BEHIND the doors of a large hangar in Bristol a team in orange suits are hard at work.

The roaring of engines can be heard from aircraft flying overhead, as they pack up bags, check equipment and clean the inside of the navy blue helicopter.

"Cleaning the helicopter, is probably something people don't think doctors will do," said air ambulance doctor Kate Sharpe.

"I also have to go down and restock the drugs for the day, by going down to the stores."

For the Great Western Air Ambulance (GWAA) crew the shift starts two hours before the helicopter is available for calls and involves them checking all the necessary equipment is both on board and packed into the kit bags they carry out to incidents, which can be several hundred metres away if they cannot find a closer landing site.

Clinical team leader Rhonda Collins checks the bag full of kit, which weighs about 22kg and is packed with everything the team could need while dealing with patients. Rhonda said the team are adept at packing everything back up again quickly as possible to speed up their departure.

Because GWAA carry out medical procedures on patients before transporting them, there are scalpels and a surgical kit along with anaesthetic.

There are different types of splints and tournaquets to control haemorrhages, along with various dressings.

"Some of the equipment is specialist to the unit and some A&E departments do not use the same kit. Certain elements have been chosen because they are used by the military," Rhonda said.

Once the crew and pilot are satisfied everything is ready, the helicopter is pushed out of the hangar with a small tractor and flown onto the helicopter pad on the other side of the airfield.

Before the helicopter goes "online" at 10am, there is the briefing, where pilot Simon Gough updates the crew on flying conditions and any obstructions they may have to look out for.

There is no co-pilot in the helicopter and the paramedics and doctors are required to navigate and act as look-outs, especially when it comes to landing. They are notified of any areas to steer clear of and events, such as the balloon fiesta, that may make the air space more busy.

The crew waits at the base until they get any calls, but usually have jobs on-site they can get on with while they are waiting.

There are reports to be filed and drugs to be checked. And, for the bulk of the paramedics who are currently trainees, there is a chance for them to be tested on their knowledge by one of the doctors or senior crew members. Every crew member carries a radio so that they can be contacted when a call comes in.

There is a member of the GWAA team based in the main Great Western Ambulance Service control room, who monitors all the calls that come in and establishes whether the incident requires a response from the helicopter or the critical care team by car.

The crew receive a phone call, providing basic details of the emergency and the location.

One of the paramedics will then plot the position on a large map of the patch mounted on the wall at their base, so they have the co-ordinates ready, before grabbing their helmets and jumping into the helicopter.

Sometimes early details are sketchy and the crew will make a decision with the help of their colleague in the control room as to whether they will fly out immediately, or wait for more information to filter through from a paramedic on the scene.

Incidents near their Filton airbase are usually attended by car, but when they are travelling further afield, the helicopter is usually the quickest option.

On some occasions, the car that supports the helicopter will head to an incident first and the aircraft will follow on if it is deemed necessary.

The crew deals with between two and four incidents a day on average.

Their first call of the day we spent with them was to a residential address in Shirehampton.

Initial reports were of a five-year-old who had drowned in the bath, just before 1pm.

The crew headed straight out in the helicopter, but when they arrived, it was discovered the child had suffered a fit while in the bath.

The helicopter landed on the sports field at the Merchants Academy and the crew ran to the incident nearby.

Air operations director Danny Hopkins said: "Fortunately the child was OK.

"There is always a danger when we pour out to jobs that it is not as given, but in this case it was nice that it wasn't what we thought it was.

"We bring A&E to the scene quicker and can get advanced life-support skills to a job like that."

Sometimes, once the crew is on the scene, they find they need more equipment or additional boards for other patients. In those cases Simon, the pilot, goes back to the helicopter to pick the extra equipment up, rather than everyone making two trips.

At about 3.30pm the crew were called to a collision between a cyclist and a car at the junction Lyppincourt Road and Passage Road in Brentry.

Initially Danny attended the scene in the car to establish the injuries of the 19-year-old cyclist, and then called the helicopter crew for back-up.

The teenager's leg was wrapped up in his bike frame. So the crew sedated him before looking at what needed to be done to his leg, which involved cutting his jeans.

That is one of the advantages of the GWAA. Danny said: "Paramedics can usually give pain relief, but not the sedation we can administer for patients."

After the teenager's leg was freed, critical care paramedic, Simon Moody, travelled to hospital with the teenager in a patient transport service ambulance that had been passing the scene.

The crew know which hospitals are best equipped to deal with specific injuries or conditions and will transport patients to the most suitable location and by the most appropriate method.

Head injuries and burns tend to be transported to Frenchay, while heart problems will go to the BRI.

But the BRI is not due to have a helicopter pad for almost a year, so patients in Bristol will be transported by road ambulance.

The team call the hospital and notify them that they will be bringing a patient in so that A&E staff are ready as soon as they arrive.

The crew were called to a collision in Bedminster the following day and landed in the Lidl car park in Sheene Road.

An 11-year-old on a bicycle had been hit by a car and was reported to have an open fracture on his leg. After assessing the youngster he was taken to Bristol Children's Hospital by road ambulance.

A few days earlier, the GWAA team attended two major incidents.

In the first call, the helicopter landed off Cumberland Road after 1.30pm and the team ran over the footbridge to Coronation Road, near its junction with Dean Lane.

They worked on the motorcyclist at the scene but were unable to save him.

From the Bedminster incident, the crew were called to another collision in Cribbs Causeway and landed on the A4018 near the petrol station.

The pedestrian suffered head injuries in the collision, which happened just before 2pm.

An air ambulance crew anaesthetised the patient at the scene and when she was stable flew her to Frenchay Hospital in Bristol.