Maritime Pre-Hospital Emergency Care Primary Retrieval Team – Operational Considerations

AbstractThis article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant. This differs from the land operations support provided by the airborne Medical Emergency Response Team (MERT) as the maritime environment requires a bespoke solution for casualty retrieval as the method of deployment and the type of casualties and their locations may be more varied, requiring greater flexibility of approach.

Download Full-text

The Maritime Medical Emergency Response Team: what do we really need?

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-103-17 ◽

2017 ◽

Vol 103 (1) ◽

pp. 17-20 ◽

Cited By ~ 1

Author(s):

S J Mercer ◽

M A Khan ◽

C M Hillman ◽

J Robin ◽

J J Matthews ◽

...

Keyword(s):

Emergency Response ◽

Hospital Care ◽

Damage Control ◽

Medical Emergency ◽

Damage Control Resuscitation ◽

Royal Navy ◽

Response Team ◽

The Individual ◽

In Transit ◽

And Training

AbstractSince 2006, the Defence Medical Services (DMS) pre-hospital care focus has been the Medical Emergency Response Team (MERT), which has enabled the projection of Damage Control Resuscitation (DCR) to the point of wounding as part of consultant-delivered care. Now in a period of contingency operations, the Royal Navy (RN)’s Role 2 medical capability, Role 2 Afloat (R2A) delivers DCR (including surgery) on a maritime platform. This article will focus on the development of the Maritime MERT component of R2A (termed Maritime In Transit Care (MITC) in Maritime Medical Doctrine) and will discuss the requirements based on experience of and preparation for an operation in 2016. Also discussed are the individual competencies and training required to be part of the Maritime MERT; it is hoped that this will simulate debate around this evolving team.

Download Full-text

A comparison of handover communication in NHS and military emergency care

Journal of Paramedic Practice ◽

10.12968/jpar.2020.12.4.151 ◽

2020 ◽

Vol 12 (4) ◽

pp. 151-156

Author(s):

Rowena Slope ◽

Catherine Pope ◽

Robert Crouch ◽

Elizabeth MM Bernthal

Keyword(s):

Air Force ◽

Emergency Response ◽

Thematic Analysis ◽

Emergency Care ◽

Transition Theory ◽

Medical Emergency ◽

Structured Interviews ◽

Royal Air Force ◽

Response Team ◽

The Military

Background: There is a gap in the literature comparing communication during handover between military and NHS emergency care settings. Objectives: This study aimed to explore differences in handover communication in the NHS and the military, and to understand how paramedics manage the transition between settings. Design: This was a qualitative study for which 13 paramedics were interviewed. It focused on handover communication in NHS emergency care settings and Camp Bastion Hospital, Afghanistan. Methods: Interviews were conducted with regular and reservist paramedics serving in the Royal Air Force who had undertaken a deployment with the Medical Emergency Response Team. Semi-structured interviews were recorded, transcribed, coded and subjected to a thematic analysis. Results: Three principal themes were identified: differences between handover communication; standardisation; and the challenge of transition. Conclusion: Participants were most concerned about standardisation. Transition theory and resilience may account for the difficulties encountered when transitioning between different care settings.

Download Full-text

The Role of the Physician at a Medical Disaster: Hospital Emergency Response Teams

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00030600 ◽

1986 ◽

Vol 2 (1-4) ◽

pp. 128-132

Author(s):

Eric Alcouloumre ◽

Davis Rasumoff

Keyword(s):

Los Angeles ◽

Emergency Response ◽

Medical Personnel ◽

Hospital Emergency ◽

Medical Response ◽

Emergency Medical ◽

Response Team ◽

Emergency Medical Personnel ◽

Emergency Medical Response

The Hospital Emergency Response Team concept, as outlined here and in the Multi-Casualty Incident Operational Procedures of the California Fire Chiefs Association, is the result of a consensus effort by all EMS interest groups in Los Angeles. It is an effective way to utilize the skills of emergency medical personnel at the scene of a disaster. The role of the physician is an important one, and this concept was specifically designed to maximize the benefit to be derived from having a physician at the scene. It is important, however, that physicians recognize their limitations; a medical degree does not automatically confer “mystic abilities”in the area of disaster management. The role of the physician should include pre-disaster planning and at-scene patient management responsibilities as a member or leader of a pre-designated hospital-based emergency medical response team.

