Air ambulance/ Police- winching/ onshore rescue
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Russell,
Ideas like this always work in theory but the reality is Air Ambulances would have to go from having a pilot and two paramedics to a SAR trained pilot, a fully trained winch operator and a fully trained winchman - rearcrew whose medical skills may be somewhat less than the incumbents. Do you really then have an improved capability?
It's easy fall into the trap of watching videos like the ones posted by TeeS & Brilliant Stuff and think - "I could do that - I'm sure an Air Ambulance paramedic could too". I'm sure he could, after the appropriate amount of training. Training that will come to the fore not on nice days like the ones shown but on sh1tty days where it's all going wrong. Can the Air Ambulance charities afford the 100 hours or so per crew member required to turn them into fledgling SAR crew? Do these charities then have the time and money to devote to ensuring that this fledgling SAR crew have adequate continuation and currency training? These are perishable skills you know. Aviation is littered with the corpses of people who have bitten off more than they could chew and when an inexperienced crew get 'rescue fever' and envisage their names in the papers, common sense doesn't always prevail.
Factor in all the other points about performance, lack of cabin space etc and you'll see that although the Air Ambulance publicity men might get all moist about a proposed winching capability, putting it into practice is somewhat different.
Ideas like this always work in theory but the reality is Air Ambulances would have to go from having a pilot and two paramedics to a SAR trained pilot, a fully trained winch operator and a fully trained winchman - rearcrew whose medical skills may be somewhat less than the incumbents. Do you really then have an improved capability?
It's easy fall into the trap of watching videos like the ones posted by TeeS & Brilliant Stuff and think - "I could do that - I'm sure an Air Ambulance paramedic could too". I'm sure he could, after the appropriate amount of training. Training that will come to the fore not on nice days like the ones shown but on sh1tty days where it's all going wrong. Can the Air Ambulance charities afford the 100 hours or so per crew member required to turn them into fledgling SAR crew? Do these charities then have the time and money to devote to ensuring that this fledgling SAR crew have adequate continuation and currency training? These are perishable skills you know. Aviation is littered with the corpses of people who have bitten off more than they could chew and when an inexperienced crew get 'rescue fever' and envisage their names in the papers, common sense doesn't always prevail.
Factor in all the other points about performance, lack of cabin space etc and you'll see that although the Air Ambulance publicity men might get all moist about a proposed winching capability, putting it into practice is somewhat different.
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Felt compelled to sign up just to comment on the last thread, what a load of PISH!!! how dare you say 'inexperienced crew get 'rescue fever'..... I've been flying air ambs for the last 8 years after a long career in the RAF and SAR. I agree that aviation is littered with corpses but please, do you really think that air ambulance's employ complete nuggets??
I dont see a need for a winch personally on ours but as stated ealier, in places where the geography suits, then why not bring another trade to the table??? After all, can you imagine the flak that would have come years ago even by suggesting taking people to hospital by helicopter.
This forum seems to be filled with a lot of people who feel no one else can achieve what they have done and yet fail to realise that once upon a time they were sat with the student hat on.
Driver attendant.
I dont see a need for a winch personally on ours but as stated ealier, in places where the geography suits, then why not bring another trade to the table??? After all, can you imagine the flak that would have come years ago even by suggesting taking people to hospital by helicopter.
This forum seems to be filled with a lot of people who feel no one else can achieve what they have done and yet fail to realise that once upon a time they were sat with the student hat on.
Driver attendant.
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Air Ambulances would have to go from having a pilot and two paramedics to a SAR trained pilot...
The pilot would need to have completed an approved winching course and the recurrent training. If the Air Ambulances in the UK want to winch because they believe it will give them an increase capability and they have completed their own feasibility study and on-going risk assessments then why not? The SAR Pilots course whilst necessarily comprehensive would be unnecessary in length and content for the limited day onshore winching that the Air Ambulances are considering, which would be more than covered by a CAA approved tailored course.
This subject is quite an emotive one with some who would deride the possibility of other agencies expanding into "their" area, personally as this will save lives I'm in the "For" camp.
