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Home for Christmas Provider profile: Flight nursing and the symbols of hope
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European Air Ambulance, medevac Luxembourg New aerial ambulance service for Dutch islands operational
helicopter anyone? 24 Instrument IFR for safety, not just a last resort Cover image: A Black Hawk helicopter from Golf Company, 1st Battalion (General Support), 168th Aviation Regiment, Washington National Guard, passes by Mount Hood in Oregon, US, en route to the National Training Center, Fort Irwin, California in January 2017 (US Army National 55 Guard / Spc. Perry Gilchrist) www.airmedandrescue.com
For this issue, we bring you a military search and rescue special edition, with stories and features from p.28 onwards celebrating the lifesaving roles of servicemen and women around the world, including air force, army, navy, marine and coast guard personnel. On p.34, there’s a day in the life of Captain Nicolas Bossé, a Canadian Royal Air Force (RCAF) SAR pilot with 424 Transport and Rescue Squadron, 8 Wing Trenton. As the pilot of a CH-146 Griffon helicopter, Bossé helps Canadian Armed Forces SAR units respond to some 400 call-outs every year in central Canada, and on 19 June 2016, he was involved in a ﬁve-hour night-time mission to locate a missing jet skier. Also concerning Canada is the feature Bye bye Buffalo (p.38), looking at the background of the FWSAR contract which will see the RCAF ﬁnally retire its ageing Buffalo and Hercules planes, which are to be replaced by 16 brand new C295Ws. Helicopters and planes are so last year though – the Full tilt, shared cost feature (p.41) looks at whether the near future will see tiltrotor aircraft more widely used for SAR. Could cost-sharing between nations could help make these hybrid machines a more attractive option? On the combat oriented side, we look the improvements made at the Europe’s last Air Centric Personnel Recovery Operatives Course (p.44), and ﬁnd out from the Italian Air Force why they love their new HH-101A Caesar helicopters (p.48). And, of course, as well as carrying out rescues, military aircraft are often called upon to put out wildﬁres, as we’ve seen in Chile recently where planes from a number of nations have worked to douse the flames. Planes sent in have included air force machines from Chile, Brazil and Spain, as well as an EMERCOM jet from Russia and the 747 Supertanker from the US. See our coverage on p.6. And then we have the news of Flt Lt Wales (Ret.), former RAF SAR captain, who’ll be hanging up his flight boots when his contract to fly as a HEMS pilot for East Anglia Air Ambulance comes to an end this March. Prince William, as he’s also known, will then be able to take on more Royal duties. It’s a move that is no doubt being celebrated by some, judging by the headlines over the years accusing Prince William of being ‘workshy’. That’s a stance that has us somewhat baﬄed at AMR HQ. It’s hard to think of a better way to contribute to society than by helping to save lives, so a moment’s silence please to mark Captain Wales’s passing from the air rescue world as he heads off to open supermarkets and hold garden parties. Right, I’m off to read Bones one zero (Racing the Reaper in Iraq), the memoir by Reuben ‘Doc’ Ryan, former US Army flight medic with a 1st Infantry Division Dustoff company in Iraq. We hope you enjoy this issue of AirMed & Rescue Magazine. James Paul Wallis Editor email@example.com
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Welcome to Issue 82 of AirMed & Rescue Magazine, the definitive resource for the global air ambulance and air rescue community.
The Russian Emergency Control Ministry (EMERCOM) held a meeting on 25 January to discuss the strategic planning and organisation of the ministry for 2017-19, including discussing how to increase and improve its medical emergency, aerial fire-fighting and SAR capabilities. The presented procurement plan, developed by the Emergency Ministry’s Civil Defence Academy, includes the purchasing of four new amphibious firefighting Beriev Be-200 planes in 2017, and two more in 2018. Also discussed at the meeting was how the new aircraft would be staffed and how obsolete or ‘worn out’ aerial equipment would be replaced. EMERCOM also said it analysed the use of its aircraft when tackling emergency situations and fighting wildfires both in Russia and abroad. Emergencies Minister Vladimir Puchkov is said to have noted that supplying aircraft to EMERCOM was important for its development. Other new aircraft that the ministry aims to bring in over the next three years include Ilyushin II-79 and Il-114 planes, along with Mil Mi-26 and Mi-8 helicopters. “They should be multipurpose aircraft, rigged with specialised equipment, including that for medical evacuations and other rescue operations,” added Puchkov. The meeting concluded with the board making a number of decisions that it said will ‘help arrange for efficient procurement in EMERCOM for the next three years, determine development of the Ministry’s strategic planning conception and work out universal approaches to higher efficiency of specialised fire and rescue stations and SAR divisions’.
