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S-61 rescue: One of longest missions ever?

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Old 27th Nov 2002, 09:48
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Thumbs up S-61 rescue: One of longest missions ever?

Maritime and Coastguard Agency
Press Release 26 November 2002

At 2100 hrs yesterday, the Stornoway based Coastguard Rescue helicopter "Rescue Mike Uniform" and its five crew, including a doctor, have carried out one of the longest rescue
mission ever, by a civilian helicopter.

Stornoway Coastguard were requested by the Spanish Rescue Centre in Madrid to evacuate a 22 year old crewman from the 54 metre long Spanish fishing vessel 'NUSKA' which was 287 miles West Northwest of Stornoway. The crewman had suffered a severe injury to his hand after it was caught in some machinery.

The vessel was outside the maximum range of the helicopter but the Coastguard arranged for the helicopter to refuel on the drilling rig JACK BATES that is operating 54 miles Northwest of the Butt of Lewis. Even with the extra fuel on board, the helicopter crew only had 5 minutes to evacuate the crewman before heading back to the rig for more fuel and then returning to Stornoway.
The RAF provided a Nimrod Search and Rescue aircraft, from RAF Kinloss, as top cover for Rescue Mike Uniform throughout the mission. The Nimrod located the vessel and relayed its position to the helicopter so time was not wasted trying to find the vessel.

The crew were in the air for a total of 5 hours and 40 minutes and
the distance was approximately 570 miles from take-off to landing at Stornoway, that's the equivalent of flying from Shetland to the Isle of Wight.

Stornoway Coastguard, Watch Manager, Duncan Mackay said: "This is the furthest that the rescue helicopter has gone to rescue a casualty in the 15 years that a Coastguard helicopter has been based here at Stornoway. The incident went very smoothly and the man is now in the care of the staff at the Western Isles Hospital in Stornoway.
Well done to the Crew.

Anyone know them?

Last edited by Heliport; 27th Nov 2002 at 13:27.
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Old 27th Nov 2002, 14:04
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Yes......Well done indeed.........

Reminds me of another epic trip down south a few years back......in one of those 412's with more fuel tanks than you can count.........at the time I can recall the comparison of Aberdeen - London- Frankfurt - Salzburg then a two man winch before turning around and heading back to base......from memory it took just over 30 hours, with about 16 hours of flight time.

And the wimps wanted the next day Off!!!!
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Old 27th Nov 2002, 14:56
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The lollapaluza might be this one, flown by the 106th Air Rescue Wing, 102nd Squadron, USAF based on Long Island, New York:

"In December 1994, the 106th launched two HH-60s from Gabreski Airport on a mission that would take them to Halifax, Canada and then, 750 miles out over the Atlantic to search for survivors of the Ukrainian merchant vessel Salvador Allende. The freighter had foundered and sunk in heavy seas almost 800 miles at sea. By the time the two helicopters and their crews arrived over the search area, most of the ship's crew had perished. A merchant ship picked up one survivor. After searching the sea, a survivor was spotted by an helicopter crew member and the two HH-60s prepared to put a pararescueman in the water to save him. TSgt. james Dougherty jumped into the water and retrieved the last living member of the crew. Then, the two helicopters began the arduous seven-hour return flight to Halifax, Nova Scotia. During the 14-hour mission, the two HH-60s had been refueled in flight 10 times by the wing's HC-130s. The pilots in both helicopters spent 14 hours without relief at the controls, all to save one life."

The squadron Commander, Mike Canders, is a friend, and his guys are always standing by for this kind of job. It was one of their aircraft that was depicted in the movie and book "The Perfect Storm"

See:
http://www.phil123.addr.com/106thRQW.html
 
Old 27th Nov 2002, 22:58
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The crewman had suffered a severe injury to his hand after it was caught in some machinery.
I don't want to **** on the parade, but why were the lives of five crew risked in this fashion for a hand injury? It would be interesting to know what the injury actually was, but if it was non life-threatening, the trawler should have steamed towards Stornoway until it was within a more acceptable distance for helicopter evacuation. Shouldn't it?

QDM
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Old 27th Nov 2002, 23:23
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Well this could be why:
Severance of arteries radial and ulna.
Interruption of nerves.
It might have been his dominant hand.
A crush injury whose pain control could not be managed by local treatment/analgesia.
The need for urgent restorative action.
And of course the mark one eyeball, of the medic aboard the rig.
]'I don't like the look of this one, casevac NOW'
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Old 27th Nov 2002, 23:37
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"Severance of arteries radial and ulna."
If they had been severed and still bleeding the fellow would have been dead anyway by the time the helicopter arrived. Severed limb arteries tend to go into spasm and if they don't the answer is direct pressure which will pretty much always stop the bleeding. In this case, the bleeding must have stopped as the fellow was alive when they arrived. I agree uncontrolled arterial bleeding is one of the best indications for emergency medevac. It would be interesting to know if that were the case here. From the limited info given, however, it seems doubtful.

