Left You Dead

37

The navy, white and turquoise helicopter of the Kent, Surrey and Sussex Air Ambulance was flying eastwards just below the 500-foot cloud ceiling. A few minutes earlier the AgustaWestland AW169 had lifted from Worthing Hospital in West Sussex and was now on a heading back to the Rochester City Airport base to refuel. And also to give the crew, who had been up early, a much-needed comfort break and a caffeine hit.

They had just dropped off a seriously injured farmworker. The unfortunate thirty-three-year-old had fallen into a threshing machine, which had severed his right leg below the knee and ripped off his right arm below the shoulder. He’d said to them apologetically, before they’d put him into an induced coma, that it had been his own damned stupid fault — he’d removed the safety mechanism, which was there to prevent just such an accident from happening. He’d done that, he said, because the machine had kept jamming and it gave him quicker access.

Luckily for the man, they’d reached him less than four minutes after receiving the call — the accident scene was almost directly in their flight path after returning from attending a motor scooter accident near Arundel. The rider there had suffered nothing worse than a broken leg and she’d been taken by road to hospital. If they’d been much longer before reaching the farmworker, he would have bled out and died, for certain.

The pilot, Andrew Delaney, and the paramedic, Kirsten Dunwoody, sat up front, and the trauma doctor, Julian Turner, sat behind them, writing up his notes. All three had their helmets on. It was 10.15 a.m. and they were just over two hours into their eight-hour shift.

Turner looked up from his tablet and peered out of the window to his right, which was beaded with tiny drops of rainwater. He took in the familiar lush landscape below. The views from the helicopter still excited him after four years of doing this job, and he joked to friends that he had the best office in the world. Swathes of green Downland slid past, patchworks of fields, isolated houses, occasional swimming pools and tennis courts, lakes, reservoirs, the dark, straight stretches and winding ribbons of road, and, far over to the right, the English Channel, the sea a flat grey today. The only thing he struggled with was the topography. From up in the air, the hills below were flattened out and although he knew the key landmarks, he got confused at times, trying to figure out exactly where they were.

Delaney, a highly experienced pilot, ex-Fleet Air Arm and then ten years ferrying workers to and from North Sea oil rigs, had an ability Turner really admired. He was able to land the machine in often seemingly impossible places and pretty much regardless of the weather, inspiring confidence in everyone who flew with him. One advantage this helicopter had over many other makes was its lack of a tail rotor blade, making landing in confined spaces with people around much safer.

‘Tell me, guys,’ the pilot’s posh voice came through their speakers, above the roar of the twin engines. ‘I don’t get it.’

‘Get what, Andrew?’ Turner queried. ‘You’re still the best-looking man in this chopper, in case you’re worried?’

‘Never forget it! I’m talking about that last shout. I mean, bloody hell? The manufacturers of that threshing machine do all they can to make it safe and the guy takes it upon himself to undo all that. I mean, hello?’

‘I agree, incredibly stupid?’ Kirsten Dunwoody said in her Aussie accent which always, Turner thought, made everything she said sound like a question, as it did now. ‘Poor man. Let’s hope he makes it?’

‘Andrew, you know the problem with making anything idiot-proof?’ Turner said. He provided the answer without waiting for a reply. ‘It’s that idiots have a great deal of ingenuity!’

At that moment the alert on the comms panel in front of the doctor flashed, signalling a new incident. He leaned forward and answered. The despatcher’s voice, sounding crystal clear, said, ‘Helimed Six Zero?’

‘Helimed Six Zero,’ Turner answered.

‘I have you approaching Brighton, correct?’

‘Correct,’ the doctor confirmed.

‘RTC in New Church Road, Hove,’ the despatcher said. ‘Car versus a schoolboy. We’ve had lots of 999s coming in. It sounds bad. It’s a wide road, Andrew, do you think you can land there? Alternatively there’s a park nearby.’

‘I know it,’ the pilot replied. ‘I can get us down there fine.’

‘RPU will clear an area for you. What is your ETA?’

