RAF SAR vs Air Ambulance

[drugsdontwork]

Slight thread drift whilst we wait with anticipation for the SARH outcome, but a few watches of the BBC Helicopter Heroes has shown the air ambulance pitching up to numerous jobs that are clearly winch jobs (base of cliffs, extensive carries to suitable landing sites etc) or the air ambulance has abandoned the patient as night looms. Surely people know about the nearby RAF SAR cab? Anything political going on? Is patient care perhaps not always the primary concern??

Standing well back..

[[email protected]]

The 999 calls are processed first by the ambulance control rooms who allocate an appropriate asset (theirs not ours). A really switched on controller might recognise from the location that a SAR helo might be the best option but more often than not they don't (can't really blame them it's not in their job description).

The first ambulance asset on scene which might be a first responder, land ambulance or the air ambulance can then assess the situation and then make the call for the SAR helo.

It might not be the ideal solution for the patient as the process can take a few hours between initial 999 call and the SAR helo arriving which, if you are broken and bleeding on a cold hillside or similar, will seem like an eternity. However, it does usually mean that the casualty gets medical care quickly unless they are in a really inaccessible place and then we are just used for the extraction.

Through liaison we try to remind the ambulance crews of our existence (generally the AAs are very onside but the control rooms can be very different in their view of us) and it works across most parts of the UK.

[TorqueOfTheDevil]

Very diplomatic of you Crab! What you say is largely true, but sadly there are occasions of air ambulance units trying to keep the stats up rather than admitting defeat and summoning a SAR aircraft. Perhaps this would happen less often if they didn't have to rely on donations from the public?

On a similar subject, here is an example of why close cooperation between SAR and ambulance control needs to be constantly pursued:

www.scotcourts.gov.uk/opinions/2010FAI29.html (http://www.scotcourts.gov.uk/opinions/2010FAI29.html)

It's a long and sad story, and the author is evidently unaware of the difference between an air ambulance and a rescue helicopter, but the point is that time was wasted summoning the SAR aircraft (see Part II Section 3 paras 29-38).

[Turkeyslapper]

Probably asking for it and its probably been asked before however...why don't the air ambulance guys have a winch particularly for occasions described above?

Different country I know, however I have been tasked to a MVA (or car accident), arrived on scene to find that no landing area is available ie in rugged terrain, and.....we have been able to winch our paramedic and doctor to the scene (they have appropriate training). Just having the capability rolled into a SAR/EMS platform gives flexibility = time saved.

Are NVG making there way into civil ops yet over there?

Cheers

Turkey

[[email protected]]

TOTD - judging by the poor girl's injuries, it would have made little difference in this case.

We have had situations in Wales where only a police officer can request a SAR helicopter (their rules not ours) whereas an MRT cannot. It all comes down to training and liaison.

Turkey - it comes down to cost, both for the winch and the training required to keep competent at winching ops - since the AAs in UK are funded by charity and only a few areas in UK would be likely to use the capability, it hasn't happened. There have also been questions raised about aircraft performance during winching.

[Geoffersincornwall]

In the early days of Cornwall AA we were roasted in the local press because one of the guys on the Seven Stones Lightship had an angina attack and called Ambulance Control to request the AA, knowing that it was a B0105 just like the one he used to get to and from his workplace. Control turned him down because the lightship was in SAR territory and passed it on to CU.

The next day an irate tirade about inflexible ambulance people and stress caused due to winch trip into a SK appeared in the Western Morning News and we had egg all over our face.

That's life I guess.

G. :ok:

[Epiphany]

Turkey - Australia has the advantage of an authority that uses common sense. Your SAR/EMS ops have no accountability below Vy.

Having flown SAR/EMS in Australia and SAR and HEMS (separate entities as you know) in UK - I know which system is by far the most sensible operationally. BUT just ask yourself when you are taking off or landing on that hospital rooftop helipad or in a 100' hover winching - 'What would happen OEI?'

Mostly you would end in in a smoking hole in the ground. In UK SAR and HEMS are not expected to be exposed to that situation. CASA apparently judge that to be an acceptable risk. That is why you operate SAR/EMS combine and why you can fly around happily at MTOW.

