Rapid response from the air
Emdad Rahman
In 1988, The Royal College of Surgeons produced a report which criticised the care that victims of major trauma received in the UK. It documented cases of patients dying unnecessarily because of the delay in receiving prompt and appropriate medical care.
London's Air Ambulance was established to address findings of this report and to find a way to respond quickly in London's increasingly congested roads.
London's Air Ambulance began its operations in 1990 from a temporary base outside central London. There was a great deal of competition from hospitals in London to have the helicopter based at their hospital. The Royal London Hospital was successful in its bid as it was the only multi disciplinary hospital with a site where it would be safe to build a roof top helipad. London's Air Ambulance began to fly from the rooftop at the Royal London on 30th August 1991.
The latest Air Ambulance operates an MD902 Explorer twin engine helicopter, one of the most identifiable in the world. This is one of a new generation of aircraft chosen for its safety features which include no tail rotor, important in an urban environment. It has been specially adapted for its purpose, to enable patients to be treated to the standard of an intensive care unit in flight.
From it's helipad at the top of the Royal London Hospital, the Helicopter can reach the furthest points of the M25 within 12 minutes. Each flying team consists of a senior trauma doctor, a paramedic, two pilots (one of whom acts as a navigator), and an observer (usually a doctor or paramedic completing their first month with London's Air Ambulance, training for their role).
The Helicopter’s main use is to get this specialist trauma team to the patient in the quickest possible time – the team can be airborne within 2-3 minutes of receiving a call. The doctor and paramedic will treat the patient, performing operations and procedures that are normally only seen in the hospital emergency department. Once the patient is stabilised they will be taken to the nearest hospital best equipped to deal with the injuries. The helicopter is equipped to take a patient to the hospital but this is not always the case. Often the patient will travel by London Ambulance Service accompanied by the air ambulance team.
The Helicopter’s medical team is equipped with a substantial range of drugs, emergency surgical kits, monitors and other equipment 'a mini Accident & Emergency Department (A&E) of their own' so that they can begin treatment straight away.
The London's Air Ambulance team have been involved in many major incidents, including the train crashes - Cannon Street, Southall and Paddington - the Soho bomb and the July 7th 2005 attacks on London's transport system when some 18 sorties were carried out by the helicopter to deliver medical care and supplies to the scenes of the incidents.
London’s Air Ambulance is a registered charity which runs London’s only helicopter emergency medical service, providing life saving care to victims of serious injury throughout London - serving the 10 million people who live, work and commute within the M25.
London’s Air Ambulance provides pre-hospital emergency medical care to victims of serious injury:
- Road traffic accidents (RTAs)
- Falls from height
- “One unders” (incidents on the rail network)
- Industrial accidents
- Stabbings & shootings
- Structural collapse
- Impalings, hangings, drownings
John Power, senior Helipad officer offered us insight into the workings of the service. He told me: “A London’s Air Ambulance paramedic is based in the London Ambulance Service control room, monitoring the thousands of calls that pass through there everyday for injuries and will then dispatch the London’s Air Ambulance team. The team can also be called by any of the emergency services, such as the fire brigade or police.
“London’s Air Ambulance doctors, supported by the paramedics, perform procedures and operations in the street which are normally only found in the hospital emergency department. Timing is of the essence for the types of injury London’s Air Ambulance attends. The patients have a critical one hour window in which to receive treatment to reduce disability or improve survival. This window is known as the ‘golden hour’ and allows treatment of patients that may not even survive the distance to hospital.”
He added: “Serious trauma or serious injury is the commonest cause of death for 1-55 year olds.
“Without London’s Air Ambulance patients will not receive critical care at the roadside and can endure delays in receiving life saving care.”
We were also able to meet Dr Dan Nevin, London's Air Ambulance Doctor. Dr Nevin is a Specialist Anaesthetist with an avid interest and extensive background in Emergency Medicine, Intensive Care and Pre Hospital Care.
He hails from Johannesburg, South Africa and has been in the UK for the last year doing HEMS work, most recently at the Royal London. His particular interests are in Resuscitation, Airway Management and Critical Care in the Pre Hospital environment.
The Rapid Response Cars
When the Helicopter is offline – either at night when it is too dangerous to land in London, or if there are dangerous weather conditions – the operation is supported by a rapid response car team which ensures 24 hour care to London.
The rapid response cars also carry a senior trauma doctor and a specially trained paramedic to the scene of the injury in the quickest time possible. The Rapid Response team will treat the patient on scene, carrying out procedures normally only found in the emergency room. The Rapid Response team patrol London awaiting a call from the London Ambulance Service's control room to send them to a serious case. The rapid response cars attend the same types of serious incidents as the Helicopter.
The Rapid Response team is equipped with a substantial range of drugs, emergency surgical kits, monitors and other equipment 'a mini Accident & Emergency Department (A&E) of their own' so that they can begin treatment straight away.
London’s Air Ambulance has six Skoda Octavias with a maximum speed of 149 MPH. All cars are equipped with blue lights, high visibility strips and badges to identify the car as part of the London’s Air Ambulance fleet.
London’s Air Ambulance is a registered charity and relies heavily on public donations. You can support the team by making a donation by credit/debit card over the phone - 020 7943 1302, or pay online through the Just Giving page - www.justgiving.com/londonaa.
Cheques made payable to London’s Air Ambulance can be addressed to Christine Margetts, The Helipad, The Royal London Hospital, Whitechapel, E1 1BB.
If you have a bank account with the Charities Aid Foundation, you can donate through their website.
MD902 Specifications:
Reg: G-EHMS
Hull No: 68
Max all up weight: 6250 lbs
Engines: 2 Pratt and Whitney 206e
Top speed: 140 kts
Mission ready endurance: 1 hour from the Helipad (130 miles)
