In February this year,Devon Air Ambulance introduced two new Critical Care Cars (CCC) into service which have built resilience and extended our enhanced and critical care capabilities across Devon. Our two fully equipped Volvo XC90 cars offer a safe speedy response to patients if our aircraft are offline due to adverse weather or maintenance. As more people see the CCCs out on our roads, we thought it would be good to take a more in-depth look at the equipment they carry and how we use them to add to our service.

Our Critical Care Cars

There are several different makes of cars which can be adapted specifically for the emergency services, also known as ‘blue-light’ conversion. Therefore, at the start of the process to select the right car, we spent some time looking at the different models available, learning from the experience of other services that use CCCs and considering our local context and needs. This led us to choose the Volvo XC90 as the best CCC for our service in Devon.

Our Volvo XC90 CCCs have a high-performance powerful hybrid engine which offer good handling at speeds over rough road surfaces and as a 4-wheel drive, they can get us safely off-road and into the Devon countryside when needed. This car also has lots of space – both in terms of roomy seating for up to three clinicians on duty (two paramedics or two paramedics and a doctor) depending on crew configuration that day and essentially, a large boot for all their kit and medical equipment.

The generous storage space means we have some spare capacity as new equipment or kit might be required. For example, having the extra space is useful now as the crew need to carry supplies of PPE to wear when assisting patients. Have a look at a recent video by Critical Care Paramedic Lee Hilton on the Level 2 and Level 3 PPE the crews need to carry to protect themselves and their patients during Coronavirus.

As part of the development of our CCCs, our paramedics have undertaken Level 3 Ambulance Response training, also known as ‘blue light’ training, to provide them with the skills to drive the CCCs safely, whilst travelling quickly to reach our patients in their time of need.

What equipment do we carry on the cars? 

We carry exactly the same advanced medical equipment in the Critical Care Cars as we carry in the helicopter, so we can deliver the same medical treatments to our patients at scene regardless of whether we arrive by helicopter or car. This includes clinical equipment such as ventilators and LyoPlas used to treat patients with severe blood loss.  

Critical Care Paramedic Jess has created a walk-through video that shows the clinical equipment our teams carry and what the inside of the CCC looks like. 

How do we use the Critical Care Cars?

The CCC are primarily located at each airbase which means our crews can quickly use the CCC at short notice should adverse weather or mechanical fault mean we can’t respond in the helicopters. The CCC may also prove beneficial if the patient is located near to the airbase, when it may in fact be quicker for our team to reach a patient by responding by car rather than using the aircraft. Patient need drives everything we do, and the crew will make these time-critical decisions based on factors including patient condition and location, access, proximity to the specialist treatment centre the patient’s reported condition might require and what other emergency resources are responding to the patient.

Where we have advance notice that the aircraft will be offline, such as when they are booked to have their annual maintenance undertaken, then we have the option to locate our CCCs at other strategic locations. Using historical data of the incidents we have attended, alongside that of the ambulance service, we are able to identify which towns, villages or major road junctions to position our CCCs to provide them the best ability to respond to the most likely predicted locations will be needed. For example, when we recently temporarily stood down the aircraft (whilst we put in place measures to protect our patients and crew from Coronavirus), we were able to strategically locate the CCCs to major road junctions around Barnstaple, Exeter, Teignbridge and the South Hams, reducing the time it took us from the when the 999 call was made to reaching the patient. To help enhance our service provision during Coronavirus, the loan of a further CCC by Kastners, our local Volvo dealer based in Exeter, has added to that road-based capability.

We are deployed on our CCCs by the same specially trained Helicopter Emergency Medical Service dispatchers who can identify the patients who are most likely in need of the specialist treatments and interventions our team can provide. Just like our helicopters have specialist aviation GPS navigations systems, our CCCs use a similar system designed for emergency services, which is particularly useful when guiding us across the extensive busy road network in Devon. Again, just like in the helicopters, a member of the team not driving the CCC is able to communicate and liaise with other emergency services while enroute to the incident.

Whilst we are a helicopter-led emergency service, it’s clear that our Critical Care Cars have enabled us to build resilience and extend our enhanced and critical care service across Devon. Indeed, since coming online in February, we have completed over 100 missions using these cars, already demonstrating the huge benefit they can bring to our communities.

We are very grateful to Department of Health and Social Care for awarding us a grant within the Autumn 2019 budget which fully covered the cost of purchasing and equipping both our CCCs, and to Volvo Car UK, who supported us in designing the specification of the CCCs to best meet our needs in Devon.