For the first time in its 32-year history, London’s Air Ambulance is now operating with two duty teams on call for London this winter. Beginning in December, an additional medical team will support the service, responding to the most critically injured trauma patients in the capital by rapid response car.
The extra team, known as ‘Medic 3’, will operate Monday to Saturday from 14:00 to 24:00 helping the advanced trauma teams of London’s Air Ambulance be more resilient and ultimately reach more critically injured patients and respond more quickly during the winter rush hour. The team wil consist of one senior doctor and one paramedic and the arrangement will be trialled for twelve months to analyse its impact.
London’s Air Ambulance currently provides one advanced trauma team 24 hours per day, 365 days per year and attends around 1,700 patients each year. The service uses a helicopter from 08:00 to sunset switching to rapid response cars at night or in adverse weather conditions. London’s Air Ambulance expert teams can deliver complex life-saving interventions at the scene of an incident such as pre-hospital emergency anaesthesia; blood transfusion; thoracotomy (a surgical procedure which opens up the rib cage cavity to manually massage the heart) and REBOA (where a balloon is fed into the major blood vessels through an injection into the leg), all of which are known to have increased patient survival rates after traumatic injury.
London’s Air Ambulance forms part of the blue light community alongside its partners Barts NHS Health Trust and the London Ambulance Service (LAS), working collaboratively to deliver the best possible care to all major trauma patients, and this additional resource will operate as part of this wider team.
As winter evenings draw in the aircraft goes offline earlier, currently around 16:00, meaning the team moves to deliver the service by rapid response vehicle at this time, significantly before rush hour and leaving the service reliant on only one team operating by road for the whole of London. Analysis of response time data, based on a single team, demonstrates that patients more distant from central London are not always reached as quickly during this window. Alongside this, the team may already be on scene with a patient when required elsewhere which results in cancelled missions for the service.
This has meant that London’s Air Ambulance has been unable to attend all the patients who could have benefited from their expertise and on-scene interventions. The service estimates that in 2019, there were 195 additional patients to whom London’s Air Ambulance would have gone to, which equates to around 60 additional emergency anaesthetics, 5 thoracotomies and 18 code red patients (when a patient is bleeding to death and needs immediate intervention). The extra team will be able to respond to these sorts of emergencies as well as providing greater resilience for the service in the event of a major incident. Currently in these instances the London Ambulance Service (LAS) will work alongside London’s Air Ambulance to ensure patients are treated as quickly as possible.
Medical Director of London’s Air Ambulance, Dr Tom Hurst, said:
“Time is precious when a life is on the line and we know that during the winter when the hours of dark overlap with peak travel times we are constrained in our response, particularly when our one team is already on scene with a patient. This additional team will help us reach more critically injured patients quickly when time is of the essence.
“London’s Air Ambulance does not stand still and is constantly striving to better the service we provide to the people of London. Thanks to our partners at Barts NHS Health Trust and the London Ambulance Service and of course to our incredible supporters we’ve been able to get this extra team up and running, providing much-needed clinical support and helping ensure that, should the worst happen, London’s Air Ambulance will be there.”
London Ambulance Service Deputy Chief Executive and Chief Medical Officer, Dr Fenella Wrigley said:
“The introduction of an additional advanced trauma team this winter will be an incredibly valuable resource for the people of London.
“The team, operated by a London Ambulance paramedic and Barts Health senior doctor, is an excellent example of collaborative working to help achieve the best possible care for trauma patients in the capital. The timing of this new expansion is also very welcome as the reduction in day light hours reduces the time the aircraft can operate. As we head into a challenging winter it will help us continue to bring clinical expertise to trauma scenes to help our most seriously injured patients.”
Alistair Chesser, Group Chief Medical Officer at Barts Health NHS Trust, said:
“The extra London Air Ambulance team is well timed coming into winter and will be a great help in ensuring the most seriously injured patients get the specialist, life-saving care they need as soon as possible, both on the scene and in hospital.
“We’re very happy to be working in collaboration with the London Ambulance Service and London Air Ambulance to allow us to reach hundreds more trauma patients.”
London’s Air Ambulance is a charity, operating in partnership with Barts NHS Health Trust and London Ambulance Service (LAS) NHS Trust. Barts Health NHS Trust employs and pays the doctors who will form part of the Medic 3 team and LAS provide the paramedics who will also form part of the duty team, as well as the flight paramedic situated in the control room who is responsible for dispatching London’s Air Ambulance to the most critically injured people in London, 24 hours a day.
Since its inception London’s Air Ambulance has developed cutting-edge medical care normally only found in the hospital Emergency Department for use at the roadside. The innovations and procedures it has developed have been adopted across the world.
