The aeroplane inside Wellington Hospital you probably don't know about

On level nine of one of the older blocks at Wellington Hospital, plastic patients lie in the beds, and one room is taken up by half a plane.

This is the simulation and skills centre, and it's designed to give medical staff hands-on experience with all kinds of scenarios - from operating theatre to air transfer, complete with turbulence.

Life Flight runs the planes, and they're staffed by ICU doctors, tasked with bringing patients from other centres into Wellington to access treatments not available at the hospital in their own region.

Currently, there are about 1200 retrievals a year - 1000 of those in a plane, and the rest via road ambulance or helicopter.

The simulator was built in 2015, sponsored by the Wellington Hospital Foundation using donations from the region, in the image of one of the old air ambulances, a J32. According to news reports at the time, it cost $275,000.

Nowadays, Life Flight uses Beechcraft King Air 200Cs. They're actually a little smaller than their predecessors, but otherwise pretty similar.

Consultant intensivist and general physician George Bax explained the simulator was used to train their team in all sorts of medical emergencies.

In addition to running practice scenarios, real cases could be played back and debriefed, with patients suffering anything from aortic dissections and heart attacks, to behavioural problems where they try to exit the plane mid-flight.

"It's about putting those things in a safe environment so we can plan how we're going to look after them when it happens in real life."

People come from all over the country to train in Wellington.

Bax said things which "might be mundane in the hospital become much more challenging in the air".

"The challenges of looking after patients in an airplane are so different from those looking after them in the hospital," he said.

"In the hospital, we can ring an emergency bell and have lots people and lots of kit really quickly. Whereas in an airplane, it's generally one or two people looking after a patient, with limited kit, limited space, inability to get out of your seats."

According to Kathy Hughes, a flight nurse with 10 years' experience, there are a number of big differences.

For example, a plane mid-flight was too loud to use a stethoscope, she said.

"Probably the biggest thing is just the lack of people," she said. "But, imaging ... you couldn't do a chest x-ray if you were worried, couldn't listen with a stethoscope, if you have an issue with your machinery you can't readily grab another one from the store room, so you have to be really prepared."

Wellington, as one of the windiest cities in the world, also faced unique levels of turblence which could make care a little harder.

Through the one-way glass, senior simulation technology specialist Peter Watt was at the controls of the simulator.

"From here, we can actually control the plane, and also the simulator that's on-board the plane," he explained. "We can make him close his eyes, we can stop him breathing, we can give him heart attacks, we can drop his blood pressure, we can actually make him fit, as well."

He pushed a button, and the plane on the other side of the glass tilted upwards.

"On the plane, we can take off, we can give you a bit of turbulence, and then we can bring you into land."

As Watt jiggled a joystick, the open-ended body of the plane wobbled side to side.

Cameras mounted inside the plane broadcasted to screens inside the control room, and in a room down the hall, so other trainees could watch and learn their peers.

Guy Ryan, the chief executive of the Wellington Hospitals Foundation, explained the story began with their founder, Bill Day. At the time, he was also chair of Life Flight.

Medical staff used to be trained in a real plane, but on one occasion, when Day had accompanied a group to the airport, the plane was called away to an actual emergency, leaving the training team waiting for its return.

"Bill had an idea," Ryan said. "Surely there's a better way of doing this. Imagine if we got a plane in the hospital?"

It was a world-first, and still one of very few, if any, globally.

The foundation provided ongoing support, Ryan said. "Equipment ages, and there's new technology and opportunities or needs for replacement equipment."

All up, it had invested about $2 million into the wider simulation service over the years, with about $300,000 of that going into the air ambulance simulator.

And Ryan himself had first-hand experience of the difference an air ambulance could make. "My second child, we were down on the West Coast of the South Island, and my partner's waters broke, and we needed an emergency flight back to Wellington, and we had the Life Flight air ambulance come down and bring us back in."