The reason most Emergency Medical Dispatchers fear the West Desk is because it contains London Heathrow Airport. And London Heathrow Airport contains the possibility of plane crashes. A plane crash is the ultimate major incident of major incidents which would entail us using all our training – and not just the bits we use every day and know off by heart. Some of the procedures are things we have only learned theoretically, and if the worst happens, we have to remember them and get them right because with something like a plane crash, there’s no room for error or slowness.

Since my promotion to Allocator, I’ve been slightly nervous that I might have to move to the West Desk, so it was therefore ironic that on my last weekend on the North East Desk, there was a plane crash at London City Airport. London City actually comes under the East Central, not my sector, but several of the nearest ambulances and officers came from the North East. The call we’d received from the airport just said “Aircraft Accident” so we had no idea if we were going to be facing hundreds of casualties, hundreds of deaths even. Our hearts were in our mouths as we waited for the report from the first ambulance on scene. Just how awful was it going to be?

“EC60 reporting. We’ve got four casualties, all minor injuries. The plane has skidded whilst taxiing and the passengers had to evacuate by emergency chute, which is what caused the injuries.”

The immediate reaction was a huge PHEW all round. We’d already sent more than enough ambulances to cover the four casualties, so our work was done. There would be no donning of luminous jackets and running out to the Major Incident room, no frantic dispatch of ambulances from all over London, no deaths, no horror, no headlines dominating the news for the next month.

The second reaction was one of anticlimax. This always brings up the question – by feeling a sense of anticlimax, was it that I wanted people to die? Am I a horrible, mercenary gore hunter who wishes tragedy on others to brighten up my shifts? My answer to this is no, of course I’m not. I wish we could somehow rid the world of plane crashes and other disasters and that everyone would die peacefully at home in bed at the age of 90, if they have to die at all. I wish no one would ever get hurt. But they do, and the fact that this plane crash turned out not to be a major disaster does not mean there will be no major disaster today, tomorrow, or next week. Sooner or later, we’ll be sitting there again waiting for that report, and this time, it’ll be worse than we all imagined. And when that day comes, I don’t want to be tucked up in bed or watching it on the news – I want to be at work, dealing with it, using my training, doing something to help. That is, after all, one of the reasons why I do this job.

The ambulance crews were stood down a few hours after this incident and carried on with their everyday work of heart attacks and broken legs. But for one, there was one last job at City Airport. A woman, not involved in the crash, having a panic attack. Well, quite frankly, I don’t blame her!

Published Feb 14, 2009 - 16 Comments and counting

16 Comments on “Plane Crash!”
  1. Josh Says:

    Ohh….a real brown trouser moment!
    I know exactly what you mean regarding the feeling of an anti-climax. I’ve questioned myself about my feelings and thoughts towards RTA’s, major incidents etc. The truth is I do get excited at the time, although I really don’t want bad things to happen.
    Maybe we’re just happier when the adrenalin is pumping?!

  2. Solomon Says:

    I get the feeling that the anticlimax isn’t because you want there to be death and destruction, but because your brain is prepped for High Alert, and it can’t cope when there is no High Alert for it to deal with. The anticlimax is the difference between what your brain thinks there should be, and what actually is.

    Perhaps it would be easier to deal with if we didn’t come equipped with adrenaline?

  3. Corrvin Says:

    “this time, it’ll be worse than we all imagined. And when that day comes, I don’t want to be tucked up in bed or watching it on the news – I want to be at work, dealing with it, using my training, doing something to help. That is, after all, one of the reasons why I do this job.”

    That is EXACTLY what it’s about.

  4. Decius Says:

    Face it: You are one of the best at what you do. When (not if) a major accident occurs, you want to be right there, allocating. That’s what you do.

    Also, why don’t you have regular refresher training on the ‘theoretical’ stuff that you never use? I would figure about once every three months you would go through a class of “You knew this before, but have never used it since, lets remind you”

    Everyone who is in a profession where mistakes kill people wants to have continuing training and preparedness. Why doesn’t LAS value lives?