New global possibilities for Capital Air Ambulance Capital Air Ambulance, based in the UK, has announced that it will now be able to offer global medical and repatriation services thanks to the acquisition of a Learjet 45. The fixed-wing air ambulance provider is Rigby Group’s aeromedical division. The new aircraft has already completed missions to India and the UAE and will be available for international missions with immediate effect, said the company. The service has also announced a 40-percent increase in staff since mid-2016 to cope with the new duties that the global repatriations will bring. “The addition of the Learjet 45 to our fleet, and the global reach that it affords us represents a hugely significant milestone for Capital Air Ambulance and our strategy for expansion,” said Lisa Humphries, Capital’s accountable manager. “With five aircraft now in active service from two UK bases,
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Thirty HEMS aircraft sold to Chinese ﬁrm On 15 December, Helicopter manufacturer Leonardo-Finmeccanica announced a deal with Chinese company Sino-US Intercontinental Helicopter Investment to supply 30 helicopters for air ambulance services in China. The manufacturer will supply AW139 intermediate and AW169 light intermediate twin engine models in HEMS configuration. They are expected to be delivered in 2017, said Leonardo, and are to be operated by Kingwing General Aviation, the parent company of Sino-US. This latest order follows on from a contract signed earlier in 2016 between the two companies for 25 AW119Kx aircraft. This order, said Leonardo, helped pave the way for the establishment of a China-wide HEMS programme. Sino-US placed orders for over 80 helicopters from Leonardo in 2016, for varying uses, and also opened a major warehouse facility in Shanghai to reinforce its growing customer support presence.
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On 20 January, the Chilean Government declared a state of emergency due to wildfires raging in the south and central areas of the country, prompting an international response. Scorching over one million acres of land, the fires have been described as the worst in the country’s history, and as of late January, had claimed the lives of 11 people, including five firefighters. The town of Santa Olga, located in the Maule Region, was particularly badly affected. UK news outlet
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BRITISH COLUMBIA NEWS
A Brazilian C-130 Hercules drops its load
ITV reported that over 7,000 residents had been displaced and more than 1,000 homes destroyed. Over the previous few weeks, various wildfires had torn through the country, with over 120 fires breaking out. Firefighters in the country have been tackling the blazes, but strong winds and high temperatures meant that containment proved difficult. Over local 40 aircraft took to the air to try fight the flames, with the fire service asking for help from private aircraft aircraft owners, as well as requesting international assistance. In response, the Russian Emergency Control Ministry (EMERCOM) announced on 28 January that it would be sending an Ilyushin II-76 waterbomber to help fight the fires. The plane flew 15,000 km (9,300 miles) to Chile, and EMERCOM said it hoped that the aircraft’s 42-ton water carrying capabilities would assist the firefighting efforts. US-based Global Supertanker dispatched
Drone SAR scheme launched in British Columbia
a 747 to join the efforts. The plane was hired at a cost of US$2 million by a wealthy Chilean living in the US, according to UK newspaper The Guardian. The aircraft completed its first drop on 25 January, using its 20,000-gallon carrying capability to assist in putting out blazes. The 747 teamed up with a Chilean Air Force P-295 twin-engine turbo prop to scout for the SuperTanker, along with an adapted Gulfstream G-4 that is being used to improve intelligence gathering. On 27 January, the 747 completed four missions, including one that helped to save the lives of five Chilean fire fighters who were ‘in imminent threat of being overrun by a fire’. It also dumped 19,200 gallons of water on a fire that was rapidly approaching a village, helping to save it from being engulfed by flames. The Brazilian Air Force (FAB) deployed two C-130 Hercules aircraft from the 1st Troop Transport Group, which took off from Rio De Janeiro on 29 January with 28 military personnel onboard. The FAB explained that one of the two planes was equipped for firefighting purposes, with a Modular Airbourne Fire Fighting System (MAFFS) onboard, whilst the other was assigned to carry supplies needed to complete the mission. Elsewhere, the Spanish Air Force sent an Airbus 310 with 56 firefighters onboard to the country, whilst additional aid has been sent from Canada, Colombia, France and Portugal.
