15 Aug 2023
Providing fly-on-the-wall footage and unprecedented insight into the work of the service, Channel 4’s documentary Emergency follows the minute-by-minute decisions advanced trauma teams like ours make to treat the most serious cases in London, featuring Dr Cosmo Scurr.
After watching him on the telly, we spoke to him to hear his thoughts on the importance of highlighting London’s frontline trauma teams.
What’s involved in a typical day, if such a thing exists?
I work as one of the consultants at London’s Air Ambulance. This means that I am there to ensure the patient receives the highest level of medical care and treatment that we as a team can deliver.
I take part in the checking and verification of our equipment, vehicles and medication at the start of the shift, and then lead a brief with our flight physician, flight paramedic, fire crew and pilots. In between responding to patients, as part of our advanced trauma team I deliver teaching and training to the team, while learning from others with specific knowledge and experience. We aim each day to clinically review the cases from the previous 24 hours and see if there is any learning from them, or clinical practice which should be shared with our wider team.
When we are dispatched to an incident, my role may be to deliver care myself or it can be to support others in providing expert trauma care to patients when they need it most.
We never know where in London we will be needed, but will always respond to those that are in need of our specialist team.
Describe the cases you were involved in during this series of Channel 4’s Emergency?
I responded as part of London’s Air Ambulance’s advanced trauma team to treat Paiwand, who was hit by an HGV whilst crossing the road. He was pinned under the vehicle and we were dispatched to assist him – our research shows patients in this scenario often suffer severe injuries and can be at high risk of death.
On arrival he was still stuck under the vehicle, in severe pain, with very limited access to clinically assess him. I was concerned that he would be in pain, and well as being terrified. In addition to that, I was concerned that the HGV may have not only caused severe injuries to his limbs and pelvis, but that the related blood vessels could have been damaged with the risk of internal bleeding. Until we had him out from under the vehicle, and were able to fully examine him, we did not know the extent of internal bleeding.
As a team we worked to safely gain access to Paiwand and communicate with him. We then provided sedation and pain relief, coordinating this with moving him out from under the vehicle. We manipulated his injuries, to reduce the ongoing discomfort and reduce tissue damage and bleeding, and transferred him under our care to the local major trauma centre.
What do you hope viewers will learn about trauma care? What do you hope they will take away from watching Emergency?
I really hope that people can see how collaborative the London trauma system is. From the moment of injury, the people of London and all the emergency services respond to help. All of these responders contribute to the care delivered and the outcome of the patient. This is only the first phase, before the patient is cared for by a huge group of professionals in the major trauma centre, and then later in the trauma unit hospitals and (when needed) rehabilitation centres. Patients go through an incredible journey and the input from innumerable people and their families and friends are critical to their outcome.
London’s Air Ambulance Charity is supported and funded by the people of London and we are a key service that responds as part of this collaboration, to help people when they need it most.
What are the biggest challenges in your job?
The job has lots of challenges and in many ways the challenge is part of why the job is so satisfying. It is not easy to provide compassionate, detailed and rapid clinical care in the extremely varied situation of an accident scene. As a team we are continually trying to improve how we do this and the real challenge is how to best incorporate all the knowledge, skills and ideas of every professional on scene to help the patient. It is a balancing act, and not easy, but immensely satisfying when you get to see amazing care being delivered.
How do you cope with the demands of your job – mentally, physically and emotionally?
The job is demanding and it is important to have a bit of balance in your life. Many of the frontline team either do the job for a fixed period of time or mix this role with their other jobs in the wider NHS. This mixture of work is helpful to cope with the emotional load that comes with the work. There is also a really close-knit team and we all look after each other. We debrief and discuss the impact of the jobs and the decisions that we have made: this process has been critical to learning as well as to coping mentally with the type of work.
What motivated you to get into this side of medicine and what are the things you love most about your job?
One of the key things I enjoy about working in pre-hospital care is the variety of new challenges you face regularly. You after often faced with a new situation and can only get through it by being well trained, rational and by using the expertise of the whole team on scene. I am also motivated by the goal to always bring comfort, dignity and help to people who were, in one moment, living their normal life and in the next suffering from major trauma. It is hard not to be motivated to help people in such need of help.
London’s Air Ambulance specialises in the treatment of the most severely injured patients in London. We provide care and expertise that is not available from the NHS-funded London Ambulance Service. We work in partnership with all the other emergency service to provide this specialist care, so that patients have the highest chance of survival.
If you weren’t in medicine, what do you think you’d be doing?
As a teenager I was interested in architecture and photography. I spent many hours studying buildings around London where I grew up, and developing the films and prints myself in a dark room. I am now extremely fortunate to see the city and those very same buildings from a different and unique viewpoint!