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What happens when you dial 999?
For many people across our region every day, dialling 999 is a matter of life and death. Read on to find out what happens at the control centre, and how our Critical Care Team are dispatched.
The South West’s clinical hub is in Exeter, and based there is a dedicated team responsible for dispatching and monitoring all of the air ambulances and critical care cars in the region - the ‘Critical Care Desk’. This team is managed by the South Western Ambulance Service NHS Foundation Trust (SWASFT) and funded by the five air ambulance charities it serves across the South West, including GWAAC.
Eight specially trained dispatchers operate the HEMS desk, with a maximum of two on duty at a time. It is down to them to decide whether a patient needs the critical care that only an air ambulance team can provide. The hub receives around 3,000 calls every 24 hours, with the team viewing every single call that is made to 999 requesting an ambulance. In 2019, they were instrumental in deciding to dispatch a charity air ambulance crew 7,000 times.
Control Officer, Paul Holmes, who manages the team, explains the process in more detail:
The call comes through to our Specialist Paramedics in Critical Care (SPCCs), who is the designated Technical Crew Member on shift. Our crew receive details of the location of the incident and decide whether to go by helicopter or critical care car, depending on distance, weather and time of day.
- The dispatcher will listen to a call. They are looking for certain criteria that may require critical care or an air ambulance team, for example, if someone has fallen from a height or been ejected from a vehicle in a road traffic collision. With thousands of calls coming in, the team are looking for calls where the skills of the Critical Care Team can bring an added benefit, or situations where the patient is inaccessible by road and in need of an air ambulance.
- The location is pinpointed on the mapping system and the dispatcher reads the grid reference to inform the Pilot how close they can get to the patient and of any suitable landing sites.
- Once a team has been deployed, the dispatcher will keep reviewing the 999 calls as they come in, diverting the team if required and keeping them up to date on the patient’s condition.
If by helicopter:
The grid reference will be entered into the GPS system which will draw a line to the incident so they can look for the best route and any controlled air spaces, as our Pilot needs to gain permission to pass through them.
They also plot the route on a paper chart, in case there is a problem with the GPS system or the iPads. Whilst the Specialist Paramedic (SPCC) is plotting the route, the Pilot and the Critical Care Doctor head out to the aircraft with drugs, blood and frozen plasma, starting the engine and doing safety checks.
Once the SPCC is also on board, they run through pre-take off checks before heading off. All of this takes just 4 minutes from receiving the call and our crew can be anywhere within the region within 20 minutes.
En route, the team will be on the lookout for a safe landing spot, and planning which hospital may be best suited to the needs of the patient. They remain in contact with the dispatcher and the land ambulance crew who may already be on scene throughout.
We need a Technical Crew Member on board to be able to land anywhere that isn’t already a designated landing site.
Our Pilot will land as close to the job as is safely possible. If they can’t land close by, the crew will often get lifts from a land ambulance, the police or sometimes even members of the public.
Safety requirements mean that the SPCC gets out of the aircraft first, and stands at the front to make sure no one approaches until the rotor blades have stopped.
Once on scene, our crew will assess and treat the patient in the best way possible, and if needed, stabilise them for the journey to hospital. Depending on the needs of the patient and how our team have travelled to the incident, we will airlift the patient to hospital or travel with them in the land ambulance.