Operations Director, Nigel Hare, shares with us how delivering life-saving treatment at the scene of an incident, may sometimes look  like ‘Devon Air Ambulance was not needed’.

The enhanced and critical care that our Doctors and Paramedics can provide patients in their time of need continues to expand each year. Indeed, part of our culture is to continually strive to provide the patient with the very best chance of a successful outcome; and when minutes matter, being able to deliver the latest contemporary care can make the difference between life and death. 

Speed is just part of the package

In rural Devon, transporting patients long distances to a hospital able to provide the specialist treatment the patient requires, is often much quicker by Air Ambulance. However, getting the patient to the right hospital quickly, is only part of the package of care that patients need to survive. 

Reaching a seriously ill or injured patient fast, whether they are in their home, at work or enjoying the great outdoors, and being able to stabilise them sufficiently that they will survive the journey to hospital, is just as important as a rapid transfer to that hospital.  

More and more of the care that Devon Air Ambulance is able to provide patients, in what we refer to as the ‘pre-hospital environment’, is otherwise only available to them once they have arrived in a hospital. The treatment we can provide to a patient with time-critical needs often means we have to consider carefully what the best mode of transport to the hospital will be, so we can continue to deliver that care safely and help keep the patient alive.  

Weighing up the options

For long distances to specialist treatment centres, the speed of the helicopter may appear the obvious choice of transport. However, sometimes, despite the sophisticated care we can deliver, and flying at around 150-160 miles per hour, the patient’s condition may be such that they might not survive the journey to hospital. 

In these circumstances our clinical team will consider whether opting to convey the patient to the closest hospital instead, perhaps for immediate life-saving surgical intervention, prior to them being transferred to the specialist treatment centre, is the best option for the patient.  

On occasion, to enable the effective delivery of care, we need to be able to access multiple areas of the patient at the same time. This is more challenging in our EC135 helicopters and is one of the main reasons, with your help, we have been able to invest in a larger H145 helicopter which provides greater access to the patient in flight. 

As we develop the ability to deliver a greater level of the care that is otherwise only available inside a hospital, we are being called to treat more and more patients in towns and cities, even though the patient may be located only a short distance away from the local hospital. For when minutes matter, our care might be what keeps the patient alive long enough to reach a hospital that is even a short journey time away.

Sadly, there are also times when a seriously ill or injured patient does not survive and dies at the scene of the incident. This is often despite the ambulance service and our team working closely together to deliver the high-quality care the patient required, even with our team delivering the very same enhanced and critical care interventions that, in different circumstances, result in us saving the patient’s life.  

Care in the time of COVID

Recently, during the COVID-19 pandemic, our team has had a new consideration to factor into their decision making on how best to transport our patients: What is the safest way to deliver the care the patient needs while keeping them, the crew and other responders safe from the risk of cross-infection? 

Due to the nature of the Level 3 Personal Protective Equipment (PPE) and the impact of taking up to an hour after the incident to decontaminate the helicopter before it can respond again, we are not available to respond to the next patient who might need us and are more frequently opting to travel with the patient in a land ambulance to the hospital.  

There in your hour of need

Along with other factors beyond our control, such as occasionally knowing the hospital we want to take the patient to is shrouded in fog, meaning transferring the patient by road is the safest and only option, there are numerous occasions where to the casual onlooker, the helicopter arrives but does not convey the patient to the hospital.  

This is often misinterpreted as ‘Devon Air Ambulance was not needed’ and indeed is frequently reported as such in social/mainstream media. With our clinical team delivering the very highest level of care, not just at the scene, but also en-route to hospital in a land ambulance, the reality often cannot be further from the truth,

The speed of Devon’s Air Ambulance helicopters will always play an essential part in enabling us to reach patients fast to transport them to specialist hospitals quickly. However, as the level of care we provide continues to develop, and the interventions and equipment we use become more sophisticated, we will continue to convey some patients to hospital by road when it is in the patient's best interest for us to do so.   

Far from ‘Devon Air Ambulance not being needed’, with your continued fantastic support, we expect the number of patients we are called to help to continue to increase, as we seek to deliver our Vision of a 24/7 Emergency Medical Service for the most critically ill and injured.  

As a charity that is 100% independent, it is entirely thanks to incredible supporters like you that we are able to keep attending our patients and delivering specialist critical care. We welcome your continued support.