AIR APPARENT
Air ambulance charities provide vital support to the emergency services, scrambling to save lives on Britain’s roads. John Evans finds out more
On average, each day five people die on UK roads and 84 are seriously injured. Those are sobering figures, but it’s comforting to know that rushing to provide assistance at the scene are not only the landbased emergency services but also one that arrives from above: the air ambulance service. There are 21 such services around the UK and, remarkably, they are all charities reliant for most of their income on donations. The first to take to the skies was Cornwall Air Ambulance, in 1987. Today, it and its 20 fellow services together fly around 80 missions per day, 32% of those involving medical emergencies while 68% are attending traumatic injuries. Providing emergency cover across a large swathe of the south-east is the Kent, Surrey, Sussex Air Ambulance Charity (KSS). From its main base at Redhill Aerodrome and its forward-operating base at Rochester airport, KSS’S two Agusta Westland 169 helicopters (there’s a third in reserve) typically fly eight missions across two shifts per 24-hour period. In 2021, 863 of its missions (28% of the total) involved road accidents (RTCS). Last year was KSS’S busiest on record, with 2063 helicopter call-outs in total, an average of nearly six per day. “RTCS are our most common mission,” says Duncan Bootland, medical director of KSS and one of the charity’s team of helicopter emergency medical service doctors who attend incidents. “Some RTCS can look really bad. However, these days, thanks to improvements in safety, modern vehicles are amazingly capable of transferring crash energy away from occupants, so we now see a smaller number of people who are seriously injured. We see fewer occupants who are profoundly trapped, too. Instead, the ages of those who are seriously injured are changing, with over half of them now aged over 65 years. The more frail that people are, the greater the risk of injury by energy transfer and the more complex their injuries are likely to be.” Despite a KSS team’s ability to be airborne in just a couple of minutes in a helicopter capable of flying at up to 190mph, it won’t always be first to an incident. What matters is the extra support they are able to bring with them including, if necessary, rushing a patient to one of the major trauma centres in London or Brighton.
“We’re a delivery service,” says Bootland. “KSS delivers a specialist paramedic and a doctor, who is not present in an ambulance crew, trained to deal with everything from trauma to performing open heart surgery on the roadside. We also bring much of the vital kit and fluids necessary to help patients survive. As recently as 10 years ago we couldn’t deliver blood and perform transfusions. We can now.” That KSS can do so is due in great part to the charity’s recently acquired Agusta Westland 169s. They first arrived in 2017, offering a much greater payload than their predecessors, in addition to a larger cabin providing easier patient access and the space to perform life-saving interventions while in the air. Thanks to its two 1000 shaft horsepower Pratt and Whitney turboshaft engines, it’s a fast and efficient machine. Even so, co-pilot Mike Jones says the fear of engine failure, especially in extreme situations, is always present. “We’re often operating in small and cramped areas where only a vertical approach and take-off are possible. These require huge amounts of power, so we’re thankful we have two engines to rely on.” As part of their daily routine, the pilot and co-pilot check the two in-service helicopters thoroughly, including that they are producing the correct power. They are clearly very experienced, but it’s all eyes on the deck as the helicopter approaches an incident. “An Agusta Westland weighs seven tonnes and the downdraught from its rotor can move sheds and churn up debris, so it does one go-around to allow all four crew members to scope out the landing area,” says Ben Macauley, clinical operations manager. It’s a dangerous business, too, as KSS knows only too well. In 1998, one of its helicopters was returning from an incident when it suffered mechanical failure and crashed. Three crew members were killed. During daylight hours, the helicopters can’t fly in cloud lower than 500ft or at night lower than 1200ft. On these occasions or during multiple call-outs, KSS deploys its fleet of four Volvo XC90 rapid response vehicles. Just like the helicopters, they are delivery vehicles bringing a doctor and a specialist paramedic, who also drives. They can carry as much as the helicopters, although not a patient. If necessary, the doctor can accompany and attend to them in the ambulance. “They’re ‘authority-spec’ cars with uprated chassis, wheels and brakes to deal with the extra weight,” says Macauley. “We like Volvos, which we’ve found to be tough, reliable and safe.” Those three words could equally apply to the life-saving teams at KSS.