Absence of doctor on air ambulance crew criticised

The country’s first community air ambulance will be unable to meet the needs of the most critically ill patients without a doctor on board, emergency physicians have claimed.

The North Cork-based helicopter emergency medical service (HEMS) will be crewed by an advanced paramedic and emergency medical technician.

However, the Irish Association for Emergency Medicine (IAEM) said the service’s medical crew should include a doctor and called for a review of the staff configuration.

The association said it would be “a matter of “serious regret” if the service was not developed in line with international best practice.

Irish Community Rapid Response, a charity dedicated to pre-hospital care, runs the service in co-operation with the HSE National Ambulance Service.

The community air ambulance service that will be available from next month is expected to respond to up to 500 calls per year. Costing €2m to run annually, it will be funded by community and donor contributions.

The air ambulance will coordinate with the existing Athlone-based Emergency Aeromedical Service (EAS) and bring the population of a 10,000 sq m area within 20 minutes of critical care.

However, the IAEM fears the “crew configuration” will not have the necessary skills or scope of practice to meet the emergency needs of the most seriously ill or severely injured.

“IAEM seeks a HEMS that meets international best practice and is staffed by a doctor/paramedic team,” it said.

The association said there were a number of specialist-trained HEMS doctors working in Ireland who were willing to work with the service.

It added that trained Irish consultants in emergency medicine and critical care working overseas might be encouraged to return home and work in hospitals with a part-time HEMS clinical commitment.

The HSE said the EAS that had been in operation since 2012 and treated nearly 2,500 patients had been crewed by an advanced paramedic.

Patients treated by EAS in the last six year differed from many similar services internationally that had a very high proportion of trauma patients.

“In Ireland, it is primarily medical patients [heart attacks, strokes, et cetera],” said EAS. “Medical patients [adults and children] make up 63% of our activity; trauma is 35%.”

And while many international models included doctors as part of the medical crew, many others did not and used a mixture of paramedics and nurses.

The HSE said future plans for crewing of HEMS aircraft may include doctors but that would be dictated by the needs of patients.