A DAY IN THE LIFE OF THE CHILDREN’S WALES AIR AMBULANCE 6th June 2018 A day in the Life of the Children’s Wales Air Ambulance The Children’s Wales Air Ambulance is a specialist division of Wales Air Ambulance providing expert care and transport for some of Wales’ youngest patients. Based at Cardiff Heliport the service is funded entirely by the charity and has the UK’s only dedicated Helicopter Transfer Practitioners who are experts in keeping patients safe and comfortable during flight transfers. Alongside the charity’s three emergency aircraft the Children’s Wales Air Ambulance is on standby every day of the year to transfer vulnerable babies and children between hospitals. Each mission is flown by two advanced multi-crew trained pilots. In 2017 alone, The Children’s Wales Air Ambulance helped 332 Neonatal and Paediatric patients across Wales. Andrew Morris – Helicopter Transfer Practitioner on-board Helimed 67 The day begins at 08.00 with a thorough check of medical and electrical equipment, including patient monitoring systems, ventilator, defibrillator and infusion pumps to ensure they are working correctly. This equipment is then loaded onto the aircraft, preparing it for the shift. This check also includes both transport incubators, which may be required to transfer premature babies across Wales and further afield. We are lucky to carry some of the most advanced air transport incubators in the UK that provide temperature control and protection and breathing support for babies up to 4 kg. The babies that are transported within these incubators can be critically ill and require maximum treatment to support their breathing, heart rate and blood pressure, until they are safely transferred to a specialist neonatal intensive care unit or emergency surgery. Once the equipment checks are complete, the daily briefing takes place between both pilots and the Helicopter Transfer Practitioner (HTP). This briefing looks at weather conditions for the day, any airspace restrictions and issues which may affect operations such as hospital helipad availability. The Children’s Wales Air Ambulance is the only air ambulance in the UK to operate multi-crew meaning two pilots operate the aircraft simultaneously. This is in line with the Paediatric Intensive Care Society’s Quality Standards for the care of critically ill or injured children. The HTP then confirms aircraft availability with the charity’s Air Support Desk at the Welsh Ambulance Service clinical contact centre in Cwmbran, who co-ordinate our taskings for the day. We also work with a range of specialist teams across Wales such as the Cymru Inter-Hospital Acute Neonatal Transfer Service (CHANTS) to discuss any potential taskings. During the shift, we can be called upon to provide air support for the specialist neonatal and paediatric teams, which includes collecting them from their bases across Wales or Bristol and transporting them and their equipment to hospitals around Wales. Should a baby or child require emergency stabilisation delivered by a specialist team, transport by air can be up to four times faster than the road, particularly considering the rural nature of many parts of Wales. In addition to emergency requests, we also provide a repatriation service for babies and children who have received the appropriate care and can now be returned to a hospital closer to home. The team have completed neonatal transfers to Northern Ireland, Southern Ireland and various hospitals in England including Watford, Coventry and Taunton. Child repatriations regularly occur throughout Wales, particularly children being discharged from the Children’s Hospital for Wales in Cardiff to Aberystwyth or hospitals in North Wales or the South-West of England such as Truro. Our repatriation work helps to free up precious beds in children’s units, while getting a child or baby closer to home and their loved ones. Requests can occur at any time and range from collecting children from West Wales who require emergency spinal surgery and transferring them to Cardiff, children who are receiving chemotherapy in Bangor who need urgent treatment in Liverpool or time-critical transfers for children who need organ transplants in London. Where a specialist team is not required, the child is cared for by the Helicopter Transfer Practitioner and where possible we will try to take a parent if they are happy to fly! The team regularly transfer children to specialist paediatric hospitals such as Great Ormond Street in London and Alder Hey Hospital in Liverpool, greatly reducing the time taken to move these vulnerable patients. Teamwork between the crew is vital to ensure efficient and effective operation of the service and conducting these transfers involves a significant amount of planning, particularly flight planning. Although we attempt to complete every request, unfortunately, issues such as poor weather can influence our ability and if the pilots say it is not practical to fly, we respect this and look at alternative ways to complete the task, usually by road. The job is demanding but incredibly rewarding and no two days are the same. The shifts can be long, but we work as a team to help the patients we have in our care. This service is completely funded by the Wales Air Ambulance Charity who receive no government or National Lottery funding. The charity relies solely on the support of the people of Wales to raise more than £6.5 million every year to keep its helicopters and the Children’s Wales Air Ambulance operation flying.