Emergency Medical Care Provided by North Shore Rescue Advanced Medical Providers

Area of Science:

• Emergency Medicine
• Search and Rescue (SAR)
• Wilderness Medicine

Background:

• The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program utilizes physicians and nurses for high-acuity medical search and rescue (SAR) callouts.
• This program operates in British Columbia, Canada, providing critical care in remote environments.

Purpose of the Study:

• To analyze the medical care provided by AMPs during SAR operations.
• To compare the medical care and outcomes of AMP-involved callouts versus non-AMP callouts.

Main Methods:

• A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022.
• Analysis included AMP involvement, rescue logistics, patient demographics, medical acuity (NACA scores), treatments, and extraction methods.
• Evaluation of medical decision-making, including over-triage and under-triage rates.

Main Results:

• Of 767 NSR callouts, 283 (37%) were medical, with AMPs involved in 99 (35%) of these.
• AMP callouts had significantly higher mean NACA scores (3.1) compared to non-AMP callouts (1.9), indicating greater medical acuity.
• Advanced interventions were common in AMP rescues: medications (40%), procedures (54%), and advanced medical decision-making (37%). Over-triage occurred in 33% and under-triage in 10% of AMP callouts.

Conclusions:

• The AMP program is a valuable asset for delivering advanced medical care in wilderness settings.
• AMPs ensure appropriate medical response and facilitate safe, efficient patient transport.
• The NSR AMP program serves as a potential model for other SAR teams to develop similar advanced medical services.