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== Emergency Medical Retrieval Service (EMRS) ==
The '''Emergency Medical Retrieval Service''' ('''EMRS''') provides [[aeromedical]] [[Critical care medicine|critical care]] retrieval and [[Pre-hospital emergency medicine|pre-hospital critical care]] to people in [[Scotland]]<ref name=":3">{{Cite journal |last=McHenry |first=Ryan D. |last2=Moultrie |first2=Christopher EJ |last3=Cadamy |first3=Andrew J. |last4=Corfield |first4=Alasdair R. |last5=Mackay |first5=Daniel F. |last6=Pell |first6=Jill P. |date=2023-08-22 |title=Pre-hospital and retrieval medicine in Scotland: a retrospective cohort study of the workload and outcomes of the emergency medical retrieval service in the first decade of national coverage |url=https://doi.org/10.1186/s13049-023-01109-6 |journal=Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |volume=31 |issue=1 |pages=39 |doi=10.1186/s13049-023-01109-6 |issn=1757-7241 |pmc=10463457 |pmid=37608349}}</ref> in the form of two retrieval teams (North and West). The service provides patients in remote and rural areas with rapid access to the skills of a [[Consultant (medicine)|consultant]] or senior doctor in emergency medicine, intensive care medicine or anaesthesia, and facilitates transfers to larger, better equipped urban hospitals.<ref name="what we do">{{cite web |title=What we do |url=http://www.emrs.scot.nhs.uk/index.php?option=com_content&view=article&id=18&Itemid=28 |url-status=dead |archive-url=https://web.archive.org/web/20090411060354/http://www.emrs.scot.nhs.uk/index.php?option=com_content&view=article&id=18&Itemid=28 |archive-date=11 April 2009 |access-date=2009-11-18 |publisher=EMRS |location=Glasgow}}</ref> 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]].
EMRS North team (in Aberdeen) is on base between 0800 and 1800, and EMRS West team (in Glasgow) are on base between 0700 and 2300, for immediate deployment; outside these hours the teams are on-call and will take at least 30 minutes longer to deploy.<ref name=":0" /><ref name=":4">{{Cite book |last=Gallier |first=Jonny |url=https://static1.squarespace.com/static/54a40119e4b0fbd5ffb33811/t/60dedd449cc52157c56eb443/1625218372992/OG028.pdf |title=OG028 ScotSTAR Referral}}</ref>
Services are provided in partnership with the [[Scottish Ambulance Service]] utilising road transport, [[helicopter]]s and [[fixed-wing aircraft]]. The EMRS now operates as part of [[ScotSTAR]], the Scottish national retrieval service, sharing a bespoke base at [[Glasgow Airport]].<ref>{{Cite web |date=2023-03-29 |title=Emergency Medical Retrieval Service |url=https://www.emrsscotland.org/ |access-date=2023-09-28 |website=Emergency Medical Retrieval Service |language=en-GB}}</ref>
== Personnel ==
EMRS Teams are composed of Retrieval Practitioners (Advanced or Specialist) and one or more doctors.<ref>{{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}}</ref> 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<ref>{{Cite web |title=Consultants |url=https://www.emrsscotland.org/consultants |access-date=2023-09-27 |website=Emergency Medical Retrieval Service |language=en-GB}}</ref> and a smaller number of registrar or clinical fellow grade doctors.<ref>{{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}}</ref>
During staffing pressures in the early COVID-19 pandemic, the service occasionally deployed a Registrar with a Retrieval Practitioner as an operational team.<ref name=":0" />
== Clinical Interventions ==
'''Pre-hospital Critical Care'''
The team attend between 2 and 3 prehospital calls a day, delivering advanced airway management to 22.8% of patients attended and other critical care interventions to 25.2% of prehospital patients.<ref name=":3" /><ref name=":1">{{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}}</ref><ref>{{Cite journal |last1=Moultrie |first1=C. E. J. |last2=Corfield |first2=A. R. |last3=Pell |first3=J. |last4=Mackay |first4=D. |date=2017-05-01 |title=46 Forecasting the demand profile for a physician-led pre-hospital care service using a mathematical model |url=https://bmjopen.bmj.com/content/7/Suppl_3/A18.2 |journal=BMJ Open |language=en |volume=7 |issue=Suppl 3 |doi=10.1136/bmjopen-2017-EMSabstracts.46 |issn=2044-6055 |doi-access=free}}</ref><ref name=":2" /> The EMRS team perform prehospital anaesthesia as required, with a complication rate of 4%,<ref name="A rural emergency medical retrieval" /> and a first pass success rate of 80%.<ref name=":2">{{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}}</ref> This is comparable to other UK prehospital services offering this intervention.<ref>{{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 }}</ref>
EMRS are able to undertake surgical procedures at the road side, such as resuscitative [[thoracotomy]], however EMRS does not have "specialist obstetric skills".<ref name=":4" />
'''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.<ref name="EMJ 2011" />
==References==
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