Helicopter retrievals in Australia

Abstract

I read with interest the letter about helicopter transfers of the critically ill (Watts. Anaesthesia 2001; 56: 589–91). I have recently worked with a dedicated retrieval organisation serving western Sydney (‘Careflight’) and believe that retrieval services in Australia represent a model of excellence on which discussions in the UK should be based. Two organisations provide retrieval teams for east and west Sydney. These organisations are part charity and part government funded (approximately 50 : 50). A 24-h service is provided for secondary interhospital transfers (about 70% of the workload) as well as scene response at the request of the ambulance service, which gains much TV exposure and sponsorship. Teams consist of a doctor (four registrars working a full shift system plus a number of part-time consultants) and paramedic (provided by New South Wales ambulance service). Trainee jobs are accredited for 6 months training by the Colleges of Intensive Care, Anaesthesia and Emergency Medicine. Two weeks at the start of the job is dedicated to training, predominantly on helicopter operating procedures and this is supplemented by regular training during the job. Retrievals are undertaken for both clinical and non-clinical reasons; there is often a shortage of ICU beds within the city, as in most areas of the UK. Incoming requests for retrieval are made via a central New South Wales ambulance co-ordinating cell, which then contacts the appropriate organisation and hosts a conference call between the ‘retrievalists’, referring doctors and receiving intensivists. Retrieval is made by dedicated road ambulance or helicopter, depending on several factors including distance, time of day (traffic), urgency, etc. Most transfers involve distances of 60 miles or less. This system has many clear advantages, notably staff familiarity with the vehicle and equipment, no loss of staff to the referring hospital and no inappropriate use of an emergency ambulance. Most importantly, the retrievals are carried out by doctors with an interest in retrieval, who are appropriately skilled and carry appropriate equipment.