[explorer99]

Three times in the last year I've received police tasking to search for a missing person where I believed that, due to more appropriate equipment (NVG) and a far greater endurance, a SAR helo would have been a better asset for the task than our MD902. On two of these three occasions I accepted the tasking but persuaded the command & control centre to ring the ARCC to request a SAR cab as well. On the third occasion, with the search area in hilly terrain on a very dark night at the limits of our useful range, we suggested that the ARCC be called but, if a SAR cab was not available, then we would launch and do what we could. We weren't called back for whatever reason, the SAR cab wasn't requested and the misper was found dead nearby the next day.

On the most recent of these tasks a Sea King was only offered once we had completed our search - in an adjacent force area, a long way from base, and therefore potentially extending the search period quite significantly. I don't know why; I am quite able to arrange in-flight deconfliction between search assets, thanks. Police C&C staff are often nearly overwhelmed with other tasking and simply do not understand aviation, it's not their role in life; those who are experts have to spell out what is available and offer what they can. On that occasion I rang the SAR Flt directly to give them a 'heads-up' and found out they were about to fly a 2 hr training sortie, so there was no practical reason why the tasking should not have been accepted. (As it happened the misper was found safe & well soon afterwards by ground searchers.)

It's frustrating to know what is available (and to have to explain the 'for free' concept each time), knowing that the ARCC is likely to decline without explanation! Please, ARCC folks, give more feedback to the police staff if you decline their requests, otherwise they simply won't bother asking next time...!

E99

[Thomas coupling]

It's all about education.
The SARF needs their liaison guy to visit as many police control rooms as possible spreading the word that their asset could be available if only they asked.
The police also need to make it known that they could do with heavy backup when the chips are down.
Pick up a phone and talk about it :*

[IrishSarBoy]

It's good to see informed opinions here. The old chestnut of dealing with the 'controllers' was and is an ongoing problem. I remember moaning about RCC when working for HM, the response from my boss was, 'do you fancy a tour at Kinloss?', of course I declined the offer but it did highlight the problem that those persons suitably qualified to understand all the different types of assets available are usually doing the job with those very assets! One thing that has helped over here is 'out-reach' to the various emergency services to increase understanding of what we as a service provider can do (sorry about the 'corporate speech').

[TorqueOfTheDevil]

One thing that has helped over here is 'out-reach' to the various emergency services to increase understanding of what we as a service provider can do (sorry about the 'corporate speech').

Totally - but unfortunately one bad experience when dealing with Kinloss will put off an emerg servs control room from bothering to ask again, no matter how hard the local SAR crews have tried to build bridges. The boss of the ARCC 7-8 years ago prided himself on having significantly reduced the number of callouts that the SAR Force got, by turning down all but the most pressing requests...sadly his mindset seems to live on, both in the attitude of some of the current ARCC pers and in the memory of civ control room staff!

[explorer99]

While it is, and always has been, highly commendable that the RAF SAR Force tries its level best to pass the message to the civilian emergency services control room staff, unfortunately it's simply never going to achieve the success it seeks.

The SAR Force is a small organisation with very limited capacity for such 'outreach' - there is only so much that a very small number of people can achieve. On the civ police side alone, there are more than 40 individual forces in the UK, many of which have a number of control rooms for separate areas within the force. Each control room has a large number of staff, only a proportion of whom will be in work if a SAR Force rep visits to spread the word and most of those who are there will be busy doing their jobs. In addition, police control rooms are inundated with a huge number of tasks, very few of which have any similarity to SAR tasking; looking at the computer screen next to me I see that my force generated 865 'logs' yesterday alone, and that was on a Tuesday well removed from the Thu / Fri / Sat public order hotspots. Further scale the problem up to include the ambulance control rooms and the scale of the task becomes even more daunting, hence why I stated that it would be nice for the ARCC staff (ie the 'experts') to be a little more forthcoming with supporting info when declining a request.

Top tip - the ideal people at which the SAR Force's efforts should be targeted would be the police Force Duty Officers (FDOs) - they are few in number but extremely influential and present in every control room -rather than trying to brief every member of staff in each control room. SAR boys & girls, you might want to consider this approach!

Keep up the good work, y'all.

