News and Business
The journey from medical sciences student to specialised CCRS paramedic wasn’t what Werno van Vollenhoven originally planned, but today he can’t imagine doing anything else.
Moving high-risk patients
As CCRS paramedics, we don’t generally go to primary scenes or incidents. Instead, we’re the specialised support unit that gets called when regular operations teams encounter cases they can’t handle – either because they lack the necessary clinical training or don’t have the specialised equipment required.
We’re called in to help critically ill patients, especially premature babies and newborns, when a hospital doesn’t have the right equipment or specialists to care for them. It’s about giving these tiny patients a fighting chance. The transfer can be risky, but it’s worth it to get them to a place where they can get the treatment they need.
The reality is that the risk of losing a patient is much higher in a critical care ambulance due to the severity of their conditions. I’ve been fortunate – I haven’t lost a patient yet in transit on a ground ambulance, though I recently experienced my first loss on a fixed-wing aircraft. That patient had a poor prognosis from the beginning, which doesn’t make it easier, but it’s a reality we face in this specialised field.
ER24’s focus on newborns
What makes ER24’s CCRS different from other services is our focus on caring for neonates. We use a specialised ventilator that offers both invasive and non-invasive breathing support designed specifically for babies. This matters because the machine can deliver air at exactly the right pressure and volume to keep premature babies safe.
Most other ventilators can’t go lower than 50ml per breath, which means they can only safely treat babies weighing around 8kg. Our equipment can go much lower, allowing us to safely care for babies as small as 500g without damaging their fragile lungs.
We also have an incubator that’s specifically strapped in and designed for long-distance transfers. It’s larger and more robust than standard units, providing better safety and workspace for our smallest patients.
Medical challenges
When working with premature babies, we often deal with complex heart problems. Some of the most common include:
Patent ductus arteriosus (PDA) – This is when oxygen-rich and oxygen-poor blood mix because a small vessel (the ductus) hasn’t closed properly after birth. Depending on how serious it is, it can either help or harm the baby, so treatment differs from case to case.
Tetralogy of Fallot – This term covers several heart defects that affect how blood flows through and around the heart.
Pulmonary atresia – This happens when the connection between the trachea (windpipe) and oesophagus (food pipe) doesn’t form properly, or one closes off while the other stays open, causing a range of breathing and feeding problems.
Each case needs careful evaluation and specialised care during transport – often when every minute counts.
Supporting families through crisis
We ensure there’s space for at least one family member in our vehicle and always offer this option to parents. However, many families choose to follow in their own transport, especially for longer transfers. This gives them independence once they reach their destination and means they can be present throughout their child’s care journey.
Having families involved adds another dimension to our care – we’re not just treating a medical condition; we’re supporting families through one of the most frightening experiences of their lives.
Reflecting on the role
Working in neonatal CCRS has taught me that emergency medicine isn’t always about the dramatic rescues you see in movies. Sometimes it’s about the quiet expertise, the specialised equipment, and the careful coordination that gives our smallest patients their best chance at life.
Every call is different, every baby presents unique challenges, and every family needs something different from us. But that’s what makes this work so meaningful. We’re bridging the gap between where critical care is needed and where it’s available, one tiny patient at a time.
Fast-tracked into critical care retrieval services
The journey from medical sciences student to specialised CCRS paramedic wasn’t what I originally planned, but today I can’t imagine doing anything else.
I joined ER24 right after qualifying in 2021. Most people must be qualified for at least two years before getting into CCRS and have three or four specific short courses under their belt. However, I was fortunate to be fast-tracked as I’d shown a strong interest in critical care during my first year of qualification.
I completed all the required short courses within my first year as a CCRS paramedic, including:
- BLS for Healthcare Provider (Basic Life Support)
- ITLS (International Trauma Life Support)
- ACLS (Advanced Cardiac Life Support)
- PALS (Paediatric Advanced Life Support)
We’re also working to make the Aviation for Healthcare Providers (AHCP) course a requirement for CCRS staff. This way, new hires can start working on the fixed-wing air ambulance right away, instead of waiting until they’ve completed the course.