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At the risk of offending some of our UK cousins, it seems to me that having your CAA not letting (or putting up roadblocks) in fitting of winches (and thus the use of winches for life saving purposes in areas where you can't land) is extremely daft.
Around the world, civilian helicopters have been successfully winching for 50 years, and most (if not all) EMS helicopters I know of have the capability. Yes, it does cost in the installation, initial and ongoing training but if a charity/organisation wishes to pay for it, then why not. The training is not difficult and the normal crew in Oz for day and night ops is a Pilot (look at me I can hover above these trees without moving too much), a winchman and the paramedic who goes down the wire.
I am suprised the Met's new 145's are not allowed to winch or fast rope as I believed that was what they were purchased for. Doesn't the CAA realise that you don't need to be a wunderbar pilot (or crew) to do the role.
Just my point of view but I would feel a bit naked if I left my winch at home.
Around the world, civilian helicopters have been successfully winching for 50 years, and most (if not all) EMS helicopters I know of have the capability. Yes, it does cost in the installation, initial and ongoing training but if a charity/organisation wishes to pay for it, then why not. The training is not difficult and the normal crew in Oz for day and night ops is a Pilot (look at me I can hover above these trees without moving too much), a winchman and the paramedic who goes down the wire.
I am suprised the Met's new 145's are not allowed to winch or fast rope as I believed that was what they were purchased for. Doesn't the CAA realise that you don't need to be a wunderbar pilot (or crew) to do the role.
Just my point of view but I would feel a bit naked if I left my winch at home.
I believe the problem will come when deciding where to draw the line on when to winch and when not to. The argument about 'where geography suits' is going to mean the Peak District and some of Cumbria as well as scores of other places well inland away from SAR flights and with poor road access.
So, whilst there may be many occassions where it is difficult to land on but easy to winch with 10 to 50 feet of cable, where does the non-SAR trained crew stop and say no? This is the rescue fever that Vie speaks of, if you have a casualty on a steep hillside or cliff on a turbulent day in crappy weather and you have a winch on the side of the aircraft, do you go for it anyway and put the crew and casualty at more risk than on your normal operations or do you wait for a SAR crew?
Do your rearcrew acknowledge the extra personal risk involved in dangling 50 feet or more on a wire?
One argument is that 'If it saves one life then it is worth it' but the counter-argument is that 'If it costs one life then it is too expensive' must also be considered.
If an inexperienced winch-op (since he is the crucial element in winching, not the pilot) injures or kills his winchman and/or the casualty because the crew had a winch and didn't think they should wait for SAR, what damage will that do do the excellent reputation of Air Ambs across UK?
All helicopter pilots can hover over land but winch-opping is a specialist skill that requires lots of training and plenty of practice. If the charities want to fund it then crack on but don't expect miracles. If it were me, I would make sure they all did a full SAR winch-ops course with annual competency checks.
So, whilst there may be many occassions where it is difficult to land on but easy to winch with 10 to 50 feet of cable, where does the non-SAR trained crew stop and say no? This is the rescue fever that Vie speaks of, if you have a casualty on a steep hillside or cliff on a turbulent day in crappy weather and you have a winch on the side of the aircraft, do you go for it anyway and put the crew and casualty at more risk than on your normal operations or do you wait for a SAR crew?
Do your rearcrew acknowledge the extra personal risk involved in dangling 50 feet or more on a wire?
One argument is that 'If it saves one life then it is worth it' but the counter-argument is that 'If it costs one life then it is too expensive' must also be considered.
If an inexperienced winch-op (since he is the crucial element in winching, not the pilot) injures or kills his winchman and/or the casualty because the crew had a winch and didn't think they should wait for SAR, what damage will that do do the excellent reputation of Air Ambs across UK?
All helicopter pilots can hover over land but winch-opping is a specialist skill that requires lots of training and plenty of practice. If the charities want to fund it then crack on but don't expect miracles. If it were me, I would make sure they all did a full SAR winch-ops course with annual competency checks.
