Twenty-five years of London's Air Ambulance paramedics
The London Helicopter Emergency Medical Service (HEMS) was established in 1989 (Botha et al, 1992; Kirk et al, 1993) in response to a report published by the Royal College of Surgeons (Royal College of Surgeons, 1988), which suggested that up to a third of trauma deaths were potentially preventable with early advanced pre-hospital medical intervention. The benefits of regionalised trauma systems encompassing early pre-hospital intervention and rapid transfer to specialist Major Trauma Centres with all the necessary medical specialties on-site has been proven in other countries (Gabbe et al, 2011). The challenge then in Greater London was to provide a system able to provide enhanced clinical capabilities and expedite transfer to appropriate receiving hospitals for major trauma patients in a city with a resident population of 8 million, a daily commuter population of a further 1 million, and a road system based on 19th Century design.
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