London's Air Ambulance service dispatches doctors and paramedics all over London to deliver essential treatments to anyone involved in a life-threatening incident.
Those emergencies could include road traffic accidents, train accidents, stabbings, shootings or falls from large heights, where every second counts in the chance for recovery. With an immediate response often meaning the difference between life and death, the helicopter team is able to fly in a straight line, over the congested roads of one of the world's busiest cities, to the scene of the accident.
The LAA has cut down its response times by up to two minutes -- a huge amount -- by replacing its outdated dispatch system with a new, custom built iPad app, that works on 4G networks.
This week I caught up with the team on top of their helipad at the Royal London Hospital in Whitechapel to find out more about it.
The helicopter -- an MD902 Explorer with a top speed of 161 mph -- is the only one operating this service in London. The team treats on average six patients in a day -- patients with injuries too severe to wait for hospital treatment.
With medical teams and equipment on board, the Air Ambulance's mission is to bring the critical hospital care to the patient, rather than take the patient to the hospital.
The Air Ambulance is a charity-funded service and runs almost entirely off donations given by the London public. The crew are currently raising funds for a second helicopter, to ensure that there is always one helicopter in London ready to provide urgent care. During my visit, when this helicopter is receiving maintenance, there are no air ambulances available.
Critical to the operation is the new iPad app, which enabled the 2-minute cut in response time. That's a vast amount of time saved, which is critical in treating patients suffering from severe trauma.
Developed specifically for London's Air Ambulance by developer Mubaloo and UK mobile network EE, it replaces the rather outdated system which relies mostly on phone calls and paper.
In the old system, a call would come through from the 999 call centre, and the information regarding the incident, the location, and other necessary information would have to be relayed to the Air Ambulance team over the phone, written down into a computer, then printed out and handed to the pilot.
With the app, as soon as an alarm sounds, the pilot can run to the helicopter and start it up, knowing the information will be pushed through to the iPad while he's getting airborne.
The iPads are connected using EE's 4G network, too, allowing the pilot and navigator to receive more info on the scene, and to track their progress through the air on the iPad's map using GPS, rather than on a paper reference.
Here's an example printout of how the system used to look. Paper maps were also carried in the helicopter. Now, it's all digital and the time saved is making a real difference to the quality of care the team can provide.
The app has a lot of potential for the future, too. Some features being discussed include the ability to stream video of the scene to a specialist doctor, who can provide live information on how to treat a particular patient. The team also explained that being able to send this video to the hospital would be extremely helpful, as it would allow the hospital to know exactly what condition a patient will be arriving in, and can prepare treatments accordingly.
These features are largely hypothetical right now, as they're not yet even in the testing phase.
Meet Rob Pennell, one of the Air Ambulance's helicopter pilots. Two pilots are always required to fly at once -- one is responsible for actually flying, while the other takes care of navigation, relaying information to air traffic control and finding a place to land.
Finding a safe landing spot is simply a matter of looking down at the landscape below and seeing what's around, explained Johnny, one of the other pilots at the LAA. "Looking down, you can see a surprising number of places to land. The helicopter needs a space about the size of two tennis courts to land safely."
The team regularly land at road junctions, multistorey car parks and other busy areas. "People tend to get out of the way," explained Johnny.
The LAA's helicopter team get priority over London's airspace, meaning that all other aircraft in the area must divert to allow Rob and his team to get to the scene of the emergency as fast as possible.
The team make on average six trips a day, although this can be as many as 10 or more. The helicopter covers an area of 600 square miles over London and the surrounding area.
Both doctors and paramedics are on board the helicopter, with equipment that allows them to perform complicated procedures -- even including open heart surgery, or reinflating collapsed lungs -- right at the scene of the incident, bringing the hospital to the patient.
A fire crew is permanently on hand at the helipad to ensure that any fire risks with the helicopter are dealt with before they become a problem and potentially destroy life-saving equipment.
"Weather is our big limiting factor," explained Johnny, one of the helicopter pilots. The helicopter is able to fly in winds up to 40 knots (around 46 mph) in speed.
Starting up and shutting down the helicopter is the most difficult part in windy conditions as the blades lose rigidity when they slow down. In strong winds, it's possible for the blades to hit the helicopter body itself, causing damage.
A look inside the cabin of the helicopter. It has fairly standard controls, as all of the navigation and information regarding the scene of the incident is provided via the iPads the pilots bring.
Note the lack of a propeller on the back of the helicopter -- that's to make it a lot more safe to fly in busy, urban environments like London, as rear blades won't hit buildings or, more likely, overhead wires.
The helicopter was also the first in the UK to carry blood supplies onboard for transfusions at the scene of incidents.
Here are the ground cars the teams use. They're Skoda Octavias, which are particularly powerful to help them get through the busy streets.
The cars are used most often at night, when the helicopter doesn't fly. There's much less traffic on the road then, allowing the cars to reach the scene of the emergency much faster than it could in the day.
The helipad -- stuck to the top of the 17-storey hospital in Whitechapel -- has a brilliant view over all of London.