EMRS Trauma Team
EMRS exists to provide access to life saving critical care interventions at the earliest opportunity for patients with serious illness and injury. The EMRS team provide this care through secondary rural retrieval and by primary retrieval, working with the ambulance service to provide pre-hospital critical care at the scene of incidents.
The consultant led team can be deployed by helicopter or by dedicated road response vehicle.
Patients with serious injuries need rapid access to critical care interventions to stabilise their airway, breathing and circulation problems. When time from injury to hospital is prolonged due to geography or entrapment, a delay in accessing critical care stabilisation can be detrimental to patient outcome and it is in these situations that rapid access to a pre-hospital trauma team can be life saving.
Requesting a team for a pre-hospital incident
The team is made up of consultants and critical care practitioners from a paramedic or nursing background.
They will work with paramedics on scene to stabilise the patients and then transfer directly to definitive hospital care.
In line with the Scottish Ambulance Service Major Trauma Pathway, paramedics and technicians who wish the EMRS to attend a pre-hospital incident should request their attendance through ACC.
On scene capabilities
The team are equipped to provide pre-hospital emergency anaesthesia to maintain and protect patients’ airways and support their ventilation.
This can be life saving in the following situations:
- Severe chest injuries
- Loss of airway maintenance and protection due to reduced conscious level
- Severe head injuries
Emergency anaesthesia can also be delivered for pain relief and humanitarian reasons in patients with severe injuries or extensive burns. Patients who are agitated, combative and difficult to manage and transport safely due to head injuries or hypoxia can also be anaesthetised to facilitate their care.
Advanced analgesia and sedation
The EMRS team can administer ketamine for patients with pain resistant to morphine. Peripheral nerve blockade is also possible. Sedation can be administered to allow pre-hospital fracture and joint dislocation reduction which can be limb saving.
Chest injury management
Advanced procedures for chest injury management can be performed by the team at the scene of incidents.
These procedures include:
- Anaesthesia and ventilation
- Chest drain insertion
- Resuscutative Thoracotomy
In cases of prolonged entrapment with severe haemorrhage, the team can arrange for blood to be delivered to the scene and can administer transfusions on site.
Very rarely the retrieval team will need to undertake a surgical airway to save patients’ lives when no other airway management technique is possible.