Air Ambulance in UK
Despatch mechanism.
HEMS helicopter tasked by NHS Ambulance control to fly 30 miles to a roundabout outside the Midlands largest trauma centre. Reason: no wheeled ambulances available to attend an RTC at that location.
That trauma centre requires a wheeled ambulance transfer from the hospital helipad to A+E. None available to be put on standby at the helipad.
Ambulance control 'ordered' the helicopter to take the casualty to another hospital 20 miles further away as it had a rooftop helipad.
Job refused by crew. Much wailing and gnashing of teeth by Ambulance control and threats of dire consequences on the (NHS) HEMS crew.
HEMS helicopter tasked by NHS Ambulance control to fly 30 miles to a roundabout outside the Midlands largest trauma centre. Reason: no wheeled ambulances available to attend an RTC at that location.
That trauma centre requires a wheeled ambulance transfer from the hospital helipad to A+E. None available to be put on standby at the helipad.
Ambulance control 'ordered' the helicopter to take the casualty to another hospital 20 miles further away as it had a rooftop helipad.
Job refused by crew. Much wailing and gnashing of teeth by Ambulance control and threats of dire consequences on the (NHS) HEMS crew.
Actually 206 Jock I agree with DeltaNg
It is indeed the system that I criticise. I believe there is an important role for helicopters in the medical arena but like any other expensive medical resource it is vital we ensure they are used efficiently and effectively.
If your CT scanner sits empty due to incompetent staffing or if your operating theatre is underused due to inefficiency you rightly complain and I am brought to task. Why not here?
It is indeed the system that I criticise. I believe there is an important role for helicopters in the medical arena but like any other expensive medical resource it is vital we ensure they are used efficiently and effectively.
If your CT scanner sits empty due to incompetent staffing or if your operating theatre is underused due to inefficiency you rightly complain and I am brought to task. Why not here?
In the case of Bertie's example (even if it's only half true), the management team of the charity are at fault - and their trustees for not providing sufficient oversight. There should be a sufficiently robust SLA between the charity and the local Ambulance Service which prevents an air ambulance asset being used merely to cover the lack of road assets. Every charity I know, works on these.
But if it's TAAS, they are undoubtedly focussing on other things that are important to them, like taking over the world.
Getting tasking right is never going to be an exact science. But if all parties agree on the correct measures and work towards them, it's a Good Thing.
But if it's TAAS, they are undoubtedly focussing on other things that are important to them, like taking over the world.
Getting tasking right is never going to be an exact science. But if all parties agree on the correct measures and work towards them, it's a Good Thing.
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Job refused by crew. Much wailing and gnashing of teeth by Ambulance control and threats of dire consequences on the (NHS) HEMS crew.
Sounds as if there is scope for the cultivation of a little camaraderie between the NHS and HEMS staff!
In the rotary HEMS/SAR part of the problem there may be scope for a new role for someone who can bang heads together. An aviator whose principle responsibility is the good of the casualty/patient?
HEMS in UK cannot 'self task'. Task has to come from (or be approved by, if HEMS crew happen upon an incident) an NHS ambulance control.
Upset 'control' by refusing a task ...then watch the helicopter call out rate drop for the rest of the month!
I observed 12 years of this. Hopefully with the increase in doctors on HEMS crews, Amb control managers' histrionics will finally be nipped.
Upset 'control' by refusing a task ...then watch the helicopter call out rate drop for the rest of the month!
I observed 12 years of this. Hopefully with the increase in doctors on HEMS crews, Amb control managers' histrionics will finally be nipped.
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The north west now have a dedicated trauma cell and a HEMS paramedic in the control room. From day one the volume and quality of our tasking has increased, this is not just used for helicopters I might add.
then watch the helicopter call out rate drop for the rest of the month!
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Victoria Park is 1000 feet from.....
Singleton hospital, a 550 bed modern hospital with 24 hour A and E and 4 consultant orthopaedic surgeons, 2 of whom specialise in trauma.
Morriston hospital is some 4-5 miles away. Less than ten minutes even if you stop at the red lights. 750 beds - one of the largest in the country.
We dont have traction splints on ambulances in general because they are not needed! Fractured legs are managed day in and day out by land ambulances. Even if there were risk to a blood vessel or nerve, the bloke could have been on the operating theatre next door before helimed could have got their frictions off.
