Air Ambulance Week

Anglia One helicopter in flight 1

This week, we celebrated Air Ambulance Week. To mark the occasion, we invited Chris Neil, Critical Care Paramedic and NARS chairman, to discuss working in collaboration with EEAST and how to utilise the HEMS service.

Over a relatively short period of time, air ambulance charities have grown into robust organisations that provide an incredibly impressive service for patients. 

Within the East of England (EoE) there are three Helicopter Emergency Medical Service (HEMS) charities offering 5 Enhanced Care Teams (ECT’s) between them.  ECT teams typically consist of a Senior Registrar or Consultant either in Emergency Medicine or Anaesthesia, and a proficient Critical Care Paramedic (CCP), who can support the provision of advanced intervention. The teams are dispatched from Chelmsford AOC, with a specialist team manning the Critical Care Desk (CCD) including a dispatcher and Critical Care Paramedic.

This level of advanced intervention, known as Prehospital Critical Care (PCC), encompasses a wide range of extended skills including:

  • advanced surgical skills
  • anaesthetic drugs
  • superior monitoring equipment
  • additional knowledge.

HEMS teams that provide PCC have shown to improve outcomes for the most critically ill and injured patients.  These teams have also demonstrated sound clinical decision-making and can safely bypass local hospitals to deliver patients to the most appropriate secondary care facility.

Although the CCD will attempt to dispatch HEMS to all critically ill or injured patients within the EoE, identifying these patients for HEMS teams to manage is a notoriously difficult task. This is mostly due to the high amount of 999 calls per day.  Another option CCD rely on, is utilising ambulance crews on the ground who attend and identify critically ill or injured patients and request HEMS directly. 

In 2018 a qualitative study, comprising semi-structured, face-to-face interviews with EEAST crews was conducted using focus groups across the EoE.

The questions for the focus groups were:

  1. Can anyone tell us what they know about HEMS?
  2. Please can anyone share any experiences they've had working with HEMS?
  3. What did HEMS offer? What went well? What needs improvement? What was their behaviour like? Involvement?
  4. Can anyone tell us what extras HEMS brings to pre-hospital care? What patient groups do you think would benefit from HEMS?
  5. Who or what would influence your decision to call HEMS? Please can anyone describe if and how they accessed HEMS?
  6. Please can anyone give an example when they thought about calling for HEMS, but didn't?
  7. Tell me positive experiences you've had with HEMS? Tell me disappointments you've had with HEMS?
  8. Of all the things we’ve discussed what is the most important to you?

 Results

Participants believe that HEMS provide a higher level of intervention for critically ill patients and improve communication and leadership at the scene of an incident. 

Participants identified barriers to HEMS collaboration and occasionally felt apprehensive while operating with HEMS. Service improvement needs were identified as many participants had poor understanding of the HEMS skillset and operations.

Recommendations from study:

This study highlights a number of important recommendations for service improvement:

  1. The need to produce a package to provide EEAST crews with information about HEMS, what HEMS can clinically provide, when to call HEMS, how to call HEMS and working around a helicopter.
  2. To regularly invite EMS to HEMS training days so crews can practice PHEA simulations with HEMS teams.

 We are working hard to put the recommendations into practice, such as creating educational packages for EEAST crews as when to call HEMS. As we work on putting this together, we suggest you call the CCD if you feel your patient would benefit from HEMS.  Below is a guide for calling critical care.

Published 11th September 2020

1 Comment
How about we discuss how to get Critical Care Paramedics on the road. Many other trusts have done this and utilise them amazingly well. Surely EEAST should not be solely relying on charities to provide our only critical care capability.

It would also be great for retention, I know of at least 5 paramedics in my area that have left in the last 6 months for other services as they have really good CCP opportunities and training!

Ben
11 September 2020


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