I ask Andy Mawson how you sew up a heart when it’s moving.
“It’s quite tricky,” he said with a wry smile.
The Maserati Levante Trofeo gleamed in the rare sunlight outside whilst I prepared for an extremely exciting tour.
I was driving up to Durham to spend four days with The Great North Air Ambulance Service for training, reenactment and emergency exercises. The GNAAS head office is located between The North Pennines and North York Moors National Park. The Director of Operations, Andy Mawson, had invited International Excellence Magazine to experience a taste of life as a paramedic in the helicopter rescue services.
GNAAS were training and evaluating new medics by putting them through extremely realistic emergencies, ranging from massive road accident style pile-ups with car wrecks scattered everywhere to terrorist attack training. It may help to gauge the realism if you know in advance that this included day and night operations involving the Fire Brigade, Ambulance Service, Northumbria Police and a host of actors playing the wounded.
The ride up in the Maserati Levante Trofeo was smooth and swift, stopping only in Northampton to pick up my colleague for the trip, Mark Turner. We arrived at the superb Derwent Hotel & Spa late in the afternoon and took some time to video and photograph the Maserati in the gorgeous fading sunset.
The next morning we headed off to GNAAS head office in Eaglescliffe, south of Durham, next to the Tactical Training Centre. The centre consists of two large buildings, the hangar and head office, and a helipad. Andy greeted us warmly and introduced us to the team and their Airbus AS365 Dauphin helicopter. We spent the entire morning meeting the dedicated paramedics, helicopter pilots and support staff who keep this extraordinary emergency service running.
Our host Andy Mawson, Operations Director and Paramedic, joined GNAAS in 2010 having previously worked as a rapid response paramedic for the North East Ambulance Service, mainly around Newcastle. He is incredibly passionate about the GNAAS, not only serving as a helicopter paramedic but also pushing the service into the future. Mawson is multi-talented, a highly skilled medical professional and a natural creative force, full of boundless energy for the work they do. He is constantly seeking new medical treatments and technological advancements in transport that enable them to reach people faster to save more lives. An excellent communicator, he made an incredible host, kind, patient and passionate about the service. He is responsible for their adoption of the Gravity Jet Suit.
Their new CEO, David Stockton is charming and friendly like all the staff here. Previously he worked in healthcare and retail in the Teesside and Tyneside areas. He also spent five years working at board level within a multi-billion pound company. He explained how complex it was running and financing such a large and important operation. He also admitted he had been planning on taking things easy for a while before the GNAAS called him up. As he says, it is a privilege to be a part of such an amazing team.
“I’m inspired by the work of the air ambulance, and through my interests in motorsport, I know just how vital it is. In the short time I’ve been at GNAAS I’ve also been inspired by the talent and passion that already exists within the charity. I’m proud and honoured to be here.”
His immediate focus is on helping the charity emerge out of the coronavirus crisis, which is believed to be costing the charity more than £100k a month in lost donations.
Dr Rachel Hawes, OBE, showed us around the medical equipment in the helicopter. She joined GNAAS in 2009, where she is the clinical lead for the Blood on Board service. An innovative service to carry blood and plasma to aircraft and road vehicles so that life-saving transfusions can be given at the roadside, rather than waiting until they get to the hospital. She received an OBE for her services at GNAAS in 2018 and brought a ton of experience saving lives from her time in Afghanistan. She is also a Consultant in Anaesthesia and Pre-hospital Emergency Medicine (PHEM) at the RVI and an Army Reservist.
Rachel spoke passionately about her work and explained how so many lives are saved by anaesthetising people correctly to slow down bodily functions and prevent any further damage whilst they are airlifted to a hospital. She went on to explain the importance of blood transfusions in preserving life.
Dr Rachel Hawes
“We’ve had a huge number of people survive that may not have if they hadn’t received the blood and plasma at the roadside. I think that must have been one of the most rewarding projects of my career! It’s such an exciting time to work for an organisation that’s forward-thinking, innovative and progressive.”
Next, I chatted at length to paramedic Ian Grey. We had a fascinating conversation about the challenges they faced every day and the responsibility that came with it. I wanted to know if they ever had any trouble sleeping as they shoulder such pressure with lives on the line almost daily. Often in extremely hazardous situations. A few things became clear during our conversation. One, that training takes over during the emergency and two, it takes a certain type of person who can handle stress well and compartmentalise. Every paramedic I spoke to shared certain characteristics. Apart from being highly trained with at least a decade of experience, they were all able to make life-changing decisions instantly whilst at the same time remaining calm, patient and communicating effectively. These are quite rare personality traits.
