EMed

Medico Cork

The Service:

Cork University Hospital Emergency Department manages the Irish Health Service Executives (HSE) National 24 hour Emergency Telemedical Support Unit.

MEDICO Cork guarantees direct access to specialist medical advice from an Emergency Medicine Registrar or Consultant through various Service Level Agreements (SLAs) with a range of end-users.

End Users:

  • Any Person within Irish Territorial Waters (Coast, Islands and Offshore)
  • Irish Coast Guard
  • Irish Defence Forces
  • National Ambulance Service
  • Dublin Fire Brigade
  • Beach Lifeguard Services
  • Mountain Rescue Ireland

Access:

  • Irish Coast Guard (radio, satellite or phone link-call)
  • NAS Strategic Reserve Control Centre
  • Naval Operations Command, Cork

Authority:

  • A Service Level Agreement (SLA) has existed between the Irish Health Service Executive (HSE) and the Irish Coast Guard (IRCG), with support from the Irish Naval Services, since July 2001. Last reviewed in 2018, it provides for the statutory provision of telemedical support to vessels in Irish territorial waters, required for Ireland to comply with its legal responsibility towards workers at sea under European Council Directive 92/29/ECC (updated via amendment 1882/2003)
  • MEDICO Cork is part of the National Framework for Emergency Management, as included in the Multi-Agency Protocol "Land Based Response To Marine Emergences" (May 2011)
  • Since April 2011, HSE Standard Operations Procedures exist to facilitate Advanced Paramedic Telemedical Support for both the National Ambulance Service and Dublin Fire Brigade
  • Telemedical Support for the Emergency Services is included in the "National Emergency Medicine Programme" (June 2012) and in the Department of Health's Steering Group report, "A Trauma System for Ireland" (2018)
  • SLAs are currently being explored between An Garda Síochána and the HSE to facilitate telemedical support with Special Tactics & Operations Command (STOC) teams and Mountain Rescue Ireland
  • MEDICO Cork has facilitated pre-deployment education, clinical placements and emergency telemedical support to Defense Forces operations abroad since 2001

Infrastructure

  • Calls are received either directly from end users or through the various State Agencies control rooms, via a dedicated recorded telephone exchange or increasingly through the National Digital Radio Service (NDRS), better known as TETRA
  • A quiet telemedicine-room, free from distraction, has the ability to forward calls, conference call, access email, and access both Intranet and Internet based electronic resources
  • The room has live video feed capability and enhanced data-transmission. Various platforms exist included Webex, supported by CISCO and the University College Cork (UCC) Network. A dedicated live video feed is currently being evaluated to link MEDICO Cork with NAS vehicles

Clinical Governance:

  • Dr. Jason van der Velde is employed as the National Clinical Lead for the service
  • The wider Consultant team at Cork University Hospital Emergency Department provide Consultant Emergency Medicine support
  • Individual Services' Medical Directorates feed into this Clinical Governance Structure
  • Lessons learnt from Audit and research is fed back to the Prehospital Emergency Care Council (PHECC) to guide and inform debate surrounding Prehospital Clinical Practice Guideline development in Ireland
  • All calls are recorded electronically and stored in a database on the HSE Network, becoming part of standard secure HSE patient records. Access to these recordings is strictly governed. Records are anonymised and routinely thematically audited to improve service delivery
  • A system of feedback to staff regarding their call handling, has iteratively led to a programme of induction and Emergency Telemedical communication training for both users and providers, which focuses on human-factors and the role of cognitive bias in influencing telemedical interactions

What We Guarantee:

  • 24/7/365 personnel always in CUH Emergency Department to take the call
  • A senior nurse at the nursing will usually be the first point of contact
  • Minimum of a Registrar in EM will provide the support
  • EM Consultant support always available
  • Additional In-Hospital Specialty advice available
  • Additional Pre-Hospital Specialty advice available
  • Written records are kept of all calls as part of standard secure HSE patient records
  • All calls are recorded electronically and stored in a securely governed database
  • Records are anonymised and routinely thematically audited to improve service delivery

Content by Dr Jason van der Velde. Last review Dr ÍOS, Dr Jason van der Velde 21/11/21.