"Interruption of nerves."
Not life-threatening.

"It might have been his dominant hand."
Irrelevant.

"A crush injury whose pain control could not be managed by local treatment/analgesia."
Severe, awful pain for one individual for a few hours more, as compared to the lives of five crew? It doesn't stack up.

"The need for urgent restorative action."
A hand injury in and of itself is not generally life threatening.

"And of course the mark one eyeball, of the medic aboard the rig."
Somebody at the Coastguard must have triaged this call. The helicopter was not dispatched on the say-so of the trawler crew alone.

I don't want to detract from this rescue, which was clearly fantastically executed by some very brave crew members, but doing this for a hand injury? I am surprised.

If it had been a pelvic and / or abdominal crush injury with a tachycardic, pale patient with low blood pressure that would be a different kettle of fish. In that case, minutes could make a difference.

QDM
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Old 27th Nov 2002, 23:45
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As my bruv was one of the duty doctors on the Stornoway Coastguard helicopter until about 8 weeks ago I will find out more.

CR
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Old 28th Nov 2002, 10:25
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Question

A job well done and carried out with great courage and skill.

I only hope that it wasn't another case of the Spanish fisherman, with his straw donkey and two tickets to the world cup, going through the revolving doors of the Accident and Emergency Unit before boarding the Iberia jet back to Madrid!! In the last month an SAR crewman broke his ankle attending a similar incident; the risks are very real and time and time again the extent of the injuries are over exaggerated.

A huge problem in the UK is that, due to language difficulties, the Spanish fishing fleet make their medical distress calls to the telemed service in Madrid. As in this case, the telemedical advice is nearly always to recommend immediate evacuation and this request is forwarded to the UK Coast Guard. It is a very brave UK doctor, or Coast Guard Watch Manager, who will overturn a medical opinion without first examining the casualty. What we have now is an issue of 'risk mitigation'. Who should make that call about whether to delay? The rescue helicopter captain rudely awoken from his bed at 3 am and expected to get airborne as soon as possible?

Does anybody have a solution?

Any of our non-uk contributors experiencing similar situations?
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Old 28th Nov 2002, 14:39
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Does anybody have a solution?
The answer has to be direct communication between a coastguard doctor and the ship with the casualty, using an interpreter in the UK if necessary. Assuming comms are taking place by a satellite phone, presumably an on-call interpreter could be patched in from home in a three-way conference call.

It is undoubtedly hard to assess a situation over a phone, but it is well nigh impossible to do so via a third hand message, relayed through another country.

I find it hard to imagine that direct communications don't already exist between the ship and the coastguard. I mean, they did have to find it and for that they had to be told where it was.

If British lives are at risk, a British decision should be made.

All this said, we still don't know the exact circumstances here.

QDM
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Old 28th Nov 2002, 22:11
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QDM

I would humbly suggest that the crew & captain would not have in anyway put themselves at undue risk.
Afterall the captain's responsibility is his crew & his aircraft, not the casualty.
They are the guys on scene, it's their call. & it's stating the obvious to say...they want to go home to their loved ones at the end of their shift!

Hats off to the Stornoway crew!!! Good job guys!
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Old 29th Nov 2002, 00:05
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The answer has to be direct communication between a coastguard doctor and the ship with the casualty, using an interpreter in the UK if necessary. Assuming comms are taking place by a satellite phone, presumably an on-call interpreter could be patched in from home in a three-way conference call.



In reality the spanish coastguard thought it was a serious case so Uk responded. If it was your hand I bet you would be cursing and balling if people said you weren't worth it.

At the end of the day the weather wasn't bad they had a rig in the right place and this meant they had the range . if that rig had not been there well they would have been no option but to delegate the mission to air to air refuel capable choppers(keflavik many extra hours) or to just abandon the poor guy to his one armmanship.

But it proves why a copter in the hebridies is vital.
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Old 29th Nov 2002, 13:02
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Several years ago was looking for information about EMS helicopters as research for a college term paper. I came across some usage guidelines on a major U.S. EMS helicopter operator’s website. They stated, as I recall that helicopters are dispatched for, car rollovers, near-drowning, motorcycle accidents, falls from 10 feet high. I know that they are currently dispatched for more than the four items on the list. The decision making process as to who gets a helicopter and who does not is a mystery to me. I have talked to several ground EMS personal and it seems once they make an initial assessment of the situation their requests are highly regarded.

