Saving babies

IT was when North-East hospital consultant David Hutchon spent a year working in New Zealand that he got the inspiration for a piece of equipment that could save babies’ lives.

It was there – in 2005 – that he first saw midwives using long flexible tubes so that babies needing resuscitation could continue to receive blood and oxygen via the umbilical cord during the first vital minutes of life.

That idea has now produced a bed tablecum- resuscitator which should save babies lives if it becomes widely used.

And Mr Hutchon, a retired consultant obstetrican who spent decades working at Darlington Memorial Hospital, is part of a team of doctors who have just won an award for the innovation.

It was Mr Hutchon’s growing conviction that too many babies were dying unnecessarily because of premature clamping of the umbilical cord that inspired the colleagues to come up with a practical way of providing bedside resuscitation of new-born babies without the need to cut the umbilical cord.

Mr Hutchon, who was presented with the award at the Medical Futures Innovation ceremony in London with his colleagues, is jubilant about the victory and what it could mean for the safety of babies in the UK and, ultimately, throughout the rest of the world.

“I have no doubt that if this is taken up widely it will save babies’ lives,” says Mr Hutchon, who was inspired when he saw New Zealand midwives connecting a remote resuscitation machine to a new-born baby by using long extension tubes.

While the tubes were not ideal, Mr Hutchon was impressed that it allowed babies to be resuscitated while still connected to their mothers via the umbilical cord.

Six years later, Mr Hutchon and his colleagues came up with the Basics Trolley – the Bedside Assessment, Stabilisation and Initial Cardiorespiratory Support trolley.

The adapted bed table on wheels combines a basic resuscitation device with a hinged tray, which swings across the bed and supports the baby while doctors and nurses check for vital signs.

The advantage the Basics Trolley has is that new-born babies who are not breathing need not be physically separated from their mothers by clamping and then cutting the umbilical cord in order to connect them to a conventional resuscitation device.

The success of the Basics concept, which is still only a prototype, has thrilled Mr Hutchon.

“We had a huge amount of interest about the trolley at the awards ceremony,” he says. “People said it was so simple and obvious that starting resuscitation beside the mother without cutting off the baby’s only supply of oxygen and blood was just common sense.”

Mr Hutchon says his team are optimistic that medical equipment firms will be interested in manufacturing the trolley. “Potentially, we think there is a UK market of thousands and a worldwide market of millions,” he says.

In the Nineties, Mr Hutchon says it was common practice in UK hospitals to clamp and cut the cord if the baby needed to be put on a resuscitator.

But he says he became increasingly convinced that it would be better, in the case of weak or premature babies, if the cord clamping could be delayed, to avoid the blood and oxygen supply being cut off prematurely before the baby’s lungs were working.

The problem was – how could you do this at the same time as putting the baby on a resuscitator?

When Mr Hutchon returned from his sabbatical in New Zealand, he initially experimented with running tubes from the bedside to the resuscitation machine in the corner of the room. After a while he decided to experiment by wheeling the resuscitation machine right up to the bedside, but this proved to be too awkward.

All the time, Mr Hutchon was organising conferences and writing scientific papers advocating the benefits of delayed clamping.

At first there seemed very little interest, but gradually he formed an alliance with likeminded specialists at hospitals in Liverpool, Worcester and London.

AKEY supporter is Dr Andrew Weeks, a consultant obstetrician at Liverpool Women’s Hospital, who persuaded his colleague, design engineer Peter Watt, to come up with a practical way of providing bedside resuscitation without clamping the cord.

The result is the Basics Trolley.

“It is crazy that the most vulnerable babies are born and whisked off and surrounded by a scrum of doctors,” says Dr Weeks. “It is an extremely tense time for a mother to have a baby taken away and not be able to see what is going on.

“The trolley means that parents of vulnerable children, such as those who are premature, will be able to stay alongside their baby while it is being cared for by the paediatricians. This can only help with bonding between the mother and child.”

Mr Hutchon, who is president of the North of England Obstetricial and Gynaecological Society, is also delighted that the wider medical profession is moving towards delayed cord clamping.

While the National Institute for Health and Clinical Excellence still advocates early clamping, the Royal College of Obstetricians and Gynaecologists recently issued new advice recommending delayed clamping.