From the roof of The Royal London Hospital in Whitechapel, London’s Air Ambulance provides a lifesaving service to people in their moment of greatest need. Their one helicopter covers more than 600 square miles of the capital’s urban sprawl.
Founded in 1989 in response to a report by the Royal College of Surgeons, it has since undertaken over 26,000 missions. Their patients are so severely injured that every minute is vital for survival. Although other UK air ambulance services preceded them, London’s Air Ambulance (LAA) was the first in the country to carry out open-chest surgery at the roadside, carry blood for on-scene transfusion and provide round-the-clock cover. What also sets it apart is that it is a charity.
On 7 July 2005, the tragic day on which terrorists detonated bombs on three London Underground trains and one bus, LAA flew 26 helicopter missions to and from the incident sites and treated over 700 people. Lady Justice Hallett, coroner at the inquest following the London bombings, recognised how crucial LAA was during the rescue operation: ‘I have acknowledged the integral role played by London’s Air Ambulance on 7/7,’ she said. ‘In short, the vast experience and considerable skills of those trained in pre-hospital care played a significant part in saving lives and limbs.’
In fact, over the past 20 years the service has witnessed all of the capital’s largest incidents first-hand, assisting in the response to the Paddington, Cannon Street and Southall train crashes and the Soho nail bomb. It’s not a job for the faint-hearted.
Every year the service treats over 2,000 patients in need of critical care, and many of them are often keen to meet and thank the crew once they recover and even get involved in fundraising. Kim Bowler was run over by a car on the busy Cromwell Road in London in October 2009: ‘I had all my ribs broken,’ she recalls. ‘My right hip was shattered, both lungs collapsed and my spine was broken.’ Luckily, LAA was able to land on the roof of a nearby supermarket, and they used their medical expertise at the roadside to help save her life before getting her quickly to the trauma unit at the Royal London Hospital.
‘I spent the first few weeks not understanding how seriously I was injured,’ Kim went on to say. ‘Now that I have had the second and third operations on my spine, I am hoping to walk 5km in May to raise money for London’s Air Ambulance. I’ll be dressing up as Supergirl.’The service also saved Sir Stirling Moss, the legendary British racing driver, who fell down a lift shaft in his home in March 2010.
An operational team includes two pilots, one doctor, one paramedic, two fire crew and an additional paramedic in the ambulance service control room. The challenge of flying and particularly landing in a densely populated urban environment such as London demands the highest level of skill. To maximise safety, every mission is flown by two of their four-pilot crew. Four fire fighters ensure the safety of the helicopter and staff, and coordinate the major incident response. The helicopter operates during daylight hours and is supplemented at night by a unit of rapid-response cars, so the service is operational for 24 hours a day, 365 days a year. Missions commonly involve patients from road traffic collisions, falls from height, industrial accidents, structural collapses, injuries on the rail network, assaults, stabbings and shootings.
it is not easy to get into the service. Attracting doctors from all over the world, high standards are maintained by a rigorous system of selection and clinical governance. The emergency response teams consist of senior trauma doctors and experienced paramedics, who are only allowed to work unsupervised after completing a rigorous academic and practical ‘sign-off’ period of four to six weeks, regardless of their previous experience.
LAA contributes to international medical guidelines and provides medical training for other services, explains doctor Gareth Davies, Medical Director and Chair of the Trustees. ‘We are recognised internationally for our high-quality medical care, pioneering innovation and outstanding training. When paramedics and doctors return to their usual working life following their attachment to London’s Air Ambulance, they take with them enhanced clinical and leadership skills and become expert practitioners, deployed to critically ill patients in the most challenging situations.’
Doctors and paramedics are trained to provide initial command and control during the early, chaotic stages of catastrophic events which involve large numbers of casualties. As the incident develops, the emergency response teams will either take the lead on medical response or, if relieved by an appropriately senior commander, will deliver hands-on medical care to injured patients.
LAA’s major incident response is coordinated from the operations room at the helipad in Whitechapel. The system allows the coordinated deployment of medical teams to multiple sites. The service is supported by a charity which relies heavily on donations from the public and corporate sponsorships. What is for certain is that this is a vital service London simply cannot do without.