  5. Mark Myers Says:

    That’s a good question. We do have refresher courses, but nowhere near every three months. I think everyone takes responsibility for keeping their own skills up to date, but it would be good if it could be done in a more team oriented manner. I don’t think it’s because the LAS doesn’t value lives, though, more because everyone is too busy getting on with the day to day stuff and simply doesn’t have the time for all the training we need.

  6. Phil Says:

    As a Community First Responder I rush to cat A patients with a defibulatior in the the hope I can make a difference in the minutes before a real ambulance arrives. So I know what you mean I don’t want people to be having hart attacks but I still feel a buzz each time I’m dispatched and a real downer when the patient is not serious enough for me to have to make a major intervention (zap ‘um). That said, I hope I’m still making a difference, in some small way.

  7. Nicky Says:

    Wow, scary! I’m so glad it was only a small incident.

    As to feeling guilty that you have the feeling of anticlimax – don’t. What you are percieving as anticlimax is probably just the sensation of all the adrenaline draining away. It’s normal and natural and nothing at all to be guilty about!

  8. Medic999 Says:

    I question my own thoughts too. There are numerous occassions when you hear about pretty horrendous things happening to people which other crews deal with and part of you actually thinks:
    “I wish I got that one”
    And there are other times during quiet shifts when you hope something happens so you can`swing into action`

    The way I try and explain this to people is that I dont want anything bad to happen to anyone, BUT, if something is going to happen, I hope that I am the nearest paramedic to that person so that I can do what I do best.

  9. Uncle John Says:

    Decius on “regular refresher training on the ‘theoretical’ stuff that you never use?”

    But I think there is a fine line between NOT practicing enough, and doing it so often it loses that “adrenaline-edge”? Unless one can think up ‘odd’ scenarios, people get to know what to expect – and, too often, when to expect it.

  10. Decius Says:

    Hrm… if “everyone is too busy getting on with the day to day stuff and simply doesn’t have the time for all the training we need.”, then you are, quite simply, understaffed. You need to have enough people that you can perform you basic functions without hardship if a fraction of them become incapacitated. (Fall ill, get injured, etc.) If you are running ragged in the best of times, then if a bad strain of the flu hits, you can’t function at all.

    As far as the bureaucratic culture goes, I think you have seen the evidence that the LAS cares more about ORCON and deflecting blame from itself and its people than about saving lives or minimizing pain and injury. After all, a bum sleeping in a doorway regularly out-prioritizes an old lady who fell down the stairs and broke her hip.

    I’m not saying that the people in the LAS don’t care, and aren’t doing everything they can. I’m saying the same thing I’ve heard implied: The system is broken, and needs fixing.

    Some suggestions:
    Don’t always assume that the caller knows medical terminology. If the caller says he has diagnosed the patient with diverticulitis, but the caller has no medical training, write it up and prioritize it with the known symptoms. If the caller says that the patient is “unconscious”, write it up based on the known symptoms; ‘Pat. is curled up in doorway, no alertness test performed’. (Assuming that ‘curled up in doorway’ is lower priority than ‘unconscious’)

    Second, regular training. Uncle John suggests that too much training might make one lose an edge- Nothing could be further from the truth. There are easily enough scenarios that one could have several annual full-on ‘drills’ for the entire dispatch side; That is to say, once per year, bring a shift in outside of regular hours, separate them from real traffic, and have them deal with a simulated emergency, along with simulated regular traffic, with simulated ambulances. Actually use the EOC for this, so that you become familiar with the layout and difficulties in communication. If ambulances and volunteers are available, dispatch real ambulances to fake victims. (I have served as ‘victim’ for such training twice.) That give the crews training in how to use their triage techniques to best effect.

    Sorry I can’t run for parliament or PM, I don’t quite meet citizenship requirements.

