Flying doctors: a bird's eye view

For air ambulance medical crews, critical injuries and life-or-death decisions are all in a day's work. Jeremy Laurance takes to the skies with them

I was holding a cup of coffee in one hand and a chocolate biscuit in the other when the phone rang. The sound it emitted – a high-pitched, piercing klaxon – sent an involuntary shiver down my spine.

The two-storey Portakabin that serves as HQ for the Warwickshire and Northamptonshire Air Ambulance sits on the edge of Coventry airfield. It was 11.57am and I was sitting on the black sofa, togged up in my orange flying suit. Mac McDaniels, a grizzled ex-marine pilot, was halfway down the stairs by the time I got to my feet. As I set off after him, Keith Rutherford, paramedic, answered the call. There had been a road accident – category A, the most serious – with one female casualty.

We headed for the helicopter 40 yards away. Mac started the engines as I climbed aboard, followed closely by Keith and Pam Hardy, consultant A&E specialist and today's on-duty flying doctor. We took off before noon, nose down, skimming low north west across the airfield.

We gained height, but not much. Most missions are flown at between 500ft and 1000ft. A red kite dodged underneath us as a patchwork of green fields unfolded below.

We banked hard and I found myself staring into someone's conservatory. Then we were winging away into the sun. I was beginning to have fun.

Not for long. Below us there was a car on its side and a person under a striped red duvet lying on the carriageway – the M1 southbound. The traffic was still flowing in the outside lane, so Mac put down in a field and we clambered up a bank by a culvert and over a fence to the road. It was 12.10pm. The casualty, a woman aged 35, was lying on her back with her knees up. A land ambulance crew was already tending to her – they had removed her shoes and placed heart monitors on her feet and hands. Her bright-pink painted toenails looked incongruous in the carnage. Every window in her car was smashed and the roof pulverised. CDs were scattered for a hundred yards. She was wearing blue jeans, a blue gauze top and there was a small patch of blood on the road. She was trying to speak.

She had been flung out of her car as it rolled across three lanes of the motorway. Miraculously no one else had been hit. A white-haired man leaning against a crash barrier had been driving the van behind. "I heard a bang and saw her car spin. She came out like a rag doll. I don't know how she is still talking," he said. A young woman next to him leaned across. "I was on my way to university and I thought I had better see if I could help. I am a student nurse. It's my duvet."

Pam and Keith and the land crew quickly established that the woman had apparently escaped critical injury. There would be no requirement on this occasion for anaesthetic, rapid sequence intubation, or thoracotomy – opening of the chest to directly massage the heart in cases of cardiac arrest – all part of their day's work.

Their main concern was that her head or spine might be damaged or she may have suffered internal injury through the force of the impact, tearing blood vessels or rupturing organs.

"Patients talk and die – we've all seen them," Pam said.

The crews manoeuvred the woman onto a stretcher, wedged her head with stabilisers and strapped her down. She began to speak: "I remember now. I was in the middle lane and a big car came in this lane and I had to pull over – and my car lost control."

Police closed the motorway so Mac could bring the helicopter up and put it down on the asphalt.

"You have to stop the traffic in both directions, otherwise you get rubberneckers smacking into the back of the car in front," he said. Keith called Walsgrave hospital to brief them. He gave them an ETA of 15 minutes, but it will actually take us six. A land ambulance would have to go down to the next junction, turn around, come back up the north carriageway and head to Leicester hospital – the nearest – where there is no neurosurgical unit; a longer journey to a less appropriate destination. It is not only the time to hospital that counts. Even more important is the time to "definitive care". That is where the helicopter scores.

With the casualty on board we took off and skimmed down the motorway. Below us people were out of their cars looking up. At 12.46pm we touched down at Walsgrave. "My hand hurts – am I badly hurt? the woman asked. "No, not too bad," said Keith, kindly. In another minute she was in A&E and Keith was briefing the intake team.

"Swerved... ejected... apparently not knocked out... facial abrasions... pain in both arms... no gross deformity."

"Unbelted, presumably?" asked the receiving doctor. But it was a rhetorical question. No one answered.

We headed back to base. From the moment we climbed into the helicopter the team was back on call.

"So many accidents you go to – they have been so lucky," said Keith. "To be ejected from a car is a massive incident – what we call a red flag." "Yeah and others, they have a little bump and they have got a really serious injury," said Pam. "Modern, expensive cars are a problem," said Mac. "They are so well-built that fire crews have a real problem cutting people out."

For speed of response with a specialist medical team, a helicopter ambulance cannot be rivalled. But it is expensive – an average £1,400-a-trip compared with £200 for a land ambulance.

Only one is state run, that serving the Scottish Highlands and Islands. Some 23 others covering the rest of Britain are all run by charities.

The Warwickshire and Northamptonshire service, which operates in tandem with the neighbouring Derbyshire, Leicestershire and Rutland service receives no Government grant or lottery funding and raised £5.25m in 2010, more than enough to pay its running costs of £4.42m.

After a shaky period in 2004, when it made a £400,000 loss, it is now secure, fiercely independent and proud of its success, based on "thinking like a business", according to medical director Dushy Kumar.

He says: "We don't want state funding. To ask for it in a time of austerity would be foolhardy. There is no way the country can afford to fund air ambulances."

But then he adds: "To the people we serve we are priceless."

It is hard to disagree.

