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{{Missing information|Organisaiton details needed|Needs NHS organisation box, and expanded details throughout|date=March 2022}}{{Lead too short|date=March 2022}}
'''Scottish Specialist Transport and Retrieval''' ('''ScotSTAR''') is the [[Scotland|Scottish]] national service for adult, paediatric and neonatal patients. The service is run by the [[Scottish Ambulance Service]] and brings together [[NHS Scotland]]'s three specialist transport and retrieval services: the Scottish Neonatal Transport Service (SNTS), the Transport of Critically Ill and Injured Children Service and the [[Emergency Medical Retrieval Service]] (EMRS).<ref>{{Cite web |date=2014-03-31 |title=Integrated unit to transport critically ill NHS patients |url=https://www.heraldscotland.com/news/13153205.integrated-unit-transport-critically-ill-nhs-patients/ |access-date=2023-11-03 |website=The Herald |language=en}}</ref> The service operates from a bespoke base near [[Glasgow]] and expects to be able to cater for 2,200 critically ill children and adults every year.
==History==
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== Scottish Neonatal Transport Service (SNTS) ==
The Scottish Neonatal Transport Service, a vital component of ScotSTAR, specializes in the secure transportation of unwell newborns within Scotland and, at times, when Scottish infants need to be relocated to more distant locations.
This service is operated by a dedicated group comprising neonatal consultants, advanced neonatal nurse practitioners, transport fellows (physicians), expert neonatal transport nurses, and ambulance personnel. The staffing for each journey is tailored to meet the specific requirements of the infant.
=== Regional Divisions ===
This national service is organized into three regional divisions:<ref>{{Cite web |title=About Us – ScotSTAR Scottish Neonatal Transport Service |url=https://www.neonataltransport.scot.nhs.uk/about-us/ |access-date=2023-11-03 |language=en-GB}}</ref>
==== Northern Team ====
The Northern team operates from its base at Aberdeen Royal Infirmary and serves the regions of North Tayside, Grampian, the Highlands, Orkney, and Shetland.
==== Southeast Team ====
Located at the Simpson Centre for Reproductive Health in Edinburgh, the Southeast team is responsible for serving South Tayside, Lothians, Fife, and the Borders.
==== Western Team ====
Situated at the ScotSTAR hangar at Glasgow Airport, the Western team covers Greater Glasgow and Clyde, Dumfries and Galloway, Ayrshire, Forth Valley, Lanarkshire, Argyll, and the Western Isles.
== Transport of Critically Ill and Injured Children Service ==
This division is responsible for the transport of sick children.
== Emergency Medical Retrieval Service (EMRS) ==
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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'''▼
▲=== 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" />
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