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Wales Air Ambulance - info please!

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Old 1st Feb 2014, 00:02
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Angry Wales Air Ambulance - info please!

As a long time resident of Pembrokeshire I am concerned that our Health Board and its collaborators in the Welsh Assembly are proposing to downgrade our A & E Department at Withybush Hospital, Haverfordwest to a daytime only service. They have already announced closure of the Special Care Baby Unit and childrens ward, Orthodaedics and A & E are to follow. Services will be 'centralised' in Carmarthen, which is approx 15 minutes drive from the major hospital at Morriston! Parts of N Pembs, where I live, are over 50 miles (and over an hour's drive) from Carmarthen.
When questioned the CEO/WAG minister stated that any emergencies would go by Helimed to Glangwilli Hospital in Carmarthen.
My question:
1. Does 'our' air ambulance operate 24/7 these days?
2. Is there a helipad at Glangwilli and cleared for night use (when I flew Sea Kings from Brawdy there wasn't).
3. What is the operating cost per hour of the AA.
4. Would it be used to transfer a woman in labour with possible complications.

Many thanks if any current Wales Helimed person can answer, PM me if preferred. Incidentally, I landed the first SK on the then new pad at Withybush and got photographed handing over the 'giant cheque' from Brawdy collections for the new baby unit.
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Old 1st Feb 2014, 03:54
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Wales Air Ambulance - info please!

Can only answer four; no. Contra-indicated, possible delivery/comps and a million other things can't be dealt with in a typical HEMS cab, no room for the escorts either.
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Old 1st Feb 2014, 09:19
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Even if the answer is 24/7, you will know from experience that the weather can modify that at a moments notice, particularly at night.
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Old 1st Feb 2014, 10:01
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1. No
2. Don't know
3. Nothing to the NHS; charity-funded
4. Don't know
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Old 1st Feb 2014, 10:44
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Thanks for your replies so far guys. Rumour has it that the Sea King can no longer land at Withybush HLS and has reverted to the aerodrome just up the road. That's progress, after 25 years . I suspect that the new A & E which opened two years ago and cost millions to build encroached on the safety clearance. Still, the plans are to close that!
Anyone from Chivenor like to comment - Crab??
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Old 1st Feb 2014, 12:09
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Given that your concerns are the reduction in healthcare provision may I interject amongst you revered pilots and offer some healthcare input about your predicament?

The NHS is in a dreadful situation. Standards are about the lowest in the developed world when you look at outcome, although there is massive spin and smoking mirrors. Units are being closed around the UK and fighting this has to be based on statutory requirements.

IMHO there is no mileage in fighting the closure of neonatal or obstetric units. Labour is not an emergency and there is no requirement to get a labouring woman into hospital in a set time. There is scant evidence giving birth at home is more dangerous. Likewise there is no requirement for a close by neonatal unit, and neonates are commonly moved hundreds of miles because local units are frequently full. It is the norm.

Your A and E is presumably going to be open in the day so that will have no effect. If it is closed at night it will have no effect on patients already in hospital, only patients with emergencies who will then have to travel further for care. The question is whether that extra distance will cause a level of harm to enough patients to justify challenging the closure, especially when failing to partially close A and E might result in other closures which themselves effect outcome.

Sadly helicopters are not part of NHS requirements in England and Wales. They are a voluntary service an NHS Trust may avail itself of, but if it doesnt exist the Board of the Trust cannot be held to account. In reality if you have a heart attack in the middle of a snowstorm in a high rise flat in the centre of a city and weigh £280kg a helicopter is of no use anyway.

You therefore need to gather evidence about land ambulances as the NHS Trusts are mandated to provide these to a certain level in a certain time. Can the ambulance service meet the time constraints? Can patients be delivered to the more distant facility in an acceptable time? Can that facility cope with the increased demand?


Healthcare professionals will often say no. Managers always say yes. Saying no but we will cope by using HEMS is very dangerous not only because of the limitations you have identified, but also because it may not exist if the money dries up.
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Old 1st Feb 2014, 12:40
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Thank you very much indeed radgirl! Do you mind if I quote you verbatim on the SWAT (save withybush action team) site?
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Old 1st Feb 2014, 12:53
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My comments are in the public domain so anyone can use them. Keep your steel hat on though and look out for incoming! These politicians dont like anyone disagreeing with them. The only thing they like less is the use of facts and statistics.

Remember your ambulance service has very detailed data on response times and much more. They have to provide them to the Government. They are available to you and others under the Freedom of Information Act..........

PM me any time
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Old 1st Feb 2014, 22:54
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...there is provision to accommodate pregnant ladies (who else?) on many AA helicopters - if there was a need.
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Old 1st Feb 2014, 23:05
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If using NHS ambulance stats be very careful how you interpret them.

