Emergency Medical Retrieval Service

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{{Location map~|Scotland|lat=55.8719|long=-4.4331|mark=Red pog.svg|position=bottom|label=EMRS (West)}}

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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.{{cite journal | vauthors = Whitelaw AS, Hsu R, Corfield AR, Hearns S | title = Establishing a rural Emergency Medical Retrieval Service | journal = Emergency Medicine Journal | volume = 23 | issue = 1 | pages = 76–78 | date = January 2006 | pmid = 16373814 | pmc = 2564140 | doi = 10.1136/emj.2005.025528 }} 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.{{cite journal | vauthors = Corfield AR, Thomas L, Inglis A, Hearns S | title = A rural emergency medical retrieval service: the first year | journal = Emergency Medicine Journal | volume = 23 | issue = 9 | pages = 679–683 | date = September 2006 | pmid = 16921078 | pmc = 2564207 | doi = 10.1136/emj.2006.034355 }}

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{{nbsp}}million.{{cite news |url=http://news.bbc.co.uk/1/hi/scotland/6237694.stm |title=Medical airlift service extended |work=BBC News |date=25 June 2007}} 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.{{cite web|url=http://www.emrs.scot.nhs.uk/index.php?option=com_content&view=article&id=44&Itemid=29 |title=History |publisher=EMRS |access-date=2009-11-18 |location=Glasgow |url-status=dead |archive-url=https://web.archive.org/web/20090411060359/http://www.emrs.scot.nhs.uk/index.php?option=com_content&view=article&id=44&Itemid=29 |archive-date=11 April 2009 }} An independent service evaluation demonstrated value for money and lifesaving benefits of critical care retrieval.{{cite report|url=http://www.gov.scot/Resource/Doc/304168/0095438.pdf |title=Evaluation of the Emergency Medical Retrieval Service | vauthors = Boyle J, Whyte R, Dickson E, Godden D, Heaney D, Munro A |publisher=Scottish Government |year=2010}}

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.{{cite news |url=http://news.bbc.co.uk/1/hi/scotland/8545508.stm |title='Flying doctor' scheme to expand |work=BBC News |date=2 March 2010}}{{cite news |url=http://news.bbc.co.uk/local/highlandsandislands/hi/people_and_places/nature/newsid_8652000/8652140.stm |title=The flying doctors |work=BBC News |date=29 April 2010}} The second team increased the number of participating consultants and doctors from eight to fifteen.{{cite news |url=https://www.bbc.co.uk/news/uk-scotland-11617569 |title=Flying doctor service takes off across Scotland |work=BBC News |date=25 October 2010}}

In 2010, around 90% of EMRS activity involved secondary retrieval.{{cite journal | vauthors = Corfield AR, Adams J, Nicholls R, Hearns S | title = On-scene times and critical care interventions for an aeromedical retrieval service | journal = Emergency Medicine Journal | volume = 28 | issue = 7 | pages = 623–625 | date = July 2011 | pmid = 20724465 | doi = 10.1136/emj.2010.091421 | s2cid = 206939562 }} Annual running costs were now in the region of £2M.{{cite press release |url=http://www.gov.scot/News/Releases/2010/03/02094826|title=Flying doctors flying high |publisher=Scottish Government |date=2 March 2010 |access-date=20 November 2015}} 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.{{cite web |url=http://www.gov.scot/Resource/Doc/362956/0122968.pdf |title=Towards a Single National Specialist Transport Service for Scotland - ScotSTAR: Strategic vision |publisher=Scottish Government |page=6 |date=18 November 2011 |access-date=22 November 2015}}

2014: In June 2014, EMRS teams began to routinely carry a stock of O negative blood to allow transfusion earlier when responding to emergencies.{{cite news |url=http://www.heraldscotland.com/sport/13164992.Flying_doctors_add_new_team_to_cover_Games_emergencies/ |title=Flying doctors add new team to cover Games emergencies | vauthors = Weldon V |work=The Herald |date=12 June 2014 |access-date=23 November 2015}} During the period of the 2014 Commonwealth Games a third team of medics was available. {{As of|2014|December}}, the staff of the service had expanded to include 27 part-time consultants and had completed more than 3,000 retrievals.{{cite news |url=http://www.scotsman.com/news/rural-fast-response-medics-to-be-celebrated-1-3624262 |title=Rural fast-response medics to be celebrated |work=The Scotsman |date=3 December 2014 |access-date=22 November 2015}}

