Dr Andrew Pearce’s career spans continents and clinical domains as a leading figure in emergency medical retrieval. 

At the South Australian Audit of Surgical Mortality (SAASM) webinar in March attendees heard Dr Pearce offer deep insights into MedSTAR, South Australia’s statewide emergency medical retrieval service. His perspective—both as a frontline physician and the Divisional Clinical Director at MedSTAR—shed light on the unique challenges and innovations involved in transporting critically ill and injured patients across South Australia.

Dr Pearce’s journey

Dr Pearce began his medical career at Flinders University before gaining international experience in the UK at Derriford Hospital in Plymouth. His passion for emergency and retrieval medicine led him to Sydney, where he worked with a rescue helicopter service. On his return to Adelaide, he built expertise in emergency, trauma and retrieval care at the Royal Adelaide Hospital.

He then joined the Royal Australian Air Force as a specialist reserve doctor to develop aeromedical evacuation training. In this role he brought critical training programs to South Australia, such as the MIMMS course (Major Incident and Medical Management and Support) and EMST (Early Management of Severe Trauma). Since MedSTAR’s inception, Dr Pearce has been in leadership positions and has served as its Divisional Clinical Director for the past eight years.

What is MedSTAR?

MedSTAR is South Australia's sole statewide retrieval service, providing 24/7, 365-day emergency and critical care retrieval for neonatal, paediatric and adult patients. Operating from a purpose-built base at Adelaide Airport, MedSTAR deploys teams via road or rotary (helicopter) and fixed-wing aircraft to reach patients across vast and remote regions.

MedSTAR’s multidisciplinary teams include emergency physicians, anaesthetists, intensivists, rural and neonatal/paediatric specialists, nurses, and special operations paramedics. Their work ensures continuity of care from the moment of retrieval through to handover at tertiary centres.

Seamless transfers through statewide coordination

At the heart of MedSTAR’s operations is a single coordination centre integrated into the statewide 000 emergency call service, streamlining the triage and deployment of teams. MedSTAR works closely with referring and receiving hospitals, using telemedicine and multi-party teleconferencing to ensure accurate assessments and timely transfers.

Lower-acuity interfacility transfers are also managed through MedSTAR, often facilitated by Royal Flying Doctor Service (RFDS) nurses on RFDS aircraft under the SA Health contract.

Working hand in hand with RFDS

In a state with vast rural areas, collaboration is critical. Dr Pearce explained how MedSTAR’s Emergency Operations Centre—staffed 24/7 by a medical retrieval consultant and nurse retrieval coordinators—works in tandem with the RFDS coordination centre at Port Augusta. Together, they allocate teams, coordinate with referring and receiving hospitals, and manage rural trauma cases, especially in the far north of South Australia.

Advanced resources to meet complex needs

MedSTAR has an impressive fleet and capabilities:

• Three rescue helicopters—two available 24/7
• Four fixed-wing planes during the day—three at night
• Rapid response vehicles equipped for emergency driving 24/7
• Two dedicated paediatric/neonatal ambulances 24/7
• Multiple 24/7 medical teams, including general, paediatric and neonatal specialists
• Three nurse retrieval coordinators during the day—two at night
• Admin support team and senior clinical leadership group
• State-of-the-art equipment such as critical care ventilators, ultrasound, defibrillators, ECMO transport, intra-aortic balloon pumps and more.

All teams have standard equipment including a critical care ventilator, vitals monitor, defibrillator/pacer, portable suction, intubation and ventilation consumables, central and arterial access, inotropes and antibiotics. They also have specialised equipment including portable ultrasounds, blood products (12 units on base), automated chest compression devices and specialist kits for cardiac, airway, obstetric and gastric emergencies.

Approximately 80 per cent of MedSTAR missions involve complex medical cases; 20 per cent are primary trauma cases for the general medical teams.

South Australia’s unique landscape of care

While comparable to interstate services such as NSW Retrieval, LifeFlight QLD and CareFlight NT, MedSTAR operates in a distinct context. As Dr Pearce explained, South Australia lacks regional critical care centres—meaning that nearly all non-metropolitan critical cases must be transported to Adelaide. This centralised approach increases reliance on retrieval services such as MedSTAR to bridge the geographical and clinical divide.

Reducing surgical mortality through collaboration

Dr Pearce emphasised that MedSTAR plays a pivotal role in reducing surgical mortality by involving consultant surgeons early in the coordination process. This ensures critical decisions, such as whether a patient should be transferred immediately or can safely remain in a rural facility, are made collaboratively. Due to the limited surgical specialist resources outside of Adelaide, prioritising which cases need immediate retrieval versus those that can wait is extremely important. Multi-party teleconferences help to allocate resources effectively and ensure that patient care decisions are timely and appropriate, reducing surgical mortality.

Looking ahead

With ongoing improvements in aviation technology, expanding clinical expertise and stronger coordination between services, MedSTAR continues to elevate the standard of critical care across South Australia. Dr Pearce’s leadership and the dedication of the MedSTAR team are central to ensuring patients receive the right care in the right place at the right time, no matter where they are.

Watch the full webinar for deeper insights:

SAASM Webinar with Andrew Pearce – March 2025