The Adult Critical Care Transfer Service serves patients from all over the East of England. They provide high quality, timely transfers of patients who require emergency and urgent escalation of care to specialist centres, as well as repatriations and capacity transfers. The team consists of a Consultant, a Transfer Practitioner and a Technician provided by St John Ambulance. They take patients under all specialities a lot of which require pupil assessment.
Pupil assessment is an important part of detecting neurological deterioration, raised intracranial pressure and herniation, and supports clinical decision-making, treatment planning and prognostication when combined with other clinical information.
During adult critical care transfer, these assessments are often performed using a pen torch in environments such as in areas with bright or dim lights . Factors such as medication-related small pupils, dark irises and varying staff experience can introduce subjectivity, which may affect clinical interpretation.
“From a transfer perspective, our data shows we transfer a substantial number of patients where pupil assessment is required. These assessments were always completed with a pen torch in several different environments with ever changing light that we can not control.
Having more accurate, reliable pupil assessment has allowed us to make informed decisions about patient care and treatment as well as providing receiving specialists accurate, time stamped results so they can pre-plan ongoing treatment.”
— Becky Pink, East of England Adult Critical Care Transfer Service
Objective pupillometry offers a reliable and standardised way of assessing pupils. Using devices such as the Neuroptics NPi® pupillometer, assessments can be completed quickly and consistently, providing objective, time-stamped, trendable results.
The East of England Adult Critical Care Transfer Service undertook a feasibility study to assess the use of pupillometry during transfer, as no other service outside of a hospital has implemented such a device before. The device was found to be feasible and has now been in routine use for over two years, helping to guide clinical practice and improve the quality of information shared with receiving specialist teams.
Discover more about NPi and the NeurOptics Pupillometer here
Photo credit – Becky Pink, Transfer Practitioner, East of England Adult Critical Care Transfer Service
