Pre Hospital Emergency Medicine

All boats at sea in Irish waters and Irish registered vessels across the world have access to senior clinical decision makers working at CUH ED through MEDICO Cork. Established in 2001, Medico Cork is the Health Service Executives (HSE) National 24 hour Emergency Telemedical Support Unit. The service also supports clinical decision making by Advanced Paramedics working with the National Ambulance Service across the country. In recent years Medico Cork has been extended to provide support to our Irish Defence Forces on deployment in the Mediterranean and Mali.

MEDICO Cork guarantees direct access to specialist medical advice from an Emergency Medicine Registrar ± Consultant through various Service Level Agreements (SLAs) with a range of State Emergency Service and military assets.

At Cork University Hospital (CUH), the Alternative Pre-hospital Pathway (APP) Team is a bespoke model of pre-hospital healthcare delivery which complements the national shift toward integrated community care.

The Alternative Pre-hospital Pathway (APP) service, founded in November 2019, comprises an Emergency Medicine doctor with an Emergency Medicine Technician from the Ambulance Service responding in an ambulance car. The team attend low acuity calls that come through the 999/112 system across the 7 days of the week, typically attending 8-10 patients per day. They respond to everything; from patients who are frail and elderly who may have had a fall at home ensuring the myriad of reasons that cause such falls are assessed for, to patients who have blocked catheters or wounds or have had a low velocity road traffic collision. The service manages to assess and complete treatment at the scene in 70% of patients. This saves that patient the journey to the Emergency Department, and frees up an ambulance to respond to more serious emergencies. The team works closely with the services in CUH and the Mercy Emergency Departments as well as the community services.

The APP Team at CUH ED is just one example of how novel collaborative initiatives between community, pre-hospital and hospital services are driving the health service towards delivery of patient-centred integrated community care.

Pathfinder is a collaborative service between the National Ambulance Service (NAS) and CUH Occupational Therapy and Physiotherapy Departments.  The service consists of an Advanced Paramedic and Occupational Therapist (OT) or Physiotherapist (PT) responding to 112/999 calls.

Pathfinder is improving outcomes for older people by minimising unnecessary ED attendances and offering safe alternative care pathways for older people in their own homes rather than in hospital.