by Gerard Robinson
London Ambulance Service (UK)
In October 2004, London Ambulance Service (LAS) began trialling a cycle response unit inside Terminal 4 of Heathrow, the world's busiest airport with more than 67 million passengers (and growing) annually. The purpose of the trial was to see if it would be advantageous to have an immediate responder on a bike inside the terminal building rather than dispatching a double-crewed ambulance for a patient who, more likely than not, would wish to continue his or her journey rather than attend a local casualty department. The cycle responder would attend any call - no matter how life-threatening - assess the situation, and call for support, i.e., an ambulance to convey the patient to the hospital if necessary.
Due to the success of the trial, airport authority and London Ambulance Service executives are now in negotiations to continue Heathrow's cycle response and expand to include another two cycle response bikes in Heathrow's Central area, providing emergency cover to another three terminals.
The brainchild behind this trial was Duty Station Officer Alan Payne, who is based at Hillingdon Ambulance Station. Some five years ago, whilst awaiting check-in at Vancouver airport, a passenger collapsed in front of him. Within minutes of him assisting this passenger, medics on bikes approached the scene. This is where Alan's idea started.
Since October 2004, we have been operating in Terminal 4, seven days a week/11 hours a day, using three riders on a rotating shift system. By the end of January 2005, we had responded to just fewer than 400 calls. Out of those calls, 74% were dealt with by the EMS cyclist, enabling the ambulance that would have been dispatched to be suitably deployed elsewhere. The average response time was a staggering two minutes, and the overall success of the trial has been unbelievable.
A typical shift for any of the three cyclists commences at 05.30hrs at a small ambulance station just north of the airport with our all-important warm-up/stretching routine. After that and the bike/equipment checks are complete, we make our way to the terminals. First we proceed to the central area (Terminals 1, 2, & 3) to gain access to the Heathrow Express, the train that links the central area to Terminal 4 (just south of the airport) and also provides a direct high-speed link to London Paddington Main line railway station. Whilst in the central area, we normally respond to emergency calls as necessary.
Upon arriving at Terminal 4, our duty really starts. Passenger levels at that time of the morning are light for check-in; however, arriving flights are at their peak, so we position ourselves at an appropriate point - closely but discreetly - so as to minimise time spent negotiating through the tired and weary passengers with only one thing on their minds, 'has my luggage arrived in the same country as me?'
With all the illnesses that a bike medic has deal with anywhere in the world, we are unique in some respect in that we deal with a lot of pulmonary embolisms (a blood clot that has made its way to the heart and lungs). We quickly grew to suspect that when we received a call to certain areas of our airport for the report of a male/female collapsed, we could and most probably would be dealing with one of these cases.
Later on in our shift, our passenger volumes move slightly to what we call "landside" - the check-in area - prior to passport control. People queuing/rushing around to catch their all-important flights raises stress to higher than normal levels; we then have our collapses with difficulty in breathing, asthmatics, diabetics, and heart patients.
As our day progresses and we patrol the terminal, passengers and staff alike approach us on a casual basis to ask questions regarding our presence in the terminal and our function/role as medics in the terminal. We have a facility to restock any consumable items of equipment, so as to reduce down time to a minimum. Towards the completion of our shift, we make our way back to the ambulance station, where we warm down, replenish our fluid levels, and end our shifts.
Gerard has been with LAS since 1983 and has been working on a dedicated ambulance at Heathrow since 1994. He completed the IPMBA EMSC Course in 2004, and is currently serving as the coordinator of the airport cycle response team.
© 2005 IPMBA. This article appeared in the Spring 2005 issue of IPMBA News.