Doctors Join Cornwall Air Ambulance

Cornwall Air Ambulance has launched a two year programme in conjunction with South West Ambulance Service NHS Foundation Trust that see doctors flying on board the county’s emergency helicopter service for up to four days a week.

Eight Education Support Physicians (ESPs) have been recruited. All have served either in the military or in other helicopter emergency services, here and abroad.

The group includes GPs, emergency doctors, intensive care specialists and anaesthetists, so providing a diverse mix of backgrounds and broad spectrum of skills.

The physicians will fly with the paramedic crew for at least three days a week for the next two years. When not tasked with missions the physicians will assist the paramedics in developing enhanced clinical knowledge and skills via simulation and teaching sessions at the Newquay airbase.

This enhanced pre-hospital care programme is designed to increase the clinical knowledge and pre- hospital critical care skills of the aircrew paramedics. This will enable the paramedic crew to deliver clinical skills such as enhanced analgesia and sedation.

Cornwall Air Ambulance already delivers high standards of pre-hospital clinical care and delivers patients rapidly to appropriate care facilities. Currently three paramedics are studying a Masters degree in Pre Hospital Critical Care Retrieval and Transfer at the University of Plymouth and three others will begin the same course later this year.

The ESPs assist in progressing the paramedic scope of practice towards the emerging role of Specialist Paramedics in Critical Care. This will ensure that both medical and trauma patients attended by the Cornwall Air Ambulance continue to receive high levels of pre-hospital critical care as a wider range of clinical interventions become available to paramedics supported by pre-hospital physicians.

A significant number of medical emergencies are of an immediately life threatening nature. They benefit from professional care delivered to high standards and rapid transportation to appropriate treatment centres via helicopter.

Fundamentally, however, medical conditions require a greater understanding of the disease process and the clinical skills to deliver these treatments even more effectively.  In part this comes down to enhanced diagnostic skills and clinical reasoning skills in which the ESPs will further train the paramedic crew.

These service developments are driven by a new aspirational document produced by South West Ambulance Service NHS Foundation Trust in collaboration with other air ambulance charities and BASICS doctors throughout the region. It is another step forward in the operational and clinical progress to deliver the very best possible care to patients.

Paula Martin, CEO of Cornwall Air Ambulance said: “We are excited to be able to deliver such a programme of excellence with our partners and are proud that patients throughout the county will benefit from the broader knowledge base of the paramedics in their hour of need.”

The physicians teach the paramedic crew:

• Enhanced understanding of physiology – the detail of how the body’s processes work and interplay both in health and during disease
• Enhanced clinical assessment and examination skills to assess the effects of disease

Detailed understanding of the pharmacology and administration of an increased spectrum of drugs now accessible to paramedics

• Analgesia and sedative techniques to improve patient comfort and facilitate specific treatments which would otherwise be unpleasant
• Skills to provide an anaesthetic in the pre-hospital environment

As technology and knowledge evolves, what can be physically and safely accomplished outside a hospital is developing all the time.

• Equipment such as defibrillators and monitors are smaller and portable
• Changes in the law now allow advanced analgesia to be administered by paramedics
• Evolution of anaesthetic techniques allow patients to be safely anaesthetised by a properly trained team outside hospital

The two year education support programme will cost Cornwall Air Ambulance £200,000. The charity is fortunate enough to have received significant legacies that enable this commitment to delivering excellence in critical care. Therefore, the charity is not appealing for extra funds to deliver this education support programme.

However, the 700 plus missions that Cornwall Air Ambulance attends each year, as well as the 100 plus missions attended in the critical care cars, are funded solely by donations from organisations and individuals. The emergency service costs more than £3 million a year to operate and receives no direct government funding.