RickInOz

This is the second in a series of posts providing detailed information on what working for the Retrieval Service entails. Last time I wrote about the referral sources for our patients. This posting will cover what happens next – the arrangements and phone calls we have to make before we go out.

The most important phone call

Firstly we have to check in with the aeromedical consultant to report the referral and find out whether we should retrieve the patient, and if there are any special considerations. It also lets them know that one team will be busy so they can appropriately triage future referrals.

Finding a destination

Once the retrieval has been approved we have to find a receiving centre for the patient. In many cases this will have already been arranged by the referring hospital, but most of the time we have to ring round the ICUs in the city to find a bed. All spinal injuries, burns, major trauma and head injuries have to come back to the Royal Adelaide. Other patients can go to any other unit, which comes in useful as our unit is often full.

Sorting out some transport

Next we make a call to SAAS Communications to arrange transport. They route our call depending on the destination. Within the city and they will send an ambulance to meet us at the Casualty entrance. If further afield means going by helicopter or plane. We will have a conference call with Australian Helicopters (the company contracted to provide rotary-wing services to the Government of South Australia) or RFDS (who provide transport for our fixed-wing missions) so SAAS can find out where and when we are going.

If we go by helicopter they can usually be on the roof helideck within 15 minutes which doesn’t give us long to get everything else ready. As a result we tend to leave phoning for the helicopter until we are pretty much ready to go ourselves. We then phone the hospital security guards who will send up an officer to open the deck and make sure it is safe for us to approach the chopper.

If going by plane, we arrange a mutually convenient take-off time which allows us to sort out other arrangements including booking a taxi to the airport. If we can’d get a taxi on demand there is a hospital car we have access to that we can take instead.

Choosing what to take

We have a variety of equipment, medications and supplies that we can take out on jobs. The standard kit includes a portable monitor, portable ventilator, procedure pack (includes all of the equipment needed to place a variety of invasive lines, tubes and catheters in patients) and resuscitation pack (this carries all of the airway, breathing and circulation equipment and drugs we need to keep a patient alive and bring them back safely). The idea is for us to be utterly independent and capable of replicating an ICU even if the patient is in the middle of nowhere.

Then we are ready to go and fetch the patient. I’ll cover the getting there aspect of a mission in the next posting.