Extended Hours Critical Care from EMRTS

Since the beginning of January, the EMRTS Twilight Critical Care Car has been operational every Friday, Saturday and Sunday between 2pm and 2am. We are able to deliver this service thanks to Welsh Government Winter Pressures funding and will continue to do so until the end of March.

The Twilight Car provides a consultant and CCP (Critical Care Practitioner) critical care service that covers South Wales. Like our usual 8am to 8pm daytime service, the Twilight Car crew are fully trained and equipped to deliver pre-hospital critical care to all age ranges, which includes the ability to deliver an anaesthetic, give blood products, perform chest surgery and numerous other interventions. This gives us the capacity to stabilise the most severely sick or injured patients and take them to the hospital that can best deal with their needs. Often, without this kind of input, patients have to be taken to the closest hospital to be stabilised and then transferred on to the specialist hospital that can provide more definitive care. EMRTS can also undertake the transfer of critically ill patients between hospitals if they are subsequently found to require specialist input at another healthcare facility.

I have personal experience of the impact of secondary transfers. As an ITU/anaesthetic consultant in a district general hospital with no specialist services, it is often my job to stabilise and then transfer patients from my hospital to the larger specialist facilities. Although my hospital and other similar hospitals provide excellent care, we are not equipped to deal with specialist medical and trauma problems such as serious heart attacks and bleeds on the brain. Therefore, for a patient coming to us first rather than the specialist hospital, the specialist treatment that they vitally need is often delayed. The requirement to transfer these patients from one hospital to another also takes crucial staff away from my hospital for several hours. This stretches us further, especially during the winter when we are at our busiest. Levels of staffing are even more reduced at night time and weekends as skeleton staff look after the hospital out of hours. Taking these precious medics away on transfer has a huge impact on the whole hospital.

EMRTS will take the sickest patients directly to the specialist centre and, if required, can undertake a transfer on behalf of the hospital. Not only is this hugely beneficial for the patients who need the specialist care, but it also leaves the hospitals better staffed to deal with the high levels of activity that we are all currently dealing with.

In the near future, EMRTS is hoping to extend to a 24-hour service. However, the ability to run this Twilight Car over the winter months is allowing us to treat some of the patients that we would not be available for as part of our current 12-hour operation.

Dr Ami Jones

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