Pre-Hospital Emergency Care in Malta

The Maltese Islands lie in the centre of the Mediterranean. They cover a total area of 316 km 2   with a population of just over 400,000. Despite being the smallest of the EU countries there is a fair share of major trauma. The emergency response to injury has over the past years improved through continual training in Emergency Medicine and Pre-Hospital Immediate Medical Care. 

The Emergency Ambulance service in Malta is hospital based and response is led mainly by trained Emergency Nurses working within the Emergency Department. There is also an ambulance service which deals with calls from the North of Malta.  

The Emergency Response Medical Team (ERT) is a specialist Pre-Hospital Response and Retrieval team of Doctors who have undertaken specific post graduate training for the role and they are equipped to provide the full range of Pre-Hospital medical interventions. The Team was set up in 2002 with the aim of improving and maintaining high standards of care in the delivery of Pre-Hospital Emergency Care in Malta. They have all undergone extensive training in Emergency Medicine. 

The Ambulance Emergency Nurses are trained to PHECC standards and have a great deal of skill and expertise in dealing with the injured or critically ill commencing  from on site through to arrival in Hospital. The Emergency Response Medial Team has taken this level of care one step further by taking  hospital  care to the entrapped patient when needed. In so doing they have improved on pain management and airway care in extrication of the entrapped injured victim. Immediate Care Doctors have an important role in scene management and in providing advice and support to the ambulance emergency nurse. 

The Emergency Response Medical Team is called out through standard established protocols in response to Major Incidents involving multiple casualties in support to the Ambulance response. 

The ERT fills a vital role in management of serious incidents including entrapment situations in road traffic accidents, assisting victims of fall from heights, and serious industrial accidents, explosions of firework factories and major fire incidents. The Team is at the forefront of serious incidents involving irregular immigration such as overturned boats resulting in drowning. Besides contributing to decreasing mortality, treatment given at the scene of an accident by a trained Immediate Care physician alleviates the suffering of victims and helps limit permanent disability. 

ERT doctors have also been giving out medical assistance to the Civil Protection Department (CPD )both as Volunteers and also as part of their training in Major trauma and CBRN training since the initial set up. An integral working relationship has been forged over the years with the Civil Protection Department and is definitely resulting in a smoother response to Trauma on the Island as evidenced by improvement of statistics of mortality rate and the overall general condition of the victim arriving in Hospital. Over the past 5 years the Emergency Response Medical Tem has been called out on over 300 occasions and have managed over 700 seriously injured casualties, many of whom having sustained life threatening injuries.

The close cooperation that exists between the Emergency Response Medical Team and BASICS is evident in the commitment to education and professional development in the specialty of Immediate Care both in training and the continual mentoring of the Maltese pre-hospital medical and nursing teams in ensuring that quality evidence based emergency care is being delivered in Malta.