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Monday 17th June 2019

SMEs support development of specialist healthcare products

3rd February 2011

In the last decade, specialist transport services have been established across the UK, providing early intervention and rapid transfer of critically ill children from district general hospitals to any one of the country’s 23 specialist paediatric intensive care units.

When the expert team from the Children’s Acute Transport Service (CATS), which transports around 1,200 children every year to intensive care units at Great Ormond Street, St Mary’s and Royal Brompton hospitals, identified a need to improve on-board safety, it took a unique partnership between the healthcare sector and a pair of private sector businesses to develop a viable solution. 

Dr Mary Montgomery was a paediatric intensive care consultant at CATS, before recently moving to Birmingham Children’s Hospital to lead the West Midlands Paediatric Retrieval Service.  Dr Montgomery discusses the steps taken to develop an ambulance child restraint - from the initial concept to product launch - enhancing the safety of patients across the UK.  She said:

“Paediatric transport teams provide immediate support and advice to district hospitals caring for critically ill children, working to stabilise or improve a child’s condition, and increasing their chances of survival before reaching a paediatric intensive care unit (PICU).  Delivering the highest possible level of intensive care - from the initial phone call to the patient handover at the receiving PICU - is a transport team’s main priority.  So when a series of incidents highlighted a potential problem with the harnesses on patient stretchers, it was clear that urgent improvements needed to be made.” 

Whilst being transported in an ambulance, plane or helicopter, children from 5kg to 18kg could be secured with a five-point harness that could be attached to the stretcher.  Children over 18kg had to be secured with the four-point harness which is fitted as standard on stretchers and intended for adult sized patients only.  Neither harness was suitable for use with a vacuum mattress for immobilising trauma cases. Recognising that a specialist harness capable of restraining children of different weight ranges would improve safety standards, the multidisciplinary team at CATS set about searching for a company that could develop a solution.

Dr Mary Montgomery explained:  “Challenges immediately presented themselves.  As a relatively new healthcare service, research on the safe restraint of critically ill children during transport was limited.  Furthermore, with only ten per cent of all ambulance journeys in the UK involving the transport of babies and children, it proved hard to justify the time and financial resource required to develop an improved product.  As a result, funding was hard to come by and many well-known and large manufacturers turned down the brief seeing little scope for commercial growth in the ‘niche’ paediatric arena.” 

Progress in the development of the new harness only began to gain momentum when lobbying of the Paediatric Intensive Care Society’s Acute Transport Group started to raise awareness of the need for such a product.  Lightweight Medical, a research and development company based in Scotland, became interested in finding a solution and with support from the Scottish Ambulance Service a design specification started to emerge.   The project was further enabled by ParAid Medical, a company experienced in the design and manufacture of bespoke neonatal and paediatric transportation equipment.  The initiative also secured government funding from Scottish Health Innovations Limited.  

“Both ParAid and Lightweight Medical were keen to develop solutions that fit the requirements of the user exactly,” added Dr Montgomery.  “Teams from the Scottish Ambulance Service and CATS worked closely with the design and manufacturing teams to develop a clear specification for the new ambulance child restraint. 

“It needed to be incredibly responsive and offer the flexibility to be used in different transportation situations, such as on aircraft, with different stretcher designs, and when using a vacuum mattress.  It also had to fit a wide range of ages and sizes, and be suitable for use in children receiving intensive care support. This meant that that harness had to provide easy access and clear views of the patient, and crucially, have the ability to be fitted safely without interfering with complex monitoring, lines and tubes.” 

The expertise and inventive mind-set of the businesses leading the research and development came into its own.  With experience in material science, and even knowledge of harnesses used for rock climbing, the companies developed a solution that met all clinical requirements.  The materials were tested for strength, durability and the ability to be easily cleaned, ensuring high standards of infection control. 

ParAid Medical also invested in dynamic testing to demonstrate its efficacy and this resulted in the new ambulance child restraint fulfilling the requirements of BSEN 1865 and BSEN 1789.

Dr Mary Montgomery concluded:  “Finding companies with the right expertise and ability to interpret the needs of clinical teams into a suitable design concept is key to successful product development.   Enthusiasm for the development of innovative solutions and a belief that problems can be overcome is essential.  A strong partnership approach is also needed, with full collaboration from the teams who put the product into use and see its benefits. 

“Those who take a lead in developing solutions in the healthcare sector should be prepared to invest considerable time and effort into the project, as the search for the necessary expertise and funding requires perseverance.  However, by employing the right approach, the UK healthcare sector can take a leading role in developing world-class products.” 

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