A rare opportunity to join the crew of the Cornwall Air Ambulance.
When it comes to air ambulance missions, they are often referred to in terms of numbers – nature of incident, time, and location – a few details on a piece of paper. However, each mission and every number represent a person; and each of those people has a story. When the crew attends to someone who is seriously sick or injured, this can be a story that goes way beyond the individual, affecting family, friends, and sometimes even a whole community. When Media and Communications Officer for Cornwall Air Ambulance, Chlöe Smith was given the chance to see first-hand what the day in the life of a Critical Care Paramedic looked like on an observer shift, she gained a unique insight into the invaluable work of the charity and its team.
“I joined Critical Care Paramedics Steve and Stu, along with Pilot Rich, as an observer on the early shift on Friday 6th August, explains Chlöe. “To head out with the crew I had to have a safety briefing to be ready to fly in a helicopter and wear the full flight suit. You’ll see from the photos as an observer I’m in orange, which is to differentiate me from the highly skilled paramedics on scene.” In Chlöe’s day job, she meets patients who have been helped by the service and is lucky enough to hear and share their incredible, sometimes miraculous stories of survival. “But I’ve never seen the patient at the point of need,” adds Chlöe, “and I knew a shift with the paramedics would help me to understand the whole journey a patient goes through, from the point of the incident to recovery and where eventually they might feel ready to contact the charity.”
The air ambulance crew never know when a call is going to come in, so Chlöe was unsure what to expect when she joined them for the start of the shift at 7am. Given it was the start of the summer holidays, the crew were expecting a busy shift and no sooner had the pilot finished the daily helicopter checks at 7.15am, the red phone rang. First call of the day was a motorbike accident on the A38 near Bodmin. “As we jumped on board and headed east,” says Chlöe, “I was amazed at just how quick the flight was. In under ten minutes we were approaching the area, looking out for the scene of the incident.”
Duty Pilot on shift that day, Rich, explained what he is looking out for when they get overhead: “The size of the site, wires, any possible obstructions and wind direction are all things we consider before landing. In this case, the road was very busy with morning commuters, we had to be sure the police had closed the A38 in both directions. When you’re landing on a road, although it can be narrower than other sites, there tends to be fewer obstructions – there’s no people or wildlife and you know you’re landing on solid ground.”
Chlöe adds: “With the road closed, the scene was very quiet. The motorbike rider suffered an open fracture on his ankle and was visibly in a lot of pain. Stu and Steve administered ketamine to the patient, while they manipulated his foot and put his leg into a splint. Due to the nature of his injury, he needed to be transferred to Derriford Hospital for an operation. In the back of the helicopter, Stu had to contend with engine noise while on the phone to the emergency department (ED) at the hospital to give them a status update.” It was just an 18-minute flight to the helipad at Derriford, where the paramedics handed over the patient to the ED staff, while Rich picked up the coffees – much appreciated as no one had breakfast.
As the helicopter lifted off from the hospital to head back to base, the South Western Ambulance Service Foundation Trust (SWASFT) control room radioed in with another job. There was a quick refuel at the helicopter base at Newquay Cornwall Airport before it headed out to Wadebridge, to an elderly woman who was found unconscious at home. “We landed at Coronation Park at 10.40am, where we were met by a police officer,’
explains Chlöe, “she drove us on blue lights to the scene of the incident. It was evident just how closely all the emergency services work together to help patients. When we got to the house, there was a land ambulance crew with the patient. Her vital signs were very poor, she needed to be transferred to a hospital quickly.” The patient was taken by ambulance to the waiting air ambulance. Paramedic Steve was now in the back (the paramedics switch roles throughout the day) and it was clear that the patient was very poorly. Steve looked up and mouthed: “I wish there was more we could do for her.”
As the crew met back on the helipad at Treliske, it was 12.30pm. They thought they might be able to head back to base for lunch, but no sooner had this been spoken aloud the radio went again – this time it was for a violent incident in Polperro. With reports of two casualties, control also dispatched Devon Air Ambulance to the scene. “Everything happens very quickly when there’s a major incident,” says Chlöe, “Stu immediately changed into level-three PPE, which looks a bit like a space suit and not the easiest thing to do at 1,000ft. He was already preparing for the type of injuries they might encounter, such as traumatic arrest. He told me it was likely to be a difficult scene to attend.” Meanwhile the team were in constant contact with control for updates, while Rich established contact with the pilot from Devon.
“As we approached Polperro, we could see the Devon helicopter looking for a landing site. With lots of coastal towns in Cornwall situated in valleys, it can often be hard to land right at the scene. Both helicopters landed side by side at a field at the top of town. The team got the update to stand down, unfortunately both casualties died from their injuries. It made me wonder how the paramedics must feel – a huge surge of adrenaline, then they are stood down. I remembered what one of the crew had once told me, ‘Sometimes it’s not what we go to, but what we are prepared to go to’, and it suddenly made a lot more sense.”
The final tasking for the day shift came as soon as the team lifted out of Polperro; it was a cardiac arrest in Fowey: “Rich landed in a playing field. This time it was about a five-minute run from the site to the patient’s house – and I mean run, which is not easy while you’re holding a monitor with a 20kg bag on your back,” says Chlöe. Stu showed how experienced he was at jumping fences; anything to save time. The survival rate for out of hospital cardiac arrests is fewer than one in ten and sadly, despite the best efforts of all the clinical team involved, the patient did not survive. “Being there to witness the moment someone loses a loved one was difficult,” adds Chlöe, “but seeing first-hand the incredible work involved to try to save a life was humbling. Everyone works together to do the very best they can.”
The team returned to base just before 3pm, but there is much to be done before they can hand over to the next shift. The crew must refuel the helicopter and restock the kit bags ready in case the phone rings again. “A cup of tea was never more welcome,” says Chlöe . “Jumping in and out the helicopter, assessing landing sites, treating patients, making important clinical decisions – it’s all a day’s work for the aircrew, but it was an eye opener for someone like me who is used to working behind a desk.” Steve summed it up well: “It’s relentless at times. Particularly in the summer when its busy, you’re on back-to-back jobs, it can be very demanding. Some days you can’t always help everyone, but when you do make a difference to someone’s life, then that is what makes it all worthwhile.”
For Chlöe, it’s back to the office, with a renewed sense of appreciation for the work the aircrew does every day. As a public-funded charity, the Cornwall Air Ambulance relies on donations in order to keep the helicopter in the air. Whether that be from a legacy donation, fundraising event, corporate sponsor, the Mission Maker Lottery or by shopping or donating to one of the seven charity stores across Cornwall, every penny goes towards to keeping this invaluable service flying high.