London's Air Ambulance, is an air ambulance, also known as a Helicopter Emergency Medical Service (HEMS), which responds to seriously ill or injured casualties in and around London, England.[1]
The service was formed in 1989 by Dr. Alastair Wilson OBE, as a response to a report by the Royal College of Surgeons which criticised pre-hospital trauma care. It is now headed by Dr Gareth Davies (also Chairman of the charity's trustees) and the service is based at the Royal London Hospital in Whitechapel. The service was the first air ambulance in the UK to carry a doctor trained in emergency medicine in addition to a paramedic at all times.[2] Since the service has started trauma deaths in London and on the M25 have fallen by more than 50%.[3]
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Operational area
The operational area of responsibility is London and the area within the M25 motorway, though it can fly further afield if requested to. The team can be airborne within 2 minutes of receiving a call. From its hospital base, the furthest section of the M25 and thus the usual limit of responsibility, is only 12 minutes flying time. The service operates from 7am until sunset, when the helicopter cannot fly because of the difficulties associated with landing on un-surveyed sites at night.
Rapid response car
At night the medical crew still respond to emergencies, but travel in a specially fitted and equipped rapid response car. The cars occasionally operate during the day with both a doctor and a paramedic, carrying backup medical teams to major incidents or responsing to local incidents or incidents that occur whilst the helicopter team is deployed.
Helicopter
The current helicopter used is a McDonnell Douglas MD 902 Explorer, registration G-EHMS, which is notable as it does not use a tail-rotor. This was felt to be a useful feature, as the helicopter has to routinely land in confined inner city areas. It replaced a SA 365N Dauphin in 2000, that was registered G-HEMS In August 2008 G-EHMS developed a mechanical fault during a mission with its internal fan system and was forced to land.[4] By September 2008 it was back in the air
Although the McDonnell Douglas MD 902 Explorer is a quieter model aircraft than its predecessors, a number of noise complaints are still filed relating to HEMS.[5]
Funding
The service costs £2.25 million a year to run, but is only partly funded by the NHS. London's Air Ambulance in a registered charity (Number 801013) and the service is funded through charitable donations and corporate donors, most notably by the Virgin Group which donates around £170,000 per annum. A full list of corporate donors is available on the HEMS website. The charity also runs a weekly lottery to raise funds for the service, and holds a number of small and large scale fundraising events throughout the year.
Missions and major incidents
During 2008 London’s Air Ambulance undertook a total of 1771 missions, up from 1 401 in 2007. The crews attended the following emergency incidents: • 687 road traffic accidents. • 381 falls from height. • 291 stabbings. • 87 shootings. • 38 hanging or strangulation incidents. • 12 sports-related and animal-related incidents.
The Air Ambulance team have been involved in many major incidents over the past few years, including the train crashes at Cannon Street, Southall and Paddington, the Soho bomb, and the July 7th terrorist attacks. On July 7 2005, the HEMS team carried out 26 missions using the helicopter and constant deployment of rapid response cars to deliver medical care and supplies to the scenes of the incidents. This was only possible because a meeting, attended by many current and former HEMS staff, was scheduled for the same day. 208 people were treated at the Royal London Hospital on that day. HEMS holds a contract with the London Ambulance Service obliging them to provide Medical oversight at declared Major Incidents.
Crew
The crew is usually 1 pilot, 1 co pilot, 1 doctor and 1 paramedic. There is sometimes an observer, who is a doctor or paramedic in training. The helicopter can carry two patients on stretchers. However, because the nature of patients transported by HEMS, the team typically only transport one critically ill patient.
Ground services
On arrival at the Royal London Hospital helipad, specialist ground crew receive the patient and a dedicated, express elevator carries the patient to the A&E department on the ground floor where a Trauma Team with A&E doctors, general surgeons, specialist surgeons and anaesthetists will be assembled to assess and treat them.
TV appearances
In 2004 the service was featured heavily in the BBC TV series Trauma.[6] In 2009 a standalone documentary about the Air Ambulance was made for the BBC by North One Television. It showcased the service in a number of emergencies and was called 'Medic One: Life and death in London.[7]
Administration
The HEMS Clinical Director is Dr Gareth Davies. He, along with other members of the team helps to run London's Air Ambulance. Gareth is also an Accident & Emergency and Pre-hospital Care Consultant working at the Royal London Hospital, Whitechapel and regularly flies in the helicopter to the scenes of accidents.
Physician Response Unit
Dr Davies has been responsible for many innovations in pre-hospital care such as the Physician Response Unit (PRU) which brings the doctor to the patient in their home, preventing an unnecessary waste of ambulance resources. The PRU also operates from the Royal London Hospital in a rapid response car.[8]
The PRU is staffed by a Doctor and an Emergency Care Practitioner (ECP). As such it is an expensive initiative and may be less cost effective than just sending out an ECP in a car or an ambulance crewed by a Paramedic and an Emergency Medical Technician.
References
- ^ http://www.bartsandthelondon.nhs.uk/ourservices/helicopter_medical_emergency_service_hems.asp
- ^ http://www.londonsairambulance.com/SecureStore/welcome.aspx?Q1788=30&J847=x30&A988=&NL477=&F=&G=&C=&SC=&S9=0&UT1=&R=1&S=&RE=www.londonsairambulance.com&D=32
- ^ http://www.londonsairambulance.com/SecureStore/welcome.aspx?Q1788=30&J847=x30&A988=&NL477=&F=&G=&C=&SC=&S9=0&UT1=&R=1&S=&RE=www.london.gov.uk&D=32
- ^ http://news.bbc.co.uk/1/hi/england/7553922.stm
- ^ http://www.london.gov.uk/assembly/reports/environment/helicopter_noise_evidence.pdf
- ^ http://www.bartsandthelondon.nhs.uk/formedia/press/release.asp?id=136
- ^ http://www.bbc.co.uk/programmes/b00l1w31
- ^ http://www.bartsandthelondon.nhs.uk/ourservices/accident_and_emergency.asp
See also
Other emergency medical services
- London Ambulance Service
- Royal London Hospital
- Air ambulance
- International SOS, Provider of air ambulance evacuation & repatriation services
Other emergency services
External links
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