It’s good to hear that everything worked out OK in this case, perhaps this will lead to a new policy on dispatching helo’s. I think in the SAR business when one gets a call for help it’s very hard to turn down. In combat SAR they do whatever it takes.

On a sad note about 10 1/2 years ago a BK117 was dispatched to a motorcycle accident on a major highway close to where I reside. It was a warm hazy summer night. The pilot caught the lighting arrest wire on high voltage lines with the skid struts and flipped over. The pilot was severely injured and the flight nurse was killed. The injured motorcyclist was taken by ground to the hospital, ironically he was released the next day.
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Old 29th Nov 2002, 21:51
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In reality the spanish coastguard thought it was a serious case so Uk responded.
Well, fair enough, if that's how the UK coastguard likes to play it. As a doctor, though, I would feel extremely uncomfortable about dispatching people into life-threatening situations which possibly aren't actually life-threatening. Assessing the criticality or otherwise of a situation remotely is a real art and you take a major risk by relying on out of house decisions.

If it was your hand I bet you would be cursing and balling if people said you weren't worth it.
Probably, but so what?

At the end of the day the weather wasn't bad they had a rig in the right place and this meant they had the range . if that rig had not been there well they would have been no option but to delegate the mission to air to air refuel capable choppers(keflavik many extra hours) or to just abandon the poor guy to his one armmanship.
You make it sound like it was no big deal, but the press release says they had five minutes only on station before they'd have run short of fuel. That sounds like a big deal to me, unless the press release was just milking it, which is always possible, I suppose.

As for abandoning the fellow to 'one armmanship', a few hours almost certainly won't make a difference in saving an arm or not.

My overall point is very simple -- on the info provided (and admittedly there may be a lot more to this which we don't know), it's questionable as to why five people were asked to risk their lives.

QDM
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Old 30th Nov 2002, 11:04
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I have to agree with QDM that if the 5-minute on scene time available has been accurately reported then that is an incredibly tight fuel margin given that it was a 5hr 40 min mission. If that was pre-planned then your fuel burn and ground speeds would only have to be 1.5% in error to see you turning around, with the casualty vessel in sight, and flying back home.

This goes back to my original point: who should make that risk assessment? The helicopter Captain will certainly have a large part to play but he, or she, is rarely in possession of the full picture.

Without discussing details, it would unfortunately appear that the actual injuries to this casualty did not merit a launch at such extreme range.
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Old 30th Nov 2002, 21:42
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This goes back to my original point: who should make that risk assessment? The helicopter Captain will certainly have a large part to play but he, or she, is rarely in possession of the full picture.
It's simple, surely? The captain clearly needs to make the final launch decision, but based on medical information provided by a UK-based, emergency medicine-trained physician, who has preferably had direct contact with the ship's crew concerned. The captain needs to know:

a) Is this person likely to die whatever I do?
b) Is prompt treatment likely to save this person's life?
c) What harm will they suffer if I evacuate them in 12 hours time when they are closer / the winds have moderated / the seas have moderated? (Delete as appropriate.)

If this doesn't already happen, then I am rather surprised that lives are put at risk in this fashion. I cannot believe that we dispatch helicopters to non life-threatening injuries, at real risk to the helicopter crew, simply on the say-so of an overseas coastguard.

QDM
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Old 30th Nov 2002, 21:52
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go or no go

Having flown on EMS jobs, may I just add my 2 cents.

On the EMS job I flew, the decision to use the helicopter rested with the MEDICAL dispatcer...... The decision to fly rested with the CAPTAIN.

Given the task/ mission/call, the captain could only offer what the a/c could do within weather and a/c limits. Regarding an extreme situation where weather was approaching or limited time available on search( fuel critical), we would pass that on to the dispatcher to either accept or reject the terms. NO COMPROMISES.

Separating the two realms of aviation and medical necessity works ideally well. On our job, the helicopter is just a resource available to the medical community.

This is the way one operation worked. However, something like a military SAR team is tasked differently and have different mandates to fill.

Just one perspective in a big world of operations!!!

D.K
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Old 30th Nov 2002, 23:46
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QDM..........

Sorry but that is against our culture..........

Everything that you seemed to mention.... that you believe belongs to the Helicopter Captains decision.....is in fact your decision.

To request the helicopter or not.........thats yours.

After you have done that......walk away with all the other stuff, as that is extra information that should not even enter the flightdeck, yet alone influence any crew.

Ask yourself......does any Airline Captain ask himself, or expect to be told that there is a particular passenger on board that just has to get to the destination!!!.... because he is a Cardiac Specialist who is going to be required for a medical procedure at the destination.....and any delay is going to be detrimental???......of course not, it would never occur.

