A doctor today spoke of his pride that all 12 seriously injured victims of the London Bridge attack who were treated at the Royal London hospital had been saved.
Malik Ramadhan, who rushed back to work to run the major trauma centre’s resuscitation unit on Saturday night, said the patients benefited from “gold-standard care” in Europe’s biggest hospital.
This included world-leading advances in treating major haemorrhage that has seen one patient a week at the hospital survive injuries that would have been fatal a decade ago.
“Of the 12 we received, they have all survived,” Dr Ramadhan told the Standard. “Very unexpected things happen. I think the last person who was intubated [put on artificial breathing support] was extubated [on Tuesday].
“I think they have had interventions that we use every day. I think they are interventions that other hospitals don’t have available to them. That is the whole point of the major trauma centre. We have got a much better understanding of the order in which we transfuse blood products.”
Prince Charles and the Duchess of Cornwall visited the hospital, in Whitechapel, to meet patients and thank the staff.
Dr Ramadhan had been cycling home after his shift on Saturday night when he saw a convoy of police cars racing north on Old Kent Road. He called a friend to ask what was happening. “She rang back and said you should pedal as fast as you could to work,” he said.
As staff flooded back, a trauma team was assembled for each of the eight resus bays – an emergency medicine doctor, an anaesthetist, an ODP (operating department practitioner, a surgeon, an orthopaedic surgeon and two nurses.
Such was the response from staff that he had 10 A&E consultants, five to six surgeons and a similar number of anaesthetists more than he required to form the trauma teams.
Six patients were taken direct to theatre for life-saving interventions. Another five underwent surgery the next day.
“We could see how some patients had been hit by something and some had been stabbed,” he said. “We got one shooting. I didn’t know what had been going on. I went home at 3.30am, got home at 4am, and turned on the telly. At that point they were saying 20 patients were involved, at five hospitals. I thought, well, we have got 12 badly injured people, which suggested there was a lot more than 20. The next morning they were saying 48, and six dead.
“At the time, it wasn’t relevant. My job is to make sure we are ready to see the next, and the next, and the next… if it gets to 150, how do we get to 200?”
He told how the Royal London had been preparing for a terrorist atrocity since the suicide attacks in Paris in November 2015 that killed 130, including 89 at the Bataclan theatre. This included guarding against a secondary attack on the hospital itself as it treated casualties.
“Each thing that has happened reinforced to me that it was going to happen to us at some point,” he said.
“With Westminster Bridge, we were not particularly involved [in treating casualties]. But we looked at that and I thought: supposing that happens and there are 50 on the bridge, what would we do?
“The point the Government escalated the terror alert level [after the Manchester bombing] got me thinking they must know something. We did a lot of thinking, including thinking about secondary targets. If they are blowing up children, the next step is schools and hospitals. Sometimes they attack the hospital the victims have been taken to.”
He said they feared that with 50 shots being fired on Saturday night they could have a similar number of casualties.
“With 50 shots fired, there was the assumption early on that lots of people would be injured. We didn’t know who had the guns.
“I don’t think 12 patients is a particularly big challenge for the Royal London. We regularly have 12 trauma calls over a night shift. Twelve at once is different. Twelve over a 12-hours period is not unusual. We see 3,500 poly-trauma patients a year – where there is trauma in more than one part of the body.”
Ironically, the recent cyber attack on the NHS, in which the hospital’s parent trust, Barts Health, was the worst affected in the country, helped to speed the response to the London Bridge atrocity.
Junior doctors and consultants had set up What’sApp and mobile text groups to get round the problem of having no access to their NHS email. This meat that alerts spread instantaneously on smartphones as off-duty staff alerted each other to the need to come to work.
“When people talks about What’sApp and how the terrorists use it to talk and how we’ve got to stop it, it makes me smile,” he said. “We were pretty much relying on What’sApp to get all the staff in.”
He is on constant alert for the next attack. “I’m worrying about Thursday [the General Election]. Then I will worry about the weekend. Then I will worry about the weekend after that.
“Let’s just make sure it absolutely doesn’t happen again. I’m thinking – Westminster Bridge, Manchester, London Bridge, all within two months.
“If we did it again [tomorrow], that would put a bit more strain on us. People are a bit tired. If this becomes a regular occurrence then relying on goodwill probably isn’t enough.”
* An edited version of this article appeared in tonight’s Evening Standard (below)