Sure the friends and enemies will find a lot of pro and contra but winching or shorthaul are normal procedures for not so few air rescue units across Europe and believe me the conditions in the UK are not so different compared to other countries from Scandinavia to Italy.
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It's important that people realise exactly what's being considered here before jumping to conclusions. A HEMS tasking can be either transporting a patient or delivering medical aid to the incident site.
All that has been asked for is the ability to deliver a member of the medical aircrew or equipment to an incident where the aircraft would not be able to land, and get said medical man back out again if necessary. In other words, winch him down and maybe back up again.
That's it. No winching up of stretchers, patients etc into the aircraft. No night winching, no cliff-face winching, no IFR winching, no maritime winching, no winching off seamen from capsizing yachts in Force 10 gale 70 miles out into the Atlantic, no "poaching" of patients from the RAF, MCA or any other acronym you care to mention. No anything else at all.
If it proves to be a white elephant that takes up lots of funds for training and is never used "in anger" then it will be dropped and funds channelled elsewhere.
If it works and actually adds something to the service then great build up experience and maybe later add a little bit more like lifting the patient/stretcher out of the inaccessible area when necessary and placing them in a more suitable area from where they can be physically lifted into the aircraft if transporting is deemed necessary.
All that has been asked for is the ability to deliver a member of the medical aircrew or equipment to an incident where the aircraft would not be able to land, and get said medical man back out again if necessary. In other words, winch him down and maybe back up again.
That's it. No winching up of stretchers, patients etc into the aircraft. No night winching, no cliff-face winching, no IFR winching, no maritime winching, no winching off seamen from capsizing yachts in Force 10 gale 70 miles out into the Atlantic, no "poaching" of patients from the RAF, MCA or any other acronym you care to mention. No anything else at all.
If it proves to be a white elephant that takes up lots of funds for training and is never used "in anger" then it will be dropped and funds channelled elsewhere.
If it works and actually adds something to the service then great build up experience and maybe later add a little bit more like lifting the patient/stretcher out of the inaccessible area when necessary and placing them in a more suitable area from where they can be physically lifted into the aircraft if transporting is deemed necessary.
Flaxton - if your AA is going to take this task on then surely you have a weight of evidence to support using these funds in the first place. There must have been sufficient numbers of jobs (rather than just the odd one or two) where the winch would have significantly enhanced your ability to provide medical care. If not then it would seem irresponsible to use donated funds on the off chance that you might use the capability.
If all you intend to do is save the paramedic/doctor a bit of a walk then the extra risk is, in my view, unjustified. Will they get paid more for the added reponsibility of winching/being winched and will their extra life insurance premiums be paid by the charity?
Tec-pilot the main difference is that there is a fully established SAR system in UK for onshore work as well as offshore to provide this capability whereas in many areas of Europe there is not.
If all you intend to do is save the paramedic/doctor a bit of a walk then the extra risk is, in my view, unjustified. Will they get paid more for the added reponsibility of winching/being winched and will their extra life insurance premiums be paid by the charity?
Tec-pilot the main difference is that there is a fully established SAR system in UK for onshore work as well as offshore to provide this capability whereas in many areas of Europe there is not.
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Crabb
I thought that the primary role for Mil SAR UK was recovery and rescue of 'downed' sevice personnel. It seems because the SAR have 'winch' capability that 'in time of need inland' no rescue agencies had anybody else to turn to for winch capability, it has now become apparent that 'flaxton flyer' is painting a diffrent picture. i don't know of any ruling that the mil SAR has overall rights to do all the uk winching inland unless you can advise me any different !
It seems times are changing and there is a need to put specialist teams, Ie USAR www.usar.org.uk personnel into areas that are inaccesible. Mil SAR are not always available. It seems we overlook the patients who are 'time critical' or who would benefit from intervention within the GOLDEN HOUR
I thought that the primary role for Mil SAR UK was recovery and rescue of 'downed' sevice personnel. It seems because the SAR have 'winch' capability that 'in time of need inland' no rescue agencies had anybody else to turn to for winch capability, it has now become apparent that 'flaxton flyer' is painting a diffrent picture. i don't know of any ruling that the mil SAR has overall rights to do all the uk winching inland unless you can advise me any different !
