Achievements

The aim of the trauma team is to halt the physical deterioration and reverse the life threatening processes caused by severe injury or the rapid onsets of acute illness which are not uncommon causes of death; consequently the chance of survival is highly dependent on the care that follows.

The sooner we are informed of an incident by the regions ambulance services then the quicker we can arrive at the casualty’s side. The crew which includes a specialist trauma doctor can immediately assess the obvious injuries and more importantly suspect and explore potential underlying injuries that could prove rapidly fatal. Only after this detailed assessment can appropriate action be taken to halt further physical deterioration, surgically if need be. This might included severe internal as well as external haemorrhage, blocked or partially obstructed airway and any cause of respiratory distress; similarly a doctor can intervene and provide additional pain relief when conventional paramedic treatment proves inadequate. Ultimately of course the trauma doctor can anaesthetise the patient, this particular skill known as RSI is not available to paramedics and therefore denies the most fragile of patients a potentially life saving intervention. There are a number of benefits associated with this procedure that include establishing a secure airway thus preventing obstruction, support breathing through mechanical ventilation, good oxygenation and inhibiting a deteriorating brain injury, this procedure once performed pre-hospital actually speeds up the process of hospital handover, transit through A&E and if needed into surgery, additionally what is often ignored but should not be underestimated is the relief of pain and anxiety that anaesthesia can bring. Evidence suggests that these advanced interventions aid recovery and reduce morbidity and mortality which is the simple truth behind this air ambulance advocating the consultant lead trauma team rather than the more commonly used paramedic only model. As we are an advanced clinical care team restricted by resource we therefore work closely with and in support of the regions ambulance services and the excellent work initiated by ambulance crews and other ground based providers.

Achievements

As a result of our work more patients than ever before are receiving a higher level of care than was previously available and although difficult to correlate it is suggested that effective pre-hospital treatment minimises post injury disability and reduces recovery time and length of stay in hospital. Also let us not underestimate the impact the whole system approach has on the family and friends of the patient who at a time of extreme emotional upset can be reassured that the very best of pre-hospital care was undertaken for their loved one.

Testament to our achievements is the approximate 3000 expressions of appreciation received last year.

Achievements

It would be wrong however to assume that all of our work is about trauma. Significant and serious illness such as heart attacks especially in the rural communities accounts for approximately 10% of the work we do. For heart attack patients the gold standard is to get them as quickly as possible to a specialist unit for what is termed angioplasty. Therefore during the year in collaboration with the James Cook University Hospital the service trialled and maintained direct access to the hospitals specialist unit, the success of this initiative and the benefit it brought to the patients was recognised by a service innovation award presented to the charity at the Houses of Parliament towards the end of the year. Due to its success a similar direct access system is to be developed for stroke victims.

The impact of these new systems will become more apparent as the service develops.

Achievements

Although much more geographically localised than the helicopter a fully equipped car donated by the regions Freemasons now enables the trauma team to attend serious incidents on those few days the helicopter is unavailable due to either bad weather or maintenance.

In the section ACTIVITIES under the operations sub heading you will recall mention of ancillary work undertaken by our senior clinicians on integrated care initiatives. These initiatives have resulted in the establishment of a Northern Trauma Network and cooperative working with the regions critical care network and paediatric intensive care unit as well as embedding the GNAA trauma team in regional major incident plans. The significance of this work to is to enable a seamless system of care from incident through to discharge, not only does this benefit the health economy of our region but what’s more important is the positive effect it has on seriously ill patients.

A further and significant development was the introduction of airplanes as an alternative to helicopters in particular for long distance critical care patient transfers. So far this year GNAA has undertaken a number of transfers by airplane for seriously ill patients who require treatment at specialist care centres. Travelling to and from Eire, Norway, Portugal and Holland as well as within the UK these transfers will often include the repatriation of  terminally ill patients consequently specialist staff have been recruited and additional training given to our own permanent crews to ensure the best of care for patients during transit. These transfers as well as providing specialist care for patients are faster and more comfortable than conventional helicopters and by using an airplane we also ensure that regional emergency helicopter cover remains unaffected. We do however charge the requesting authority for this work as some of these missions are classified as humanitarian or urgent rather than emergency and by charging avoid any criticism of using charity money to surreptitiously fund NHS work, any profit from this work is applied to the charity.   

Achievements

This new initiative is of enormous benefit to regional NHS Trusts by removing the administrative burden previously undertaken by busy hospital staff and providing for them a one call solution in planning complex patient movements and therefore significantly improves a hospitals ability to transfer patients between treatment centres quickly and safely. As an alternative to this we also provide vehicle road transfers where appropriate.  

As you have probably realised by now the safety of the patient and the effectiveness of the care we give is paramount however we believe the patients personal experience is equally as important which is why for the last three years we have canvassed patient opinions of the service. The survey returned a 90% excellent rating from randomly selected patients, however this was a relatively small sample consequently the survey will in future run continually throughout the year.