Naomi Yamamoto, minister of state for emergency preparedness in Canada, announced a one-year pilot project for the use of UAV’s by crews in Coquitlam and Kamloops for SAR purposes. The programme has been endorsed by Emergency Management British Columbia (EMBC).
“We are always looking for new technologies and techniques that will improve our search capabilities or reduce risks for SAR responders,” said Tom Zajac, vice-president of Coquitlam Search and Rescue. “We are looking forward to being part of a joint effort to explore the potential of UAV technology to increase the capacity of SAR teams in British Columbia to operate safely and efficiently.” Alan Hobler, SAR president for Kamloops, said: “We have been testing and training with these UAVs for a while now and are very excited to apply this technology to
real searches. In some applications UAVs will be a more-effective means of searching terrain that would otherwise be difficult or impossible to search by traditional ground searchers. Searcher safety is paramount for us and now we have a new tool that we can use in places or circumstances that may pose a risk to our searchers.” In 2016, the Province committed CA$10 million funding for SAR purposes. This is being distributed by the British Columbia Search and Rescue Association (BCSARA) over a two-year period. BCSARA said that funding is allocated according to the needs of local SAR teams to replace or update equipment, provide administrative support and pay for new or additional training. Yamamoto added: “Search and rescue volunteers demonstrate a steadfast commitment to the safety of families and communities throughout this province. I am proud to support these local heroes and this pilot project which could save so many lives.”
Prince William to quit HEMS duties
International firefighting aid sent to Chile
Prince William shows his grandparents, Queen Elizabeth and the Duke of Edinburgh, round EAAA’s Cambridge base
Prince William is set to end his role with UK HEMS charity East Anglian Air Ambulance (EAAA) in mid-2017, as his two-year contract expires. The Duke of Cambridge will be stopping his work as a helicopter pilot with the organisation to focus more on his royal duties. In an official statement, the Prince said: “It has been a huge privilege to fly with EAAA. Following on from my time in the military, I have had experiences in this job I will carry with me for the rest of my
life, and that will add a valuable perspective to my Royal work for decades to come.” He continued: “I would like to thank the people of East Anglia for being so supportive of my role and for letting me get on with the job when they have seen me in the community or at our region’s hospitals. I would especially like to thank all of my colleagues at EAAA, Babcock, and Cambridge Airport for their friendship and support. I have loved being part of a team of professional, talented people that save lives every day. My admiration for our country’s medical and emergency services community could not be any stronger.”
