Coordinated co-response to immediate life-threatening emergencies in adults in remote and rural Scotland Scottish Ambulance Service

The SAS provides services to more than five million people across Scotland. Immediate life-threatening emergencies, eg out-of-hospital cardiac arrests (OCHA), are the SAS’s highest priority call, requiring a rapid response. However, delivering this timely response can be challenging, especially in remote and rural areas.

The SAS worked with the SFRS to establish a consistently effective and efficient response to immediate life-threatening calls. Through this project, patients in cardiac arrest in the three pilot areas received a co-ordinated co-response from both emergency services.

Key results show:

• a quicker response time to OHCA
• an increase in the number of responders (achieving recommendations from the Association of Ambulance Service Chief Executives)
• SFRS responders can be trained to successfully recognise and deliver effective cardio pulmonary resuscitation (CPR) and defibrillation
• on-scene communication between SAS and SFRS personnel was effective
• an effective training programme can be delivered to SFRS personnel on the wider issues of OHCA management eg care of the patient’s relatives
• staff satisfaction with the trial.

Key learning points, which will help inform further roll-out include:

• communication between both organisations control rooms could be improved to speed up SFRS dispatch
• CPR quality was generally good, but the training package can be modified to stress the importance of full chest compression release
• staff engagement with SAS employees in co-responding areas could be more effective.

Both organisations’ strategic leadership teams and boards concluded that further development and expansion of evidence-based approaches would be supported, and options are now being considered.

Contact information

For more information about this project, please contact Dr James Ward, Medical Director, Scottish Ambulance Service.