The gadget is used to secure a catheter or tube so that it does not bend and obstruct blood flow to the legs during treatment. PHOTO: LIANHE ZAOBAO
SINGAPORE – A cable organiser – used to hold cords for charging electronic devices so that they are not tangled – may have little to do with healthcare.
But it has inspired a group of nurses from the National Heart Centre Singapore (NHCS) to design an unlikely device – one that ensures heart patients get their life-saving treatment without the risk of leg amputation.
The gadget, measuring about 19cm long with a groove in the middle, is used to secure a catheter or tube so that it does not bend and obstruct blood flow to the legs during treatment.
It is used with a machine called extracorporeal membrane oxygenation (Ecmo), which is a life-saver for 50 to 60 patients with cardiopulmonary failure at the centre each year. The life-support machine takes over the functions of the lungs and heart by continuously pumping blood out of a patient’s body, then adding oxygen and removing carbon dioxide before pumping the blood back into the body.
However, there are potential problems associated with its use.
One such complication is the impairment of blood circulation to the legs, or limb ischaemia, which can lead to amputation in more severe cases.
The condition can occur in up to 70 per cent of Ecmo patients, according to one study published in the peer-reviewed clinical medical journal Critical Care in 2019.
At NHCS, distal perfusion catheters, which divert blood and improve arterial circulation in the legs, are used to reduce the risk of limb ischaemia.
But it is not a foolproof solution. For example, there can be sharp bends in the catheters when they are connected to the Ecmo circuit, or the movements of patients can produce kinks and blockage in the catheters.
Nurses and doctors must check the catheters regularly to ensure that they remain unobstructed.
This prompted seven NHCS nurses – together with Dr Hong Rilong, an associate consultant with the cardiology department at the centre – to develop a solution that could ensure the blood flow in patients was unobstructed while reducing the workload for staff.
Led by assistant nurse clinician Charmaine Ong, the team began work on the project in 2023.
By February 2024, they started using the gadget, and it has worked well on 20 patients so far.
Ms Ong said the team hopes to patent the product, adding that it is now exploring its use for other procedures. “We are still trying to spin off this idea to other (procedures which require) invasive lines,” she said.
Dr Hong Rilong, associate consultant with the cardiology department at the centre, (left) and assistant nurse clinician Charmaine Ong secure the distal perfusion catheter tubing. PHOTO: LIANHE ZAOBAO
Dr Hong said that the device could be used in situations such as when fluid needs to be drained from a patient’s lungs.
For their work, the NHCS team won a Best Practice Medal (Care Redesign), part of the National Healthcare Innovation and Productivity Medals.
Organised by the Centre for Healthcare Innovation (CHI) and supported by the Ministry of Health, as well as the Ng Teng Fong Healthcare Innovation Programme, the medals recognise innovations that increase productivity and efficiency while reducing waste and cost.
NHCS was recognised for showcasing “exemplary innovative qualities or elements in redesigning care model and demonstrating sustained productivity outcomes”, said CHI.
Entries from Singapore General Hospital (SGH) and Tan Tock Seng Hospital (TTSH) also won in the same category.
TTSH introduced a model where patients suffering from pain because of sprains, bruises or falls see a trained advanced practice physiotherapist instead of a doctor when they go to the emergency department. This has resulted in a 75 per cent reduction in waiting time.
Meanwhile, SGH’s project aims to expedite the start time of a treatment that removes blood clots in the brain during an acute ischaemic stroke, thereby improving the outcome for patients and reducing the rate of disability.
The three teams beat 82 other entries in the category, CHI said.
The winning teams each received an award plaque and a cash prize, as well as a seed funding grant for their next innovative project, which is to be utilised within a year.
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