Air ambulance viable?
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Air ambulance viable?
My question is regarding the air ambulance biz in Europe. From what I know, it appears that this biz is cannabalizing itself by two factors: a surplus of air ambulance companies price dumping in a race to the bottom and EASA doing a one size fits all approach when addressing aircraft operational requirements, one example is the cpdlc requirement for aircraft in the near future...which is hilarious for a majority of ambulance aircraft , i.e...the Learjet35 which uses the old fashioned steam gages similar to the Cessna 172. Fantastic...pilot still has to fight with his old fashioned flight director...but hey at least he has cpdlc capabilities...lol.
Anyhow, I digress...I see this industry heading in one direction, where there are maybe just two or three air ambulance companies left, granted they will probably be flying Challenger 604s at Piper Seneca prices.
cheers
Anyhow, I digress...I see this industry heading in one direction, where there are maybe just two or three air ambulance companies left, granted they will probably be flying Challenger 604s at Piper Seneca prices.
cheers
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I donīt think EASA mandates CPDLC. Thats ICAO, Eurocontrol etc...
This stuff has never ended and will never end, granted, the frequency of changes seems to be higher these days...
As for the prices and oversupply: not new either...
This stuff has never ended and will never end, granted, the frequency of changes seems to be higher these days...
As for the prices and oversupply: not new either...
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I also have questions how viable it can be. Problem is also the "unfair competition". Some companies are only dedicated to ambulance flights, having an aircraft completely converted into flying ambulances with highly specialised med crew, while other normal taxi operators just put a stretcher in and sell it as an ambulance flight. The latter will be be able to sell it for a much lower price. Insurance companies are only interested to charter as cheap as possible. They dont care about the comfort of that aircraft.
Second issue: beside the learjet 35 (which is getting old and noisy and perhaps expensive maintenance wise) what is the perfect aircraft to do this kind of flights? I know that Rega is using the challenger, but how expensive is this? Are insurance companies willing to pay these amount of prices?
Second issue: beside the learjet 35 (which is getting old and noisy and perhaps expensive maintenance wise) what is the perfect aircraft to do this kind of flights? I know that Rega is using the challenger, but how expensive is this? Are insurance companies willing to pay these amount of prices?
Last edited by Woody12; 5th Jul 2014 at 16:06.
First question, are you inside looking out or outside looking in?
Lear 35 has an advantage is that it can get into an awful lot of airports the challenger can't, door height from the ground on the challenger increases loading risks particularly intensive care patients, but it's nice to be able to walk around inside though.
The UK requires all UK AA operators to be registered with and inspected by the Care Quality Commission (CQC) as a statutory requirement enacted by law, plus companies are accredited by EURAMI or CAMTS inspection regimes as well. Also all the usual CAA AOCs requirements
insurance companies may want the cheapest possible option but in AA situations, competence of the company and aero-med crews, both pilots and medical teams is the most important. Remember a trip to the Coroners Court is in no-ones interest, and believe me a Coroner would want to have the insurance company give evidence if anything went wrong as to their reasons for choosing the company.
Believe me AA work is increasing due to people living longer, or are born early and travel further and unfortunately they get sick and need to be repatriated to their home country.
Lear 35 has an advantage is that it can get into an awful lot of airports the challenger can't, door height from the ground on the challenger increases loading risks particularly intensive care patients, but it's nice to be able to walk around inside though.
The UK requires all UK AA operators to be registered with and inspected by the Care Quality Commission (CQC) as a statutory requirement enacted by law, plus companies are accredited by EURAMI or CAMTS inspection regimes as well. Also all the usual CAA AOCs requirements
insurance companies may want the cheapest possible option but in AA situations, competence of the company and aero-med crews, both pilots and medical teams is the most important. Remember a trip to the Coroners Court is in no-ones interest, and believe me a Coroner would want to have the insurance company give evidence if anything went wrong as to their reasons for choosing the company.
Believe me AA work is increasing due to people living longer, or are born early and travel further and unfortunately they get sick and need to be repatriated to their home country.
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cpdlc
altough currently cpdlc is "mandated" (by feb 15) by icao/easa but an exemption will be given for the manufacturer or to a specific operator if the manufacturer wont ask for the exemption.
imri
imri
The Lear 45 has no advantage over the 35 with extra tanks.
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This is really an interesting thread. Most jet and turbo props are utilised in air ambulance configuration to different advantages globally. As stated earlier in the UK the importance is registration to the CQC (and maybe CANTs or EURAMI) and to be a dedicated air ambulance operator.
What plane.... REGA operate CL604s arguably the worlds leader in fixed wing air ambulances with a dedicated fleet but these are costly to operate but have advantages. All planes have benefits to both operators, insurers and patients.
The 35 Vs 45 is an interesting debate with some European operators changing their fleet from a 35a to a 45xr due to some advantages. These could be suggested to be part availability, APU for remote operations, bigger cabin for medical care, ability to do double patient transfers, bathroom facilities and newer aviation technology. This is traded by the 35a tip tank conversion which gives it additional range to that of a 45xr. However the plane decision needs to be based on the service required, location of operations and the patients it's collecting...
What plane.... REGA operate CL604s arguably the worlds leader in fixed wing air ambulances with a dedicated fleet but these are costly to operate but have advantages. All planes have benefits to both operators, insurers and patients.
