Challenges of postpartum haemorrhage: a case study in the aeromedical retrieval environment

The Emergency Medical Retrieval Service (EMRS) now forms part of the specialist transport and retrieval division (ScotSTAR) within the Scottish Ambulance Service. EMRS provides critical care to acutely ill and injured patients in remote and rural Scotland and transfers them either by ambulance, helicopter or plane.

EMRS is a consultant-led service, therefore affording patients the highest degree of critical care possible within the NHS. Each team comprises of two team members, the consultant and either a trainee registrar or critical care practitioner (CCP).

The service's CCPs are from either a paramedic or nursing background and have extensive experience in their respective fields prior to joining EMRS. The CCP role has many responsibilities and functions but the primary focus is to augment the critical care delivery led by the consultant to provide safe, robust and timely intensive level care to patients.

Retrievals are categorised as primary or secondary. Primary retrievals are those requiring the EMRS Trauma Team to provide critical care in the pre-hospital environment before transferring patients to definitive care. Secondary retrievals require the team to attend patients in remote or rural healthcare facilities. These facilities vary in size, staffing and capabilities. Patients at such locations who require HDU or ICU levels of treatment are stabilised and transferred by EMRS to larger metropolitan hospitals.