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HEMS SCRAM moving shot

The SCRAM™ Portfolio

The SCRAM™ (Structured CRitical Airway Management) portfolio provides a structured, reproducible approach to critical care and retrieval medicine in both the hospital and prehospital settings, with the aims of reducing cognitive load and improving performance.


The initial concept for SCRAM™ was the idea of Paul Swinton and Neil Sinclair, whilst Air Ambulance Paramedics at Scottish Ambulance Service. Working with InnoScot Health, the portfolio of products has been developed and manufactured in partnership with Openhouse Products.

HEMS checks SCRAM

High-performance solutions

After initial success with the Adult variant, the portfolio now extends to a further eight high-performance solutions – Paediatric, Paediatric EMS, Tactical, Rx, Tactical Rx, Crash Rx, Resus and Surgical, with several variants used by high-performance teams globally.


Whilst most manufacturers focus on the storage and transportation of equipment, the core principles to the design and philosophy of SCRAM™ are systemisation, standardisation, cognitive offloading, human factors and good governance.


Manufactured by license partner Openhouse Products using their unique micrAgard™ material – a wipe clean, durable, anti-bacterial, anti-microbial material – the full portfolio is for sale via their website.

Peadiatric SCRAM in theaters

Grounded in research

The Adult SCRAM™ has been the focus of several clinical trials, which have consistently shown that the system of pre-preparation of equipment and drugs facilitates a quicker, less challenging kit dump leading to significantly fewer errors, and has the potential to reduce on-scene time by up to a third.


Additionally, multiple studies carried about by teams across NHS Scotland have shown similar results across the Paediatric SCRAM™ line, with the Highland Critical Care Team planning facilitating continued training using the system across the North of Scotland.


University programs are also integrating SCRAM™ into programs to help teach the importance of systemisation, standardisation, cognitive offloading, human factors, and good governance within emergency airway management.

The SCRAM™ Portfolio

Adult SCRAM™

An original idea from Paul Swinton and Neil Sinclair, then Air Ambulance Paramedics at Scottish Ambulance Service, the Adult SCRAM™ was the first product from the SCRAM™ portfolio; and offers structured, reproducible approach to airway management.


Features of the Adult SCRAM

  • A stencilled kit dump standardises layout and allows efficient pre-stocking
  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Basic Airway and Rescue Adjuncts
  • Drug storage loops – ability to have pre-drawn drugs for emergency anaesthesia readily available
  • Dual weighted pull out surgical kit dump that can be rapidly deployed for two techniques scalpel, finger, bougie (yellow) and surgical kit (blue)
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Checklist pouch – clearly visible and easy to access
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Fidlock system – magnetic connection to other SCRAM™ products
  • Platform to simplify and standardise emergency anaesthesia
  • Removable Trach pouch
  • New mechanism for storage of bougies
  • Additional handle for easier access


More information about the story behind SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.


View the Adult SCRAM™ photo album

Paediatric SCRAM™

Following the success of the Adult SCRAM™, there was strong demand from the community for a Paediatric variant of the product, which presented unique challenges and required distinct specifications. Paul Swinton and Neil Sinclair, alongside Dr Jon McCormack (NHS Lothian) undertook this challenge to create a paediatric version using the same principles as the Adult SCRAM™ and tailoring them to the specific requirements of paediatric airway management.


The resulting Paediatric SCRAM™ is designed to enhance the performance of paediatric airway management, both within and outside of the operating theatre environment.


Features of the Paediatric SCRAM™

  • A structured, reproducible approach to paediatric airway management both within and outside of the operating theatre, in prehospital, retrieval environments
  • Stencilled kit dump standardises layout and allows efficient pre-stocking
  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Basic Airway and Rescue Adjuncts
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Checklist pouch – clearly visible and easy to access
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • Encompasses the neonatal to adolescent age range
  • An easily accessible information board that can house an age-per-page clinical handbook
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Fidlock system – magnetic connection to other SCRAM™ products
  • Platform to simplify and standardise emergency anaesthesia
  • New mechanism for storage of bougies
  • Ability to have drugs for emergency anaesthesia readily available


More information about the story behind the Paediatric SCRAM™ line can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products

PaedEMS SCRAM™

Alongside the larger Paediatric SCRAM™, PaedEMS SCRAM™ is designed to be a compact paediatric emergency airway bag that provides a structured, reproducible approach to airway management.


Features of PaedEMS SCRAM

  • A structured, reproducible approach to paediatric airway management within or outside of the operating theatre, in prehospital, retrieval environments
  • Platform to simplify and standardise emergency anaesthesia
  • A compact design
  • Stencilled kit dump standardises layout and allows efficient pre-stocking
  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Basic Airway and Rescue Adjuncts
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Checklist pouch – clearly visible and easy to access
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • Encompasses the neonatal to adolescent age range
  • An easily accessible information board that can house an age-per-page clinical handbook
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • New mechanism for storage of bougies


More information about the story behind PaedEMS SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

Tactical SCRAM™

Using the guiding principles of the growing SCRAM™ portfolio, and in conjunction with colleagues within the military, Paul Swinton developed the Tactical SCRAM™ as an emergency airway bag that provides a structured, reproducible approach to emergency airway management in the tactical environment.


Alongside the principles of SCRAM™, the Tactical variant was developed to also incorporate the principles of Tactical Combat Casualty Care and Battlefield Advanced Trauma Life Support (BATLS).


