Essex & Herts Air Ambulance (EHAAT) is enhancing the care of head-injured patients with the introduction of pupillometers at the scene of accidents, to improve the assessment of patients who have suffered a severe head injury.

As part of our strategy to advance care for people who experience sudden and unexpected injuries, we are introducing the NPi-300 Pupillometer for our patients. Our critical care doctors and paramedics assess pupil size and reactivity as part of a complex evaluation to determine injury severity. This examination also helps guide the initiation of life-saving treatments at the scene and during the journey to the hospital.

Serious head injuries are common in the incidents EHAAT attends, and early intervention is key to improving patient outcomes. Traditionally, pupil assessments have relied on subjective observation using a pen torch. The pupillometer, however, provides an objective, specific measurement, supporting clinicians in making informed treatment decisions at the roadside. By introducing this technology in prehospital care, we hope to enhance the care we offer and contribute to broader advancements in patient treatment across the UK and beyond.

The pupillometer will be used as part of the initial patient assessment and throughout their journey to the hospital. By identifying subtle neurological changes, it will assist EHAAT’s clinicians in determining the best course of treatment and the most appropriate hospital destination for each patient. This development is the result of work by our Head Injury Special Interest Group at our Centre for Excellence. Our operational team has undergone specific training and developed specialist guidance for using pupillometers in the early stages of patient care.

Pupillometers are sometimes used in specialist hospital settings, such as intensive care units. By incorporating them into prehospital care, we aim to provide a more evidence-based approach to early decision-making, working closely with hospital teams to ensure seamless and effective patient management. EHAAT plays a vital role in the treatment of patients with severe head injuries, and we continue to collaborate with specialists, former patients, and their families to drive future innovations in care. 

Laurie Phillipson, Centre for Excellence Clinical Academic Fellow, who is leading a PhD research project into the early detection of brain trauma, highlighted the significance of the addition of this piece of technology:

“This device removes the subjectivity from pupillary assessments. It provides reliable, numerical data, taking the guesswork out of the process, which is beneficial for our teams who often work in extraordinary conditions with extremely ill or injured patients. It is a straightforward piece of equipment to use, but the benefits it provides in helping assess and monitor the patient’s condition could be significant.”

Dr Gareth Grier, Associate Medical Director at EHAAT and lead for our Centre for Excellence, said:

”We have a major focus on improving care for patients with head injury. The use of pupillometry is an important step in our ambitious strategy to deliver even better care to our patients at the scene of their accident and on their journey to hospital. We’re excited about this innovation, and about the potential for further developments in the coming months and years. Thank you to everyone who supports us in being able to continually improve our patient experience.”

The acquisition of six NPi-300 Pupillometers has been made possible thanks to the generosity of EHAAT’s supporters. Their contributions enable the charity to invest in cutting-edge equipment that enhances the quality of care provided in critical emergencies.