Emergency rescue at the Oseberg oil field in Norway

The Oseberg Oilfield – my second home

Peter doesn't know it any other way. He's been withEquinor for ten years now and loves his job.The Oseberg oil field, around 140 kilometres northwest of Bergen, has become like his second home over the years. The individual production platforms – called rigs – are just as familiar to him as the up to 900 workers who do a difficult and dangerous job here. “The number of injuries has decreased significantly in recent years”, says Peter. “Ten years ago, over 30 percent of our missions out here were the result of accidents. The rest were medical emergencies. Today the proportion of injuries is only around 15 percent.” The companies that literally have to deal with the forces of nature to do business have a high responsibility for the health of their employees. It goes without saying that there is always an emergency nurse or nurse on duty on every oil rig. They have not only professional experience, but have also completed special training courses for offshore work. You can reach a physician ashore at any time – thanks to high-end telemedicine – to discuss the situation with them and coordinate the further course of action. The Norwegians rely on corpuls.mission for this, which can handle all possibilities in such situations. It combines medical data, such as blood pressure, heart rate, ECG and oxygen saturation, with a chat and video function, via which, for example, images of the scene of the incident can be transmitted. At the same time, all information is automatically documented and is available to those involved in real time.

Equinor takes its responsibility very seriously and therefore employs around 100 emergency nurses for its offshore facilities. There is always at least one of them on duty on every platform. Internally they are called HSE Managers, which stands for “Health, Safety and Environment”. Peter is one of them. He is a trained anesthetist and has completed further training in emergency medical care. In the course of his career he worked in clinics as well as in the ambulance service. But offshore is a completely different challenge, he says. “It's like everywhere in the health sector, sometimes you can help, in certain cases you can even save a life. It is important to take care of the patient and to convince them that they are safe and that they are being looked after as best as possible”, explains the emergency nurse. The corpuls3 is a very good tool in this regard. It is extremely robust, both salty splash water and low temperatures down to –20 °C do not bother it.

Peter Stark

140 kilometers from the nearest hospital

These are very specific criteria for missions on the oil rigs in the European North Sea. The life of one battery is up to ten hours. The Norwegian believes that the new touch technology also makes handling easier. Many functions can be operated like on the display of a smartphone. In combination with the corpuls cpr, synchronized therapy is a valuable option, especially during the often long transport times. "What makes us really happy is that our offshore emergency system seems to be very efficient when someone is seriously injured or ill", says Peter. The corpuls family plays its part. When Peter starts his two-week shift on the Oseberg oil field, he is available to his colleagues as a general practitioner for half the time. He also takes care of minor illnesses as well as acute emergencies. The rest of the time he mans a SAR rescue helicopter stationed on one of the three platforms in the Oseberg oil field. On board of the Sikorksy S92, he takes on the tasks of flightparamedic and is the top emergency medical authority 140 kilometres away from the nearest hospital. He forms a team together with the pilot and a HEMS Technical Crew Member from CHC Helicopter Service, which carries out the SAR (Search and Rescue) service on Norway's coast.

In total, Equinor has chartered four SAR helicopters for its offshore activities, which perform around 200 missions annually. If necessary, the Norwegian Rescue Coordination Centre can also request the machines for search and rescue missions off the coast.“Emergencies are reported to the main control room of the Oseberg Field Centre. They alert me via pager. We call this the house alarm. While I then go to the helicopter and put on my survival suit, the emergency nurse on-site takes care of first aid”, says Peter, describing the well-practiced procedure. First responders and other first aiders are on hand to assist the emergency nurses on all platforms in order to bridge the time until the rescue helicopter arrives

Nurse winching from a rescue helicopter

"We'll be in the air in 15 minutes, but then we need 30, 45 or 50 minutes to reach the respective platform", says Peter. "It is not uncommon for us to take up to an hour to be on site for a cardiac arrest." Without a well-established rescue chain, many emergency patients would not survive. That is why there is a sophisticated emergency system on board the rigs and everyone is required to take part in first aid training and emergency exercises on a regular basis. Cardiopulmonary resuscitation is the focus. The aim is to start chest compressions after no later than two minutes. This is probably also the reason why the probability of surviving an observed cardiac arrest offshore is over 75 percent, according to a study a few years ago. A value that is almost impossible to achieve on land.

