A Brief History
almost as long as powered flight had become a reality in the early years of this century the immense potential for aircraft to
transport goods and people at speed over long distances and with little regard
for terrain, was soon recognised. Even before the First World War a Dutchman
named deMooy, who was Chief of Dutch Medical Services, realised that surface
transport of casualties was a major cause of death among combatants. To
counteract this he devised a huge stretcher which was to be suspended beneath a
balloon and drawn along by horses. During the Great War the first true Air
Ambulance flight was made when a Serbian officer was flown from the battlefield
to hospital by a plane of the French Air Service. Records kept by the French at
the time indicated that, if casualties could be evacuated by air within six hours
of injury, the mortality rate among the wounded would fall from 60 per cent to
less than 10 per cent - a staggering reduction!
The first recorded British ambulance flight
took place in 1917 in Turkey when a soldier in the Camel Corps who had been shot
in the ankle was flown to hospital in a de Havilland DHH in 45 minutes. The same
journey by land would have taken some 3 days to complete. In the 1920s several
services, both official and unofficial, started up in various parts of the
world. In Queensland, Australia, a plane hired from Quantas at the rate of 2
became operational in 1928. The aircraft was a de Havilland model 50 with a
cruising speed of 80 miles an hour and fuel consumption of some 8 to 10 miles
per gallon. It carried a pilot, doctor and nurse, and also had room on board for
one stretcher patient. In its first year the de Havilland made fifty mercy
flights covering approximately 20,000 miles to treat 225 patients for various
illnesses and injuries. It was claimed that the lives of 25 people had been
saved, thanks to the medical care provided by what subsequently became known as
"The Royal Flying Doctor Service of Australia" and renowned the world
Britain sick passengers were ferried by air from the Western Isles of Scotland
to the mainland in the early I 930s. The first such flight to be recorded was on
14th May 1933 when a fisherman suffering from a perforated stomach, with
consequent risk of peritonitis, was flown from Islay to Glasgow's Western
Infirmary in a DH Dragon owned by Midland and Scottish Air Ferries. This
service, sponsored by the Department of Health for Scotland through local
authorities, was gradually developed, and continues to this day operated by
Loganair using fixed-wing aircraft from bases at Glasgow; Kirkwall in Orkney and
Lerwick in Shetland.
Many countries now have air
ambulance services and the advent of the helicopter has added an extra dimension
to the effectiveness of such operations.
In Switzerland, with the increasing interest
in winter sports during the early post World War 2 years, the use of air
ambulances evolved from the increasing difficulties experienced in mountain
rescue work. Initially fixed-wing aircraft were used, landing medical teams with
equipment as close as possible to the injured parties so that rapid first aid
treatment could be applied prior to evacuation. The major disadvantage was the
lack of suitable landing sites close to where the incident had occurred in what
was inevitably a mountainous region. To overcome this it was even at one stage
proposed to parachute medical personnel with equipment and sledges into the
rescue area. Although training was undertaken there is, however, no documentary
evidence to suggest that this technique was ever put into practice.
technology advanced helicopters, because of their greater maneuverability and
flexibility in being able to land practically anywhere, became more widely used
in all kinds of air-rescue work. It was in the war-torn battle zones of Korea
during the early fifties that the value of the helicopter for moving wounded
troops quickly from the combat area was first widely realised. Probably the most
publicised use of helicopters in the rescue role is the work undertaken by the
RAF Air-Sea Rescue Services. Although they are not a true air ambulance service,
they do, obviously perform that function as part of their general duties.
EMS helicopter programmes are well established throughout the United States and
many countries in Western Europe. The US has some 200 operations whose services
are paid for primarily by the patients and their insurance companies. As well as
Switzerland, France, Austria, Italy Scandinavia and the former West Germany all
have very successful versions of the helicopter-based EMS, the benefits of which
have in some instances been particularly well-documented. In Germany for
example, there is now a network of helicopters which has evolved over the past
twenty years to cover the entire country Statistics which have been gathered
over this period of time show:-
average response time to the scene of the incident of just 10 minutes.
care stays in hospital have been shorted by between five and seven days.
are 9% fewer wound infections.
has been a significant reduction in the number of deaths which have occurred
during transport to hospital.
Head injury mortality has been reduced by 15%.
have achieved a 3% success rate in cases of cardiac arrest. These are impressive
figures, indeed, so why has Britain, one of the major helicopter users in the
world, lagged so far behind in this field? It has been suggested that a lack of
will at national government level, coupled with decidedly differing local
interests, has resulted in the idea never receiving formal backing from the
health authorities generally Moreover, cost obviously has been a major deciding
factor with a fixed NHS budget leaving little room for the introduction of major
and relatively expensive innovations such as air ambulances.
in the past few years has this country faced with a developing and ever more
complex system of motorways, leading to increasingly horrific accidents, come to
address itself seriously to the prospect of using flying ambulances where access
to conventional emergency vehicles would prove extremely difficult. A major step
forward came in 1988 when a report made by the Royal College of Surgeons
recommended the setting up of a network of trauma centres, geared specifically
to dealing with the types of injury sustained in major accidents, and to which
patients would be flown direct by a national fleet of EMS helicopters.
this plan were to be implemented it would herald the dawn of a new era in the
treatment of trauma victims in this country
the meantime, several counties have taken the initiative into their own hands,
Cornwall leading the way with the first Air Ambulance Service in 1987. They were
followed by Kent, Scotland, the West Midlands, London and Devon, most of whom
are funded by charitable donations given by members of the public. Various
others have watched these developments with interest, and it seems possible that
they will follow in due course.
How long it may be before there is a nationally funded and co-ordinated air ambulance network in Britain along the lines envisaged by the Royal College of Surgeons is anyone's guess. Only time and the experience gained from these pioneering early services will tell.