Download Full-text

The need for purposeful teaching, learning and assessment of crisis resource management principles and practices in the undergraduate pre-hospital emergency care curriculum: A narrative literature review

Australasian Journal of Paramedicine ◽

10.33151/ajp.18.820 ◽

2021 ◽

Vol 18 ◽

Author(s):

Mugsien Rowland ◽

Anthonio Oladele Adefuye ◽

Craig Vincent-Lambert

Keyword(s):

Resource Management ◽

Situation Awareness ◽

Emergency Care ◽

Care Setting ◽

Clinical Skills ◽

Hospital Setting ◽

Technical Skills ◽

Care Plan ◽

Crisis Resource Management ◽

Hospital Emergency

IntroductionTraditionally, undergraduate emergency medical care (EMC) training programs have, over the years, typically focussed on developing individuals with proficiency in clinical skills who can perform complex procedures in the act of administering safe and effective emergency care in the pre-hospital setting. A shortcoming of this training relates to the attention given to the soft skills needed to work efficiently in a team-based environment. Crisis resource management (CRM) is a structured, evidence-based approach to training that is designed to enhance teamwork performance in critical circumstances where the absence of coordinated teamwork could lead to undesired outcomes. MethodsA narrative review of GOOGLE SCHOLAR, MEDLINE, PUBMED, CINAHL as well as paramedic-specific journals was conducted. Articles were included if they examined the importance of CRM in pre-hospital emergency care; training undergraduate pre-hospital emergency care students on the principles and practices of CRM; and non-technical skills in pre-hospital emergency care. DiscussionResearchers found limited articles related to CRM and the pre-hospital emergency care setting. Our findings reveal that CRM focusses on addressing non-technical skills necessary for effective teamwork and that those identified to be relevant for effective teamwork in pre-hospital emergency care setting include situation awareness, decision-making, verbal communication, teamwork as well as leadership and followership skills. ConclusionEffective team management is a core element of expert practice in emergency medicine. When practised in conjunction with medical and technical expertise, CRM can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of a pre-hospital emergency care plan.

Download Full-text

Out-of-hospital emergency care providers’ work and clinical skills in Finland: A follow-up study

Clinical Nursing Studies ◽

10.5430/cns.v6n1p51 ◽

2017 ◽

Vol 6 (1) ◽

pp. 51

Author(s):

Riitta Mikkola ◽

Mari Salminen-Tuomaala ◽

Eija Paavilainen ◽

Päivi Leikkola

Keyword(s):

Educational Intervention ◽

Emergency Care ◽

Clinical Competence ◽

Clinical Skills ◽

Further Education ◽

Care Providers ◽

Hospital Emergency ◽

Hospital District ◽

Follow Up Study

Objective: This follow-up study is part of a larger study on emergency medical services. Its purpose was to describe emergency care providers’ perceptions of their work, its challenges and their clinical competence. The study aimed at producing knowledge of the perceived influence of an educational intervention, to be used in developing emergency care providers’ further and updating education.Methods: Data were collected from staff working in out-of-hospital emergency care of a hospital district in Finland using a questionnaire developed for this purpose. The results were analyzed statistically using SPSS for Windows 24.Results: Over 90% of the respondents found that their work was interesting and provided sufficient challenges. The majority were also interested in continuous professional development. After the educational intervention, respondents found the work somewhat more challenging and slightly more strenuous both physically and mentally compared to the first survey. Respondents more commonly reported that new capacities were required at work and they rated their practical skills lower than in the first survey. However, work in a multiprofessional environment was found less challenging. Over 70% of the respondents planned to have further education in the near future. They rated their clinical skills as good, but slightly lower compared to the first survey.Conclusions: The results regarding work, its challenges and self-rated clinical competence remained the same or were somewhat poorer after the educational intervention. The results help improve the education to meet the needs of emergency staff.

Download Full-text