London Air Ambulance

The current London Air Ambulance, pictured in action at King's Cross station, airlifting a patient to the Royal London Hospital, Whitechapel

London's Air Ambulance, also known as London HEMS (Helicopter Emergency Medical Service), is an air ambulance service that responds to 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 that criticised pre-hospital trauma care. It is now headed by Dr. Gareth Davies (also Chairman of the charity's trustees) and is based at the Royal London Hospital in Whitechapel. The service was the first air ambulance in the United Kingdom to carry a doctor trained in emergency medicine in addition to a paramedic at all times.^[2] Since the service was founded, trauma deaths in London and on the M25 motorway have fallen by more than 50%.^[3]

Operational area

The operational area of responsibility is London and the area within the M25, though it can fly further afield if requested to. The team can be airborne within two 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 helicopter operates during daylight hours only because of the difficulties associated with landing on un-surveyed sites at night; during the dark hours it is replaced by rapid response cars.

Helicopter

The former London Air Ambulance, an SA 365N Dauphin pictured in 1998, which was replaced in 2000

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 a useful feature, as the helicopter must routinely land in confined inner city areas. It replaced a SA 365N Dauphin, registered G-HEMS, in October 2000.

Although the MD 902 Explorer is a quieter model aircraft than its predecessors, a number of noise complaints are still filed relating to HEMS.^[4]

The helicopter usually cruises at 175 to 180 mph, at an altitude of 1,500 ft. A regular fuel load, around 400 kg, allows for one hour's flying time.^[5]

From 6 March 2012, the helicopter became the UK's first air ambulance to carry emergency blood supplies, allowing transfusions to be administered at the scene of an accident rather than later in hospital. A specialised refrigerator installed in the helicopter allows the transport of four units of the universal O-negative blood type which can be stored in the aircraft for up to 72 hours (unused stocks can be returned to the hospital).^[6]

Rapid response cars

One of five rapid response cars, this one with a personalised "rescue" number plate

At night or when the helicopter is offline the medical crew, including a paramedic and senior trauma doctor, still respond to emergencies, but travel in a specially-equipped rapid response car. The six cars, Škoda Octavias, occasionally operate during the day, carrying backup medical teams to major incidents, or responding to local incidents or those that occur while the helicopter team is already deployed.

Funding

The service costs £2.25 million a year to run, but is only partly funded by the National Health Service. 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 2009 London's Air Ambulance undertook a total of 1,741 missions, down slightly from 1,771 in 2008. The crews attended the following emergency incidents:

• 672 road traffic collisions
• 377 falls from height
• 349 stabbings
• 69 shootings

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; and the 7 July 2005 terrorist attacks, when 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 bombings. This was only possible because a meeting, attended by many current and former HEMS staff, was coincidentally 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 usually consists of one pilot, one co-pilot, one doctor and one paramedic. There is sometimes an observer, who is a doctor or paramedic in training.

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 accident and emergency department on the ground floor—where a trauma team with A&E doctors, general surgeons, specialist trauma surgeons, and anesthesiologists assemble to assess and treat them.

Television appearances

In 2004 the service was featured heavily in the BBC television series Trauma.^[7] 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.^[8]

Administration

HEMS Clinical Director Dr Gareth Davies

The HEMS Clinical Director is Dr. Gareth Davies. Davies is also an Accident & Emergency and Pre-hospital Care Consultant working at the Royal London Hospital and regularly flies in the helicopter to the scenes of accidents.

Concerns were expressed in the media after the London Air Ambulance charity dismissed its Chief Executive in 2009.^[9] The Charity Commission promptly made recommendations on governance to the Trustees, but did not express an opinion over the dismissal.^[10]

Physician Response Unit

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.^[11]

The PRU is staffed by a doctor and an Emergency Care Practitioner (ECP). Compared to just sending out an ECP in a car or an ambulance crewed by a paramedic and an emergency medical technician, a higher level of diagnostics and treatment can be initiated on-scene, giving the optimal outcome for the patient, and saving expensive procedures that could otherwise have been initiated.

See also

• London Ambulance Service
• Royal London Hospital
• Air ambulance

References

This article uses bare URLs for citations. Please consider adding full citations so that the article remains verifiable. Several templates and the Reflinks tool are available to assist in formatting. (Reflinks documentation) (December 2011)

1. ^ "Helicopter Emergency Medical Service (HEMS) - Barts and the London NHS Trust". Bartsandthelondon.nhs.uk. http://www.bartsandthelondon.nhs.uk/ourservices/helicopter_medical_emergency_service_hems.asp. Retrieved 2012-02-22. 
2. ^ About us, London's Air Ambulance. Retrieved 2 February 2012.
3. ^ 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^{[dead link]}
4. ^ [1]^{[dead link]}
5. ^ 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^{[dead link]}
6. ^ Neil Bowdler (6 March 2012). "Air ambulance first in UK to carry blood". BBC. http://www.bbc.co.uk/news/health-16928621. Retrieved 6 March 2012. 
7. ^ [2]^{[dead link]}
8. ^ "BBC One - Medic One - Life and Death in London". Bbc.co.uk. 2009-06-01. http://www.bbc.co.uk/programmes/b00l1w31. Retrieved 2012-02-22. 
9. ^ Laura Donnelly and Alison Moore, Air ambulance chief sacked after he raised financial concerns, Daily Telegraph, 28 November 2009
10. ^ Tania Mason, Charity Commission provides governance advice to air ambulance charity, Civil Society, 20 January 2010
11. ^ "Accident and Emergency - Barts and the London NHS Trust". Bartsandthelondon.nhs.uk. http://www.bartsandthelondon.nhs.uk/ourservices/accident_and_emergency.asp. Retrieved 2012-02-22. 

External links

Wikimedia Commons has media related to: London Air Ambulance

• Official website
• Official Blog
• The Association of Air Ambulance Charities