RickInOz

A couple of posts have appeared on here now about my work for the RAH Mediflight Retrieval Service and I thought it was about time we covered what the job entails and why such a facility exists.

Mediflight was founded in the mid-1970s to provide a means of transporting the critically unwell around South Australia. Of course the need for such a service had existed before, but retrievals were always done in a rather casual and ad-hoc way as no formal department existed. This is where a little explanation of the need for an organisation is appropriate.

In the UK few cities and towns are more than a couple of hours drive from a tertiary centre. Therefore the need to move a critical care patient is infrequent, and if required is usually a short distance. Compare this to South Australia, a state of over a million square kilometres in which a fair number of towns are as much as 1000km from Adelaide. The sheer obstacle of geography was one of the limiting factors dictating the need for an airborne service. The other was the limited resources found in some of the distal hospitals. Many of them have only one GP and scarce resuscitation facilities for a small yet disparate community. They certainly are not equipped to look after critically unwell patients for days on end. This meant it came down to a simple matter of economics in making the provision of tertiary care in Adelaide only. Therefore any significantly sick patients elsewhere in the state must be transported back to Adelaide. Obviously moving such patients is inherently risky, hence the need for a highly trained mobile intensive care – with appropriate staff and equipment.

So this brings us back to Mediflight. We are based in the Royal Adelaide Hospital but can deploy anywhere in the state within minutes. During the day there are two doctors and two nurses on constant availability. This means we can operate two jobs at a time or deploy both teams to the same incident, for example to a major car smash. We can provide a wide variety of options:

1. Interhospital, within metro, by road
2. Interhospital, outside metro, by road, rotary wing or fixed wing
3. Interhospital, interstate, by fixed wing or jet
4. Primary response to incident, within metro, by road
5. Primary response to  incident, outside metro, by rotary wing or fixed wing

As you can see, we have a variety of transport options available to us. If the patient is less than 100km away or within the metro area we will usually take an ambulance. This is often quickest since there is always an ambulance at the RAH we can borrow and the roads in the city are generally good. If the patient is more than 100km away we will usually take the helicopter. If the trip is further than that we will take the RFDS plane as it is far quicker than the helicopter, but obviously limited by needing a landing strip whereas the helicopter can land on any wide open space. If the job is across the state border we will usually take a charter jet to save time in the air.

The logistics can be complicated, but on the whole we manage to get to and from our destination in a surprisingly timely and efficient fashion. This is mostly because the agencies we work with are motivated and highly trained too. They realise that lives are at stake and rise to the challenges we set them.

Stay tuned for Part 2 of this post …