It seems times are changing and there is a need to put specialist teams, Ie USAR www.usar.org.uk personnel into areas that are inaccesible. Mil SAR are not always available. It seems we overlook the patients who are 'time critical' or who would benefit from intervention within the GOLDEN HOUR
jackjack - that downed military personnel was the original concept of ops but we have moved on from WW2 - 95% minimum of our jobs are civilian rescues and more than half are inland. It may still be our priority but it is not a very regular occurence.
We don't have automatic rights to overland winching but we are the only ones to do it at night and will be in the future, regardless of how many AA get winches.
This is not a protectionist standpoint, SAR and AA fulfill different roles with a small amount of capability crossover - I believe the need for AA winching does not justify the cost or the extra risk to the crews.
USAR teams are likely to be at least as big as MIRG teams and therefore you need a big helicopter to get them and any kit in, so SAR (whether mil or not) will still be the answer. Some Fire Brigades have mooted the idea of having their own dedicated helicopters but, since government funding for normal Fire Brigade ops is dwindling, this is unlikely to come to fruition since the capability (in the form of SAR) alrerady exists.
We don't have automatic rights to overland winching but we are the only ones to do it at night and will be in the future, regardless of how many AA get winches.
This is not a protectionist standpoint, SAR and AA fulfill different roles with a small amount of capability crossover - I believe the need for AA winching does not justify the cost or the extra risk to the crews.
USAR teams are likely to be at least as big as MIRG teams and therefore you need a big helicopter to get them and any kit in, so SAR (whether mil or not) will still be the answer. Some Fire Brigades have mooted the idea of having their own dedicated helicopters but, since government funding for normal Fire Brigade ops is dwindling, this is unlikely to come to fruition since the capability (in the form of SAR) alrerady exists.
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Crab -
We have a traction splint on the aircraft on on the off-chance we might need it. We have a KED on the aircraft on the off-chance we might need it. (I can remember using it once in two and a half years)We will have a winch on the aircraft for the same reason. Different finances, same concept.
Saving the paramedic a bit of a walk...The whole point of the initial phase of this trial is to get the paramedic and kit to the inaccessible patient in the shortest time possible. I'm sure you would have no trouble fighting your way up 200 metres of steep, wet, boggy, bracken covered hillside carrying a 30lb+ rucksack full of gear, but the average paramedic does. Discounting the time involved, they would probably be needing medical care themselves. How is that helping the patient?
As said, if it proves feasible, safe and a useful addition to our service we will look at lifting the patient to a more accessible location for loading.
Very public-spirited of you to question the use of "donated funds". But then again you don't know how the funding for this project was raised, now do you? Assumption can be a terrible thing, Crab.
Any funds donated from the public to run the operation (which I guess is where you are aiming with this) are freely given to spend as the Trustee board feel is appropriate. If the public don't like what the money is being spent on, they have a right not to donate.
Risk and expense justified? We'll have to wait and see. But even if it only helps to save one life a year wouldn't that be justification enough? (For the expense that is - I appreciate your earlier comments about balancing possible saving of life against possible loss of rescuer's life)
Oh and consider this - every hour we spend sat on lonely hillsides waiting for Fell / Mountain resue teams to arrive to help extricate a patient from a difficult location is an hour off-line where somebody else may need our help.
And no, that is not a dig at those agencies who, do a stirling job, it' s just a fact.
We have a traction splint on the aircraft on on the off-chance we might need it. We have a KED on the aircraft on the off-chance we might need it. (I can remember using it once in two and a half years)We will have a winch on the aircraft for the same reason. Different finances, same concept.
Saving the paramedic a bit of a walk...The whole point of the initial phase of this trial is to get the paramedic and kit to the inaccessible patient in the shortest time possible. I'm sure you would have no trouble fighting your way up 200 metres of steep, wet, boggy, bracken covered hillside carrying a 30lb+ rucksack full of gear, but the average paramedic does. Discounting the time involved, they would probably be needing medical care themselves. How is that helping the patient?