Flying doctors

* The Warwickshire and Northamptonshire Air Ambulance covers most of the UK's main motorways such as the M1, M6 and the M40.

* It costs around £1,400 per mission, reaching an annual cost of more than £1.7 million and the service receives no funding from the Government.



* The service covers more than 2,200 square miles and a population of 1.2 million people.



* In 2010, the WNAA attended 1,500 incidents, averaging around four call-outs a day. In 2011 so far, they have attended 1,200 incidents already.



* The average response time is around six minutes.



* The service consists of 15 doctors, 15 paramedics and 6 pilots



* WNAA are able to bypass the nearest hospital and provide a fast transfer to the best hospital or trauma centre to treat the patient's specific injuries.



* The additional skills of the crew can bring the hospital emergency department and surgical intervention to the accident scene, often meaning the difference between life and death.

DAVID BRAKE

PROMOTED VIDEO
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Sport
Two christmas trees ,Moonbeam (2L), Moonchester (2R) and Santa Claus outside the Etihad Stadium
footballAll the action from today's games
News
Sarah Silverman (middle) with sister Reform Rabbi Susan Silverman (right) and sister actress Laura Silverman (left) at Jerusalem's Western Wall for feminist Hanuka candle-lighting ceremony
peopleControversial comedian stages pro-equality Hanukkah lighting during a protest at Jerusalem's Wailing Wall
Arts and Entertainment
The Bach Choir has been crowned the inaugural winner of Sky Arts’ show The Great Culture Quiz
arts + ents140-year-old choir declared winner of Sky Arts' 'The Great Culture Quiz'
Life and Style
food + drink
News
i100
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Finance Director

    £65000 - £80000 per annum: Recruitment Genius: Finance Director required to jo...

    Recruitment Genius: Medico-Legal Assistant

    £15000 - £25000 per annum: Recruitment Genius: This is a unique opportunity fo...

    Ashdown Group: (PHP / Python) - Global Media firm

    £50000 per annum + 26 days holiday,pension: Ashdown Group: A highly successful...

    The Jenrick Group: Quality Inspector

    £27000 per annum + pension + holidays: The Jenrick Group: A Quality Technician...

    Day In a Page

    Homeless Veterans appeal: 'You look for someone who's an inspiration and try to be like them'

    Homeless Veterans appeal

    In 2010, Sgt Gary Jamieson stepped on an IED in Afghanistan and lost his legs and an arm. He reveals what, and who, helped him to make a remarkable recovery
    Could cannabis oil reverse the effects of cancer?

    Could cannabis oil reverse effects of cancer?

    As a film following six patients receiving the controversial treatment is released, Kate Hilpern uncovers a very slippery issue
    The Interview movie review: You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here

    The Interview movie review

    You can't see Seth Rogen and James Franco's Kim Jong Un assassination film, but you can read about it here
    Serial mania has propelled podcasts into the cultural mainstream

    How podcasts became mainstream

    People have consumed gripping armchair investigation Serial with a relish typically reserved for box-set binges
    Jesus Christ has become an unlikely pin-up for hipster marketing companies

    Jesus Christ has become an unlikely pin-up

    Kevin Lee Light, aka "Jesus", is the newest client of creative agency Mother while rival agency Anomaly has launched Sexy Jesus, depicting the Messiah in a series of Athena-style poses
    Rosetta space mission voted most important scientific breakthrough of 2014

    A memorable year for science – if not for mice

    The most important scientific breakthroughs of 2014
    Christmas cocktails to make you merry: From eggnog to Brown Betty and Rum Bumpo

    Christmas cocktails to make you merry

    Mulled wine is an essential seasonal treat. But now drinkers are rediscovering other traditional festive tipples. Angela Clutton raises a glass to Christmas cocktails
    5 best activity trackers

    Fitness technology: 5 best activity trackers

    Up the ante in your regimen and change the habits of a lifetime with this wearable tech
    Paul Scholes column: It's a little-known fact, but I have played one of the seven dwarves

    Paul Scholes column

    It's a little-known fact, but I have played one of the seven dwarves
    Fifa's travelling circus once again steals limelight from real stars

    Fifa's travelling circus once again steals limelight from real stars

    Club World Cup kicked into the long grass by the continued farce surrounding Blatter, Garcia, Russia and Qatar
    Frank Warren column: 2014 – boxing is back and winning new fans

    Frank Warren: Boxing is back and winning new fans

    2014 proves it's now one of sport's biggest hitters again
    Jeb Bush vs Hillary Clinton: The power dynamics of the two first families

    Jeb Bush vs Hillary Clinton

    Karen Tumulty explores the power dynamics of the two first families
    Stockholm is rivalling Silicon Valley with a hotbed of technology start-ups

    Stockholm is rivalling Silicon Valley

    The Swedish capital is home to two of the most popular video games in the world, as well as thousands of technology start-ups worth hundreds of millions of pounds – and it's all happened since 2009
    Did Japanese workers really get their symbols mixed up and display Santa on a crucifix?

    Crucified Santa: Urban myth refuses to die

    The story goes that Japanese store workers created a life-size effigy of a smiling "Father Kurisumasu" attached to a facsimile of Our Lord's final instrument of torture
    Jennifer Saunders and Kate Moss join David Walliams on set for TV adaptation of The Boy in the Dress

    The Boy in the Dress: On set with the stars

    Walliams' story about a boy who goes to school in a dress will be shown this Christmas