I believe some service think its acceptable to use volunteer first responders/community responders to stop the clock. Along with managers, response cars and motorbikes - few cases can be transported in these...

HTC
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Old 2nd Feb 2014, 11:01
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Volunteers

Raising my head above the popular parapet, there's nothing wrong with using volunteers/responders to 'stop the clock'. What's wrong is the clock! 8mins is a meaningless government set target and to achieve it an ambulance service has to deliver ANYONE with a defibrillator and the training to use it to a casualty inside that window.

From a medical point of view - you'll start to develop irreparable brain damage within 3mins but the government realises they're setting themselves up for failure if they set that as the target. What we are left with is an arbitrary target which can be met in London but nowhere else! Personally, if I have a cardiac arrest one day I'd desperately love Butcher Bill to shut his shop and come and do CPR and defib within 8 minutes while we wait for transport to hospital with my paramedic colleagues. Contrary to Daily Fail opinion, they are well trained, well supported and an invaluable part of any rural Ambulance service.

As for centralising services....does anyone know where the very sickest major trauma patients go when they are too unstable to last the trip to the Major Trauma Centre? Yes, you got it, they go to the nearest Trauma Unit hospital to be stabilised. Here you will find a hard-working team of clinicians who are trying to make the best of that while all the services and expertise we need is being stripped out around us
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Old 2nd Feb 2014, 19:31
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Wales Air Ambulance - info please!

Rigga,

Is not the pregnancy that's the problem, it's getting to the 'business end' if required. I may be out of date, I'll check with some HEMS mates.
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Old 3rd Feb 2014, 05:49
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It's a few years since I left the ambulance service but the requirement to stop the clock was a fully crewed ambulance. Has that changed?

I wasn't intending to put down the community responders in anyway but after your butcher or whoever had defibbed me I'd like some definite airway care, treatment of arrhythmias and be on my way to hospital.

HTC
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Old 3rd Feb 2014, 07:28
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About 5 years ago, waiting outside an A+E after delivering a casualty by air, I was talking to a 'First Responder' (a volunteer) who was there. He had been sent by ambulance control, in his car, to 'stop the clock' on an emergency transfer out of the A+E to another hospital.
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Old 3rd Feb 2014, 11:33
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HTC, fair point although a CFR can at least hold your airway open and do a bit of bagging. And yes, the clock-stopping is now all about a defib-trained individual.

Bertie, i've heard of those scenarios as well and that's clearly book-cooking on the targets. Ironically in those cases the 8-minutes is automatically met by the patient being in a hospital so there's no requirement to get anything there before 19mins and that has to be transport anyway.

Cheers
DAC
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Old 3rd Feb 2014, 22:30
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Hi Al,

Sorry to wade in (first post on here as not in aviation professionally - my extra-tenuous link is that I used to be an Air Cadet at Brawdy in the late 80s/early 90s so may have flown in your SK some time ).

I've certainly seen SKs land at Withybush since the new A+E building, I have a pic somewhere of TWO on the gound: one on the pad and one in the staff car park, from a couple of years back, looked like the first was having technical difficulties.

I could offer two guesses as to why thy aren't using the pad at the mo:
1- It could be fire appliance cover - I understand the access/pump fire appliance at Haverfordwest that used to attend any SK landing has been temporarily assigned elsewhere and only a conventional pump appliance or a Sprinter van-based unit is available. The latter a product of yet more public sector cutbacks! Withybush 'Airport' has it's own 4x4 heavy crash tender, but not sure of out of hours availability etc.
2 - Could be due to the building works for the Renal unit, with plant trundling about the site a lot at the mo. Might be way off on both counts however

As for Glan Gwilli having a heli pad, using a very unscientific approach and looking on the (admittedly dated) Google satellite imagery it appears to be a no. Losing parking space might be a difficulty to make one, as there isn't much of that either.

As a local to Hwest, with two kids, it's all very concerning to say the least.
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Old 3rd Feb 2014, 23:52
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Thank you to all responders, first and subsequent! What I thought but hoped for an opinion from the Swansea based guys.
All inputs gratefully received - there seems to be a good deal of apathy amongst the good folk of Pembrokeshire. Many haven't woken up to the fact that there won't be a Sea King next year (although we should be getting Civsar at Swansea) and misinformation from the health board and deafening silence from the Welsh Assembly helps fuel this complacency.

Sime17 Hi, might well have flown you myself but it was the Queen's
helicopter, not mine! I doubt that lack of fire cover is the reason as it was always classed as desirable (goodness knows why) not essential.

Hi Bertie
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Old 4th Feb 2014, 13:17
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If using NHS ambulance stats be very careful how you interpret them
Same applies to some air ambulance units in UK too. There's at least one where a good proportion of their "incidents attended" numbers are by "Rapid Response Car" and not by helicopter.

Remember "lies, damn lies and statistics"
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