Provider Profile: Scotland’s Charity Air Ambulance

SCotland's charity air ambulance team
Bonnie Scotland’s Emergency Angels

AirMed&Rescue spoke to Scotland's Charity Air Ambulance (SCAA) about the unique challenges they face on a daily basis, providing the population with access to emergency air medical transport services

AirMed&Rescue spoke to Scotland’s Charity Air Ambulance (SCAA) Senior Pilot Captain Russell Myles has flown with the charity since it launched in 2013. He has personally flown the charity’s original Bolkow 105 and then its replacement, the EC135 T2i, over 60,000 nautical miles. 

What are the main challenges that SCAA faces in terms of serving a large population spread over a wide area with many different climates and urban/wilderness environments?

The weather can be significantly different at opposite sides of the country. It can be beautiful on the west coast and foggy on the east coast and vice versa.

Our base is in Perth (with a second helicopter coming on line at Aberdeen next spring), which is fortunate in that we have our own microclimate in the lee of the mountains. The Carse of Gowrie takes advantage of this and is a prolific fruit growing area.

In our own local area, we can be responding to an RTC at sea level in the morning and then to the mountains for a skiing accident in the afternoon.

The size of the area also dictates the way we respond – unlike some air ambulance units in England where the pilot runs out the door to start the aircraft when the ‘Bat Phone’ rings, we take an extra 30 seconds to gather all the information about the job, especially the location.

A job further away may require more fuel than our standard load, and we can quickly top up at base or get going and refuel on the way. The distance back to hospital also has a bearing on our planning; we regularly drop the paramedics on scene and then transit to the nearest refuelling location for a top up before returning. Usually by the time we get back the patient has been stabilised and packaged and is ready to load. In the old Bolkow days when we were day VFR only, I even dropped the guys on a hill and ran away for home before it got dark; they and the patient were subsequently winched off the hill by a Royal Navy Sea King.

Russell Myles and John Pritchard

Russell Myles and John Pritchard

How do you manage your pilot’s flight hours schedule to ensure that they adhere to regulations when they are covering such large distances?

We cover the whole of Scotland, but a job to the far end of the country and back is well within the 12-hr shift time. Orkney and back, for example, may involve the aircraft being away from base for up to five hours, but that is completely manageable within our FTL scheme.

In an emergency, we have the option of exercising commander’s discretion to extend a flying duty period

In an emergency, we have the option of exercising commander’s discretion to extend a flying duty period – this is usually when a job comes in late in the shift. Extending by up to two hours gives us the flexibility to get the job done, deliver the patient to hospital and return to base.

This can have a knock-on effect the next day if the same pilot is on duty, leading to a late start. It doesn’t happen often and if it does start to become a regular occurrence, then we can look at changing our operating hours.

At the moment our shift on the EC135 is from 07:30 hrs to 19:30 hrs, but in the past when we did 10-hour shifts on the Bolkow 105, we varied from 08:00 hrs to 18:00 hrs to 10:00 hrs to 20:00 hrs, depending on the time of year.

Do you work with volunteer mountain rescue teams (MRTs)often? What, if any, training do you do with such teams to ensure their safety and understanding regarding working with helicopters?

The MRTs work closely with the Maritime and Coastguard Agency (MCGA) and are used to working with rescue helicopters. They are experienced and capable and always a pleasure to work with as they understand helicopters and know the dos and don’ts.

The paramedics also host helicopter awareness training days at the base for other services.

Flying a single pilot helicopter means the crew have to perform air crew functions as well. What training do your medics undergo in terms of aviation training?

Helimed 76 is a single pilot helicopter, with one pilot and two paramedics, designated as Helicopter Technical Crew Members (HTCM).

All paramedics undergo the Babcock HEMS crewmembers course

All paramedics undergo the Babcock HEMS crewmembers course, which is two-to-three weeks long and covers fundamentals such as meteorology, principles of flight, helicopter technical subjects, navigation, aeromedical subjects and crew resource management.

Navigation exercises are flown in the aircraft and the course culminates in a final line check.