‘I have visual on Shoreham Power Station chimney. I’m two minutes west of it.’

‘Two minutes, A-Firm.’

Instantly Julian Turner focused his mind. A car versus any human being was never going to be good news, let alone a child. It was sheer luck for the boy that they were so close — if anything could be done for him, this Air Ambulance, which was to all intents and purposes a fully equipped mobile Emergency Department, would give him the best chance.

It was against the regulations to unclip his harness before landing but, as they flew over the city limits and started to descend, Turner placed his hand on the buckle, at the ready, so as not to waste a split-second when they were down. Immediately following a major trauma, there were two critical time frames for the victim: the Platinum Ten Minutes and the Golden Hour.

The Golden Hour was that crucial first hour during which a severe trauma patient arrived in a hospital, when the team threw every resource they had at them to understand the extent of their injuries and do all they could to keep them alive. Because if they could get them through that hour then they had an increased chance of saving them.

The Platinum Ten Minutes was all down to him and the paramedic — so long as the victim wasn’t trapped. If he assessed they needed urgent hospitalization, their task would be to stabilize them and to ensure they moved them safely, then get them off the scene and into the helicopter within ten minutes — to give the victim as much of the Golden Hour as possible in hospital.

Boy versus car.

Blunt force versus a robust but fragile human.

Turner had done a PhD on the subject of trauma as well as having written a series of articles for The Lancet, the widely respected medical journal, on the subject of blunt trauma. He was now writing a medical textbook on the treatment of trauma victims.

The subject that interested him greatly was the amount of impact a human being could sustain and live. He had an opportunity to study it through the victims of accidents he came across in his current work with the Air Ambulance, as well as through forums of trauma doctors and collision investigators around the world.

A straight fall of fifty feet onto a hard surface was the maximum the majority of normal, healthy adults could survive, and that was if they landed feet first with bent legs. Falling from significantly higher than that, the odds reduced to ten per cent. Beyond seven storeys, any fall onto hard ground would be fatal. Lighter, more supple children had a slightly better chance.

He had a particular interest in road traffic accident injuries. Wearing a tightly fitting seat belt, without allowances for crumple zones, the maximum sudden stop an adult human could survive, in theory, was a 60 mph impact — two cars head-on at 30 mph each. Any higher speed and there would be massive rupture damage to the internal organs. The spleen, kidneys, liver and heart would all tear their restraining tendons, and the brain would ricochet around inside the skull, causing severe internal damage.

The pilot’s calm voice crackled through their speakers. ‘Shoreham, Helimed Six Zero, five hundred foot Portslade, inbound Hove, major road accident.’

The crisp reply from Shoreham Air Traffic Control came back. ‘Acknowledged. Surface wind at Shoreham two four zero at ten knots. We have IFR traffic, a King Air inbound 1,500 feet Devil’s Dyke.’

‘Thanks Shoreham, will call again lifting.’

For tight landings like this, both medics acted as crew, peering out of the windows for hazards and, in particular here, cables. As their speed of descent slowed, he could see flashing blue lights on the roofs of several police vehicles, each marked with their call signs. A white-and-blue BMW i8 had slewed at an angle. A short distance behind it several people stood or knelt around a crumpled figure lying on the road. A police officer in a fluorescent jacket was acting as batman, signalling them in.

Turner knew this long and very wide road well — as a child he had lived in one of the quiet, tree-lined streets that ran south from it down to the seafront. With its mix of detached houses, many now occupied by medical practices, elegant Victorian semis and terraces and low-rise flats, this whole area, being so close to the beaches, was a popular and much sought-after residential neighbourhood.

The pilot manoeuvred the helicopter by hover-taxiing just a couple of hundred yards in front of the BMW, a little to the right, then left, before it touched down almost imperceptibly and settled on its wheels. The pilot, keeping the rotors turning, said, ‘Go!’

Turner pulled off his helmet, grabbed his bag, pushed open the door and jumped down, followed a few seconds later by the paramedic. She stopped when she was clear of the rotor blades to turn back and give the pilot a thumbs-up.