As said, if it proves feasible, safe and a useful addition to our service we will look at lifting the patient to a more accessible location for loading.
Very public-spirited of you to question the use of "donated funds". But then again you don't know how the funding for this project was raised, now do you? Assumption can be a terrible thing, Crab.
Any funds donated from the public to run the operation (which I guess is where you are aiming with this) are freely given to spend as the Trustee board feel is appropriate. If the public don't like what the money is being spent on, they have a right not to donate.
Risk and expense justified? We'll have to wait and see. But even if it only helps to save one life a year wouldn't that be justification enough? (For the expense that is - I appreciate your earlier comments about balancing possible saving of life against possible loss of rescuer's life)
Oh and consider this - every hour we spend sat on lonely hillsides waiting for Fell / Mountain resue teams to arrive to help extricate a patient from a difficult location is an hour off-line where somebody else may need our help.
And no, that is not a dig at those agencies who, do a stirling job, it' s just a fact.
Last edited by Flaxton Flyer; 7th Feb 2008 at 10:33.
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It sounds like someone has done a lot of research on this subject and somebody will of put a solid case forward to the CAA for approval, whichever AA or 135 it is !
I can only say that having options for treatment of patients is paramount and if this extra 'add-on' gives the team that, then I say Well Done. Thinking ouside the box helps develop new and innovative ways of dealing with patients.
The echoes of 'It can't be done by civvies' is obviously going to change.
Well done to those who carried on fighting through the CAA red tape and came out the other side smiling.
I can only say that having options for treatment of patients is paramount and if this extra 'add-on' gives the team that, then I say Well Done. Thinking ouside the box helps develop new and innovative ways of dealing with patients.
The echoes of 'It can't be done by civvies' is obviously going to change.
Well done to those who carried on fighting through the CAA red tape and came out the other side smiling.
Flaxton - if you use the KED or the traction splint inappropriately you don't put the crew at increased risk nor do you endanger the life of the patient so your analogy is invalid. As it happens ours get used quite a lot.
My remark about saving the paramedic a walk was intentionally flippant but you haven't answered the question about showing a need for the winch before spending the money on it. Yes the trustees can use the donations as they wish (we've been round this buoy before) but what will you do if the winching goes wrong and the public stop donating? Your remark about the public having a right not to donate is rather arrogant - have you asked them all if they want to pay for the extra capability?
You are also changing your tune since you stated previously that the winch would only be used to deploy the paramedic, now you talk about repositioning the casualty as well - this is the sort of mission creep that turns into full blown rescue attempts.
And you want to do the fell/mountain rescuers jobs for them as well - if the casualty is in an inaccessible place then call a SAR heli while you maintain your standby for jobs you are equipped to do.
As I strive to remind our crews, knowing when to say no is the most difficult part of being in the rescue business - I think the addition of the winch to AA will make it far more difficult for your crews to do this.
My remark about saving the paramedic a walk was intentionally flippant but you haven't answered the question about showing a need for the winch before spending the money on it. Yes the trustees can use the donations as they wish (we've been round this buoy before) but what will you do if the winching goes wrong and the public stop donating? Your remark about the public having a right not to donate is rather arrogant - have you asked them all if they want to pay for the extra capability?
You are also changing your tune since you stated previously that the winch would only be used to deploy the paramedic, now you talk about repositioning the casualty as well - this is the sort of mission creep that turns into full blown rescue attempts.
And you want to do the fell/mountain rescuers jobs for them as well - if the casualty is in an inaccessible place then call a SAR heli while you maintain your standby for jobs you are equipped to do.
As I strive to remind our crews, knowing when to say no is the most difficult part of being in the rescue business - I think the addition of the winch to AA will make it far more difficult for your crews to do this.
FF wrote
So just how often go you propose to train with the hoist? Once/twice a blue moon?