E99

[TorqueOfTheDevil]

E99,

Great idea - TVM.


it would be nice for the ARCC staff (ie the 'experts') to be a little more forthcoming


If only...the pigs will not just be flying solo but will be on a mission to Mars before this happens:ugh:

[jayteeto]

When we go to the lakes, we look at the map on the way and liaise with Mountain rescue. We would then warn control that SAR may be needed and they start the ball rolling. If it seems ok and then we get on-scene to a SAR situation, I call on 121.5 to RCC and call the SK. We get there much faster if they are at base. It seems to work, there is nothing political. We don't want a winch, WE ARE AN AMBULANCE, NOT SEARCH AND RESCUE. The issue about flying at night on HEMS. I will say one thing, can the charities afford it?

[griffothefog]

TorqueOfTheDevil,

How do AA units keep the stats up? The ambulance service have a duty to respond to emergencies, but that has nothing to do with the units.(unless charity run AA's have changed since my day) In the case of who and what they dispatch from control, charity money wouldn't even come in to the equation.

This is a genuine question and not a look for a poke in the eye, your post confused me. :confused:

[TorqueOfTheDevil]

Jayteeto,

Great post - it's a shame that the mods re-named this thread-ette "SAR vs Air Amb" as this may inadvertently provoke strife and angst...

[tigerfish]

What a great thread. All constructive and well reasoned comments from a series of obviously experienced practitioners. Wish others were similar!

Tigerfish

[TorqueOfTheDevil]

Griff,

For a start, I'm not having a dig at all air ambulances, as I have a great deal of respect for the excellent service they provide. Secondly, I may have misunderstood some of the things I've seen happen. But for what it's worth, my point is simply that I have seen occasions when an air ambulance has got stuck in, sometimes of their own accord, when it seemed obvious right from the start that a SAR helicopter would be better suited to the incident, and this led me to wonder what the motives were.

For instance, a woman fell on rocks on the coast 2 miles north of RAF Boulmer and broke her leg (this is about two years ago). The call went to the ambulance service, who asked for an air ambulance. Being the weekend, the nearest one was in Carlisle; the aircraft launched, got to the scene, couldn't land anywhere nearby, so landed some way away, tried to reach her and eventually realized they couldn't do anything for the casualty (terrain unsuitable for stretcher carry, not enough people to do it in any case). At this stage, the Boulmer Sea King was requested, and the SAR crew recovered the woman in short order. Given that the location was shown on the map as an area of low cliffs and tidal rocks, I was surprised that a distant air ambulance crew decided to have a go when they knew there was a SAR base only one minute's flying time away. As it was, the delay while they attended meant the casualty spent the best part of an hour unnecessarily stranded. Another point is that the SK crew were surprised on arrival to find an air ambulance parked not far from the incident, given that no call had been made to Boulmer as the air amb approached (not mandatory to do so, of course, but good airmanship would suggest calling a SAR base when operating so close) - a cynic would surmise that the air amb crew didn't want to let on that there was an incident on Boulmer's doorstep in case the beastly SAR crew dared to resolve the situation quickly and successfully, and deny the air amb the chance to deliver a casualty to hospital. There are other incidents similar to this which I could relate but won't!

And there are the incidents which DDW alluded to in his post where it's difficult to understand why a lengthy and sometimes risky stretcher carry (two hours, in one episode I saw!) is preferred to getting a SAR aircraft. And the occasions when air amb personnel try to bully control room staff into giving them more trade (I've been told this in person by the boss of an ambulance service control room) while discouraging them from asking for a SAR aircraft by telling them that they will be charged for using it - the control room staff in many cases don't know any better and fall for this tripe!

Like I say, maybe I have it all wrong, but from what I've seen there do seem to be occasions when casualty welfare is not the over-riding priority when an air amb attends an incident. At the same time, what better way is there for a charity to keep the funds flowing in than to have an impressive list of people delivered to hospital...

[[email protected]]

TOTD The boss of the ARCC 7-8 years ago prided himself on having significantly reduced the number of callouts that the SAR Force got

Surely not the same person heavily involved in Soteria?:{

In defence of the ARCCK, they are hardly likely to get a lot of experienced SAR boys and girls (although there are some there and OC ARRCK is a SARboy) because the front-line can't spare them. They do make a huge effort to spread the word and do many visits themselves and get involved (along with the RAFLOs) with exercises organised by civilian emergency services.