Once back at base, we teach them the specifics of our helicopter, as the aircraft used for their course usually has a different avionics fit than G-SCAA.

The HEMS crewmember course is a great grounding, but the final line check is basically a licence to learn. For a new paramedic, I like to do an interim line check after about six months just to check progress.

What’s been your most challenging case you’ve ever worked on, and why was it more difficult than all the others?

Some of the landing sites can be a bit more challenging than others. On occasions, we have to land further away and the paramedics get a lift to the scene from the police or a passing local.

Sometimes the most challenging thing about the job can be the infamous Scottish biting midges, basically teeth with wings, they swarm into the attack as soon as the rotors stop. But it’s all in a day’s work.

John Pritchard

John Pritchard

AirMed&Rescue also spoke to John Pritchard, Lead Paramedic, who helped set up the air ambulance station ready for launch in 2013 and has led the team ever since.

What first attracted you to working for SCAA?

I have over 17 years’ experience of living and working in a beautiful semi-rural area in Scotland, delivering patient care as part of remote and rural healthcare teams made up of General Practioners, Nurses and Ambulance staff – often on call and responding to incidents that could be at least 50 miles away by road.

On occasions, we would be met by a Scottish Air Ambulance helicopter. Working with the Helimed teams, I witnessed the fact that the speed of transferring time-critical patients to definitive care centres was often crucial to the patient’s survival.

In early 2013, Scotland’s Charity Air Ambulance (SCAA) was launching its aircraft, based from its central Scottish location of Perth, which would be fully integrated into the Scottish Ambulance Service Air Ambulance Division fleet and 999 response network.

Helimed 76 is the first charity air ambulance to launch in Scotland and become an important life line to the people of Scotland.

For these reasons, it was an attractive role for any paramedic.

SCAA team 500 missions

The early days of SCAA, celebrating the way the team worked with other emergency services

You spent seven years as a medic in the Royal Air Force (RAF) before returning to civilian life – was this a challenging transition for you to make?

Having developed my early medical career in the RAF, I was fortunate to work in many remote areas such as the Falkland Islands and Norway, where air transport is key in movement of both people and consumables.

This gave me a greater understanding of working with multidisciplinary teams from RAF, Army, Navy and Civilian patients.

The move from RAF Medic to Ambulance Service Paramedic was quite easy as both professions have the patient at their heart and a similar discipline and rank structure. Not forgetting the humour that is needed when working at the front line.

Continuing professional development is a key part of keeping current for paramedics – what training do you and your team undertake to ensure your emergency medical skills are as good as they can be?

Maintaining core emergency medical and trauma skills is essential in the pre-hospital arena and we are fortunate to have a clinical skills room with a varied selection of training equipment such as airway, trauma and paediatric mannequins to refresh procedures and re-run a unique case that the team has encountered.

We learn a huge amount in protected simulation and it also helps with cognitive overload, non-technical skills and working as a team to deliver the best care to the patient within our scope of practice.

What’s been your most challenging case you’ve ever worked on, and why was it more difficult than all the others?

Sometimes a call comes in where a patient is in a whole heap of trouble somewhere in a remote part of Scotland and you know that you are their best hope of surviving their illness or injury. And if the Scottish weather conspires against you, that hope can soon be in jeopardy.

One such call saw us respond to a heart attack patient living away at the head of one of our remote glens.

Helimed operations had already been thwarted that day because of bad weather and we relied on expert flying to get us there.

We worked as a team to find a route through the cloud, over the mountains, out to clear skies above the sea and then along the valleys to reach our patient.

This challenging flight – for which SCAA’s pilot won a national award – saw the helicopter touch down in front of the remote house, allowing us to rush to the patient’s aid, assess the severity of the heart attack and administer treatment.

We knew he was in a serious condition and we knew we had to get him to critical coronary care as quickly as possible – the helicopter was his only chance.

Luckily, the weather allowed us to get through to the hospital and the day ended happily for all. Although the patient suffered heart damage in the attack, he made a steady recovery.

It’s being able to reach this sort of patient and get them to definitive hospital care that makes the Helimed service so vital - and so rewarding for all of us involved.

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