Best EMS helicopter?
Crazy Scandihooligan
Joined: Nov 2003
Posts: 482
Likes: 0
From: Damn, some mountain goat is nibbling my ear ;-)
EMS Best config
Thomas Coupling
You may be an accomplished Pilot, but just exactly was the last time you intubated from the side - or ever at all? 
Again, i would stick to flying mate 
All i would like to say, is that it has to be a very good paramedic who can intubate from the side, and then it is not guaranteed to get into the trachea, but induce vomiting from entering the oesophagus. Even if a bougee was inserted you would still need to get the macintosh blades in the right angle to insert the damn thing, and get it into the correct hole (Since the two sit practically ontop of each other) I could appreciate that a tracheostomy can be performed side on, but most paramedics arn't trained to that level.
Visualisation of the vocal chords is the gold standard in intubation, and i am sorry mate, that ain't possible. Even when you are directly behind the head it is quite difficult, especially with all the vibration of a chopper going on.
XEMS
Never a truer word spoken. Nice one.
Avnx EO
EC 135 Config showing two seats available
Fish eye view of EC 135 passenger bay
BO-105 with four people in it
I could only find some pikkies, but the EC-135 shows room for both views, both side and head. The BO is like a sardine can. The patient is supposed to be where the defib is ..
I know which one i would rather be in. Couldn't find more on the other types.
The position when in a normal flying attitude,. is good, because it keeps the blood pool in the centre of the body and head. i think it is called the trendellenburg position, and sometimes the paramedic can alter the stretcher in normal ambulances to simulate this position.
Regards
MD 900
Refusing to intubate from an aside position is a bit short sighted of your paramaedics XEMS
If a paramedic can access a patients head, thats good enough given the circumstances!! I appreciate head on is the best, but not the only approach
All i would like to say, is that it has to be a very good paramedic who can intubate from the side, and then it is not guaranteed to get into the trachea, but induce vomiting from entering the oesophagus. Even if a bougee was inserted you would still need to get the macintosh blades in the right angle to insert the damn thing, and get it into the correct hole (Since the two sit practically ontop of each other) I could appreciate that a tracheostomy can be performed side on, but most paramedics arn't trained to that level.
Visualisation of the vocal chords is the gold standard in intubation, and i am sorry mate, that ain't possible. Even when you are directly behind the head it is quite difficult, especially with all the vibration of a chopper going on.
XEMS
Biggest mistake I have ever seen in EMS was having the aviation side of the house outfit the aircraft without any input from the medical side. Talk about some infighting! Anyway, I say as long as the crew is happy with the configuraiton, you will be just fine.
Avnx EO
EC 135 Config showing two seats available
Fish eye view of EC 135 passenger bay
BO-105 with four people in it
I could only find some pikkies, but the EC-135 shows room for both views, both side and head. The BO is like a sardine can. The patient is supposed to be where the defib is ..
I know which one i would rather be in. Couldn't find more on the other types.The position when in a normal flying attitude,. is good, because it keeps the blood pool in the centre of the body and head. i think it is called the trendellenburg position, and sometimes the paramedic can alter the stretcher in normal ambulances to simulate this position.
Regards
MD 900
Last edited by MD900 Explorer; 27th November 2003 at 02:59.
Joined: Aug 2000
Posts: 3,670
Likes: 1
From: UK
MD900:
Seems you agree after all - intubation can and has been done from the side...atleast here with our paramedics.
Nice excerpt from one of your paramedics (above) though
If you do this job long enough, you'll see quite a lot, it seems
As you'll no doubt find out for yourself one day!
Nice piccies though...paramedic pilot and photographer to boot .
RU West Mids?
All i would like to say, is that it has to be a very good paramedic who can intubate from the side, and then it is not guaranteed to get into the trachea, but induce vomiting from entering the oesophagus. Even if a bougee was inserted you would still need to get the macintosh blades in the right angle to insert the damn thing, and get it into the correct hole (Since the two sit practically ontop of each other) I could appreciate that a tracheostomy can be performed side on, but most paramedics arn't trained to that level.
Nice excerpt from one of your paramedics (above) though
If you do this job long enough, you'll see quite a lot, it seems
As you'll no doubt find out for yourself one day!
Nice piccies though...paramedic pilot and photographer to boot .
