London's Air Ambulance

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London's Air Ambulance
G-LNDN Explorer MD900 Helicopter London's Air Ambulance Ltd (29633620852).jpg
London's Air Ambulance Logo.jpg
Founded 1989; 29 years ago (1989)
Type Charitable organisation
Area served
Key people
Gareth Davies, Clinical Director
Charles Newitt, Interim CEO & Chief Operating Officer

London's Air Ambulance, also known as London HEMS, is a British registered charity that operates a Helicopter Emergency Medical Service (HEMS), dedicated to responding to serious trauma emergencies in and around London.[1] Using a helicopter by day and rapid response vehicles by night, it functions as a mobile emergency department in life-threatening, time-critical situations.

London's Air Ambulance was founded in 1989 in response to a report by the Royal College of Surgeons which documented cases of patients dying unnecessarily because of the delay in receiving prompt and appropriate medical care, the charity was the first in the UK to carry a senior doctor in addition to a paramedic at all times on a helicopter, introducing a system that reduces the death rate in severe trauma by 30–40%.[2]

From its base at the Royal London Hospital in Whitechapel, east London, a helicopter can reach any patient inside the M25 London orbital road, which acts as the service's catchment area, within 15 minutes. Missions commonly involve serious road traffic collisions, falls from height, stabbings and shootings, industrial accidents and incidents on the rail network, the team can provide advanced life-saving medical interventions, including open heart surgery, blood transfusion and anaesthesia, at the scene. The charity operates 24 hours a day, serving the 10 million people who live, work and travel within the M25. Of up to 5,000 999 ambulance calls made every day in London, up to seven of the most critical are passed to the air ambulance.

Pre-hospital emergency medical care[edit]

London's Air Ambulance delivering an advanced trauma team to a critically injured patient at Tower Bridge

London's Air Ambulance has been at the forefront of innovation in pre-hospital emergency medical care since its inception in 1989, the service has adopted elements of medical, military and aviation culture to deliver the highest standards in intensive care to the roadside. The governance system and Standard Operating Procedures developed by the organisation are seen as a benchmark for other air ambulances across the world.

London sees some of the highest level of trauma in the world and the service is internationally renowned for clinical excellence and pioneering procedures. Innovations introduced by the service can dramatically increase patient’s chances of survival and recovery.

London’s Air Ambulance was the first service in the world to perform open heart surgery (thoracotomy) at the roadside, the service has the world’s highest survival rates from this procedure in pre-hospital environment, with patient’s chances of survival rising from zero to 18%.

London’s Air Ambulance was the first service in the UK to carry a senior doctor in addition to a paramedic at all times, provide a 24/7 advanced trauma care outside of hospital, provide general anaesthetics on scene, and carry blood on board and administer blood transfusion on the roadside, from 2018, a consultant in Pre-Hospital Emergency Medicine will be present on most shifts, in addition to the other physician and paramedic.

In 2014 London's Air Ambulance performed the first pre-hospital Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)[3] in the world.[4][5]

Key treatments further include surgical chest draining (thoracostomy), surgical and non-surgical Rapid Sequence Induction (RSI), pelvic splinting (crucial to prevent blood loss in high impact crashes and crush injuries), advanced pain relief and sedation.

The service started a trial of a portable brain scanner which can detect blood clots on the brain in April 2015.[6]


The former London Air Ambulance, an SA 365N Dauphin pictured in 1998, which was replaced in 2000

The current helicopters used are two McDonnell Douglas MD 902 Explorer aircraft, registration G-EHMS, and G-LNDN. They are notable as they do not use a tail-rotor, this is a useful feature, as the helicopter must routinely land in confined inner city areas.

The helicopters usually cruise at 130 knots, at an altitude of anywhere between 500 and 1,000 ft. A regular fuel load, around 400 kg, allows for one hour's flying time.[7] Although the MD 902 Explorer is a quieter model aircraft than its predecessor, a number of noise complaints are still filed relating to HEMS.[8]


MD 902 Explorer helicopter G-EHMS entered service in October 2000, replacing the earlier SA 365N Dauphin, registered G-HEMS, from 6 March 2012, the helicopter became the UK's first air ambulance to carry emergency blood supplies, allowing transfusions to be administered at the scene of an accident rather than later in hospital. A specialised refrigerator installed in the helicopter allows the transport of four units of the universal O-negative blood type which can be stored in the aircraft for up to 72 hours (unused stocks can be returned to the hospital).[9]


