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Continuing the cycle of innovation image

The cycle of innovation never stops, and SHIL maintains strong relationships with all our NHS Scotland inventors, supporting continuous improvement and development of products and ideas.

Back in 2013, SHIL supported the development and commercialisation of the SCRAM (Structured Critical Airway Management) System – a structured reproducible approach to airway management from Scottish Ambulance Service Air Paramedic, Paul Swinton and Consultant Paramedic, Neil Sinclair.  

By standardising, and optimally organising equipment and drugs prior to anaesthesia being required, the SCRAM System offered a meaningful cognitive offloading tool, and facilitated airway planning by reducing the time to intervention, reducing error, standardising practice and promoting good governance.

Following great success including sales throughout the UK and Australia, and use by air ambulance, trauma teams and emergency departments in Scotland, the product has been refined and further developed with an improved model of the system – SCRAM 2.0 due for release in August 2018.

Some of the features that made the original SCRAM System so effective included:

  • A stencilled kit dump that standardised layout and allowed efficient pre-stocking
  • Integrated kit dumps, reducing time to prepare for the intervention
  • A weatherproof system, that wouldn’t blow away, was portable, and easy to use
  • Inclusion of Basic Airway and Rescue Adjuncts
  • The ability to have drugs for emergency, anaesthesia readily available.

These features are maintained but the new SCRAM system is manufactured using micrAgard™, an FDA approved high tenacity system with exceptional mechanical properties. It is durable, anti-bacterial, fire-retardant and wipe clean, with improved chemical, oil, and abrasion resistance, and upgraded protection from external temperature changes.


Other new features introduced in SCRAM 2.0 include:

  • New surgical kit dump – pull-out panel rapidly deploys the surgical, weighted airway kit dump. Once deployed it offers a “clean slate” to work off and its colour clearly indicates a change in approach from the previous attempt at intubation. It can be set up overlaying the original kit dump or easily removed from its velcro attachment to set up a second kit dump for a planned surgical airway
  • Gross motor indicators – (yellow & blue tags) signpost the location of the relevant equipment required for the intervention, and to help reduce cognitive load. (i.e. yellow denoting surgical airway, blue denoting equipment for thoracostomy)
  • Higher contrast colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • Drug storage loops – Ability to have drugs (pre-drawn drugs) for emergency, anaesthesia readily available
  • Checklist pouch - clearly visible and easy to access
  • Secure storage – improve storage of Laryngoscopes, HEM filters, pre-filled syringes for RSI, and rescue devices
  • Improved zip technology – YKK water resistant zip with T-shaped easy-pull lockable sliders allowing the bag to be checked, stocked, and sealed ready for use.

Complementing the launch of SCRAM 2.0, a Paediatric Airway Module that can be used in tandem with improved System is currently in development, and will be available later this year.

Paul Swinton, co-inventor of the SCRAM System, said of the newest version: “The SCRAM System was inspired by my experience working with the air-ambulance service, attending accidents and emergencies in the pre-hospital setting. The effectiveness and speed of potentially lifesaving pre-hospital airway management can significantly impact the care of critically ill or injured patients. SCRAM 2.0 improves upon this model, and promotes the delivery of safe, timely, well-governed emergency anaesthesia and tracheal intubation, wherever it is necessary.”

SCRAM 2.0 has been manufactured by Openhouse Products and is due for release in August 2018 – pre-order the improved System on our products page.

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