2015: In September 2015, the EMRS announced their move to a new purpose-built base, located at Glasgow Airport.{{cite press release |url=http://www.glasgowairport.com/corporate/media-centre/posts/2015/september/22/new-glasgow-airport-base-for-patient-retrieval-team/ |title=New Glasgow Airport base for patient retrieval team |publisher=Glasgow Airport |date=22 September 2015 |access-date=22 November 2015 |archive-url=https://web.archive.org/web/20151123043124/http://www.glasgowairport.com/corporate/media-centre/posts/2015/september/22/new-glasgow-airport-base-for-patient-retrieval-team/ |archive-date=23 November 2015 |url-status=dead }}

2019: A second EMRS base opened in Aberdeen, predominantly covering the North of Scotland.{{Cite web |title=Scottish Trauma Network {{!}} EMRS North |url=https://www.scottishtraumanetwork.com/emrs-north/ |access-date=2023-09-24 |website=www.scottishtraumanetwork.com |language=en}}

The EMRS is 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.{{Cite web |last=Scottish Ambulance Service |title=FOI Request |url=https://www.whatdotheyknow.com/request/879854/response/2102601/attach/3/FOI%201597%20Response%20Letter.pdf?cookie_passthrough=1}} File:EMRS2.jpg

EMRS Teams are composed of Retrieval Practitioners (Advanced or Specialist) and one or more doctors.{{Cite web |title=Retrieval Practitioners |url=https://www.emrsscotland.org/retrieval-practitioners |access-date=2023-09-27 |website=Emergency Medical Retrieval Service |language=en-GB}} Retrieval Practitioners come from a nursing or paramedic background and receive additional training in retrieval medicine. There are 47 part-time consultants who work with EMRS{{Cite web |title=Consultants |url=https://www.emrsscotland.org/consultants |access-date=2023-09-27 |website=Emergency Medical Retrieval Service |language=en-GB}} and a smaller number of registrar or clinical fellow grade doctors.{{Cite web |title=Registrars and Fellows |url=https://www.emrsscotland.org/registrars |access-date=2023-09-27 |website=Emergency Medical Retrieval Service |language=en-GB}}

During staffing pressures in the early COVID-19 pandemic, the service occasionally deployed a Registrar with a Retrieval Practitioner as an operational team.

Collaboration with the Scottish National Blood Transfusion Service (SNBTS) allows the EMRS teams to have O-negative blood immediately available to take on all missions.{{cite press release |url=https://www.scotblood.co.uk/news/collaboration-with-emergency-medical-retrieval-service.aspx |title=Blood on board |publisher=Scottish National Blood Transfusion Service (SNBTS) |date=27 March 2015 |access-date=12 December 2015}}{{Clarify|reason=Is blood taken on all missions, or only available to be taken on missions?|date=March 2022}} The EMRS have developed a bespoke app to make their standard operating procedures available to clinicians.{{cite news |url=http://www.scotsman.com/news/smartphone-app-to-help-rural-healthcare-wins-two-awards-1-2592184 |title=Smartphone app to help rural healthcare wins two awards | vauthors = Walker N |work=The Scotsman |date=22 October 2012 |access-date=12 December 2015}} The team also carry equipment to facilitate the provision of anaesthesia and surgical interventions.{{Cn|date=October 2023}}

