Clinical Impact Clinical Excellence and Expertise Clinical Excellence and Expertise Thames Valley Air Ambulance is proud to strive for clinical excellence and expertise in all aspects of the service. Over the past few years we have introduced new and innovative technology in both the aircraft and car, helping us to deliver the highest level of care to patients in the region. Read more about our excellence and expertise below. Use of Ultrasound Read more Thames Valley Air Ambulance has pioneered the use ultrasound in the Pre-Hospital Emergency Medicine (PHEM) environment. TVAA carries ultrasound machines on the helicopter and in all vehicles. PHEM ultrasound can be used to detect potential bleeds inside the abdomen in trauma patients and is used to help insert intravenous lines. It is used extensively in helping us treat cardiac arrest patients. Ultrasound has revolutionised the treatment of patients with trauma or cardiac arrest by giving real time information on whether there is evidence of injury within the chest or abdomen. Blood on board Read more In 2012 Thames Valley Air Ambulance (TVAA) became only the second Helicopter Emergency Medical Service (HEMS) unit in the country to carry blood. This was achieved by working in partnership with the John Radcliffe Hospital Haematology Blood Transfusion Unit. About half of all trauma deaths are due to bleeding or its complications. Injury, shock and blood loss all contribute to a failure of the body’s normal blood clotting mechanisms (coagulation), which then leads to more bleeding. Research from military surgery and resuscitation in places such as Afghanistan has led to the understanding that blood is the best replacement fluid for victims of trauma. However the biggest issue has always been the transportation of the blood. The invention of the specialised "blood cool box" allows TVAA to carry and store blood for 72 hours. Blood not used will be recycled within the hospital so there is no wastage. This is an excellent example of how expertise within the NHS and TVAA have worked together to ensure "gold standard" medical practice for victims of major trauma. TVAA now carries two units of O negative blood on the aircraft and in the car. Plasma Read more TVAA was the first HEMS unit in the country to use plasma on board for critically injured trauma patients. Blood is made up of two major component parts; red blood cells and plasma. Until recently TVAA carried packed red blood cells on board. Plasma has not been carried previously due it being frozen and having a short shelf life. Modern techniques and equipment have now made it possible to carry both. Red blood cells are important as they carry oxygen, whilst plasma is vital as it contains the necessary clotting factors that allow significant injuries to heal and stop bleeding more quickly. Current evidence and the National Institute of Clinical Excellence (NICE) have now recommended that if a patient is severely losing blood, they should receive both red blood cells and plasma. This clinical intervention has been shown to greatly increase the chances of such patients to survive the initial trauma. This life saving critical intervention was only made possible by working together with the Haematology/Blood transfusion service at the John Radcliffe Hospital, Oxford University Hospitals NHS Trust. Forming multi-disciplinary partnerships with the local Major Trauma Centre has significantly improved trauma care for patients within the Thames Valley region. Blood Analyser Read more Thames Valley Air Ambulance (TVAA) was the first HEMS unit in the country to carry a blood analyser. Our mantra is to "bring the hospital to the patient". The blood analysers we carry are able to give immediate 'hospital level' blood test results on scene. Understanding the effects of blood loss and electrolyte imbalances can be crucial for the rapid diagnosis and treatment of a critically ill patient. The analysers help our doctors and paramedics to save valuable time once the patient arrives at the hospital by providing vital information quickly to the receiving medical teams. TVAA now only carry the system on the ERV.