HELMAND PROVINCE, Afghanistan — The patient on the stretcher was in grave shape. His patrol had struck a roadside bomb, and the soldier had apparently been right on top of it. All his limbs were severed, he’d lost too much blood and he’d gone into cardiac arrest.

As the British ambulance helicopter raced back to a field hospital, one paramedic pumped the young soldier’s chest in a desperate effort to keep his heart beating while the rest of the team gave the victim every bit of life they could find in their bags.

It was not enough. The soldier died a short time later.

Thus began another difficult morning for the members of the Medical Emergency Response Team, the British military’s flying war ambulance service.

“There’s an officer and a padre on the way to somebody’s house to give them bad news,” said Sgt. Alan McLean, 41. “All you can do now is feel for the families.”

It’s not always this grim. Emergency response team members say that with the technology, preparedness and experience with war injuries their teams have been accumulating over the course of the wars in Iraq and Afghanistan, they save a majority of their patients.

“Far more than don’t, most of the patients we bring in live and live fine,” said Army Maj. Steve Davies, 40, an emergency room consultant from Salisbury, England.

“That’s what I joined up for. To make a difference and save as many as you can,” said Flight Lt. Fiona McGlynn, 36. “Sometimes, if you’ve had a bad outcome, a person needs a few moments on their own. But then they come back, have a little chat, then put on their smiley face and get ready to do it again.”

Midmorning, a fresh team arrived to take over from McGlynn’s group, which had just completed 24 hours on call. The two teams caught up. Then a call came in.

At the helicopter, the fresh team learned that several Afghan soldiers were killed and wounded in a firefight, but the situation was too intense for them to go out yet. An hour’s wait on the helicopter led to an all-clear, giving these emergency crewmembers some time to reflect on what they do.

“I think more people are surviving,” said RAF Sgt. Martin Horton, 29, a nurse from Liverpool, England, who is serving his third tour in Afghanistan. “But more people are getting injured, so more people are dying,” he added.

“The British spend a lot of money training us to do this,” he said, rattling off six full years of courses he had to go through to qualify for a position on the team. In addition to regular nurse’s training, he was given courses in emergency care, major incident care, emergency response, weapons and military training, helicopter and aeromedical evacuation training, trauma life support and anesthetics training for nurses, among them.

“All our training is in medicine. It’s to do the best medicine, the best interventions and treatments in the world.”

At Camp Bastion, the British team works alongside an American Pedros team. Pedros are Air Force helicopters carrying pararescue special forces who are trained to go into heavily combative zones to extract casualties. The two forces complement each other and highlight two approaches to combat emergency medicine, said British army Maj. Andy Haldane, the second team’s doctor.

“The experts are not in agreement over the best way to handle these trauma patients, whether for speed or for the interventions we can do,” said Haldane, 33, of Birmingham. “We are still not 100 percent clear whether what these people need is ‘as fast as possible back to surgery’ or ‘as fast as possible back to surgery with the intervention we can do with anesthesia and a blood infusion.’ We feel it is best to take the emergency care unit to the patient as best as possible.”

For the newest member of the team, Tony Stephens, 37, the opportunity to participate in emergency response is exciting. Unlike other reserve forces who come to a war zone leaving their job and their civilian expertise behind, as medical professionals, team members are practicing their chosen careers, only more intensely.

“This is the sort of pinnacle of emergency care,” said Stephens, an ambulance paramedic in the civilian auxiliary in North Wales who volunteered to serve. “Just think what’s happening medically to guys on the ground getting injured. It’s phenomenal to be a part of that.”

Haldane wondered if folks back home even realize their country is at war, rather than some simmering counterinsurgency. People count up the dead, but nobody notices the wounded, he said.

“There’s not much mention of people coming home with injuries,” he said. “There’s just a sort of ongoing body count.”

The day passed without another job, giving an unlikely foursome a lot of time on their hands. Needing to stick together in case of a call, they drove around conducting errands together and helping Senior Air Craftman Cathryn Strong, 31, search for her brother who’d just arrived in camp that day.

Then, as the night rolled in, so did a call. The team scurried to the helicopter and launched into the dark night.

An IED. One severely wounded. One less so.

They landed on a dark piece of Helmand in blackness and returned with a patient on a stretcher. He was missing a leg and his second leg was bandaged up to his groin.

But, unlike in the call 12 hours ago, this young man was awake and his body was withstanding the damage of an inhuman blast.

For him, the medicine he’d receive that night in the air would be life nectar. He would survive.

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