In 2015 London's Air Ambulance service launched a public appeal to raise £6,000,000 to purchase, convert, equip, and operate a second helicopter. Of the total needed, just over £4,000,000 represented the purchase price of the aircraft;[10] in January 2016 London's Air Ambulance took delivery of the second MD 902 Explorer, registration G-LNDN. This was in part due to a £2,000,000 donation by London Freemasons,[11][12] which covered half the purchase price, the United Kingdom Government contributed £1,000,000, using funds obtained from fines imposed on banks,[12] with the remaining £1,000,000 being raised by public subscription. Both helicopters wear the same red-based livery, with green and yellow flashes, although G-LNDN additionally has the masonic Square and Compasses symbol on each side, and the words "London Freemasons" lettered under the doors, to reflect the significant funding of the aircraft from that organisation. G-LNDN is identical to G-EHMS in model, equipment and crew. Only one helicopter is operational per day - the other acts as a spare in case of break down, maintenance or, in a major incident, both helicopters are able to deploy.


Following a children's competition, the two helicopters were given names which are displayed on the side of each aircraft; in February 2016, G-LNDN was named 'Walter' after the winning entrants grandfather, on the basis that he lives "in the moon and stars with the angels so he would help keep the helicopter safe in the sky when it's helping people";[13] whilst in April, 'Rowan' (meaning little red one) was chosen as the name of G-EHMS, after that entrants sister.[14]

Rapid response cars[edit]

One of London's Air Ambulance's older RRVs, which was replaced in 2014 with a fleet of brand new ones.

At night or when the helicopters are offline the medical crew, including a paramedic and senior trauma doctor, still respond to emergencies, but travel in a specially equipped rapid response car, the six cars, Škoda Octavias and also Škoda Superbs, occasionally operate during the day, carrying backup medical teams to major incidents, or responding to local incidents or those that occur while the helicopter team is already deployed. They are noticeable from other ambulance vehicles as they are painted in red with high-visibility markings to display their ‘advanced trauma team, status.

A four wheel drive Superb is operated 7 days a week under the name of ‘PRU’, or Physician Response Unit, this unit responds commonly to cardiac rests to help administer advanced support to prevent brain cells dying, although they are sometimes deployed as backup to helicopter cases or used when it is quicker to drive from base. The 4x4 is also used by the Trauma Team when weather is poor.

Both PRU and Trauma Team are operated by the same doctors and paramedics, able to be dispatched interchangeably between incidents.


The service income is £6.8 million a year, with an expenditure of £4.8 million (figures for 2014/2015), but only a very small part of that is funded by Barts Health NHS Trust - which has a long-running partnership with the charity from its foundation, and provides a helipad facility at the Royal London Hospital.[15][16] London's Air Ambulance is a registered charity (number 801013) and the service is funded through charitable donations and corporate donors, the charity also runs a lottery for £1 a week to raise funds for the service, and holds a number of small and large scale fundraising events throughout the year.

Missions and major incidents[edit]

London’s Air Ambulance has attended more than 33,000 missions since its inception in 1989; in 2014, London's Air Ambulance attended 1,806 patient missions.

  • 603 Road traffic collisions
  • 480 Penetrating trauma (stabbings and shootings)
  • 434 Falls from height
  • 289 Other (incidents on the rail network, industrial accidents, asphyxiation, drowning etc.)

Over the past 24 years, the service has coordinated medical response to the majority of London’s major incidents, including the 7/7 bombings, the Soho nail bombing, the Bishopsgate and Aldwych terrorist attacks and Paddington, Cannon Street and Southall rail crashes. On 7 July 2005, London’s Air Ambulance dispatched 18 teams and flew medical supplies to the bomb sites across London, triaging and treating over 700 patients, at the Westminster terror attack in 2017, both helicopters were deployed carrying back-up medical teams who volunteered to work an extra shift.


Helicopters crew

The helicopter crew consists of a Pilot and co-Pilot, in addition to medics - a HEMS paramedic, senior doctor and typically a consultant - who can provide additional guidance to the other doctor. There is a team of 9 consultant who cover most shifts.

Rapid response car

At night, the crew operates an identical service to the helicopters, but using cars at night for landing-safety. Therefore, only a doctor and paramedic form a crew - as no pilots are required.

Physician Response Unit[edit]

The PRU is staffed by a senior doctor and an Paramedic.

Helipad Fire & Rescue[edit]

On arrival at the Royal London Hospital helipad, the dedicated helipad ground crew (fire crew) receive the patient and a dedicated, express elevator carries the patient to the accident and emergency department on the ground floor—where a trauma team with A&E doctors, general surgeons, specialist trauma surgeons, and anaesthetists assemble to assess and treat them.

