When disaster strikes, plans and preparations become a real-life response. No room for error, no time to waste.
On March 22, those plans were brought sharply into focus for the major trauma team at St Mary’s Hospital. Within moments of a shocking terror attack at nearby Westminster Bridge, staff were primed for a major incident and ready to receive the initial influx of casualties.
Shehan Hettiaratchy, Major Trauma Director and Lead Surgeon, was at the heart of the hospital’s response. In the midst of the confusion watched by millions on rolling news, Shehan’s team executed their plans with pinpoint precision.
“Everyone performed really well, it was all very smooth, very slick,” Shehan recalled. “They performed how I’d expect them to, given the professionalism that exists within our centre.
“We’d been expecting a terrorist attack in the UK for six months and assumed London had to be one of the most likely targets. It arrived and then you switch to a well-rehearsed plan – and that worked very well.”
The hospital’s response was captured by camera crews and later broadcast in the ground-breaking first episode of BBC Two’s acclaimed documentary series, Hospital, in June.
It showed emergency staff scrambling to postpone non-essential treatments and free up beds for patients arriving from the scene, while specialists moved the most serious casualties quickly through the system and into surgery.
“We have a major incident plan and we’d actually been rehearsing for having a far greater number of casualties than this,” Shehan added. “We prepare by practicing scenarios, practicing the pathways and practicing how we respond.”
Among the victims cared for at St Mary’s that day were Stephen and Cara Lockwood. The couple had been visiting London to celebrate Stephen’s 40th birthday when they were both struck by the attacker’s car.
Cara escaped with bruises and a twisted ankle but Stephen suffered injuries to his face, chest and leg, requiring a four-hour operation.
“The attack happened and they would have been affected by it like anybody would,” said Stephen, reflecting on his care three months after the attack. “But then they had a job to do on top of that. It really is incredible.”
In recent years, Imperial Health Charity has awarded millions of pounds in grants to help emergency teams handle major crises at St Mary’s Hospital.
Last year the charity paid for a £3.5 million upgrade of the emergency department, creating extra resuscitation bays and new triage rooms to boost capacity, with a raft of other improvements also in the pipeline.
Meanwhile, the Major Trauma Appeal raised £1 million to support the hospital’s major trauma centre, which played such an important role in the terror response.
On the wards themselves, charity funding has also paid for a Belmont Rapid Infuser – vital equipment that allows staff to quickly transfuse blood and fluids into patients at high volumes.
“It’s a really important bit of equipment,” explained Shehan. “We get a lot of people in our centre who have had penetrative trauma, particularly from knife cuts, which is a real problem in this part of London. We have a large number of people who need to have rapid blood volume replacement.
“We saw that with some of our casualties from the Westminster Bridge incident. The infuser really makes a big difference to what we can deliver quickly. It’s state of the art and that’s where we want to be.”
Due to the high number of stabbings treated at the hospital, the charity also teamed up with the Redthread organisation to address youth violence in London.
The Redthread programme helps young people involved in violence turn their lives around by connecting with youth workers while they are recovering in hospital.
Shehan added: “We often get people who have been stabbed once come back in again and often when they come back, they are dead. If we can break that cycle and break into their mindset and change their behaviour, then that’s a good thing. Prevention is always better than any kind of cure.
“We’re massively appreciative for everything the charity has done for us. Everything the charity provided is being used every day to good clinical effect. It’s made a big impact.”