J R Army Med Corps 153:269-273 doi:10.1136/jramc-153-04-10
  • Systems Analysis

Determining the Composition and Benefit of the Pre-Hospital Medical Response Team in the Conflict Setting

  1. JE Ollerton3
  1. 1Consultant Emergency Medicine, 16 Close Support Medical Regiment
  2. 2Emergency Medicine Glasgow
  3. 3Consultant Emergency Medicine, Queens Medical Centre, Nottingham
  1. Consultant Emergency Medicine, 16 Close Support Medical Regiment, Southern General Hospital, Glasgow G51 4TF petedavis{at}


Aim To determine the optimal composition of the pre-hospital medical response team (MERT) and the value of prehospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care.

Method A comprehensive review of the literature incorporating a range of electronic search engines and hand searches of key journals.

Results There was no level 1 evidence on which to base conclusions. The 15 most relevant articles were analysed in detail. There was one randomized controlled trial (level 2 evidence) that supports the inclusion of a doctor on MERT. Several cohort studies were identified that analysed the benefits of specific critical care interventions in the pre-hospital setting.

Conclusions A doctor with critical care skills deployed on the MERT is associated with improved survival in victims of major trauma. Specific critical care interventions including emergency endotracheal intubation and ventilation, and intercostal drainage are associated with improved survival and functional recovery in certain patients. These benefits appear to be more easily demonstrated for the rural and remote setting than for the urban setting.

Free Sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of JRAMC.
View free sample issue >>

Email alerts

Don't forget to sign up for content alerts to receive selected information relevant to your specialty interests and be the first to know when the latest research is published.

Submit to JRAMC

JRAMC is fully peer reviewed and all content is published online ahead of print
Submit an article >>

Navigate This Article