The National Health Service in the UK is so strapped for cash that paramedics are being forced to use bicycle "ambulances" as can be seen in this photo.
OK, that's the version as it would be pedalled by Fox News and Daniel "My party leader disavows every lie I spread about the NHS" Hannan MEP. The truth?
In Britain, the ambulance service is part of the National Health service. In London it is a separate NHS Trust as it serves the whole city. For England there is a target for 75% of all "Category A 999 calls" to be attended within 8 minutes. These are the most serious emergency calls. In the UK the number for all emergency services is not 911 but 999 (although the EU wide standard number of 112 also works) As you can imagine, in a crowded city achieving those times can be almost impossible in a conventional ambulance. What is needed is a highly qualified paramedic on the spot ASAP to stabilize the patient while the ambulance arrives. Specially equiped motorcycles are used but even these have problems with one way streets and pedestrianized areas. Enter the bicycle ambulance.
The London Ambulance Service (LAS) began cycle patrols in central London in 2002. After trials starting in August 2004, the LAS signed an agreement with BAA, the owners of Heathrow Airport, to provide cover for all its five terminals. (The link is a press release so restrictions on quotes do not apply)
The bicycles are sent to all types of calls within the airport and, where the patient is believed to be in a life-threatening condition, it is sent at the same time as an ambulance so that treatment can be started before the crew arrives.
In cases where the patient is believed to be suffering from a more minor injury or illness, a bicycle paramedic or emergency medical emergency technician is sent initially on his own and can then request further assistance if required—freeing up ambulances to attend other, potentially life-threatening, 999 calls in and around the airport.
All Cycle Response Unit riders have been trained to the International Police Mountain Bike Association (IPMBA) standard. Applicants to the team face rigorous fitness tests in addition to special tuition in subjects as varied as bike-handling and nutrition before being recruited.
The bicycles themselves are the same as those used by the traffic-busting bicycle unit already working in and around the West End of London.
Medical kit carried in the high-visibility yellow panniers that straddle both wheels of the bicycles is both comprehensive and lightweight. Designed to London Ambulance Service specifications, it includes a heart-starting defibrillator, bag-and-mask resuscitator, blood-pressure monitor, burns dressings, oxygen and pain-relieving gas cylinders, and even a maternity pack for delivering babies.
This BBC 3 minute video shows the work of the one paramedic. He is called to a boy suffering from an allergic reaction to peanuts. Although the adults think he recovered enough to travel, the paramedic arranges for them to take a later plane to make sure. Last year the Heathrow cycle unit had a 100% record in attending within the 8 minute target.
This is what happened to the co-founder of the Lonely Planet guides, who lives in central London, in May last year.
On Saturday afternoon I managed to trip over a chair, fall full length across the room, crash my head against the corner of the wall and arrive on the floor bleeding profusely. Maureen did the British thing, called 999 and asked for an ambulance. Ten minutes later medical assistance arrived. On a bicycle.
It makes perfectly good sense, I wasn’t about to die, I could find my own way to a hospital to get stitched up and he probably arrived faster than a real ambulance would have found its way through Saturday afternoon London traffic.
While these are fairly minor incidents, these paramedics save lives. The American Heart Association calculates that for every minute delay in getting to a cardiac arrest patient, their chances of resuccitation decrease by 10%. From the LAS press release:
In August 2005, Graham Clark, a British Airways customer service arrivals agent, had been sitting with his work colleagues in a rest room at Heathrow Airport’s Terminal One when he suffered severe pain in his chest and arms. Within seconds, he lost consciousness and stopped breathing. His British Airways colleagues immediately dialled 999 for an ambulance and began attempts to resuscitate him.
"All I can remember is getting up from the sofa and saying to my colleagues that my chest and arm hurt," explained Mr Clark. "After that, everything went blank."
Within seconds of the 999 call being made, Bicycle Emergency Medical Technician Mick Hampson reached Mr Clark. Mick was able to continue resuscitation and re-start Mr Clark’s heart after three attempts using the portable defibrillator that is carried on ambulance bicycles.
Paramedics, dispatched in an ambulance at the same time as the bicycle ambulance, arrived a few minutes later to continue treatment and take Mr Clark to Hillingdon Hospital.
A "fly on the wall" documentary team caught a similar incident on film at Heathrow when a woman passenger from America collapsed in cardiac arrest and was revived. Talk about coming to the UK for treatment!
This, from a citation for an award for a bicycle paramedic, Kieth Plummer, shows how they are far more than simple first aiders.
On arrival at the scene of an accident involving a motorcycle and a car, Keith established a safe area within which he could treat the patient by positioning his bike on the busy road (Shaftesbury Avenue) to fend off on-coming traffic.
· He provided professional medical help to the injured parties.
· He called all the necessary assistance and managed the assistance upon arrival - co-ordinating the helicopter service, the ambulance and the police.
Cycle paramedics are used in other parts of the UK where their access to pedestrian areas are needed. Edinburgh, especially during the Festival period is one example. They are also likely to be deployed on the Olympics site in 2012.
One word of advice if you are unfortunate enough to need emergency medical attention on a visit to the UK. You may be concerned that you are not being taken to hospital immediately. The paramedics are trained to assess and stabilize patients before transporting them to hospital to achieve the best outcomes. The days of "scoop and run" are over. Oh and the cost for emergency treatment, even if you are an illegal immigrant because you have overstayed your visa will be ... £0.00
UPDATE:
Many thanks for the recommends and the placing on the recommended list. By a crafty bit of timing, I have now published a new diary on the NHS about a new approach in London for treating heart attacks. BTW, I do not want to denegrate the work of paramedics in the USA either in this diary or the new one. It is just that by being part of the same overall organization and having a single provider in a given area, novel and coordinated approaches that save money and lives can be swiftly implemented.