I can just imagine the conversation in your aircraft. Something like, " I've seen them do this on Seaside Rescue, no problem for us! O.K. left a bit, a bit more, whats that noise?? Oh S
t!!"
It's not a dark art but does need regular practice.
We have a traction splint on the aircraft on on the off-chance we might need it. We have a KED on the aircraft on the off-chance we might need it. (I can remember using it once in two and a half years)We will have a winch on the aircraft for the same reason. Different finances, same concept.
I can just imagine the conversation in your aircraft. Something like, " I've seen them do this on Seaside Rescue, no problem for us! O.K. left a bit, a bit more, whats that noise?? Oh S
t!!"It's not a dark art but does need regular practice.
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Crabb
if you use the KED or the traction splint inappropriately you don't put the crew at increased risk nor do you endanger the life of the patient
Your comment above shows how little knowledge you have of the devices you say you use.
The KED is an inline immobilisation device for the extrication or rescue of a suspected spinal injury patient. used incorrectly, permenant disability to the patient can be the end result.
The traction splint is used for long bone fractures, any other associated fractures can be compromised by this device, IE fractured pelvis. using this device with a long bone injury and a pelvis fracture can cause that much blood loss that the patient could die in your arms. Not nice !
It seems that everyone is centred around the recurrent training. I would think that whoever/whenever this begins the CAA will have already approved a recognised training programme and put in BIG black letters the amount of minimum recurrency training for each winch operative per month/per annum.
if you use the KED or the traction splint inappropriately you don't put the crew at increased risk nor do you endanger the life of the patient
Your comment above shows how little knowledge you have of the devices you say you use.
The KED is an inline immobilisation device for the extrication or rescue of a suspected spinal injury patient. used incorrectly, permenant disability to the patient can be the end result.
The traction splint is used for long bone fractures, any other associated fractures can be compromised by this device, IE fractured pelvis. using this device with a long bone injury and a pelvis fracture can cause that much blood loss that the patient could die in your arms. Not nice !
It seems that everyone is centred around the recurrent training. I would think that whoever/whenever this begins the CAA will have already approved a recognised training programme and put in BIG black letters the amount of minimum recurrency training for each winch operative per month/per annum.
FF, I take it that if this goes ahead you will then have to carry a winch op in the back of the A/C as well as the Medic? Will you have the space and the payload available, or will the front seat medic also do the winching?
Just curious as I drive a 135 and don't think that the Police cabs would have the capability without taking a big hit on the fuel.
Just curious as I drive a 135 and don't think that the Police cabs would have the capability without taking a big hit on the fuel.
Crab,
only in the very small countries of Europe we find not an immediate military SAR system. But from Norway to Italy and from Poland to Portugal military and civ air rescue units working hand in hand. And nearly everywhere the military decrease his engagement due to other problems in the last years pleased about mor civ power.
In the UK it seems more like a struggle about future funds? I donīt feel rescue times of 60 minutes like in the military SAR system in some areas are ok. Civ rescue operators are able to bring help in 10 to 15 minutes.
But there are no questions, the mil have done a superb job in the last decades and it will need years for civ operators to reach the same power and skills. But itīs possible, why not?
Timex,
(rescue) winching is done regularly by police units in Europe, also and especially with EC 135. Also under NVG and in high altitudes. Of course with limited weight.
only in the very small countries of Europe we find not an immediate military SAR system. But from Norway to Italy and from Poland to Portugal military and civ air rescue units working hand in hand. And nearly everywhere the military decrease his engagement due to other problems in the last years pleased about mor civ power.
In the UK it seems more like a struggle about future funds? I donīt feel rescue times of 60 minutes like in the military SAR system in some areas are ok. Civ rescue operators are able to bring help in 10 to 15 minutes.
But there are no questions, the mil have done a superb job in the last decades and it will need years for civ operators to reach the same power and skills. But itīs possible, why not?
Timex,
(rescue) winching is done regularly by police units in Europe, also and especially with EC 135. Also under NVG and in high altitudes. Of course with limited weight.