Date: 16 Apr 2004
Time: 18:52
Air-Rescuetek spent one day in March 2004 with the Thames Valley and Chiltern Air Ambulance Service, in the UK, recently. Gill Smith tells the story …..
Spending time with the Air Ambulance team is nerve-wracking. Sitting in a small portacabin on the airfield, paramedics, pilot and engineer are all relaxed, but at any moment could be rushing out the door.
A few strides away is the bright yellow Thames Valley and Chiltern Air Ambulance helicopter, ready for any callout in Berkshire, Buckinghamshire, Oxfordshire or North Hampshire. It’s there to get help to patients fast, then get them to suitable care quickly and efficiently.
Today’s team – paramedic Mark Begley, technician Steve Cartwright and pilot Alf Gaparro – have already been to a road traffic accident, and their next call could come any time.
Preparing for the mercy dash
Funded totally by donations, they’re ready from 8 am to 6 pm, seven days a week. They’re called around four times daily – rising to ten at weekends.
Often, they’re first there for road accidents. This doesn’t necessarily mean free helicopter rides for the victims. Sometimes it makes sense to transport them in land ambulances. Sometimes most treatment is done at the scene. On rare occasions, the helicopter fetches hospital specialists.
With today’s team on the wind-swept airfield are Gilly Peachment, a paramedic retraining after maternity leave; Director of Fundraising, Stevie Horton and Phil Mitchell, the engineer who ensures that the helicopter is always ready.
Flying around Thames Valley saving lives seems glamorous, but dressed in orange reminiscent of EasyJet, the team quickly dispel any idea of ‘easy.’
Mark explains “In an ambulance, it takes time to get to a scene compared to a helicopter. The helicopter is used for incidents where we can get there first or if there’s an ambulance en route and the situation needs more than one. Or, if an ambulance is there but struggling to get to a patient. Also, where the helicopter can provide specialist skills.”
Regular calls include riding and golf accidents, and those on farms, railways and canals, where land ambulances struggle to reach patients.
Training and experience
The helicopter’s sixteen paramedics had to work full time for their local ambulance service for three years before they started training.
All were already very experienced in the skill and practise of their job. “You have to be able to prove you’re good at the job you do, and competent with whatever’s thrown at you,” Mark reports. There then follows three weeks of helicopter training on the various difficulties encountered in the air.
Paramedics learn to map read while flying, and take turns navigating. High above the Chilterns, it isn’t easy. Steve says “People think it won’t be difficult but, from the air, it’s so different looking down.”
Mark continues. “It’s mentally more demanding and tiring than land ambulance work.” He should know – paramedics do this as overtime, still doing regular shifts for their ambulance service.
The NHS pays only for this overtime, so the charity has to fund salaries for the two pilots, vehicle maintenance, and expensive air fuel, which costs £100 per hour in the air. Thankfully, most callouts involve less time actually flying.
Once a paramedic has trained, they are re-tested annually. Trust in each other is vital. Mark says “You need that on the road anyway, but it’s heightened because it’s so dramatic if you get it wrong. Flying, taking off, landing, they’re all dangerous. You get very tuned in to the importance of each other. We all agree on a landing site, or we look for somewhere else. You need your crew mates. You rely on each other heavily.”
Pilots, although not necessarily first-aid trained, are a vital part of the team. Often they fly without navigators, while paramedics tend patients. They quickly pick up skills, such as what equipment to fetch. They are also quick to adapt helicopter layout to fit paramedics’ continual treatment of stretcher-bound passengers.
Equipment and platform requirements
Since June 1999 the air ambulance has flown to over 5800 patients. Stevie Horton believes that without it “around three quarters maybe wouldn’t be here today.”
They take off from White Waltham, near Maidenhead, and land at several nearby hospitals such as the Royal Berkshire Hospital in Reading; Reading’s Battle Hospital; Stoke Mandeville near Aylesbury; Basingstoke’s North Hampshire Hospital; the John Radcliffe in Oxford; Wexham Park near Slough; Swindon’s Princess Margaret Hospital, Milton Keynes, and Frimley Park, Camberly. It’s a sizeable area to cover, but doesn’t take long by helicopter.
