STEPPING onto airfield tarmac on a quiet summer morning, we surveyed our surroundings at Wales Air Ambulance’s (WAA) Cardiff base.

Right on schedule, the silence was broken by the distinctive hum of a helicopter rotor as a flash of red and green appeared on the horizon.

Bringing the craft down, the pilot swept across airfield with speed and precision, playfully rotating the helicopter to display its distinctive branding emblazoned with Wales’ famous dragon.

Staff smiled with pride as the craft touched base and with good reason — the aircraft is now the fourth helicopter in the Wales-wide charity’s fleet, allowing it to respond to more lifesaving emergencies in Wales.

From its airbases in Swansea, Caernarfon and Welshpool, an air ambulance can be anywhere in Wales within 20 minutes of an emergency call with a top speed of 150mph.

Since its launch on St David’s Day 2001, the charity has carried out 24,000 missions, reaching difficult locations and flying patients to the most appropriate hospital for their recovery.

Our pilot for the day was 54-year-old Mario Carretta, a former Navy helicopter pilot with more than 5,500 hours of flying experience.

As he took the Argus into the clouds we were treated to panoramic views of Gwent, spotting landmarks on the way from Caerphilly Castle and Blaenavon’s Big Pit Museum to the Newport Transporter Bridge.

“My job is a touring pilot so I go around the country filling in for the base pilots when they are on leave or otherwise engaged,” he said.

“In my seven months, I imagine I have flown over Gwent about four or five times. These call-outs have ranged from motocross accidents, road traffic collisions to cardiac arrests.

“We 're part of a team and as I don’t have the specific knowledge of the area, this is where the local paramedics come in handy. They are the people who know the area and they know all the bad weather routes.

“For us touring pilots, on a bad weather day, the valleys around the area all look the same. As they know the area, they can suggest alternative routes where the helicopter may be able to get through.”

Official Wales Air Ambulance mission stats — between August 1, 2014 and July 31 2015, list road traffic incidents as the highest call-out with 468 incidents out of a total of 1744 missions.

This is followed by cardiac arrests (328), other medical issues (301), trauma falls (223), other trauma (212), transfers (129) and heart problems (83).

Mr Carretta added: “From our point of view, having the extra helicopter means that when there is a transfer, it would take out the Helicopter Emergency Medical Service (HEMS) aircraft for a long part of the day.

“An extra machine will free up the HEMS aircraft for what it was meant to do will be a great asset.”

After returning to base, we were introduced to Critical Care Practitioner, Jason Hughes, a paramedic of 15 years who has worked with the WAA helicopters for four years.

The critical care service has been operational in Wales for the last 15 months and before this, Mr Hughes was working as part of a double paramedic team working with the charity.

Today, his role includes working with the pilot to provide navigation, weather and site surveys and “supporting critical care doctors with advanced clinical and critical care for patients”.

This include 'advanced critical care' such as providing treatment at the roadside, anaesthetising patients and transferring blood products before flying the patient to hospital.

“Each person has a background in either paramedicine or nursing. Before you can be selected for the service, the person will have had a certain amount of time within that field,” he said.

“Time is so important when it comes to treating a critical injury. The earlier a patient can be seen to and the quicker we can deliver definitive care improves the survivability.

“The primary role of the aircraft is to deliver the team and that works for the retrieval of the injured person and the team too [...] the speed of the aircraft works alongside the speed of delivering the team.”

Speaking about the addition of a fourth helicopter, he explained that it has a “dedicated responsibility” and will serve an addition to the critical care service WAA provides.

“The project is new and we are working through an identification of the need at present. We could be doing up to 200 missions per year but it’s hard to work out at this stage,” he added.

As part of the new project Wales Air Ambulance will fit two helicopters with £70,000 incubators, which will replace long road ambulance journeys for vulnerable babies.

The incubators have been paid for by NHS Wales, whose medical staff worked with its Swiss manufacturer to design it to their specific requirements.

Known as a mini-hospital, or a heated house for a baby, incubators provide warmth, oxygen and air and are attached via a bridging system to external equipment such as the ventilator.

Although the fourth helicopter won't officially go an active missions until Thursday, September 1, the new incubator was used for the first time this week as part of a neo-natal mission transporting a baby from Rhyl to Carmarthen.

From 2015, Wales Ambulance also introduced flying doctors on board their aircraft, meaning the charity can provide even more advanced treatment, including blood transfusions and anaesthesia.

For WAA's chief executive, Angela Hughes, this development has helped the charity achieve its ‘gold standard', putting it at the cutting edge of emergency care.

The former HR and quality manager for Siemens in Europe joined WAA in 2001 as it's first employee, when the charity only had one helicopter and helped open its shop in Newport the following year.

“A lot of the training and medics came (to us) because we had some of the consultants who worked in Afghanistan so some of the best practice they had there, with high trauma, they brought to us," she said.

“We have received different pieces of cutting edge equipment because of that and that’s what people are looking at from the outside. Before it was all about time saving and saving lives but now we’re taking theA and E and intensive care unit to the patient.

“The same consultants you would see if you went into a trauma unit are actually in the helicopter doing different shifts so it’s just so different to how it was when it began.

“Wales should be really proud and I still get that sense of pride when I see the helicopters going up.”

In the early years the helicopters were donned in the striking yellow of sponsor AA but it was chief exec Ms Hughes who helped establish develop the charity's Welsh identity and bilingual focus.

“I decided that everything needed to be bi-lingual and embracing the Welsh language [...] we felt that the people of Wales deserved it,” she said.

“We changed the colours to red and green and we have the dragon on the side now. It belongs to Wales and now Wales is leading the way.”

Wales Air Ambulance relies entirely on charitable donations to raise over six million pounds each year to keep its helicopters flying and does not receive funding from the National Lottery or Government.

For more information or to support WAA, visit walesairambulance.com or call 0844 85 84 999.