Pre-hospital Critical Care

The team attend between 1 and 3{{Cite journal |last1=Neagle |first1=Gregg |last2=Curatolo |first2=Lisa |last3=Ferris |first3=John |last4=Donald |first4=Mike |last5=Hearns |first5=Stephen |last6=Corfield |first6=Alasdair R. |date=2019-04-01 |title=Epidemiology and location of primary retrieval missions in a Scottish aeromedical service |url=https://www.ingentaconnect.com/content/wk/ejeme/2019/00000026/00000002/art00009 |journal=European Journal of Emergency Medicine |volume=26 |issue=2 |pages=123–127 |doi=10.1097/MEJ.0000000000000483 |pmid=28746084 |s2cid=23053968|url-access=subscription }} prehospital patient a day, delivering advanced medical management and other critical care interventions many of these patients. In one study, 59.7% of patients received one of the following interventions; pre-hospital Blood transfusion, Chest drain insertion neuroprotective measures or Emergency ultrasound. In the same study 52.5% of patients were mechanically ventilated. In another study critical care interventions (emergency anaesthesia, thoracostomies, sedation, thoracotomy, chest drain insertion or administration of blood products) were provided to 17% of patients and 21% received an advanced medical intervention (these include patients who died on scene, gaining intraosseous access and any patient the team escorted to hospital).

The EMRS team perform prehospital anaesthesia as required, with a complication rate of 4%, and a first pass success rate of 80%.{{Cite journal |last1=Ross |first1=Mark |last2=Corfield |first2=Alasdair |last3=McCormack |first3=Jon |last4=Loughrey |first4=John Paul |date=2015-11-01 |title=Tracheal intubation in primary and secondary retrieval patients: A study of tracheal intubation practice and complications in ICU and aeromedical retrieval |url=https://www.resuscitationjournal.com/article/S0300-9572(15)00509-2/abstract |journal=Resuscitation |language=English |volume=96 |pages=49–50 |doi=10.1016/j.resuscitation.2015.09.114 |issn=0300-9572|url-access=subscription }} This is comparable to other UK prehospital services offering this intervention.{{Cite journal |last1=Lockey |first1=D. |last2=Crewdson |first2=K. |last3=Weaver |first3=A. |last4=Davies |first4=G. |date=August 2014 |title=Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients by pre-hospital physicians |journal=British Journal of Anaesthesia |volume=113 |issue=2 |pages=220–225 |doi=10.1093/bja/aeu227 |pmid=25038154 |issn=0007-0912|doi-access=free }} EMRS are able to undertake surgical procedures at the road side, such as resuscitative thoracotomy, however EMRS does not have "specialist obstetric skills".

Retrieval and Transport

EMRS provide a retrieval service for adult patients across Scotland (paediatric retrieval is performed by ScotSTAR). EMRS' average (median) on-scene time with a patient requiring inter-hospital transport before transporting is one hour.

• File:Scottish Ambulance Service Helicopter - geograph.org.uk - 731425.jpgIn 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”.{{cite web |url=http://www.mddus.com/resources/resource-type/publications/summons/2010/summer-2010/qa-dr-stephen-hearns-of-emrs/ |title=Q&A: Dr Stephen Hearns of EMRS |publisher=Medical and Dental Defence Union of Scotland (MDDUS) |date=30 June 2010 |access-date=22 November 2015}} This award recognised hospital teams that demonstrate improved outcomes of medical & surgical conditions.{{cite web |url=http://groupawards.bmj.com/secondary-care-team-of-the-year-2010 |title=Secondary Care Team of the Year 2010 |publisher=BMJ Group |archive-url=https://web.archive.org/web/20120522015804/http://groupawards.bmj.com/secondary-care-team-of-the-year-2010 |archive-date=22 May 2012}}
• 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.
• In 2023, the EMRS won the Military & Emergency Services Champion category at the Scotland's Champion's awards.{{Cite web |last=plc |first=Reach |title=Scotland's Champions 2023 - Finalists |url=https://scotlandschampions.co.uk/2023/en/page/finalists |access-date=2023-09-24 |website=scotlandschampions.co.uk |language=en}}

• Air ambulances in the United Kingdom
• BASICS Scotland
• Emergency medical services in the United Kingdom
• Highland PICT Team

{{reflist|30em}}

• {{Official website}}

Category:NHS Scotland

Category:Scottish Government

Category:2004 establishments in Scotland