[Bertie Thruster]

Yes, we had an ARCC controller visit our air ambo unit last year to discuss cooperation and control. Very friendly and useful information.

RAFSAR (v) Air Ambulance?..... For me means: 280 rescue sorties in 13 years (v) 4900 AA tasks in 9 years.

(2 a month (v) 3 a day)

[RODF3]

280 rescue sorties in 13 years (v) 4900 AA tasks in 9 years.

(2 a month (v) 3 a day)

Interesting maths and figures. 4900 in 9 years makes it 1.5 a day. The SARF has, on average, over 1000 callouts per year so 2.7 a day.

[jayteeto]

Torque, what you do have to bear in mind, is that a lot of units are run by different organisations. Some units have a 'reputation' for, how can I put it diplomatically, looking after their own interests at the expense of other units. Also individual crews can have agendas as well. This can also happen in the military when people are trying to justify their existance. If you have problems with specific units, it might be nice not to tar us all with the same brush.......

[explorer99]

Unfortunately the whole corporate intent of an organisation can be spoilt by the actions of a very few 'non-aligned' individuals in this game as in any other. For example...

Some months ago there was a fairly large-scale emergency services event 'somewhere in England' that included attendance by police, fire service, ambulance service, coastguards etc etc plus the local SAR helo. The organisation meetings went quite well, except that the SAR rep (one of the aircrew from the local unit) was regarded by most attendees as being fairly unco-operative - actually, the rep was described as being a procreating posterior cavity, or words to that effect.

On the day, the air ambulance, police helo and police mounted section were all in attendance. The SAR helo arrived via a thundering low flypast and landed straight off a wingover. Once shut down the crew asked for the 'VIP tent' (!) and left for the cafe in a coastguard vehicle with no PR effort for all the assembled civvies at all other than referring to the police & air ambulance aircraft as 'toys'.

The organisers had arranged an RAF Falcons parachute drop, for which they had paid; it took some effort to convince the SAR crew that they would be unable to depart while the parachutes were in the air and that cancelling the drop (which had been clearly discussed in the meetings and NOTAM'd accordingly) was not viable. When they eventually departed - having significantly delayed the drop - the crew did so without any attempt to talk to their admiring public and, immediately after take-off, flew so low over the event that leaves fell from a nearby tree and many people reportedly ducked, thinking the aircraft had actually hit it. It made for some quite interesting photos!

No names, no pack drill, but very few emergency services professionals there were impressed and, sadly, it wouldn't surprise me if only 2 'toys' attend the next event...

The whole performance was a great shame because, for want of a bit of effort and thanks to an overdose of prima donna pills, SAR corporate Co-operation aims were set back quite significantly in this part of the world. Individuals all have their part to play, and trying to show off in front of others tends to be counterproductive. :=

E99

[TorqueOfTheDevil]

Jay,

Sincere apologies - I serioulsy didn't mean to tar everyone with one brush.

E99,

What appalling behaviour by the SAR people involved. I'm embarrassed to be associated with whoever that was - I wish they hadn't acted like that, and please believe me that not all (mil?) SARBoys are like that...but I realize the damage has been done...

RODF,

You won't fool anyone with maths like that! I think we all know that air amb units get many more calls than most SAR bases...a SAR unit might log almost as many hours though in a set period just because an average SAR shout takes longer than an average air amb shout (and that's not just because the King of the Sea and Queen of the Skies is so slow!).

TOTD

[Bertie Thruster]

Sorry RODF, I wasn't clear enough. The figures just showed what the (vs) meant to me. My jobs from my log book.

I will rearrange them to my shift average: RAFSAR; 1 job every 5 shifts. AA; 3 jobs every shift.

[jimf671]

... they are hardly likely to get a lot of experienced SAR boys and girls ...

Not my finding during a visit.


They do make a huge effort to spread the word ... ...and get involved ... with exercises organised by civilian emergency services.

Yes. That's how I ended up visiting.

Impressed.

[Flaxton Flyer]

Why have the AA attend only to find they need to call out SAR, increasing the time it takes to get the patient to safety plus paying for two aircraft and two crew?

Because the AA is a first response vehicle for the Ambulance Sevice, and SAR is a specialist asset which can be kept up your sleeve for appropriate taskings.

