"Helicopter and crew put at great risk to rescue man with indigestion."
Join Date: Oct 2012
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In the civilian systems I have worked, the management decided what was accepted. I presume here HMG has decided to provide SAR whenever the ground services feel it needed
The doctor has then decided whether there is a clinical need and if so passed the request to the aircrew. The pilot has decided whether the flight can be undertaken but he (she) has not been told who the patient is nor why they need transportation. Equally the medical crew has never been told of any aviation issues such as deteriorating weather, maintenance etc. This Chinese wall has not been foolproof but has IMHO reduced risk. We didnt launch if there was a risk.
We are talking about a civilian patient requesting NHS care, not a theatre of war, nor a sinking ship. Do you really launch and push the boundary because it is a sick patient??? The patient's pathology was irrelevant...... If you wouldnt position for maintenance in that weather should you launch for a patient....
The doctor has then decided whether there is a clinical need and if so passed the request to the aircrew. The pilot has decided whether the flight can be undertaken but he (she) has not been told who the patient is nor why they need transportation. Equally the medical crew has never been told of any aviation issues such as deteriorating weather, maintenance etc. This Chinese wall has not been foolproof but has IMHO reduced risk. We didnt launch if there was a risk.
We are talking about a civilian patient requesting NHS care, not a theatre of war, nor a sinking ship. Do you really launch and push the boundary because it is a sick patient??? The patient's pathology was irrelevant...... If you wouldnt position for maintenance in that weather should you launch for a patient....
EASA And their predecessors did a lot of work in developing a 'risk philosophy' for HEMS and Air Ambulance taskings Page 1147. The underlying principle is that the aviation risk should always be proportional to the task. Agreed - no heroes, but to say that a genuine HEMS tasking should meet the same risk profile as a maintenance flight, or indeed an air ambulance flight is misguided. There are a number of areas where additional risk is permitted, rightly so in my opinion, for taskings meeting HEMS, many of which apply to 3rd parties on the ground, I shan't list them but if you're interested (as someone who's been working in the field a long time) you may wish to have a peruse of the linked document's section on the HEMS philosophy.
I agree that HEMS aircraft are all too often sent to patients who don't meet the criteria, but this is poor tasking, and they should be downgraded and therefore not afforded the exemptions if the most up to date information given suggests it's not a HEMS job. However, when it is a time critical head injury and you need to get that person to a proper Neuro unit there exist plentiful jobs where the exemptions, and added risk profiles are well warranted.
Having experienced the sort of indigestion which seems exactly like a heart attack, severe pain in the chest and left arm and sweats, I am not surprised that the emergency services give it their best shot. In my case, late on a Friday evening, they sent an ambulance and paramedic. By the time they arrived I was feeling a bit better but it was good to get confirmation that all was well. If I had been halfway up a mountain in a severe snowstorm I like to think that I would have done my best to cancel the ambulance as soon as I started to improve.
Homonculus - I take your points regarding HEMS tasking but this thread is about a CG SAR helicopter doing SAR
you often launch on minimal information (not even a very accurate position).
If a walker falls and injures their leg and their companion dials 999 - they may think it is a broken leg even if it is just a twisted ankle but you won't know until you get there. At what point do you turn round and go home? A much trickier decision than some seem to believe.
If Emergency services are on scene then the crew can get real-time medical information via Airwave or by phone through the coastguard.
I have been called out to someone who 'had their arm bitten off by a horse' (nothing of the sort, just a fall), 'has been gored by a bull' (got caught between a big cow and a fence) and 'a person trapped in a flooded carpark' (Boscastle). And 250 nm off the West coast of Ireland for a merchant seaman with appendicitis (he walked off the aircraft at the hospital and discharged himself from their care as there was nothing wrong with him). You just never know........
If a walker falls and injures their leg and their companion dials 999 - they may think it is a broken leg even if it is just a twisted ankle but you won't know until you get there. At what point do you turn round and go home? A much trickier decision than some seem to believe.
If Emergency services are on scene then the crew can get real-time medical information via Airwave or by phone through the coastguard.
I have been called out to someone who 'had their arm bitten off by a horse' (nothing of the sort, just a fall), 'has been gored by a bull' (got caught between a big cow and a fence) and 'a person trapped in a flooded carpark' (Boscastle). And 250 nm off the West coast of Ireland for a merchant seaman with appendicitis (he walked off the aircraft at the hospital and discharged himself from their care as there was nothing wrong with him). You just never know........
That philosophy has kept me and the crew alive through 25 years of medicine and aviation as well as saved countless lives, without accepting increased risk. If I wouldn't do the flight as a positioning, ferry or maintenance flight due to operational risk from weather, environment, fuel range, whatever; I wouldn't do it on-task either. I've seen enough people die 'heroically' to know there's phuck-all heroic about dying for this job.
So how would you approach a night job in the mountains in low light levels and just acceptable conditions - there is plenty of risk and you are searching for a missing walker who may or may not be injured?
HEMS isn't SAR, a great deal of routine SAR carries risk above and beyond what a HEMS pilot might accept - but the risks are accepted as a crew and everyone has a say.
HEMS isn't SAR, a great deal of routine SAR carries risk above and beyond what a HEMS pilot might accept - but the risks are accepted as a crew and everyone has a say.
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HEMS isn’t SAR
So true and that’s why in most parts of the world they are regulated differently. However as SAR provision increasingly becomes part of the commercial rather than (para)military world the appetite for risk becomes more difficult to manage and assure.
So true and that’s why in most parts of the world they are regulated differently. However as SAR provision increasingly becomes part of the commercial rather than (para)military world the appetite for risk becomes more difficult to manage and assure.
I couldn't disagree more.
It may be a commercial helicopter provider, but whether it is Bristow's or CHC, they are (9.9 times out of 10) providing the service on behalf of the parapublic agency such as the coastguard etc - with their risk management matrix, SOP's et al.
The risk appetite doesn't change overnight, because the provider has changed - although normally the technology is far more capable.
Ultimately, the decision is, rightly, in the hands of a very experienced SAR Commander.