The speed of air travel means regardless of distance, accident victims can go to the best place for their treatment. This could be Stoke Mandeville for burns, Battle for cardiac patients or John Radcliffe’s major trauma centre. It also allows transfers between hospitals, when this is best done rapidly.
Even with lights and sirens, Reading’s Royal Berks to Oxford’s John Radcliffe by road takes around 45 minutes. By air, it takes six.
Thames Valley and Chiltern Air Ambulance Trust has around six weeks’ funds in the bank. That doesn’t seem much, but Stevie Horton reports “the public are supporting us wonderfully at the moment.”
The paramedics still hope for a newer, better equipped helicopter called the Eurocopter. This would allow them to fly fitting patients, parents with their children, and even women in labour. It’s also faster, quieter for the crew, and more powerful, making it safer if there are engine problems.
The time-scale for this is two years, but any sponsor keen to donate sooner would be welcomed.
While I was there, the helicopter was called to a cycling accident in Hook Norton. From the time of the call to being in the air was a few minutes, mostly checking take-off safety.
Medical equipment includes two removable stretchers; a Propaq Encore Patient Monitoring System to read blood pressure, respiration, pulse oximity and exhaled CO2; Life PAK 12; a 12 lead ECG; Laerdal aspirator; bottled oxygen; bottled entonox; Parapaq ventilator; large box splint; Sagar traction splint; spinal board; stiff neck collars; orthopedic stretcher; carry chair; burns kit; maternity pack; response bags containing dressings, drugs, fluids, intubation equipment, cannulation kit, DEF 18; thermal blanket and spare laundry. Given warning, they take a vacuum mattress to immobilise spinal patients on longer journeys.
The funding challenge
Many Air Ambulances use the same helicopter provider, Bond Air Services. Stevie has contact with these on issues of money, as all struggle to maintain funds. Funding the Air Ambulance is full-time work for her. She has to find £950,000 – just under a million pounds sterling – per year.
She arranges talks, for example to the Lions, Rotary, Inner Wheel and the WI. These raise awareness, as “people often believe we’re NHS-funded.” She says, “We can always use volunteers, and find something that would suit them.”
Interesting recent projects included Kylie signing a brochure (available to the highest bidder – contact Stevie) and a motorbike club raising around £2000 from naked chocolate wrestling.
There’s a champagne lunch at Newbury Racecourse, a Gala dinner at the Coppid Beech hotel, a lottery, a log chopping contest, carol singers, mobile phone recycling and open gardens events.
The children’s club is Whirlykidz. For £6 kids get a newsletter full of jokes, a crossword, and safety tips. They’re sent a pack including felt tips and a Frisbee.
Details of Whirlykidz and upcoming charity events are on the website, www.airambulancetvac.org.
The government doesn’t directly fund them, but until April 2004, covered 6% of the costs. This £57,000 each year, paid through Royal Berkshire Ambulance Service, who will still provide paramedics and medical equipment, won’t continue.
Stevie says some air ambulances aren’t keen on government funding, wary that in a cash-flow crisis, hours could be cut. She, however, says “I think it would be great.”
They recently moved premises. Their new office is donated by Southern Electric. The move came because Legato were bought out and moved, after two years of providing a home. After a plea, the new donors now actually give more space.
Office supplies are usually donated. Appeals on Radio Berkshire bring these in from local companies. So, donations go straight to funding the helicopter.
Weather affects daily operations. It’s difficult to take off in warm, thinner air but this rarely grounds them in Britain. Steve says “I enjoy the snow when we’re flying,” but fog is dangerous. Fields can be too soft to land in when wet.
Gilly explains that once in the air, it’s easier. “The Air Ambulance is exempt from civil aviation authority regulations so we land as near as possible to accident sites. It takes total priority in the air.”
Despite avoiding traffic jams, there are problems finding the exact spot. Gilly says “From the air, you can’t read house numbers. You don’t know which end of a long road to approach.”
Recent rescues include a multiple trauma from a road accident, a man trapped with his foot in a rotorvator, a collapsed diabetic, a fitting epileptic, a rugby accident, riders – including children – thrown by, or trapped under their horses, and several sledging accidents that no land ambulance could reach. One road traffic accident took an hour to get a rear passenger released, before crew could get the victim to hospital.
