An Aortic Aneurysm (AAA) is a diseased weakening of the body’s largest artery. Ruptured aneurysms (rAAA) affect at least 3000 NHS patients/year, and are fatal without urgent lifesaving surgery. The problem is that aneurysm surgery can only be performed in a few regional specialist centres.
Identifying ruptured aneurysms at the scene of the emergency is tricky, and about half are initially misdiagnosed. Patients are often collapsed and seriously ill, and taken quickly to the nearest hospital. If an aneurysm is discovered, this often requires a second journey to the specialist centre for aneurysm surgery. The delay can be fatal.
Death from a ruptured aorta – the main blood vessel from the heart – is more likely in English hospitals than in the USA, where patients have a better chance of getting an operation that could save their lives. It is possible that if we could improve our ability to detect these ruptured aneurysms at the scene of the emergency, more patients might get lifesaving surgery.
Aneurysm FILTR is a trial of a smartphone app to help ambulance crews diagnose ruptured aortic aneurysms (rAAA) at the scene of the emergency.
We need about 100 volunteer paramedics/ EMTs or trainee paramedics to download our simple smartphone scoring system. The app should take about 15 seconds to use, and only asks for routine information you already collect in the PRF.
For a 12-month period, LAS crew will use the app to record the "aneurysm score" of patients observationally - meaning patient triage/care will be unaltered. The app won’t tell you whether or not the patient might have an aneurysm – as we need to prove it works before it is used to alter patient care! Any patient aged >18 with abdominal/back/chest pain or collapse will be included in the study. Patients currently triaged as myocardial infarction, stroke or trauma are excluded.
Each smartphone will upload data to a secure, anonymised database. The FILTR trial manager will talk to receiving hospitals to discover each patient’s final diagnosis.
This will tell us whether or not our app really can identify patients with rAAA. We will assess feasibility by reporting the time taken to use the software, and asking your feedback on ease-of-use.
The study has been approved by ethics committee and adopted on the NIHR portfolio. Initial funding has been provided by the Academy of Medical Sciences, and the team are working on further grant applications.
Alan Karthikesalingam, NIHR Clinical Academic Lecturer in Vascular Surgery, St George’s Vascular Insitute.
The trial is open to all LAS crew members dealing with acutely ill patients: paramedics, trainees, and techs.
You only need a working smartphone (Android or iPhone are supported).
Come to our training days:
12 November 2014 18:00 in Lecture Theatre F at St George’s Hospital, Tooting
11 December 2014 18:00 in The Paterson Centre at St Mary's Hospital, Paddington
19 January 2015 18:00 in Seminar Room LNB_00_293 (Ground Floor, Central Tower) at The Royal London Hospital, Whitechapel
20 January 2015 18:30 at Croydon Ambulance Station (To book a place email email@example.com).
16 February 2015 18:00 in The Brian Drewe Lecture Theatre (of the Reynolds Building) at Charing Cross Hospital, accessed from St Dunstan's or Margravine Road
18 February 2015 14:00 EFP (evidence for practice) event at London Ambulance HQ, Waterloo Road
5 March 2015 18:00 Conference room, London Ambulance HQ, Waterloo Road
8 April 2015 18:00 4th Floor East Seminar Room at Charing Cross Hospital, Fulham Palace Road
19 June 2015 14:00 Conference room, London Ambulance HQ, Waterloo Road
Please email firstname.lastname@example.org to register your interest.
We want LAS crew to be active members of the FILTR team and shape the way this research is used to benefit patients. Any LAS crew recruiting patients will have the opportunity to be listed in the acknowledgements of all resulting scientific publications. Any LAS crew recruiting over 100 patients will be invited to join publication authorship teams. We will host regular “trial recruitment” and “trial update” days and hope to keep you up to date with progress regularly throughout the study. Participation is entirely voluntary.