In profile: East Anglian Air Ambulance prepares for new venture to fly at night
For years it has provided an emergency service during daylight hours but the East Anglian Air Ambulance is embarking on a landmark new venture to fly at night. KIM BRISCOE finds out how training is progressing.
The East Anglian Air Ambulance took delivery of a new night-capable helicopter in September and hopes, subject to the necessary approvals from the Civil Aviation Authority, to be able to start saving lives at night towards the end of this year.
While exact times of operations are yet to be decided, it is thought the charity will at first concentrate on starting at 6am and finishing at midnight.
At the moment, if the helicopter is called out near dusk, it is always on the pilot's mind that he needs to get back before it gets dark.
Sometimes that can mean clinicians have only five or 10 minutes to make a decision about whether to stay with a patient or return with the helicopter.
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There is also the potential for the aircraft to be used for very urgent transportations, for example if a patient needs to be quickly transferred from one hospital to another for neurosurgery or cardiac surgery.
East Anglia covers a vast area, much of it rural, and poor road networks and isolated terrain can sometimes make it difficult for land ambulances to reach accidents and emergencies and transport patients to hospital quickly. Air ambulances in Germany and the Netherlands which have introduced night flying have been able to attend around 30pc more cases and the charity is hoping it will see a similar increase in the number of call-outs they can attend.
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The move would be a national landmark in air ambulance operations.
While Bonds Air Services, which has the contract to provide the EAAA's two helicopters, already provides a night-time air ambulance in Scotland, this is only able to fly to and from lit landing sites, such as hospital helipads.
Other air ambulances have been able to operate in darkness using other aircraft already authorised for night flying, for example a police helicopter.
But if they get the final go-ahead, the EAAA will become the first air ambulance in the country to provide night-time Helicopter Emergency Medical Services (HEMS).
The new aircraft, Eurocopter's EC135T2, will be based in Cambridge but cover Cambridgeshire, Norfolk, Suffolk and Bedfordshire at night.
Once a second new helicopter is delivered at the end of 2013, the charity will make a decision on whether or not to introduce night operations at its other base, Norwich International Airport.
The training towards night flying started with paramedics, doctors and pilots all going back to 'ground schooling' where they were taught about how night vision goggles work, how perception changes at night, the dangers of fatigue and how to look out for it in other members of the crew, and about different equipment and restrictions on flying.
The night vision goggles alone cost �22,000 per pair and all the crew have had to be fitted with expensive new night-time helmets which have counterweights at the back to balance out the weight of the goggles.
Then the crews moved on to familiarisation flights which they have started without wearing the night vision goggles so they are prepared to cope in case the goggles fail for any reason.
This involves practising the difficult skill of navigating at night using maps.
They will have access to satellite moving maps, but the crew need to be able to know they can manage without in the event of a failure.
Jemma Varela, who has been a paramedic for 10 years and has spent three years flying with the air ambulance, says: 'They have not left a stone unturned to get us prepared for this.
'We've been up to King's Lynn and into deepest darkest Norfolk. Places do look different at night. During the day I would normally navigate using things like 200ft wires, train lines, a windmill, or a village with two churches, but in the dark all that is gone.
'You have to rely a lot on the outline of the villages, lit masts, bigger structures and some railway lines.'
They have also been practising their clinical teamwork in the dark. Jemma says: 'We have been going out to the middle of the airfield where it is pitch dark and running through scenarios with just our head torches on. We've also got new lights which we can set up on stands and we have been practising using them.'
While the paramedics will be well used to working in the dark, from their shifts on regular ambulances, some of the clinical procedures carried out by the air ambulance medics can be more complicated and the doctors are more accustomed to working in brightly-lit hospitals. To practise this, the crews have been undertaking later shifts and working from a response car up until 1.30am so they can spend more time working as a team in the dark.
Most of the air ambulance pilots are ex-forces and very experienced at flying in the dark, but the change means the helicopter will not be able to land in such tight spots and will need larger landing sites at night, where they can be 100pc sure it is completely safe to land.
Parks and football fields could become ideal night-time landing spots, and the teams are just starting to practise this type of landing as they have been using lit helipads at hospitals and airports so far.
Jemma says: 'The hardest part is going to be finding suitable landing sites near the scene. We also need to practise running with all the kit a bit further.'
Anaesthetist Neil Berry is working with the air ambulance full-time until next February, when he will take up a post at the James Paget University Hospital in Gorleston. The senior registrar has also worked at hospitals in Cambridge, Ipswich and Norwich.
He said: 'The biggest thing for us is knowing how to work in the dark – even putting on seatbelts means you have to feel for them and we need to work out how to treat patients in the back of the helicopter if they need us, as you can't use any lights because of the night vision goggles.
'Examining patients becomes harder because it's more difficult to see the subtle signs you look for and it's quite difficult to see some stab wounds, like ones made with screwdrivers or small implements, in the day let alone at night.
'We have been working very hard with the equipment to make sure we can give as good a care at night as in the day.'