Ian joined GNAAS in 2018 after fifteen years with the North East Ambulance Service where he started as an advanced technician to a paramedic, working in ambulance control, with the Hazard Area Response Team and serving a stint as a line manager.
I was then introduced to the equally fascinating helicopter pilot Phil Lambert. Phil has been a pilot with GNAAS since 2012. Prior to this, he spent 23 years in the Army Air Corps both as a ground soldier and a pilot. During this time he saw operational service in Iraq, Northern Ireland, Bosnia and Afghanistan. In the Army, Phil flew both Squirrel and Lynx helicopters.
“I was born in Cumbria so to be able to fly in this area while being part of a team that makes such a difference to people is a great privilege. I do rely heavily on the flying experience I gained in the military.”
Phil showed us around the controls of the Airbus helicopter, comparing the skills required to riding a bicycle, only just a tad more complicated. His experience in the Army Air Corps and ten years with GNAAS meant he had many adventure tales to tell of dangerous air-sea rescues and hair-raising mountain landings
All the paramedics, doctors and pilots had the most fascinating career paths from military medicine to civilian paramedics. They appeared to live life at an accelerated pace, experiencing so much from a young age.
We were then treated to a tour of the new office, Progress House. Downstairs is taken up by operations and training rooms. The air desk was a revelation. A two-man team, consisting of Stuart Thompson and John Kirton, monitor the police, emergency and flight communications on a bewildering array of radio receivers and screens. Thompson is the senior aircrew paramedic and data and information services manager at GNAAS. He oversees patient information security and sits on the Clinical Standards panel. John Kirton is the latest paramedic recruit and clarifies for us the technical aspects of monitoring the services.
These chaps are responsible for filtering high priority emergencies from the rest and liaising with other emergency services. They are the ones who decide when an emergency is serious enough to send out the team. A massive responsibility and the speed at which they take that decision is vital. Loo breaks are fraught as they never want to leave the desk for long, though of course they relay each other.
We toured the various training rooms with model body parts, mannequins and a plethora of medical tools and equipment. All surfaces are white tiled so they can be washed down easily. A reminder that the job comes with some gruesome realities.
The upper floor is a modern, open-air gallery office that houses the support staff, covering fundraising, lottery and administration teams as well as media outreach and strategy. Reminiscent of a California tech startup with a positive and bustling work atmosphere. Everyone there clearly shared the same passion and dedication to the GNAAS mission of saving lives.
Then it was down to the nitty-gritty of the work the GNAAS undertake. We sat down to watch a video of the paramedics performing open-heart surgery in the street, known as a thoracotomy. If someone is dying from heart or lung failure and there is no other way to save them the paramedics will make an on the spot decision to open them up. This is a last-ditch attempt to bring them back long enough to get to a hospital. Every second counts, so they must decide fast. If the patient will die if nothing is done, then they go in.
They cut open the chest from side to side and attempt to identify whatever has stopped the heart or lungs from working. They must stop the bleeding and find any wounds quickly. Then seal or repair these to get the heart or lungs working, just long enough to get them to the hospital. This often takes place in very bad conditions; by the side of the road, on a street pavement or in a town centre. Perhaps with bystanders interrupting them for any number of reasons, day or night, rain or shine.
Think about that for a moment, open-heart surgery with no time to plan, no prior scan, on the street, perhaps looking for a tiny knife wound amongst all the blood. With just a rucksack of medical equipment to work from.
My colleague Mark and I are taken aback that this is even possible. But if the patient is going to die without help then they will go in. The success rate is understandably low, but many lives are saved that would otherwise have been lost. Open heart surgery is complicated enough in a hospital when everything has been prepared in advance and the surgeon knows exactly what to expect. On the street, they are working blind and under extreme conditions. It is clear now why so many paramedics have previous military experience.
I ask Andy Mawson how you sew up a heart when it’s moving.
“It’s quite tricky,” he said with a wry smile.
Suddenly the alert goes out and the team scramble into action. The helicopter and paramedics are in the air in under two minutes. It is awe-inspiring watching them race off to another emergency. Who knows what they will be faced with?
Just another day at the GNAAS office for the paramedics.
The Great North Air Ambulance Service is 100% self-funded. It receives no money from the NHS. The team raise all the money to save people’s lives independently each year. They even buy in their blood supplies. Anything you can do to help, contribute a little cash, raise funds, tell people about them etc, every little counts.