Generally speaking the type of civvy taskings SAR usually get involved with will be remote locations or difficult access. Note that these two situations are not necessarily one and the same.

Quite often the AA will be first on scene, and will attend to the patient. IF the access is difficult, or the AA had to land some way off the patient giving a lengthy or difficult extraction by MRT, SAR may be requested to winch.

It's all a case of an appropriate response based on the information available at the time of call. No point calling SAR out for every job when 9 out of 10 of them wouldn't require their specialist skills.

FF

[louisnewmark]

Is there any reason why they don't have aircraft equipped for both HEMS+SAR?

Fair question, simondlh.

Air ambulance helos in the UK are almost exclusively the smallest, and therefore cheapest, types that meet the CAA's requirements ie light twins such as the EC135 and MD902. The UK SAR philosophy, by comparison, is to use a larger, and therefore individually more expensive, machine that can be used for a multitude of scenarios including long range tasking.

Safe winching requires a significant amount of training, which would increase operating costs for AA units (the arguments surrounding this have been done to death previously on this forum!). Furthermore, hoist-equipped light twins may not be able to meet the single-engine performance required by the CAA to conduct winching ops.

Some operators overseas winch very successfully from light twins - REGA in Switzerland uses A109s, for example - but at present the UK AA and SAR philosophies don't really match up. That doesn't mean that AAs couldn't carry out winch ops in the future, but you specifically asked about SAR which is a rather wider requirement.

Louis

[Tallsar]

Lets not forget either that most AA's are charity funded, with some struggling to meet the flying task with the money that comes in. As Louis discussess, the additonal engineering requirements, the more limtied flight envelope (C of G issues) and often shorter winch wires, the extra training and the risks associated with winching would add a considerable financial burden to any AA charitable organsation even if they were cleared by the CAA to do it. Its simply not worth the effort in most parts of the UK when there are perfectly competent SAR winch platforms at immediate readiness not far away. Lets not forget either that AAs are day only too.

It is a noteable however, that as AAs have proliferated in recent times, there has been tendency to send an AA first sometimes when the immediate tasking of a SAR cab would have been better. This of course comes down to what information comes from the accident scene and how the control room responds to the request. While it is also true that SAR cabs have been tasked to what would have been better done by a cheaper AA, from a casualty's perspective that error (from a time saving perspective) is better than having to wait while an arriving AA asseses that there is a need for a winch platfrom.

Much has been done in recent years to get good working relationships and coordination going..particularly at the tasking level...but there is still more to be done.

Cheers

[Thud_and_Blunder]

Tallsars comment "but there is still more to be done" was bang-on; read the following article to see how things can (nearly) go pear-shaped if good decisions aren't made in good time. And very-well-done to the R169 crew who persevered under such difficult conditions.

Article from This is North Devon (http://www.thisisnorthdevon.co.uk/news/Low-fuel-adds-drama-helicopter-s-cliff-rescue/article-2955362-detail/article.html)

