An essential part of our team are the HEMS Desk Dispatchers. Paid for by the three charities it serves – Dorset and Somerset AA, Devon AA and Cornwall AA – this team is responsible for deciding where and when our helicopter is deployed.
Senior Dispatcher Nikki Bolt takes us behind the scenes …
"Someone help me… quick!” All too often these are the first words heard by the call taker in the ambulance clinical hubs (control rooms) where 999 calls are answered. A multiple traffic collision on the motorway, a fall from a horse out on the moor, a heart attack on the 16th green at the local golf club – all typical scenarios, which result in a 999 call and the dispatch of an air ambulance.
Air ambulances go faster and cover greater distances than their land-based counterparts. They fly over traffic jams, don’t need to negotiate country lanes and can touch down on difficult terrain and in remote locations. They can also take a patient directly to the hospital with the most suitable medical capability, not just to the nearest one.
But who decides when to use it? What criteria determine if an emergency requires an air ambulance or if a land vehicle can do the job? Who ensures that the air ambulance isn’t deployed unnecessarily?
The answer is a dedicated Helicopter Emergency Medical Service (HEMS) dispatch team. Based at the South Western Ambulance Service NHS Foundation Trust clinical hub in Exeter, the HEMS team tasks four emergency helicopters – two in Devon, one covering Dorset and Somerset and one in Cornwall. The dispatch team can also call on support from the coastguard, police or search and rescue, should the need arise.
Just over four years ago, it became apparent there was a need for dispatchers who understand the helicopters’ capabilities and the regulations that govern their deployment, so a HEMS dispatch team was set up. The HEMS desk itself is just one of many stations sitting in a dimmed clinical hub, lit by hundreds of computer screens amid the low, yet constant, hubbub of voices taking 999 calls.
The team work a combination of 10- and 12-hour shifts. They sit facing a bank of four computer screens, which help them monitor every emergency call made to the control room. It is the HEMS dispatcher’s decision to deploy the helicopter based on the details provided by the individual making the call. This can often be a very distressed member of the patient’s family, or member of the public, and obtaining full details of what has happened is often challenging.
So, how do we decide which calls need an air ambulance to attend? There are a number of factors that have to be taken into account and these all have to be considered at the same time. Some of the main points are:
Where are they and how far away is the nearest ambulance to provide immediate help to the patient?
How far is the most appropriate hospital? There are a number of specialist treatment centres within hospitals across the south west and the nearest hospital might not actually be the one to provide the right treatment for the patient.
Can any other resources access the patient’s location? The South West has a number of remote locations where access may be limited by land.
Once these and other air ambulance specific considerations have been made, the aircrew are notified via a touch screen, while a mapping system on the adjacent screen identifies the location of the incident down to house level. This enables the HEMS dispatcher to appraise landing conditions and give the aircrew an idea of how close they may be able to get to the actual patient. Ultimately, the pilot will decide once overhead of a safe landing point, but at least the aircrew will be aware of landmarks and possible sites to look out for on arrival.
Land ambulances are deployed to every call-out. There are times where land crew arrive first and other times where the air ambulance is first on scene. The HEMS desk co-ordinates and updates each unit on timings and the patient’s status. Another important task for the team is to ensure the caller not only stays calm, but arranges a spotter. House names and numbers mean nothing from the air and so directing someone on the ground to wave something bright can also be useful.
At the end of the day, the role we play is indeed an important one but teamwork is the key. To hear that we might have helped to save someone’s life is extremely rewarding and we are proud to be able to play our part.