Emergency Medical Retrieval Service

The Emergency Medical Retrieval Service (EMRS) provides aeromedical critical care to people in Scotland. It provides patients in remote and rural areas with rapid access to the skills of a consultant in emergency medicine, intensive care medicine, or anaesthesia, and facilitates transfers to larger, better equipped urban hospitals. The EMRS functions supplementary to the regular Scottish Ambulance Service Air Ambulance service. Unlike air ambulance services in other parts of the UK, both services are funded by the Scottish Government. The service responds to seriously ill and injured patients, often in remote locations, who require early critical care interventions and quick transfer to a better equipped, urban hospital.[1]

Emergency Medical Retrieval Service
Established2004
HeadquartersGlasgow airport
NHS regionScotland
Budget£2 million
Websitewww.emrsscotland.org

The EMRS has occasionally featured on the Channel 5 documentary series Highland Emergency, which charts the work of rescue services in the Scottish Highlands.[2]

The team is available 24 hours a day for inter-hospital transfers, although overnight this is on an on-call basis, with services provided in partnership with the Scottish Ambulance Service utilising both helicopters and fixed-wing aircraft. The EMRS now operates as part of ScotSTAR, the Scottish national retrieval service, sharing a bespoke base at Glasgow Airport.

History

2004: The EMRS was formed in 2004 when NHS Argyll and Clyde approved a 12-month trial which involved 11 consultants in emergency or intensive care medicine.[3] The EMRS was initially based at Glasgow City Heliport and operated only in the Argyll and Clyde area. During the first 12 months the EMRS attended 3 patients a month.[4]

2007: In 2007, the service was extended to cover three rural general hospitals and 13 community hospitals as part of an 18-month trial funded with £1.59 million.[5] The success of the service saw its operating zone expanded throughout the west coast of Scotland and the EMRS now operates from Stranraer in the south to Stornoway in the north.[6] An independent service evaluation demonstrated value for money and lifesaving benefits of critical care retrieval.[7]

2010: In March 2010, the Scottish Government acknowledged that due to its continuing success, the service would be further enhanced by the addition of a second team, operational from October 2010.[8][9] The second team increased the number of participating consultants and doctors from eight to fifteen.[10] In 2010, around 90% of EMRS activity involved secondary retrieval.[11] Annual running costs were now in the region of £2M.[12] In 2011, annual activity was estimated to be 324 transfers each year with around 60% of these by rotary wing and 35% by fixed-wing aircraft.[13]

2014: In June 2014, EMRS teams began to routinely carry a stock of O negative blood to allow transfusion earlier when responding to emergencies.[14] During the period of the 2014 Commonwealth Games a third team of medics was available.[14] As of December 2014, the staff of the service had expanded to include 27 part-time consultants and had completed more than 3,000 retrievals.[15]

The EMRS team (red) with Paramedics (green) in 2009, loading a patient into a helicopter

2015: In September 2015, the EMRS announced their move to a new purpose-built base, located at Glasgow Airport.[16]

Resources

As the retrieval service doesn't have any vehicles to transport patients, they are supported by land ambulances, aircraft from the Scottish Ambulance Service's Air Ambulance Division, the Scottish Charity Air Ambulance and the helicopters of the UK Coastguard. [17]

EMRS North team on base between 0800 and 1800, and EMRS West between 0700 and 2300 for immediate deployment, outside these hours they’re on call and will take longer to deploy.[17]

Equipment

Collaboration with the Scottish National Blood Transfusion Service (SNBTS) allows the EMRS to have O-negative blood immediately available to take on all missions.[18]

The EMRS have developed a bespoke app to make their standard operating procedures available to clinicians.[19]

Clinical Interventions
Map of areas covered by the EMRS, showing some medical facilities served

The EMRS team perform prehospital anaesthesia when needed, with a complication rate of 4%.[20] Their average (median) total on-scene time with a patient requiring inter-hospital transport before transporting is one hour.[21]

Historic Awards

In March 2010, EMRS won the Secondary Care Team of the Year category in the BMJ awards for its work in “transforming the care and transfer of seriously ill and injured patients in remote and rural Scotland”.[22] This award recognised hospital teams that demonstrate improved outcomes of medical & surgical conditions.[23]