Low fuel adds drama to helicopter's cliff rescue

Rescue watch is a weekly column about the work of North Devon's RNLI and RAF rescue teams. This week it's the Chivenor search and rescue team.
THE Chivenor helicopter has so far been called out 15 times this month, but despite being quiet in terms of the number of rescues, there have been some eventful and challenging ones.
Probably the stand out rescue came on November 10 when rescue 169 was called away from a training trip to a man who had fallen while climbing on a coastal cliff near Cardiff.
The crew, who were airborne on a training sortie, offered assistance to the coastguard after hearing of the incident on the radios.
A nearby air ambulance had been tasked by ambulance control and the coast guard stood Rescue 169 down.
The air ambulance arrived and managed to deploy their paramedic by hovering with one skid on the bottom of the cliff and the paramedic jumping out. He was unable to take all the necessary kit due to the treacherous location of the casualty and the risky technique used to get to the aid of the injured climber.
As Rescue 169 returned to training, they sought assurance on the radio that the evacuation of the climber was possible by the air ambulance.
Ten minutes later Rescue 169 was re-tasked as the casualty needed to be winched.
The casualty was at the base of 30ft cliffs, in a small rocky bay, with the advancing tide quickly approaching the casualty's position.
It wouldn't be long before the casualty's location was completely submerged.
The on scene paramedic had quickly assessed that the casualty had serious head injuries, a possible fractured pelvis and was drifting in and out of consciousness.
Rescue 169 arrived on scene, but due to the delayed call and the fact they had been conducting flying training, they were running very short of fuel.
The initial plan was to winch down the winchman/paramedic with the necessary kit, and while he was preparing the casualty to be winched, the aircraft would make a quick dash to St Athan Airfield in Cardiff for fuel before returning and completing the rescue. It soon became apparent that this would not be possible.
As the crew prepared to deploy the winchman, the incoming tide began lapping around the casualty and there was no time for fuel.
There was a simple choice to make, either go for fuel and let the man almost certainly drown or complete the rescue at the risk of running out of fuel before making it to an airfield.
With this in mind, the winchman worked as quickly as possible, stabilising the casualty and securing him in the stretcher. Twice his equipment was washed off the rock by large waves, with him and the casualty now soaking wet through as the waves were breaking over them.
With all the low fuel warnings sounding and lights flashing in the cockpit, the hook was deployed to recover the winchman and casualty, but there was not even enough time to recover them to the aircraft.
Instead they were hoisted, crane-like to the top of the cliff where the aircraft left them with the awaiting air ambulance and made a mad dash towards St Athan for fuel.
It was at this point that the crew knew they couldn't make it and had to land the aircraft in a field some eight miles short of the airfield with absolutely no spare fuel left.
The local farmer was very understanding of the crew's situation and provided plenty of tea while the crew waited for a fuel bowser from RAF Lyneham to come and save the day.
As this is the last Rescue Watch of the year from Chivenor, can we also take this opportunity to wish everyone a very merry Christmas and and best wishes for the New Year.
PS: Don't forget to wave to Santa Claus who often comes to fly with us on the days leading up to Christmas.
Seaweed

[BobbyBolkow]

Jusy got back from lying down in a dark room for a couple of hours as I found myself agreeing with CRABS sensible and informed comments! (no offence meant!).

Is there REALLY a V's? I think not. The two operations are totally different beasts, with different deployment criteria and operation. Or, as they say, 'Horses for courses'

Down here in God's own county, we have, I think, a good working relationship with the SAR boys. On tasking, if the information (and that's the crux of any deployment) is that it's a difficult or remote location, then our HEMS dispatcher will pre-notify ARCC of the possibility that SAR may be needed for winching. Sometimes, on arrival at scene, things are not what we were expecting. So my guys give the treatment and I get control to acquire other assets. No problem. :ok:

The thing is that if an Ambulance service has AA's at it's disposal, they will be used as the first response. The problem, as already stated, is one of EDUCATION! What resource can do what, where and how long will it take.

Deep respect for the SAR boys and what they do :D long may they continue.


Oh! Before I forget............

TOTD - 'Helicopter heros', it ain't real life mate! I would be embarressed to be seen doing some of the things they've shown in the series! As for the 2 hour carry...........It's very difficult to call in other agencies and be seen 'to fail' when you've got a camera crew egging you on to do a 2 hour carry 'cos it good TV! (IMHO) :=

[Flaxton Flyer]

It's very difficult to call in other agencies and be seen 'to fail' when you've got a camera crew egging you on to do a 2 hour carry 'cos it good TV! (IMHO)

Bobby, Bobby. If you had watched the series you would have seen many occasions when SAR have been called in to winch. As for a two-hour carry, well it must been MRT because I have yet to meet the paramedic who would want to carry a single pound an inch further than absolutely necessary!

As for the"good tv" comment, if you really think that, you need a good slap as that shows a massive disrespect to your fellow professionals. So, here, have one back:=

Not real life? Jets crashing on Emmerdale village, a tram leaping from Coronation St. viaduct right through Rita'a Kabin window, every new resident of that street being either a psychopath or mass murderer, Nigel from Eastenders getting a job as a surgeon in Holby...that's not real life, matey!

Twisted ankles up on the dales, old people falling over and breaking their hip, crews needing help due to access problems, HEMS crews helping out on non-life threatening jobs because they have stronger painkillers than the land crews, hospital transfers...and every now and then a jet-car crash to relieve the tedium.

Unless Devon is such a dangerous place that you only get called to weapons-grade HEMS tasking, I suspect you too will have to attend "embarrassing" incidents just like the rest of us.

That, my friend is real life.

FF