title: Structure of Rapid Response Car Operations in an Urban Trauma Service.
abstract: OBJECTIVE
  Emergency medical vehicle collisions are an inherent risk for health care providers, patients, and other road users. Air ambulance services often use rapid response cars (RRCs) to maintain operational resilience. We aim to describe the operational concept of London's Air Ambulance (LAA) RRCs and activity over a 1-year period.
  
  
  METHODS
  This was a retrospective dispatch database study. The RRC operational concept, car configuration, and training are also described.
  
  
  RESULTS
  LAA implemented principles from motorsports and aviation including car configuration, training, navigation, and communication. RRCs were activated a total of 2,241 times during the study period (average of 6.1 activations per day). RRCs traveled a total of 22,973 km and a median of 8.7 km (interquartile range = 5-15.1) with blue lights; there were missing data for 123 (5%) activations. Furthermore, the RRCs spent a total of 28,536 minutes with blue lights and a median of 12 minutes (interquartile range = 7-18); there were missing data for 89 (4%) activations. The safety management system included 5 reports, none of which were related to serious RRC incidents.
  
  
  CONCLUSIONS
  Translating lessons from aviation and motorsports, LAA has developed an RRC operation concept to improve safety and operational capacity. One-year operational data indicate high activity without any serious incidents.
authors.affiliation: London's Air Ambulance, Barts Health Trust, Royal London Hospital, London, UK; The Norwegian Air Ambulance Foundation, Drøbak, Norway; Field of Pre-hospital Critical Care, University of Stavanger, Stavanger, Norway. Electronic address: marius.rehn@bartshealth.nhs.uk.
authors.forename: Marius
authors.initials: M
authors.lastname: Rehn
authors.affiliation: London's Air Ambulance, Barts Health Trust, Royal London Hospital, London, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Davies
authors.affiliation: London's Air Ambulance, Barts Health Trust, Royal London Hospital, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
authors.affiliation: London's Air Ambulance, Barts Health Trust, Royal London Hospital, London, UK; Field of Pre-hospital Critical Care, University of Stavanger, Stavanger, Norway.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lockey
mesh_terms: D017732:Air Ambulances / Q000458:organization & administration*; D000552:Ambulances / Q000458:organization & administration*; D006801:Humans; D008131:London; D012189:Retrospective Studies; D014193:Trauma Centers / Q000458:organization & administration*; D019037:Urban Health Services / Q000458:organization & administration*