With rubbish like this is it any wonder HEMS have a bad reputation amongst so many doctors.
Singleton hospital, a 550 bed modern hospital with 24 hour A and E and 4 consultant orthopaedic surgeons, 2 of whom specialise in trauma.
Morriston hospital is some 4-5 miles away. Less than ten minutes even if you stop at the red lights. 750 beds - one of the largest in the country.
We dont have traction splints on ambulances in general because they are not needed! Fractured legs are managed day in and day out by land ambulances. Even if there were risk to a blood vessel or nerve, the bloke could have been on the operating theatre next door before helimed could have got their frictions off.
With rubbish like this is it any wonder HEMS have a bad reputation amongst so many doctors.
Jateeto is correct regarding behaviour of SOME control staff, and worse than that, some control room staff are quite adept at "sexing up" a job in order to justify sending a helicopter knowing full well it does not require one.
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Yorkshire AA have been self-tasking for at least 5 years. Stand down rates immediately plunged dramatically in our own region, but unfortunately neighbouring areas still call us in for the flimsiest of reasons. (Usually because they have no road crews). Stand down rates are huge, but they insist we are needed even when we point out that we are at least 25 minutes from the incident.
15 minutes flying time later and we are stood down. Apart from one one famous occasion when they forgot to stand us down, and we arrived at a job 60 miles from base to find a policeman with a broom sweeping up the broken taillight glass from the "emergency".
I should be able to let it all flow over me by now, but it annoys me beyond all reason. Unfortunately I'm just the driver and have no say in the despatch procedure, this being the realm of the "medical professional". Ha.
15 minutes flying time later and we are stood down. Apart from one one famous occasion when they forgot to stand us down, and we arrived at a job 60 miles from base to find a policeman with a broom sweeping up the broken taillight glass from the "emergency".
I should be able to let it all flow over me by now, but it annoys me beyond all reason. Unfortunately I'm just the driver and have no say in the despatch procedure, this being the realm of the "medical professional". Ha.
Sorry Bladecrack but as a prehospital care practitioner I am far from detached
This wasn't a badly fractured leg. If you look at the press article it was merely a suspected fracture, and newspapers are so well known for melodrama I am happy to postulate it was merely a strain. But whether or not the leg was broken, ambulance services have a range of responses including senior officers, paramedic vehicles, ambulances, first responders, pre care practitioners and even midwives and GPs
If the local control confirms they had absolutely nobody and couldn't pull a response unit from a less urgent task such as a GPs request for admission, then so be it but in reality it is very rare for an ambulance service to be so over stretched in an urban setting to justify using a helicopter merely to meet government response. Even when they are stretched to the limit a specific plan is used which don't involve helicopters.
This wasn't a badly fractured leg. If you look at the press article it was merely a suspected fracture, and newspapers are so well known for melodrama I am happy to postulate it was merely a strain. But whether or not the leg was broken, ambulance services have a range of responses including senior officers, paramedic vehicles, ambulances, first responders, pre care practitioners and even midwives and GPs
If the local control confirms they had absolutely nobody and couldn't pull a response unit from a less urgent task such as a GPs request for admission, then so be it but in reality it is very rare for an ambulance service to be so over stretched in an urban setting to justify using a helicopter merely to meet government response. Even when they are stretched to the limit a specific plan is used which don't involve helicopters.
Homonucleus, you are in danger of making yourself look a prat. As a "prehospital care practitioner", you ought to know better.
Let's look at a few of the things that we do know. I won't call them facts, as we weren't there and none of us know - that includes you. Just because you think something is true, doesn't make it so.
- as land based assets were also on scene (read the article!), it seems likely to me that this was a crew request for aircraft assistance. Not only does the article say that there were three assets on scene, the second pic shows guys in green: almost certainly ambulance techs or paramedics
- the fact that the patient was airlifted to Morriston would indicate that the people on the ground (air and land) decided that this was the best option for the patient.
I'm sure there's a valid point somewhere in your arguments, but for the life of me, I cannot see it.
And on a wider note, if you really think that Air Ambulances are any use in meeting government response targets, you need to get out more. An air ambulance will almost always take longer to get to scene than a land-based asset: just getting the aircraft airborne takes at least 3 minutes.
