ArticleScandinavian journal of trauma, resuscitation and emergency medicine2023
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.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Under-5 mortality trends and leading causes of death in Greece, 2016-2020: A nationwide study.Public health in practice (Oxford, England) · 2026Article
- Prehospital Performance of Five Early Warning Scores to Predict Long-Term Mortality in Patients with Suspected Respiratory Infections.Diagnostics (Basel, Switzerland) · 2025Article
- Accuracy of early warning scores for predicting clinical worsening in COPD patients.ERJ open research · 2025Article
- Equity in the provision of helicopter emergency medical services in the United Kingdom: a geospatial analysis using indices of multiple deprivation.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Effects of Community Assets on Major Health Conditions in England: A Data Analytic Approach.Healthcare (Basel, Switzerland) · 2024Article
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6 authors.
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Abstract
backgroundThe Emergency Medical Retrieval Service (EMRS) has provided national pre-hospital critical care and aeromedical retrieval in Scotland since 2010. This study investigates trends in the service and patients attended over the last decade; and factors associated with clinical deterioration and pre-hospital death.
methodsA retrospective cohort study was conducted of all service taskings over ten years (2011-2020 inclusive). The EMRS electronic database provided data on location, sociodemographic factors, diagnoses, physiological measurements, clinical management, and pre-hospital deaths. Binary logistic regression models were used to determine change in physiology in pre-hospital care, and factors associated with pre-hospital death. Geospatial modelling, using road and air travel time models, was used to explore transfer times.
resultsEMRS received 8,069 taskings over the study period, of which 2,748 retrieval and 3,633 pre-hospital critical care missions resulted in patient contact. EMRS was more commonly dispatched to socioeconomically deprived areas for pre-hospital critical care incidents (Spearman's rank correlation, r(8)=-0.75, p = 0.01). In multivariate analysis, systolic blood pressure < 90mmHg, respiratory rate < 6/min or > 30/min, and Glasgow Coma Score ≤ 14 were associated with pre-hospital mortality independent of demographic factors. Geospatial modelling suggested that aeromedical retrieval reduced the mean time to a critical care unit by 1 h 46 min compared with road/ferry transportation.
conclusionEMRS continues to develop, delivering Pre-Hospital and Retrieval Medicine across Scotland and may have a role in addressing health inequalities, including socioeconomic deprivation and geographic isolation. Age, specific distances from care, and abnormal physiology are associated with death in pre-hospital critical care.
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