—could offer better outcomes for patients experiencing refractory VF or pVT.
