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Air ambulance emergency - what really happens in the sky

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Despised for Saving Lives - London's Air Ambulance fights for survival  

The Daily Express Air Ambulance in London celebrated its fifth birthday this week. It has saved many lives but has recently been criticised. Dr Patrick Dixon followed a day in the life of the crew. 

6.47pm With a clattering roar our orange helicopter flew a few hundred feet above the busy London streets. At two hundred miles an hour the air ambulance co-pilot was struggling with an A to Z map.

"That's it. That's it!" he pointed as we swept into a tight circle.

I scanned the tightly packed rows of terraced houses, the busy junction, trees, railway line and then I saw them: road ambulance, police car and a gathering crowd.

It had taken less than two minutes to scramble us into the aircraft with a mobile intensive care unit, doctor, paramedic, myself and two pilots, and five minutes flying to arrive overhead - but there was nowhere to land.

"Details just through now," bellowed the bearded pilot into his helmet mouthpiece above the roar. "Multiple gunshot wounds, stabbing and other injuries". His chances were slim, perhaps minutes to live without extra equipment and medical expertise. We were still spiralling around looking for a clear area.

"The school! It'll have to be the school. I'm going down now. Watch out below."

The helicopter twisted and turned, hovering above the deserted playground. The site was a fortress with twenty foot high fencing and huge metal gates. The co-pilot opened his door and leaned out, guiding the descent and checking no one was below.

Two hundred feet, one hundred, fifty, twenty, ten, five. I could feel my heart thunder as the craft settled.

"Now!" ordered the pilot as we tore at our helmets and straps, pushing the side doors open with heavy kit bags. We jumped and sprinted to the fence in our orange flying gear. Young children were already gathering on the other side.

"How do we get out?" I shouted.

They just shrugged their shoulders and watched us run around like rats in a cage.

Two hundred yards later we were sweating. We vaulted over a gate and into the street, urged on by anxious adults as we ran towards the police lights.

There he was on the pavement, completely surrounded by a crowd ten deep. Not much more than twenty five years old perhaps with several bullets through him or still inside. Coshed over the head, then stabbed and left to die. Blood everywhere but still very much alive.

The road ambulance crew were relieved to see us. Some twenty police were struggling to keep the swarm of onlookers away. Their friend had been shot and revenge was in the air.

Oxygen up, intravenous fluids, wound packed, monitors wired for blood gases, blood pressure, heart rate, and we were ready to go.

A two minute run in the land vehicle took us through the school gates (cut open by the pilot). Then a quick transfer and into the air. Six minutes later we landed on the rooftop heli-pad, and swept him into the lift down to the trauma unit were he was instantly surrounded by an expert team of fifteen people - and police protection.This is exciting stuff but not for the faint-hearted.

The helicopter has flown over 6,500 missions and saved dozens of lives. Hundreds more have walked out of hospital sooner, or with brains that still work as a direct result of expert medical care.

Yet there is growing opposition to the service. Some doctors feel it is a costly gimmick. They see the helicopter as a massive vacuum cleaner collecting sick people off the streets of London and taking them to the Royal London Hospital, with other hospitals later footing the bill.

There has also been tension at times between road and air crews. In the early days it was not unknown for a road ambulance to rush off with a casualty, just as the helicopter was hovering overhead, even though the nearest specialist unit was miles away.

Then came an unfortunate remark by a coroner a few weeks ago suggesting that a woman would not have died if she had been carried by road - the truth was that she was mortally ill anyway. Worse still was a report published in the British Medical Journal in July saying that the numbers of lives saved were far fewer than hoped (only twelve a year). But the study design made true comparisons difficult, and it failed to measure other benefits.

The future may be uncertain as the NHS market begins to bite. We could see the helicopter forbidden to land in more than half the streets of London if local health officials refuse to pay. That would be a tragedy.

Air Ambulance information


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