The inclusive London Trauma System works in conjunction with a number of prehospital providers both in and outside the greater London area. Major trauma centres and trauma units are fortunate enough to have excellent working relationships with the following pre-hospital organisations:
London’s Air Ambulance (LAA) is a charity that operates in partnership with both Barts Health NHS Trust and London Ambulance Service (LAS). Advanced trauma doctors from Barts Health are seconded to LAA and LAS provide specialist paramedics. LAA’s home helipad is located at the Royal London Hospital.
A LAA advanced trauma paramedic operates from the LAS control room and is responsible for dispatching the LAA to the most critically injured people in London, 24 hours a day. Their paramedics are constantly monitoring and interrogating the 4,500 daily ‘999’ calls, actively looking for seriously injured people who require a trauma team response.
LAA treat an average of five seriously injured people in London every day. During the day, the helicopter is airborne within four minutes of activation and the average flight time to patients is six minutes. At night, LAA use rapid response cars on blue lights to reach patients as quickly as possible.
The combination of a senior trauma doctor and an advanced paramedic form an advanced trauma Helicopter Emergency Medical Service (HEMS) team. The team blend civilian medical procedures with aspects of aviation and military practice to deliver intensive trauma care to people with life-threatening injuries at scene. The doctor led teams are trained to make complex medical decisions and perform surgical procedures when and where the patient needs them.
London Air Ambulance (LAA) have produced a booklet documenting the stories of 10 trauma survivors, with the objective of giving severely injured patients and their families hope. You can download it here. If you'd like to be involved with the service or know more about LAA, please contact their outreach officer Frank Chege
More information is also available on the LAA website.
London Ambulance Service (LAS) is the busiest emergency ambulance service in the UK and the only London-wide NHS trust. LAS serve a population of more than seven million people who live and work in the London area, handling 1.6 million calls a year and attending over 1 million incidents.
LAS employs over 4,500 staff, who work across a wide range of roles based in 70 ambulance stations. LAS's main role is to respond to emergency 999 calls, providing medical care to patients across the capital, 24 hours a day, 365 days a year. Other services include providing pre-arranged patient transport and finding hospital beds. LAS also work with the police and the fire service to handle large-scale or major incidents in the capital, such as the July 2005 terrorist bombings.
The Service has a number of direct referral pathways, facilitating the bypass of closer Emergency Departments in order to transfer certain categories of patients straight to specialist centres where they will get the best care for their condition. Pathways in place include major trauma (ie direct transfers to major trauma centres), stroke and STEMI heart attacks.
As noted above, LAS highly trained critical care paramedics are an important part of London's HEMS response.
More information is available on the LAS website.
Download LAS Major Trauma Triage Tool (Adults)
Download LAS Major Trauma Triage tool (Children)
East Anglian Air Ambulance (EAAA) Charity provides a HEMS service for the critically ill and injured in Bedfordshire, Cambridgeshire, Norfolk and Suffolk. They fly two aircraft, including an EC145 T2 which is ‘fully night-capable’, meaning it can be used for HEMS missions after dark. EAAA is the first air ambulance to achieve this.
In addition to the pilot, both aircraft are crewed by a trauma specialist doctor and paramedic team.
All 999 calls received by the East of England Ambulance Service Trust (EEAST) are monitored by the Critical Care Desk, staffed by a specially trained dispatcher and critical care paramedic. Their role is to identify the most serious or life-threatening incidents and send critical care resources to help treat severely ill patients. At the scene, these enhanced medical teams work alongside ambulance crews to ensure the best possible pre-hospital care before transferring the patient to hospital.
EAAA and EEAST’s extended skilled and critical care paramedics are part of the pre-hospital critical care network within the East of England.
More information available on the EAAA website.
Essex and Herts Air Ambulance Trust
The Essex & Herts Air Ambulance Trust (EHAAT) is a Charity that provides the only HEMS service for the critically ill and injured in Essex, Hertfordshire and surrounding areas. It manages two helicopter services - Essex Air Ambulance and Herts Air Ambulance.
The HEMS crews comprise a Pilot, a Pre-hospital Care Doctor and Critical Care Paramedic. Pre-hospital critical care is brought to a patient at the scene enabling life-saving procedures to start at the earliest opportunity. In addition to trauma, EHAAT HEMS also respond to other time critical life threatening calls such as cardiac arrest and stroke. They work with partner organisations such as the police, fire rescue and ambulance service to deliver the patient to the most appropriate treatment centre as quickly and as safely as possible.
The Essex Helicopter is based at Earls Colne Airfield, with the Herts helicopter operating out of North Weald Airfield. The HEMS Service is operational 7 days a week from 7.00am to 9.00pm or sunset whichever occurs first. Each aircraft is deployed on average 2-3 times per day.
In addition, the Charity provides fully equipped Rapid Response Vehicles (RRVs) for use when the aircrafts are grounded due to bad weather, require urgent unplanned maintenance or during the hours of darkness. The RRVs carry full life-saving equipment exactly like the helicopters.
These services are a vital part of the North East London and Essex Trauma Network, as well across the East of England. EHAAT (HEMS) works closely with air ambulances in London, Kent, Surrey, and East Anglia to ensure full coverage and mutual support of the areas where they operate.
More information available on the EHAAT website.
The Kent, Surrey & Sussex Air Ambulance Trust (KSSAAT) is a Charity that operates two HEMS aircraft out of bases at Marden in Kent and Redhill in Surrey. Each KSS aircraft is crewed by at least one experienced Pilot and a minimum of one Doctor and one Paramedic, who are trained in advanced pre-hospital care, which gives them the knowledge and skills necessary to assess and stabilise critically ill and injured adults and children. This means that a number of specialist clinical procedures that are normally only available in the resuscitation area of an emergency department can be delivered to patients at the scene, such as, general anaesthesia, advanced pain relief and for a small number of patients surgical interventions.
KSS work very closely with South East Coast Ambulance Service NHS Foundation Trust (SECAmb) responding to over 2,000 emergency calls a year. The normal operating area of the charity is therefore defined by the region that SECAmb covers and includes Kent, Surrey, Sussex, and a small area of North Hampshire. The total region covered has a resident population of 4.5 million people and crews are able to reach any destination across these counties in under 20 minutes flying time.
The air ambulance is deployed by a specialist paramedic working on the HEMS desk at the control centre of SECAmb, who screens all 999 emergency calls coming into the ambulance service to establish if the air ambulance would be of benefit to the patient.
More information is available on the KSS Air Ambulance website.
South East Coast Ambulance Service
The South East Coast Ambulance Service (SECamb) NHS Foundation Trust provides emergency ambulance care across in Surrey and Sussex as well as non-emergency patient transport services (pre-booked patient journeys to and from healthcare facilities). SECamb responds to calls overs a geographical area of 3,600 square miles (Brighton & Hove, East Sussex, West Sussex, Kent, Surrey, and North East Hampshire) covering rural areas and busy stretches of motorway.
Over 3,600 staff work across 110 sites in Kent, Surrey and Sussex, responding to over 860,000 calls a year.
As indicated above, SECamb works closely with KSS Air Ambulance, providing specialist paramedics in the control centre to identify when a HEMS response is needed and to assist with on the ground critical care delivery during KSS trauma cases.
Both KSS and SECAMB are a vital part of the South East London, Kent and Surrey Trauma Network.
More information is available on the SECamb website.