In 2012, the app developed by the EMRS won the EHI award for best use of mobile technology in healthcare and the NHS Scotland eHealth award for Best NHS Scotland use of Mobile technology.[19]

Controversy


2022: It comes to light that EMRS have been deploying without a Consultant on board.[17]

See also

References
  1. "What we do". Glasgow: EMRS. Archived from the original on 11 April 2009. Retrieved 18 November 2009.
  2. "Spin Doctor (EMRS Newsletter)" (PDF). Glasgow: EMRS. January 2009. Retrieved 18 November 2009.
  3. Whitelaw AS, Hsu R, Corfield AR, Hearns S (January 2006). "Establishing a rural Emergency Medical Retrieval Service". Emergency Medicine Journal. 23 (1): 76–78. doi:10.1136/emj.2005.025528. PMC 2564140. PMID 16373814.
  4. Corfield AR, Thomas L, Inglis A, Hearns S (September 2006). "A rural emergency medical retrieval service: the first year". Emergency Medicine Journal. 23 (9): 679–683. doi:10.1136/emj.2006.034355. PMC 2564207. PMID 16921078.
  5. "Medical airlift service extended". BBC News. 25 June 2007.
  6. "History". Glasgow: EMRS. Archived from the original on 11 April 2009. Retrieved 18 November 2009.
  7. Boyle J, Whyte R, Dickson E, Godden D, Heaney D, Munro A (2010). Evaluation of the Emergency Medical Retrieval Service (PDF) (Report). Scottish Government.
  8. "'Flying doctor' scheme to expand". BBC News. 2 March 2010.
  9. "The flying doctors". BBC News. 29 April 2010.
  10. "Flying doctor service takes off across Scotland". BBC News. 25 October 2010.
  11. Corfield AR, Adams J, Nicholls R, Hearns S (July 2011). "On-scene times and critical care interventions for an aeromedical retrieval service". Emergency Medicine Journal. 28 (7): 623–625. doi:10.1136/emj.2010.091421. PMID 20724465. S2CID 206939562.
  12. "Flying doctors flying high" (Press release). Scottish Government. 2 March 2010. Retrieved 20 November 2015.
  13. "Towards a Single National Specialist Transport Service for Scotland - ScotSTAR: Strategic vision" (PDF). Scottish Government. 18 November 2011. p. 6. Retrieved 22 November 2015.
  14. Weldon V (12 June 2014). "Flying doctors add new team to cover Games emergencies". The Herald. Retrieved 23 November 2015.
  15. "Rural fast-response medics to be celebrated". The Scotsman. 3 December 2014. Retrieved 22 November 2015.
  16. "New Glasgow Airport base for patient retrieval team" (Press release). Glasgow Airport. 22 September 2015. Archived from the original on 23 November 2015. Retrieved 22 November 2015.
  17. Scottish Ambulance Service. "FOI Request" (PDF).
  18. "Blood on board" (Press release). Scottish National Blood Transfusion Service (SNBTS). 27 March 2015. Retrieved 12 December 2015.
  19. Walker N (22 October 2012). "Smartphone app to help rural healthcare wins two awards". The Scotsman. Retrieved 12 December 2015.
  20. Corfield AR, Thomas L, Inglis A, Hearns S (September 2006). "A rural emergency medical retrieval service: the first year". Emergency Medicine Journal. 23 (9): 679–683. doi:10.1136/emj.2006.034355. PMC 2564207. PMID 16921078.
  21. Corfield AR, Adams J, Nicholls R, Hearns S (July 2011). "On-scene times and critical care interventions for an aeromedical retrieval service". Emergency Medicine Journal. 28 (7): 623–625. doi:10.1136/emj.2010.091421. PMID 20724465. S2CID 206939562.
  22. "Q&A: Dr Stephen Hearns of EMRS". Medical and Dental Defence Union of Scotland (MDDUS). 30 June 2010. Retrieved 22 November 2015.
  23. "Secondary Care Team of the Year 2010". BMJ Group. Archived from the original on 22 May 2012.
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