  11. Aled Treharne Says:

    It seems to have been a week for it. We (Mountain Rescue – http://www.cbmrt.org.uk) got called to an “aircraft crash – no further info” which turned out to be http://news.bbc.co.uk/1/hi/wales/7883338.stm. Frustratingly, having pressed the “big red button” for this kind of event, the police immediately realised it was a small-scale event and scaled down the response somewhat and we were stood down en-route. Much feelings of frustration and deflation all around.

    Personally, I don’t look at it as “I wish someone had been hurt” but rather that I have a skill which I can use for good and this kind of event guns you up ready to deal with an unusual event which may need you to go beyond your normal response. When you’re then stood down, there is an element of deflation because those few moments you took to gather yourself ready to prepare for the Big Thing are no longer needed.

    I’m just glad we didn’t get an incident like the one in the states.

  12. LASBod Says:

    Decius,

    I think you are wrong, LAS doesnt only care about performance, I think you will find that some of Suzi’s questions for her Allocator role was about Patient Care and Heart Patiets.

    You also have to look at the other side of the coin, of course, if you reach 75% call connect, you are reaching 75% of your most seriously ill/injured patients within 8 mins.

    Part of working for the NHS and in turn having AfC as your pay you should maintain your own personal development, if Suzi doenst feel that she is fully aware of a policy she can find it in EOC or the relevant web site or ofcourse she could ask someone. The LAS does do training courses in event control and management but they arent too close together, there are a few issues with this, obviously one being that not all staff are trained in ICR ops and feel a bit left out. However im not sure that Suzi has been ICR trained but I would be confident she would be able to do most roles. They are after all only an extension of allocation skills.

    I dont think the system is broken, it may well have a hairline fracture that could do with some TLC. A few more resources on the road would be nice to fill in for all the ones who magically go VOR at 18:15 with dirty wheels or somethig equally as stupid.

    Again, self development in EOC is one of the most underused tools around, I have only seen a handful of people doing portfolios etc and thats because they have just had promotion so have to.

    Anyway…..im sure youll disagree

  13. Decius Says:

    @LASBod

    That was a large dump of TLAs there, but I can understand most of them well enough from context.

    “Again, self development in EOC is one of the most underused tools around, I have only seen a handful of people doing portfolios etc and thats because they have just had promotion so have to.”

    So, you agree with what I was trying to say – That the culture of the LAS does not encourage practicing professional skills that are rarely needed.

    I’m not sure from what you said, but I infer that if anyone is uncertain about a policy or procedure, they should research it on their own time. Properly, any training or practicing skills that are only used at work should take place on company time.

    Yes, there are some performance metrics that are intended to measure how well care is provided. But when the press is to boost those metrics, then loopholes are found and exploited to make the metrics useless. (ORCON being stopped by a vehicle not equipped to treat the patient)

    And finally, my assertion wasn’t that the LAS cares only about performance, but the opposite: What the LAS cares about isn’t the average quality of care that their patients receive. That is, they don’t prioritize performance, but rather they prioritize what looks like performance.

    Note that I make a distinction between the organization and its members; It’s quite probable that almost everyone who works for the LAS wants to help people as best they can. A few people at the top, however, tried to come up with an easy way to measure that, and made the measurement what is important.

    And I suspect the real issue comes from higher up than the org chart labeled “LAS”. I strongly suspect that a large bit of the UK government is little more than a bunch of Jobsworths trying to prove that they are worth the oxygen they consume. I can imagine a better system, but I can’t imagine a good way to get there from here.

    Also, who is this ‘Suzi’ you refer to? I hope that’s not anybody’s real name.

  14. Clare Says:

    Not a regular reader then, eh, Decius?
    Strange that you can waffle on with such apparent authority on someone’s blog, yet not even know their name………….

  15. Decius Says:

    I was under the impression that a the author was remaining pseudonymous by choice; There have been no mainline posts using anything other than “Mark Myers”.

    Now, back under the bridge, troll.

  16. Adobe Coupon Says:

    yeah i hear that

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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