The 35 Vs 45 is an interesting debate with some European operators changing their fleet from a 35a to a 45xr due to some advantages. These could be suggested to be part availability, APU for remote operations, bigger cabin for medical care, ability to do double patient transfers, bathroom facilities and newer aviation technology. This is traded by the 35a tip tank conversion which gives it additional range to that of a 45xr. However the plane decision needs to be based on the service required, location of operations and the patients it's collecting...
The 35a is able to undertake twin patient transfers, it just depends on the configuration internally of the cabin. The toilet problem for patients all depends on the patient condition and presenting illness, the crew is another matter but this can be overcome. The range issue is actually quite significant as a 45 from the UK has to refuel, I believe, before transiting to somewhere like Tenerife where as an extended 35a with belly and tip tanks can do it in one journey. As the majority of operations are into airports which have Jet A1 available they should have GPUs to run the air con system, occasionally you may when safe to do so or the ground security situation means you have to run the right engine. The problems of GPUs is the cost against patient and crew comfort but normally comfort wins out every time.
Cabin dimensions are always a problem in AA missions, you never have enough room, it's not the length in a 35a but the overall width which I suspect is the same in the 45 in any variant. In either aircraft it is difficult to roll a patient and nobody in the insurance industry is addressing the elephant in the room, literally, which is the increasing weight of patients requiring transfer and the manual handling risks to the load teams. A company I know does take this into account, but sometimes the need of the patient especially in a move to greater care may require a risk to be quantified and may have to be accepted in the patients interest.
The King Air does have a powered load system, but is heavy and unwieldy and requires a bigger load team as the cabin floor is far higher off the ground then a Cheyenne or a Lear.
Cabin dimensions are always a problem in AA missions, you never have enough room, it's not the length in a 35a but the overall width which I suspect is the same in the 45 in any variant. In either aircraft it is difficult to roll a patient and nobody in the insurance industry is addressing the elephant in the room, literally, which is the increasing weight of patients requiring transfer and the manual handling risks to the load teams. A company I know does take this into account, but sometimes the need of the patient especially in a move to greater care may require a risk to be quantified and may have to be accepted in the patients interest.
The King Air does have a powered load system, but is heavy and unwieldy and requires a bigger load team as the cabin floor is far higher off the ground then a Cheyenne or a Lear.
Last edited by air pig; 9th Jul 2014 at 20:40.
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Your completely right there is a big selection of airframes available and this link reviews the 35 Vs the 45 and why companies are changing to the 45:
Spoilt for choice | International Travel & Health Insurance Journal
The details on the 45 range maybe a little short, just looked on flight scanner (if thats correct) with the 45 you mentioned regularly does the UK to the canaries with no fuel stops and flew from Canada (all being Gander - CYQX) to Ireland (EINN) at the start of the year.
If you are talking about all round access to a patient for the medics in the back then the Challenger or the ADAC Dornier may provide a solution.
The KingAir air ambulances you mentioned have a role in short air ambulance flights such as the Scottish services. Again it always comes down to the balance being correct with numerous factors... the right patient; right air frame; right aircrew; and right medical crew and then making the purchaser of the service aware why that is safest and most efficent patient option.
Spoilt for choice | International Travel & Health Insurance Journal
The details on the 45 range maybe a little short, just looked on flight scanner (if thats correct) with the 45 you mentioned regularly does the UK to the canaries with no fuel stops and flew from Canada (all being Gander - CYQX) to Ireland (EINN) at the start of the year.
If you are talking about all round access to a patient for the medics in the back then the Challenger or the ADAC Dornier may provide a solution.
The KingAir air ambulances you mentioned have a role in short air ambulance flights such as the Scottish services. Again it always comes down to the balance being correct with numerous factors... the right patient; right air frame; right aircrew; and right medical crew and then making the purchaser of the service aware why that is safest and most efficent patient option.
Air pig, just to clarify, the tip and fuselage tanks on a 35A are standard, you cannot get a 35A without them. The same airframe is available with a bigger fuselage tank - it's the 36A. The 35A will do Tenerife from England. The 36A has about an hour longer endurance but with the penalty that the internal cabin length reduces by about a row of seats.
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Australia's Royal Flying Doctor Service uses mainly King air 200's and PC 12s. I think they also have a few c208's. Over in the west, they also have a hawker 800. The fleet is pretty big, about 60 aircraft IIRC.
Most have modified landing gear as most of their work is on unimproved airstrips. I think they also have modified loading doors.
There is some other air ambo fleets in Aus too, careflight uses the 45's and there is also a heap of other King Airs around the place. I think the king air is the preferred aircraft in australia for medical stuff.
Most have modified landing gear as most of their work is on unimproved airstrips. I think they also have modified loading doors.
There is some other air ambo fleets in Aus too, careflight uses the 45's and there is also a heap of other King Airs around the place. I think the king air is the preferred aircraft in australia for medical stuff.
In an AA any extra space is positively desirable and I am sure your aware the removal of a row of seats would preclude using a double stretcher configuration using a 'Lifeport' type system. In fact the removal of that extra space may actually make working inside a 36 far more difficult in particular in the event of an emergency,
I did think that the extra belly tankage was an optional extra on the 35a but as you say the tip tanks are standard fit.
I did think that the extra belly tankage was an optional extra on the 35a but as you say the tip tanks are standard fit.
Andy P: Agree the King Air is becoming the default aircraft for AA operations in particular as the Cheyenne is slowly becoming too old to operate. The other thing for turbo prop operations is the use of pressurisation as a standard for patient comfort, but in some areas aircraft such as the Caravan is the aircraft of choice for the reasons of environment terrain and cost.
