High Nr
"and yes a fractured leg with Haemodynamic deteriotion [sic] can indeed be life threatening" - fine, but a stabilised tibia/fibula fracture in a good splint in an otherwise well young adult is *not* an emergency - I've personally been involved in taking folk out with fractured femurs from remote islands in "bumpy old boats" (yes in traction, yes with IV line in, yes with a nerve block in for the pain) because there was no other way. It's not a no-no.....
There are fractures and there are fractures (....many fractures can wait for a week or so and be still set/treated quite successfully (true!)) and I for one do not pretend to know what type the one in this case was.
But, the fact seems to be that the Hamilton Island pt was evac'd the
next morning, and furthermore there was no use that night of other possibly available fixed wing acft from TVL, RK or BUD into a long strip with lights and a GPS and VOR/DME appch on a night that wasn't too crappy for IFR flight. To me that implies that they were were perhaps not dealing with a life/limb threatening event, as the other available agencies would have picked up and filled that tragic gap, as they have done in the past.
Whenever I had to assess a call for assistance in the dark hours, the one of the first questions was - can it wait until daylight? Aircrew are more alert, aeromedical crew are more alert, and the receiving hospital is more likely to have it's "A" team on...all has to be balanced against the pain being suffered and the likelihood of an adverse outcome if there is any delay. On top of this the possible medevac modalities have to be considered, along with their costs and risks, especially added risks of night travel, wheter by air, sea or land. It's not straightforward, there is scant statistical analysis of the relative risks available, but doctors/nurses (and others) who often have to go along on the serious flights have a right to say how their lives are risked or otherwise.
Again, in aeromedical work, sometimes things are done because they can be done, not because they should be done.....yes it's faster, yes it's more exciting, yes it's sexier, yes it has saved lives... and yes it can have grave risks and has a higher cost per life saved than virtually any other medical modality.
Safe flying
NOtimTAMs
PS And in case you think I'm arguing for twin engine, twin pilot ops for all circumstances-- I'm happy in my private flying time to fly single pilot, single engine IFR at night in an aircraft I know the maintenance history of - but that's my choice, knowing the risks - I wouldn't force that on anyone else.