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Taking the hospital to the roadside with doctor Asher

An ICU (Intensive Care Unit) consultant’s first day on the job is challenging at the best of times – but for Dr Asher Lewinsohn, it also coincided with the start of the Covid-19 pandemic. Having just completed a secondment year with another air ambulance, Asher felt he was ‘out of the frying pan and into the fire’ as Covid patients filled his wards.

But that wasn’t all – Asher was also applying to join us here at Thames Valley Air Ambulance as a Pre-Hospital Emergency Medical (PHEM) Doctor. The pandemic meant we had to delay his start, but he arrived with us in August 2020 and fitted in straight away as a valued member of the crew.

‘I immediately felt accepted and part of the team,’ Asher says. ‘Any apprehension melted away quickly because the working environment is so inclusive and welcoming.’

Having a doctor like Asher on board in addition to our highly qualified Critical Care Paramedics is one of the ways our service differs from a standard road ambulance. Together, the crew brings the ideal blend of expertise, and Asher is quick to emphasise that the doctor is not considered ‘the boss’.

‘Our skills complement each other,’ he says. ‘There are some legalities about doctors being qualified to use certain drugs or perform procedures that paramedics can’t, but in practice we act so closely as a unit that there is no hierarchy and we’re all essential in everything we do. The paramedics also have that long experience of pre-hospital care on the scene, and their ability to relate well with the road ambulance crews is really important.’

The role of a PHEM doctor is different from working inside the hospital too – it involves being there in the crucial first minutes of the patient’s fight for life, without the back-up of a large clinical team.

‘When you’re at the roadside in the middle of the night with the rain beating down, you’re that patient’s only chance,’ Asher says. ‘There’s a sense that if you weren’t there, no one else would be. When you successfully tip the balance in their favour, it’s because you got there just in time to give that extra level of care at the exact moment when it really mattered, and we know that we have our community to thank for putting us there.’

Attending such intense situations has an emotional impact, and at Thames Valley Air Ambulance we have a strong culture of ensuring support is available whenever the crew need it.

‘We’re seeing scenes that other doctors never see in hospital,’ says Asher. ‘The work is high pressure too – at every incident, not only are we trying to save critically ill patients with their life in the balance, but we are also working with new people from other (sometimes multiple) services, building a new team, communicating, co-ordinating and delegating, and it all has to be done in a short space of time. You can walk away from these scenes exhausted. But there is so much support from the rest of the crew and our colleagues – for example, if you’ve had a difficult incident, colleagues will often phone later to make sure you’re OK.’

‘Thames Valley Air Ambulance’s success as an organisation has a lot to do with the sense that it is a family. Everyone is absolutely professional – the training and kit is top class, and yet the atmosphere is so warm, welcoming and relaxed. As a team we regularly review cases together and discuss things maturely to work out what we can learn and how we can grow as a team.’

During the Covid-19 pandemic, our crew have had to wear extra Personal Protective Equipment (PPE) and be aware that any patient they attend could be infected. The PPE is uncomfortable in hot weather and getting fully kitted out takes up valuable seconds, but for Asher the biggest challenge is the communication barrier it places between the crew and the people they are helping.

‘One of the most important parts of our job is being a friendly face to people who are having the worst day of their lives. Everyone on the crew is a ‘people person’ and it’s hard not to have the personal connection that families and patients need. I write my name on the front of the PPE suit and perhaps draw a smiley face too, to try and keep that important human connection.’

Like all our crew members, Asher never forgets who enables him to do his job – our amazing supporters. Without donations from the community, Thames Valley Air Ambulance simply could not continue being there for critically ill and injured patients.

‘From the bottom of my heart, thank you!’ he says. ‘The whole team – the crew, the operations support staff, everyone in the office – plays their part and everything we do has our generous supporters behind it. We wouldn’t be here without them. Our supporters are without a doubt a fundamental part of our team, and therefore a fundamental part of our life saving ‘family’ too.’