Helicopter can't climb
Joined: Sep 2023
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From: Montana
we had specific assigned transponder codes,
The question being are we an aircraft that has medical crew on board or are we a flying ambulance.
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From: Once a Squirrel Heaven (or hell!), Shropshire UK
2 Points:
Firstly there were certainly occasions as others have mentioned when transporting patients with major conditions requiring oxygen where I was asked to go 'as low as possible', and definitely not above 1000ft, and on one occasions taking a VSI young child down from Sheffield to the HLS for Great Ormond Street Hospital for Children in London when I was asked to try to stay below 500ft AMSL - we were able to plan a route whilst the medical team boarded, although it was very tight on fuel, which included a straight line through the London TCZ (and between high rise buildings) which was immediately cleared by Heathrow including diverting landing traffic.
Secondly using a 'Rescue' callsign and Squawk on missions in the UK usually (always) gave you priority through almost any airspace on direct track (apart from USAF base Woodbridge that wanted me to land and file a flight plan before entering their MATZ - we also told them to keep the approach pattern clear whilst we winched people off a sinking vessel just off shore; they weren't happy).
Firstly there were certainly occasions as others have mentioned when transporting patients with major conditions requiring oxygen where I was asked to go 'as low as possible', and definitely not above 1000ft, and on one occasions taking a VSI young child down from Sheffield to the HLS for Great Ormond Street Hospital for Children in London when I was asked to try to stay below 500ft AMSL - we were able to plan a route whilst the medical team boarded, although it was very tight on fuel, which included a straight line through the London TCZ (and between high rise buildings) which was immediately cleared by Heathrow including diverting landing traffic.
Secondly using a 'Rescue' callsign and Squawk on missions in the UK usually (always) gave you priority through almost any airspace on direct track (apart from USAF base Woodbridge that wanted me to land and file a flight plan before entering their MATZ - we also told them to keep the approach pattern clear whilst we winched people off a sinking vessel just off shore; they weren't happy).
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From: Yorkshire
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From: Den Haag
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From: Australia
Sorry AC your first paragraph is incorrect. Decompression to 8000 feet as in FW can be a significant issue for spontaneously breathing patients and those with air inside cavities in the wrong place such as the abdomen, but below 3000 feet there is no clinical reason at all not to climb to 3000 ish. I will leave the aviation aspects to my esteemed colleagues
The people I work with are incredibly professional and would not request this if they did not think it was required.
Joined: Aug 2000
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From: A very long way North
In the UK, the callsign has a suffix which denotes whether a helimed is enroute to an incident, enroute to hospital with a casualty, or just in transit to base (see https://www.caa.co.uk/publication/do...%2001%E2%80%9D). I would hope, but don't know for sure, that when a casualty is onboard, some kind of priority will be assigned to the flight.
“Are you Cat A?”, the response:
”Very much so”
”standby…”
about 20 seconds later
”route direct to {whichever hospital it was, Royal Something}
No idea how many airliners were on approach at that point, but there was no hesitation, send them around.
Joined: Sep 2001
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From: Yorkshire
I disagree with this statement. I am not a clinician but have flown for 10 years with them. There have been plenty of times height has been an issue and while not often, I have had request for as low as possible been 500ft AGL, normally it’s associated with certain TBI’s or Hemothorax
The people I work with are incredibly professional and would not request this if they did not think it was required.
The people I work with are incredibly professional and would not request this if they did not think it was required.
Sorry AC your first paragraph is incorrect. Decompression to 8000 feet as in FW can be a significant issue for spontaneously breathing patients and those with air inside cavities in the wrong place such as the abdomen, but below 3000 feet there is no clinical reason at all not to climb to 3000 ish. I will leave the aviation aspects to my esteemed colleagues
I am both a clinician (anaesthetist) and aviator (CPL/FI).
Anecdotal evidence does not carry any scientific value.
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From: HLS map - http://goo.gl/maps/3ymt
Radgirl is correct.
I am both a clinician (anaesthetist) and aviator (CPL/FI).
Anecdotal evidence does not carry any scientific value.
I am both a clinician (anaesthetist) and aviator (CPL/FI).
Anecdotal evidence does not carry any scientific value.
Seems odd they use the term altitude ‘above the ground level’, where ground level has nothing to do with it unless relative and flying over a totally flat surface. I interpret they mean altitude.
Thread Starter
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From: USA
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From: Canada
While not standard practice we were often asked by the ALS medics to transit “as low as possible”. Usually +-500 /1000 ft AGL kept everyone happy day VMC.
When transporting a scuba diver suffering from “The Bends” we stayed pretty darn low all the way to the nearest decompression chamber at VNE. These were very infrequent trips but procedure, location of chambers ( there were 3 in our area ), helipads etc. were well covered in crew training briefings whenever new crew came onboard.
When transporting a scuba diver suffering from “The Bends” we stayed pretty darn low all the way to the nearest decompression chamber at VNE. These were very infrequent trips but procedure, location of chambers ( there were 3 in our area ), helipads etc. were well covered in crew training briefings whenever new crew came onboard.
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From: Here
Not having a go at you, but I want to assess the authority of your info.