But yet you are placing all that information on the Captain..........

I would hope that your Captains would smile politely at you and then walk away and disregard that extra baggage.

There is a well proven International policy, that EMS / SAR pilots are given the flight information, timing, destination etc....with very vague information regarding patients...[only for the planning of altitudes etc for eye and head injuries]....then the crew will respond to the limit of their training and the limitations of weather, fatigue, equipment servivability and all the other aspects that will be considered.....but the patients condition, sex, age [child etc] and relative to anyone known.......NO.

If the Medical Triaging is undertaken correctly [ I accept there will always be some vagueness with international ops]........the helicopter will only be sent on worthwhile tasks.

And the crews will always come home.
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Old 1st Dec 2002, 06:34
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I was a flight physician on our rescue helicopter here in Cairns, Aust, for 5 years and I can add a little light on the thought processes that go on before a flight is committed. I have to say though that these points are not cast in stone and vary from service to service and crew to crew.

A comment about the case in question - Despite it 's apparent non-lifethreatening nature, the injury as described is a very significant one. Dual neurovascular bundle loss (ie: both radial and Ulna arteries and their accompanying veins and nerves) is 100% certain of loss of the hand if circulation is not restored by microsurgery within a few hours. Actual time depends on a number of factors but is in the order of four to six hours. Death of the hand could be lifethreatening if that time is exceeded from death of the hand and release of toxic breakdown products and infection. Low odds I agree but there none-the-less.

Would I have asked the pilot to go?
If was a long flight with refuelling available but otherwise safe - Of course
But if the trip was compromised by weather etc - no way.

Someone has already posted a list of things -
Is it life threatening etc which are all fair points so I won't repeat them.

Add to this:
Do you believe the information you have?

We regularly used to arrive at sites to find the story we had bore little resemblance to the final medical situation. Untrained people at the scene can't give a an experts opinion. Even direct communication doesn't always help. The situation was far worse than expected just as often as it was far better.


Is the problem likely to lead to some worsening condition that may demand extraction when its less safe to go. If so go early despite the seeming lower need now?

We had places which fogged in after dark so we would go early to get there and out before the fog set in.

Do you need the trip/practice?

(I don't mean for risky trips but for straight forward ones.)
This is not as silly as it sounds. You can't competently conduct difficult ops if you don't take every sensible opportunity to conduct simple ones. Simple ones were when we took new docs and nurses so they could get a feel for managing medical conditions in the hostile environment of the 412.

There were also other safety based questions like fatigue etc. and to a small degree in later years the medico-legal considerations crept in. We started, unhappily, to have to consider the legal ramifications of law siuts if we did or didn't go and there were bad outcomes.

The director of our unit was suspended, sacked, then reinstated by court order after he refused to go out to pick up a child one night when the conditions were unsafe. Child actually did fairly well in its home town and didn't suffer from the lack of retrieval but that wasn't good enough for the people at the other end and they complained to the hospital administration.

I got out of the system about then.
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Old 1st Dec 2002, 09:11
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After you have done that......walk away with all the other stuff, as that is extra information that should not even enter the flightdeck, yet alone influence any crew.
I'm just a private pilot and a doctor, but I don't see how the captain can do without this information. If the case is a 'semi-routine' one and the weather closes down the captain should have no compunction in turning back, even though he thinks he could probably make it. If, however, two people with multiple injuries are at risk of death, then that may well influence the captain's decision. I'm not saying it should, just that it may. If I was a captain I'd want to know what I was going to, and why, to aid decision-making during flight. Without that I'd feel an important piece of the jigsaw was missing. No way I'd risk my life and that of my crew for a non-urgent situation. I possibly would if people were in danger of dying.

I take your point about the difficulty of remote assessment -- it is extremely difficult and having the threat of medico-legal action hanging over your head does not make it any easier. It's a sad world when people doing their best, to acceptable standards, have to deal with this kind of stuff.

QDM
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Old 1st Dec 2002, 15:22
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to QDM

With all due respect!!!

You are confusing the captain of an aircraft responsibilities with the medical necessity.

As an ATPL-H rated pilot, one is responsible for the safe conduct of the helicopter flight...within air reg's, company sop's, etc...

Pilots are not medically trained, therefore hold no medical responsibility in an EMS/ SAR operation. Just as a doctor or medic is not responsible for how much fuel is loaded onto the a/c.

If we default to a court of law, should an a/c be intentionally flown into a lightning storm and suffer damage/ loss of life, who is responsible...... the a/c commander or the doctor/ medic in the back?

D.K.
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