Retrieval Principles for Rural GPs

Abstract

The isolated rural general practitioner will, from time to time, be faced with a critically ill patient or medical emergency which requires a higher level of care than can be provided locally. These patients need to be resuscitated, stabilised and transferred to another centre and therefore may need to be escorted by medical personnel. Retrieval services aim to provide a level of expertise and equipment which can be taken to the patient so that management of the patient is optimised prior to transport and continued during transport. The medical retrieval teams which operate from Sydney are: • Westpac Surf Life Saving Association, based at Prince Henry Hospital; • NRMA Careflight, based at Westmead Hospital, and • neonatal teams from Royal Alexandra Hospital for Children and Prince of Wales Children's Hospital. These teams utilise helicopters provided by NRMA Careflight. SLSA and Childflight and fixed wing aircraft from NSW Air Ambulance. Road ambulance retrievals are also provided within the metropolitan area. Country areas in NSW are serviced by retrieval teams from Base Hospitals such as Orange Base Hospital and Tamworth Base Hospital. These services arc primarily by road, but distance sometimes necessitates the use of fixed or rotary wing aircraft. This paper aims to discuss stabilisation of patients prior to transport. There is nothing more daunting than to have strange medical personnel descend on your local hospital and seemingly ‘take over’. Nursing and medical staff who have been caring for the patient, in many cases for hours, may feel pushed aside and not understand why certain things are done to their patient. This discussion will hopefully shed some light on the mysterious ‘transport environment’ so that personnel at the referring hospital can help prepare the patient appropriately and understand the needs of the retrieval team.