Fire crew must always be present when a helicopter lands or takes off from the helipad.

Television appearances[edit]

In 2004 the service was featured heavily in the BBC television series Trauma;[17] in 2009 a standalone documentary about the Air Ambulance was made for the BBC by North One Television. It showcased the service in a number of emergencies and was called Medic One: Life and death in London.[18] In 1994 they featured in a special episode of the BBC series 999 entitled "The Flying Doctors", they also featured in BBC Two's An Hour to Save Your Life.


The HEMS Clinical Director is Dr. Gareth Davies. Davies is also an Accident & Emergency and Pre-hospital Care Consultant working at the Royal London Hospital and regularly flies in the helicopter to the scenes of accidents.

Concerns were expressed in the media after the London Air Ambulance charity dismissed its Chief Executive in 2009,[19] the Charity Commission promptly made recommendations on governance to the Trustees, but did not express an opinion over the dismissal.[20]

Physician Response Unit[edit]

Davies has been responsible for many innovations in pre-hospital care such as the Physician Response Unit (PRU), which brings the doctor to the patient in their home, preventing an unnecessary waste of ambulance resources, the PRU also operates from the Royal London Hospital in a rapid response car.[21]

The PRU is staffed by a senior doctor and an Paramedic. Compared to just sending out an ambulance crewed by a paramedic and an emergency medical technician, a higher level of diagnostics and treatment can be initiated on-scene, giving the optimal outcome for the patient, and saving expensive procedures that could otherwise have been initiated, the PRU also responds to cardiac arrests in support of ambulance crews, delivering life saving procedures such as general anaesthetic at the scene and offering pioneering care, including pumping cold fluids around the body to prevent brain cells dying under sedation in the event of cardiac arrest - minimising the risk of death or serious, life long disability suffered through brain damage.

See also[edit]


  1. ^ "Helicopter Emergency Medical Service (HEMS) - Barts and the London NHS Trust". Retrieved 2012-02-22. 
  2. ^ Botker et al. "A systematic review of controlled studies: Do physicians increase survival with pre-hospital treatment?" Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17:12.
  3. ^ "REBOA: Resuscitative Endovascular Balloon Occlusion of the Aorta". Retrieved 12 August 2016. 
  4. ^ "World's first pre-hospital REBOA performed". Retrieved 12 August 2016. 
  5. ^ "Balloon surgery stops fatal bleeding at roadside". BBC News. 17 June 2014. Retrieved 12 August 2016. 
  6. ^ "Portable brain scanner trialled by London's Air Ambulance". BBC News. 30 December 2015. Retrieved 1 January 2016. 
  7. ^ "The Helicopter". London's Air Ambulance. Archived from the original on 24 July 2013. 
  8. ^ "Helicopter Noise in London – Written Evidence" (PDF). London Assembly. Archived from the original (PDF) on 15 August 2012. 
  9. ^ Neil Bowdler (6 March 2012). "Air ambulance first in UK to carry blood". BBC. Retrieved 6 March 2012. 
  10. ^ Cost details outlined at Londonist website.
  11. ^ "Your 2nd helicopter has landed – London's Air Ambulance". Retrieved 2018-02-04. 
  12. ^ a b "Capital gets second air ambulance in 'momentous day for Londoners'". Evening Standard. Retrieved 2016-02-06. 
  13. ^ London's Air Ambulance (4 April 2016). "Second Name Your Helicopters competition winner revealed". London's Air Ambulance. Retrieved 18 May 2016. 
  14. ^ London's Air Ambulance (19 February 2016). "Six year old Fulham resident names our new helicopter". London's Air Ambulance. Retrieved 18 May 2016. 
  15. ^ "Finances". London's Air Ambulance. Retrieved 31 October 2014.  External link in |website= (help)
  16. ^ "London Air Ambulance helicopter gets makeover". BBC. Retrieved 31 October 2014.  External link in |website= (help)
  17. ^ "The Royal London's A&E and HEMS staff featured in BBC series Trauma". Barts and the London NHS Trust. 31 March 2004. Archived from the original on 2 May 2009. 
  18. ^ "BBC One - Medic One - Life and Death in London". 2009-06-01. Retrieved 2012-02-22. 
  19. ^ Laura Donnelly and Alison Moore, Air ambulance chief sacked after he raised financial concerns, Daily Telegraph, 28 November 2009
  20. ^ Tania Mason, Charity Commission provides governance advice to air ambulance charity, Civil Society, 20 January 2010
  21. ^ "Accident and Emergency - Barts and the London NHS Trust". Retrieved 2012-02-22. 

External links[edit]