Let's look at a few of the things that we do know. I won't call them facts, as we weren't there and none of us know - that includes you. Just because you think something is true, doesn't make it so.
- as land based assets were also on scene (read the article!), it seems likely to me that this was a crew request for aircraft assistance. Not only does the article say that there were three assets on scene, the second pic shows guys in green: almost certainly ambulance techs or paramedics
- the fact that the patient was airlifted to Morriston would indicate that the people on the ground (air and land) decided that this was the best option for the patient.
I'm sure there's a valid point somewhere in your arguments, but for the life of me, I cannot see it.
And on a wider note, if you really think that Air Ambulances are any use in meeting government response targets, you need to get out more. An air ambulance will almost always take longer to get to scene than a land-based asset: just getting the aircraft airborne takes at least 3 minutes.
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a bona-fide collector for my local AA knocked on my front door a few months ago, and I gladly reached for my wallet to give him some notes.
Oh no, he says, he wants my credit card and shoves a form at me wanting to sign up to a monthly direct debit for 20 quid minimum.
Oh no, he says, he wants my credit card and shoves a form at me wanting to sign up to a monthly direct debit for 20 quid minimum.
Last edited by DX Wombat; 10th Sep 2013 at 12:59.
206: I flew HEMS for many many years. Believe me when I tell you that Hospital trusts through the AA use(d) the helo to tick off several government targets none less prolific than the then 6 minutes from "x" percent of the population statistic.
I need to add one more thing to not only you but anyone else "questioning" Homonculus' credentials. Be very very careful when you address this particular pseudonym...one never knows who or what lies behind it. Do your research
I need to add one more thing to not only you but anyone else "questioning" Homonculus' credentials. Be very very careful when you address this particular pseudonym...one never knows who or what lies behind it. Do your research
206 jock
The article says the diagnosis was a suspected fractured leg and I am commenting on the article as I have no other information. The point you can't understand is that I question is why there was a reason to use a helicopter.
I am bemused by the article stating that other resources were on the ground because I can't understand why the other resources didn't take the suspected fractured leg to the next door hospital. That doesn't make me a prat but just reflects the fact that this is a rumour network where we discuss the issues as presented to us. The media often get it wrong and this article may be total rubbish, but that is the fun of participating on this site.
I stand by my original opinion, namely that a suspected fractured leg next door to a major a and e department is normally properly managed by any front line vehicle and does not need a helicopter.
The article says the diagnosis was a suspected fractured leg and I am commenting on the article as I have no other information. The point you can't understand is that I question is why there was a reason to use a helicopter.
I am bemused by the article stating that other resources were on the ground because I can't understand why the other resources didn't take the suspected fractured leg to the next door hospital. That doesn't make me a prat but just reflects the fact that this is a rumour network where we discuss the issues as presented to us. The media often get it wrong and this article may be total rubbish, but that is the fun of participating on this site.
I stand by my original opinion, namely that a suspected fractured leg next door to a major a and e department is normally properly managed by any front line vehicle and does not need a helicopter.
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The article says the diagnosis was a suspected fractured leg and I am commenting on the article as I have no other information. The point you can't understand is that I question is why there was a reason to use a helicopter.
I am bemused by the article stating that other resources were on the ground because I can't understand why the other resources didn't take the suspected fractured leg to the next door hospital. That doesn't make me a prat but just reflects the fact that this is a rumour network where we discuss the issues as presented to us. The media often get it wrong and this article may be total rubbish, but that is the fun of participating on this site.
I stand by my original opinion, namely that a suspected fractured leg next door to a major a and e department is normally properly managed by any front line vehicle and does not need a helicopter.
I am bemused by the article stating that other resources were on the ground because I can't understand why the other resources didn't take the suspected fractured leg to the next door hospital. That doesn't make me a prat but just reflects the fact that this is a rumour network where we discuss the issues as presented to us. The media often get it wrong and this article may be total rubbish, but that is the fun of participating on this site.
I stand by my original opinion, namely that a suspected fractured leg next door to a major a and e department is normally properly managed by any front line vehicle and does not need a helicopter.
Last edited by Bladecrack; 11th Sep 2013 at 23:56.