An Cosantóir

23 Our relationship with the NAS has evolved with the service and in the coming years there will be further developments to strengthen our link in the chain of patient survival. Every day of the year there is an inter-agency crew in Athlone on immediate readiness to answer the call of people having the hardest day of their lives. We continue to fly by the motto that No.3 Ops Wing has lived by for many years… Go Mairidis Beo: That Others May Live. The National Ambulance Service Perspective by Prof Cathal O'Donnell, Medical Director, NAS At the beginning of the last decade, with several changes in the Irish health system, it was clear to many of us in the National Ambulance Service that a dedicated HEMS (Helicopter Emergency Medical Service) was needed. The Irish health service was concentrating specialist care in fewer hospitals - this was absolutely the right thing to do, as outcomes for patients in specialist centres with higher volumes are much better than fewer numbers in smaller hospi - tals. However, from an ambulance perspective, this meant these patients, often the sickest, needed to be transported much longer distances. We had a long and successful collaboration with the Irish Air Corps over many decades, so the Air Corps were the obvious solution, and the end result was the establishment of the Emergency Aeromedical Support Service (EAS). In the ensuing 10 years, EAS has served thousands of patients. Probably the biggest impact has been in STEMI patients. A STEMI (ST Elevation Myocardial Infarction) is an acute heart attack – the sooner the patient gets to a specialist centre for angioplasty and stenting (restoring blood flow to an acutely blocked coronary artery), the better the outcome. Minutes mat - ter, and there are only 6 centres in Ireland. EAS treatment and transport has ensured that hun- THE EMERGENCY AEROMEDICAL SERVICE: IRELAND'S FIRST HEMS dreds of STEMI patients have got the treatment they need as quickly as possible, and undoubtedly count- less lives have been saved. This has been particularly important in the west of Ireland, with a more dispersed rural population, and less developed road infrastruc- ture, which from an ambulance perspective means longer response times to scene and longer transport times to hospital. EAS has also been hugely important for seriously in- jured patients, who also need complex care in special- ist centres. As the HSE National Trauma Programme starts to roll out in the months and years ahead, we will see trauma care being delivered in two trauma networks nationally, each with a single Major Trauma Centre and supporting Trauma Units. Helicopter trans - port for seriously injured patients will become even more important with this development. EAS has also been a significant assistance for oth- er time critical patients - stroke care has advanced considerably in Ireland, and will continue to evolve into concentrating care for more patients into specialist centres. Equally the care of ill and injured children na - tionally is advancing under the guidance of Children's Health Ireland, which will culminate in the opening of the new National Children's Hospital. EAS will contin- ue to be an important part of emergency treatment and transport of these and many other categories of patients into the future. Collaboration with the Irish Air Corps has a long and distinguished history, but it took on a new impetus with EAS, and in that time, NAS have been hugely grateful for the professionalism, co–operation, flexi - bility and commitment of the men and women in blue that have worked alongside us. EAS is a great example of two state agencies working together for the com- mon good. As well as the direct patient benefit, there has been considerable transfer of ideas, new ways of working and mutual learning. For example, we have become very interested in the application of Crew Resource Management in healthcare settings. The principles of CRM, which have contributed so much to flight safety, are equally applicable in a healthcare setting, and we have incorporated some CRM teaching into our paramedic education programmes. We look forward to continued collaboration on this vital service that has over the last ten years saved many lives, brought relief to countless seriously ill and injured people, and supported the development of a modern health system for Ireland. Help comes from above! The aircraft departs on another mission.

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