Peter still remembers a mission he experienced in May 2017 on board the “Scarabeo 5” oil rig. He was alerted after a 47-year-old worker below deck suffered a cardiac arrest. The mission site was very narrow and extremely difficult to reach. The emergency nurse on board and the patient's colleagues did a very good job as first aiders. During the outbound flight, the crew tried to get as much information as possible, for example whether the stretcher and the corpuls cpr needed to be taken and how far it was from the heli-pad to the patient. "As soon as I approached, I sensed that this mission could be difficult", says Peter. “Before we arrived, however, they had been performing uninterrupted chest compressions and the man had been defibrillated twice. When we arrived he was somnolent and complained of severe pain”, said Peter. “It was a touch-and-go situation for us. He had to be flown ashore to a clinic as quickly as possible. "The team always has to ask itself which hospital the patient should be flown to. There are two main factors involved: The patient's condition and the expected flight time. "In critical situations, it is necessary to start as quickly as possible instead of long on-site treatment", explains Peter. In view of the exposed location of the mission site, there is almost no time for “stay and play” – a large portion of the treatment takes place during the flight. The 47-year-old's colleagues worked feverishly to make their way to the helicopter as quickly as possible. While a couple of them fetched a rescue basket with which the patient could be carefully transported, others made sure that the way to the helicopter was clear. On board the SAR helicopter, Peter connected the patient to the corpuls3, checked the vital parameters, recorded a 12-lead ECG, and administered pain medication. The man was flown to the Haukeland Clinic in Bergen. The hospital was informed, and the cardiologist, anesthetist and other specialists were on standby.

Here too, corpuls.mission was used: Although the patient was still somewhere over the North Sea on the way to Bergen, the physicians in the hospital were able to get a comprehensive picture of his condition. "All up, it only took two hours from the moment his heart stopped beating to the end of our mission at the Bergen Clinic", says Peter happily. Thanks to his helmet camera, a video of this successful mission was made, which was viewed almost 2,000 times on the Internet. The man survived the cardiac arrest without any complications and is now working on a platform in the North Sea again. After his recovery, the 47-year-old said that he had suffered a heart attack a few years earlier. At that time he was at home in Bodø, the largest Norwegian city north of the Arctic Circle with over 50,000 inhabitants. But it took eleven hours before help came. The Oseberg oil field in the middle of the North Sea seems to be the better place to survive a heart attack.

Stroke Finder

Despite corpuls3 and corpuls.mission, the diagnostic capabilities for the emergency nurses and SAR teams are limited on the Equinor platforms. For example, it used to be impossible for them to determine the type of apoplexy in patients with a suspected stroke. In 85 percent of cases, a blood clot is the cause and must be resolved immediately with a  thrombolytic. The appropriate treatment should begin at the mission site or during transport. In 15 percent of the cases, however, bleeding is the cause of the apoplexy. In such cases, administering a blood-thinning drug would be life-threatening for the patient. In the hospital, this question can be answered using computed tomography.

This technology is not available on the platforms or on board the SAR helicopters. Instead, the so-called “Stroke Finder” has been used for several years. It consists of three parts: a helmet-like system of antennas that is worn on the patients head, a microwave unit and a computer for device control, data collection and signal processing.

Clinical studies on this took place between 2011 and 2014 at the Sahlgrenska University Hospital in Gothenburg (Sweden). For the SAR teams today, it is the safest option to pre-clinically determine the cause of an apoplexy and to initiate life-saving therapy.

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