Your stated areas of expertise give you some authority in this discussion, but
are you Av Med qualified, Diving Med qualified, &/or AME qualified and current?
Joined: Sep 2001
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From: Yorkshire
Best patient outcome is obtained by following evidence based guidelines (evidenced based medicine).
There is minimal high quality, peer reviewed, published research to support the need for low level transfers.
A risk/benefit analysis would show that any perceived clinical benefit is far out-wayed by the increased risks associated with low level flying.
Joined: Feb 2022
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From: Here
Fair point, I have no direct expertise or experience in aeromedical transfer.
Best patient outcome is obtained by following evidence based guidelines (evidenced based medicine).
There is minimal high quality, peer reviewed, published research to support the need for low level transfers.
A risk/benefit analysis would show that any perceived clinical benefit is far out-wayed by the increased risks associated with low level flying.
Best patient outcome is obtained by following evidence based guidelines (evidenced based medicine).
There is minimal high quality, peer reviewed, published research to support the need for low level transfers.
A risk/benefit analysis would show that any perceived clinical benefit is far out-wayed by the increased risks associated with low level flying.
Thus we are left with theory, and doing the least harm.
Of course aircrew safety is vital and must be a major part of the equation.
However a blanket statement that it is safe to transport at 3000ft, especially when we do not know what particular medical condition we are talking about, seems unwarranted.
Possibly there is evidence based material that would make that a safe protocol, but I am not aware of such info. However I am no longer current and up with the literature or protocols.
It is too important a decision to be referred to here unless we have input from people doing it actively and currently. I fear aircrew will be put in an invidious position unless we post on this subject with actual current expertise.
I for one will be interested in the protocols for transport of suspected acute DCS/DCI & CAGE patients, amongst others.
Joined: Jan 2008
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From: LONDON
If there is minimal evidence based, peer review literature to support, there is also minimal peer reviewed research to refute the need for altitude restriction in AME.
Thus we are left with theory, and doing the least harm.
However a blanket statement that it is safe to transport at 3000ft, especially when we do not know what particular medical condition we are talking about, seems unwarranted.
Possibly there is evidence based material that would make that a safe protocol, but I am not aware of such info. However I am no longer current and up with the literature or protocols.
Thus we are left with theory, and doing the least harm.
However a blanket statement that it is safe to transport at 3000ft, especially when we do not know what particular medical condition we are talking about, seems unwarranted.
Possibly there is evidence based material that would make that a safe protocol, but I am not aware of such info. However I am no longer current and up with the literature or protocols.
Joined: Jan 2024
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From: Finland
While it’s based on anecdotal evidence, we can conclude that the medical crew do occasionally request low altitude due to the condition of the patient. It is irrelevant if that is a researched fact or an opinion of the medical crew, the flight crew will anyway do their best to heed that request if it doesn’t add unproportional risk to the mission.
Flying at 500” AGL when in day VMC is usually not an increased risk for competent crew.
Flying at 500” AGL when in day VMC is usually not an increased risk for competent crew.
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From: Kiwiland
Thank you to those who have posted replies - they have brought a smile to my face, and in some cases led me to choke on my breakfast. When I was running aeromedical services we provided a short course for pilots on the effects of air transportation on sick patients as well as trying to teach them common terms the back of the cabin might use. We also insisted all medical crew had some basic aviation knowledge - not to fly the aircraft but to understand the effects of attitude as well as altitude, ATC restrictions, crew duty hours etc etc. Then we put in place a Chinese wall so the front were not aware of the patient's condition and the rear were ignorant of fuel, weather, etc et on a particular flight.
Sadly it seems some medical crew are ignorant of pressure changes and even how to use a balloon pump. In one FW service I am aware of they routinely pressurise to sea level. Clearly this is resulting in risk for RW when pilots understandably have to follow such requests. May be these courses need to be resuscitated......
Sadly it seems some medical crew are ignorant of pressure changes and even how to use a balloon pump. In one FW service I am aware of they routinely pressurise to sea level. Clearly this is resulting in risk for RW when pilots understandably have to follow such requests. May be these courses need to be resuscitated......
Avoid imitations
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From: Wandering the FIR and cyberspace often at highly unsociable times
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From: EGDC
Agreed Shy.
I asked the question about bendy divers many years ago and contacted experts in the field at a decompression centre in Ireland so I could give best advice to the rest of the RAF SAR Force. Generally remaining below 500' was the best option but a short excursion higher could be tolerated as long as it wasn't too high or for too long and oxygen was available.
When a highly trained medical professional asks you to do something as a pilot to protect your casualty, why would you ever question it if it is safe for you to comply?
I asked the question about bendy divers many years ago and contacted experts in the field at a decompression centre in Ireland so I could give best advice to the rest of the RAF SAR Force. Generally remaining below 500' was the best option but a short excursion higher could be tolerated as long as it wasn't too high or for too long and oxygen was available.
When a highly trained medical professional asks you to do something as a pilot to protect your casualty, why would you ever question it if it is safe for you to comply?
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From: Texas
That won't help you during a lawsuit, so maybe you and the pedant can curb your enthusiasm.