A proposed definition of Critical Care Retrieval in the South African context

Background: Critical care retrieval is a nascent field in South Africa. An increasing number of private and provincial emergency medical services are starting to invest in developing and setting up dedicated critical care retrieval services (CCRS). To date, there are no minimum standards or definitions on what constitutes a CCRS in the South African context. The aim of this paper is to describe the development of and propose a consensus definition of CCRS within the South African context. Methods: A literature search was performed to determine the key aspects of CCRS definitions elsewhere. An initial draft definition was circulated to the CCRS working group of the Emergency Care Society of South Africa (ECSSA) for commentary. Comments were collated, and a second round of commentary was undertaken. Finally, a consensus meeting was held through video-conferencing to finalise the definition presented herein. Thereafter, the definition was circulated to key role-players in emergency and critical care, both locally and internationally, for endorsement. The definition, as it is presented, has been endorsed by the ECSSA, the Southern African Society of Critical Care (SASCC), and the International Board for Specialty Certification (IBSC). Results: The proposed definition outlines five equally important aspects that should be demonstrable and interlinked to be denoted a CCRS. These five aspects are: specific patient populations, case selection, dedicated crew with additional training, dedicated equipment, and continuous quality management and training. Conclusion: Numerous questions remain unanswered regarding the best approach for CCRS development in South Africa and internationally. Defining what CCRS is in a South African context is a necessary departure point for further research endeavours to develop a core curriculum and practice standards.