Care is divided into 3 phases based on the location relative to the threat:

  • Care Under Fire
  • Tactical Field Care
  • Tactical Evacuation Care


The design was then developed by mapping the airway interventions within each of the phases of care, reviewing current evidence and focusing on:

  • differences in skill i.e Combat Medical Technician (CMT) vs Medical Emergency Response Team (MERT)
  • airway escalation model
  • environment lighting
  • procedural time, error reduction, ergonomics and cognitive off-loading


Features of the Tactical SCRAM

  • Designed to enhance the performance of emergency airway management within the tactical environment
  • Platform to simplify and standardise emergency anaesthesia
  • Stencilled kit dump standardises layout and allows efficient pre-stocking
  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Basic Airway and Rescue Adjuncts
  • Surgical airway kit dump – pull-out panel rapidly deploys the surgical, weighted airway kit dump
  • Dual Surgical airway kit dump for both Medical Emergency Response Team (MERT) in yellow and Combat Medical Technician (CMT) in blue
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Checklist pouch – clearly visible and easy to access
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • A compact design
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Removable Trach pouch
  • New mechanism for storage of bougies


More information about the story behind Tactical SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

Rx SCRAM™ and Tactical Rx SCRAM™

Rx SCRAM™ is an innovative emergency airway drug bag designed to simplify and standardise emergency anaesthesia. It focuses on the classification of drug needed to perform emergency anaesthesia, complimenting other products within the SCRAM™ portfolio.


Tactical Rx SCRAM™, for use in the tactical environment, has all the features of Rx SCRAM™. The only difference is exterior colour (green and black).


Features of Rx SCRAM™ and Tactical Rx SCRAM™

  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • A compact design
  • Correct size of pre-filled syringe and ampoules can be co-located
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Fidlock system – magnetic connection to other SCRAM™ products
  • Consumables stored in one place – needles, syringes, alcohol wipes, drug labels
  • Drugs labels for ease of identification
  • Customisable qualities cater for pre-filled syringes / Ampules/ Vials or team's bespoke setup
  • Customisable – integrated cord lock system
  • Visible expiry date window


More information about the story behind Rx SCRAM™ and Tactical Rx SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

Crash Rx SCRAM™

Crash Rx SCRAM™ is the lite version of the Rx SCRAM™ line, an innovative emergency airway drug bag designed to simplify and standardise emergency anaesthesia. It focuses on the classification of drug needed to perform emergency anaesthesia.


The Crash Rx SCRAM™ is designed and developed by Professor Scott Weingart (Director of Clinical Education and Faculty Development, Nassau University Medical Center) and Paul Swinton.


Features of Crash Rx SCRAM™

  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • A compact design
  • Correct size of pre-filled syringe and ampoules can be co-located
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Fidlock system – magnetic connection to other SCRAM™ products
  • Consumables stored in one place – needles, syringes, alcohol wipes, drug labels
  • Drugs labels for ease of identification
  • Platform to simplify and standardise emergency anaesthesia
  • Customisable qualities cater for pre-filled syringes / Ampules/ Vials or teams bespoke setup
  • Customisable – integrated cord lock system
  • Visible expiry date window


More information about the story behind Crash Rx SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

Resus SCRAM™

Resus SCRAM™ is an emergency airway bag designed for institutions and systems that offer video laryngoscopy as a primary modality of emergency airway management.


The Resus SCRAM™ is designed and developed by Professor Scott Weingart (Director of Clinical Education and Faculty Development, Nassau University Medical Center) and Paul Swinton.


Features of Resus SCRAM™

  • A structured, reproducible approach to airway management
  • Platform to simplify and standardise emergency anaesthesia
  • Stencilled kit dump standardises layout and allows efficient pre-stocking
  • Reduces intervention time, risk of error and cognitive load
  • Weatherproof – portable and easy to use
  • Basic Airway and Rescue Adjuncts
  • Surgical airway kit dump – pull-out panel rapidly deploys the surgical, weighted airway kit dump
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Checklist pouch – clearly visible and easy to access
  • Wipe Clean note board and pen holder
  • Easy to clean – wipe down, exterior and interior
  • 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
  • High contrasting colours – reduce cognitive load and draw attention to the ‘working’ kit dump
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)Easy to use with gloves
  • Fidlock system – magnetic connection to other SCRAM™ products
  • Easy to deploy and removable difficult airway kit dump
  • Removable Trach pouch
  • New mechanism for storage of bougies
  • Additional handle for easier access
  • Visible expiry date window


More information about the story behind Resus SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

Surgical SCRAM™

Surgical SCRAM™ is a brain-friendly tool specifically tailored to meet the requirements of resuscitative emergency surgical procedures, outside the operating theatre with the aim of improving performance.


To achieve this goal, Paul Swinton, National Education Lead for the Scottish Air Ambulance Service and co-inventor of SCRAM™, and Stian Mohrsen, Advanced Paramedic in Critical Care utilised the same design principles that led to the creation of the SCRAM™ portfolio, alongside information from a survey of pre-hospital critical care services in several European countries (Norway, Germany, Switzerland, Sweden and Finland) that allowed for the development of a standardised loadout.


Features of Surgical SCRAM™

  • Stencilled kit dump standardises layout in an easy-to-orientate way and allows efficient pre-stocking
  • Gross motor indicators – signpost the location of the relevant equipment required for the intervention and help reduce cognitive load
  • Sharps management solution
  • Removable surgical panels that allow for flexibility in working on both sides of the patient
  • A compact design
  • Auditing options available unique barcode, checklist pocket and RFID/NFC pocket (tags not included)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
  • Designed around common surgical equipment required for emergency surgical procedures
  • Removable components for a modular approach adaptable to any situation
  • Weatherproof – portable and easy to use
  • Easy to clean – wipe down, exterior and interior


More information about the story behind Surgical SCRAM™ can be found on Paul Swinton’s website, and the full portfolio is available to purchase from Openhouse Products.

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