The evolving role of the Emergency Medical Retrieval Service critical care practitioner


BackgroundEMRS has two teams available 24 hours a day. Each team comprises of two, the first person being a consultant with a specialty in emergency medicine, anaesthetics or intensive care, and the second person being either a senior registrar from the same specialities or one of the CCP team.‘Retrieval can be described as the deployment of a critical care team to a seriously ill or injured patients’ location to undertake resuscitation and stabilisation prior to safe transfer to definitive care (Hearns, 2012).’Secondary retrievals are necessary due to the unique geography of Scotland, as there are many remote healthcare sites situated on the west and north coast. These retrievals take place from a variety of healthcare facilities including district nurse practices, remote GP surgeries, community hospitals and rural general hospitals. The patients who arrive at these facilities are often critically ill and with limited equipment and specialist staff available at these facilities, patients can easily exceed the local critical care capability. The service ensures these patients have equal access to the appropriate level of care (Sturgeon, 2008) by bringing the emergency department resuscitation room or intensive care department skills to the patient, regardless of location.In the pre-hospital environment, the service responds as the EMRS trauma team. This has provided a dedicated pre-hospital critical care team for the west coast of Scotland and the densely populated area of greater Glasgow, thus ensuring critical care support to the ambulance clinicians of the west of Scotland (Findlay et al, 2007). Within the Glasgow area, the service responds in one of their dedicated response vehicles, whilst further distances are reached by helicopter in a Helicopter Emergency Medical Service (HEMS) configuration with the Scottish Ambulance Service rotary aircraft Helimed5.Due to the range of locations and geography, the service utilise various transport platforms to reach secondary locations. Transport is predominantly by air in association with the Scottish Ambulance Service rotary and fixed wing aircraft, although at times due to weather the service utilises the search and rescue rotary aircraft. Even with these multiple aviation options, there have been instances of severe weather or high demand where it has not been possible to get to the patient, which has seen the team utilising transport platforms such as ferries and lifeboats.

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