Operations Director, Nigel Hare, discusses the variables crews must consider when assisting a patient.

To fly or not to fly...That is the question: 

Or rather, one of the many questions our clinical crew must consider when treating the patients we are called to assist.

Although the majority of patients we convey to hospital are flown by Air Ambulance, the crew will often decide that the patient’s best interests will be served by taking them to hospital in a land ambulance. So far this year (2018) around one in five of the patients we have taken to hospital we have done so in a land ambulance.

Why not fly?

There are various reasons why the crew might opt to drive rather than fly. Sometimes, although the helicopter and crew have been able to reach the patient’s location, the hospital we wish to take the patient to may be shrouded in fog and would be too dangerous for us to fly to or land at, so the safer option of driving is chosen.

As the clinical capabilities of our service continue to develop, we are being called to assist an increasing number of patients located quite close to our main hospitals, as often we still provide the quickest means of the patient having their specialist care initiated, which means you may have noticed the increased frequency that we are now flying into incidents located in the heart of Barnstaple, Torquay, Exeter and Plymouth.

When the incident is a short distance from the hospital, it is often as quick - if not quicker - for us to convey the patient in a land ambulance. Our crew will travel with the patient and continue to deliver care alongside the Paramedic from the South Western Ambulance Service.

Access all areas

Another aspect of our increasing clinical capabilities is the need to maintain good access all around the patient for some of the interventions we provide. This is especially important when performing life-saving surgical procedures.

Depending on the nature of the procedure we need to undertake, or have undertaken at the scene, but may need to continue to deliver during the journey to hospital, sometimes the space around the patient in the helicopter is not sufficient for us to safely undertake the task. With the inside of a land ambulance providing more space around the patient, we will in these circumstances opt for the safest option and travel by road.

Maintaining sufficient space around the patient to safely deliver our enhanced lifesaving interventions, not just those we are currently able to provide patients, but also those that we wish to introduce into our service in the future, is one of the main factors behind our decision to purchase a larger helicopter to replace G-DVAA in 2020.

The speed of an Air Ambulance helicopter will always be essential to enable us to reach patients suffering life-threatening illness or injury quickly. Once with the patient, whether we opt to convey the patient to the hospital by air or by road, our decision will always be based on the needs of each individual patient and how we can provide them with the best possible chance for a successful outcome and full recovery.

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