RU West Mids?
Joined: Jan 2001
Posts: 1,365
Likes: 0
From: UK
J-R,
Its a bit more complicated than just which type is best. Where do you want to do EMS (which country), what is the operational requirement, what hours, what type of flying (VFR/IFR) what sort of operational area, how much money do you have?
All these things affect basic features of the aircraft (starting with single or twin).
Its a bit more complicated than just which type is best. Where do you want to do EMS (which country), what is the operational requirement, what hours, what type of flying (VFR/IFR) what sort of operational area, how much money do you have?
All these things affect basic features of the aircraft (starting with single or twin).
Joined: Dec 2002
Posts: 42
Likes: 0
From: ...where the girls are so pretty
It would be operational in the Republic of Ireland pretty much 24/7 and in most weather conditions, operating in and out of a select few suitable hospitals within the Dublin area...
Joined: Jan 2001
Posts: 1,365
Likes: 0
From: UK
J-R,
I am no expert on Irish requirements but I vaguely recall that they require FULL IFR at night. That presumably means M/E with all the IFR bits. In the UK HEMS does not work at night, because they would need extra kit to do off-airfield landings (nightsun possibly TI etc.) Don't know if this would also apply in Ireland.
How are the Irish regulators about IFR approaches to helipads? Do they permit GPS approaches?
If you need all the bits, then I doubt that the EC135 will have the necessary grunt (especially if you need full IFR fuel reserves)
Are we talking single pilot?
I don't have direct experience of the type but a BK117/EC145 sounds about the right size/performance etc. I am sure that McAlpine would be happy to sell you one (or two) given their latest sales initiative.
Interesting Project
I am no expert on Irish requirements but I vaguely recall that they require FULL IFR at night. That presumably means M/E with all the IFR bits. In the UK HEMS does not work at night, because they would need extra kit to do off-airfield landings (nightsun possibly TI etc.) Don't know if this would also apply in Ireland.
How are the Irish regulators about IFR approaches to helipads? Do they permit GPS approaches?
If you need all the bits, then I doubt that the EC135 will have the necessary grunt (especially if you need full IFR fuel reserves)
Are we talking single pilot?
I don't have direct experience of the type but a BK117/EC145 sounds about the right size/performance etc. I am sure that McAlpine would be happy to sell you one (or two) given their latest sales initiative.
Interesting Project
Last edited by Helinut; 3rd July 2004 at 17:49.
Joined: Apr 2004
Posts: 483
Likes: 0
From: The Dark Side
B412 upgraded to an AB139 if you want the best mix of SPIFR/search/winch rescue capability/specialist doctor-paramedic/two attended intensive care patients - anything else is a compromise.
GAGS
E86
GAGS
E86
Nice
Joined: Oct 2003
Posts: 322
Likes: 0
From: All Over
Ok Guys, reality check time.
I'm sorry, but intubating is an extremely demanding and difficult skill at the best of times, let alone side on in a HEMS aircraft.
Pilots may think it easy and indeed some big-balled Paramedics may say its easy, but lets stick with the facts.
Its not easy at the best of times, doesn't alway go right and I defy anyone to listen for breath sounds after an intubation on a helicopter ! Capnography is wonderful, if you have it !
I'm sorry, but intubating is an extremely demanding and difficult skill at the best of times, let alone side on in a HEMS aircraft.
Pilots may think it easy and indeed some big-balled Paramedics may say its easy, but lets stick with the facts.
Its not easy at the best of times, doesn't alway go right and I defy anyone to listen for breath sounds after an intubation on a helicopter ! Capnography is wonderful, if you have it !
Last edited by Paracab; 10th August 2004 at 01:04.
Joined: Jun 2004
Posts: 10
Likes: 0
From: PNG
Ok Guys, I have watched this post for a while and took into consideration all the pros and cons for each machine but I personally think the best platform for EMS operations is the Kaman K-max.
Unsurpassed Visiblity
No tail rotor strike issues
Huge payload
Small foot print to get into the tight confined areas
Plenty of power
Single pilot ops.
EMS K-MAX
Unsurpassed Visiblity
No tail rotor strike issues
Huge payload
Small foot print to get into the tight confined areas
Plenty of power
Single pilot ops.
EMS K-MAX