Italian rescue helicopter crash kills six
Helijet International Inc. announced on 2 December that it had received the necessary regulatory approvals from Transport Canada to re-establish full 24-hour emergency air ambulance service to all hospital heliports in British Columbia, including Vancouver General Hospital, Surrey Memorial Hospital and Royal Columbian Hospital in New Westminster. Helijet provides emergency medical services transport for B.C. Emergency Health Services with three Sikorsky S-76C+ aircraft. The fleet was temporarily forced to land at alternative sites near hospitals following a restriction imposed by Transport Canada. Full service resumed from 2 December at 08:30 hrs. Questions raised by Transport Canada in spring 2016 resulted in Helijet voluntarily suspending its Sikorsky 76C+ air
Six people have died in Italy after a rescue helicopter crashed during while airlifting a wounded skier. The crash happened near the resort of Campo Felice, close to the
ambulances from landing at up to seven B.C. hospital helipads, pending resolution with the federal regulator, said the firm. In August, exemptions were granted resulting in the restoration of Helijet flights to five hospitals, but restrictions remained at the Royal Columbian and Surrey Memorial Hospital helipads, Helijet explained, adding that B.C. Emergency Health Services used an alternate service provider for day flights to those facilities. Helijet stated that the matter had been resolved due to extensive work undertaken with Transport Canada, the aircraft manufacturer and an independent aviation expert, Maxcraft Avionics. Detailed aircraft data verification was done and a new supplemental type certificate was issued by Transport Canada, said the company. This certificate is being permanently added to the S76C+ flight manual documentation
and permits the full resumption of landings at all previously restricted elevated hospital heliports. “This outcome is a real credit to the hard work, collaboration and support we received from our client, the British Columbia Emergency Health Services, as well as Transport Canada, Sikorsky Aircraft, Maxcraft Avionics and all the employees at Helijet,” said Rick Hill, vice-president of commercial and business programs at Helijet. “Passenger and crew safety is of upmost importance to Helijet, which is why we voluntarily took steps to suspend some of our air ambulance service while this issue was being addressed. With the additional STC documentation, we have resolved all issues with Transport Canada and look forward to providing crucial emergency care service for British Columbians in need, as we have for the previous 18 years.”
Helijet resumes service to hospital heliports in B.C.
site of a recent avalanche that killed 14 guests of a hotel after it was submerged. The helicopter crew included two who had been involved in the rescue operation at
the hotel. The helicopter, which was an AW139 registered to Inaer Italia, tail number ECKJT, was dispatched south of L’Aquila in order to rescue a man who had a broken limb. Italian media reported that IT was flying in poor weather conditions, with thick fog and low clouds, but the pilot decided that the conditions were safe enough to make the flight. The aircraft crashed into Mount Cefalone at an altitude of about 600 m (2,000 ft). It is thought that the crash was due either to an electrical fault or due to hitting cables. The helicopter was destroyed upon impact, with the pilot, two members of the alpine service crew, a doctor, a rescue operator and the wounded man all being killed upon impact.
Study to test whether airborne blood is best
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treatments of people with major traumatic injuries treated by the NHS.” Crombie explained how the trial will be conducted: “In the trial, air ambulances and [ground] ambulances will be randomly stocked with or without blood products. Therefore, for eligible patients, the receipt of blood products prior to hospital admission will be determined by what the ambulance that attends to them is carrying. The research team will then look at a number of outcomes, including mortality as well as physical and biochemical evidence of the effectiveness of resuscitation, in order to determine whether there are any differences
between those who receive blood products and those who receive clear fluids. We will ensure that people who may not wish to receive blood products, such as Jehovah’s Witnesses, are identified and specifically excluded from the trial in accordance with their wishes.” West Midlands Ambulance Service, East Anglia Air Ambulance, Essex and Herts Air Ambulance, MAGPAS Helimedix, The Air Ambulance Service and the NHS Blood and Transplant Service will all also take place in the trial, which will be managed by the University of Birmingham Clinical Trials Unit (BCTU).
A new study being carried out by the NIHR Surgical Reconstruction and Microbiology Research Centre in the UK will investigate the effectiveness of giving helicopter air ambulance patients blood products immediately after a major injury. Midlands Air Ambulance (MAA), one of the HEMS charities taking part, said it hopes the trial will determine the method’s effectiveness ‘one way or the other’. The project has been awarded £1.8 million funding from the NIHR, the research arm of the National Health Service (NHS). The chief investigators are Gavin Perkins, professor of Critical Care Medicine at the University of Warwick and a consultant at Heart of England NHS Foundation Trust, and Dr Nicholas Crombie, consultant trauma anaesthetist at University Hospitals Birmingham NHS Foundation Trust and a doctor with the Midlands Air Ambulance Charity. “Major trauma is a major cause of death in the UK. Treatment with blood and clotting factors can be lifesaving, but blood is a scarce resource and we currently don’t know when and where the best place to administer it is,” said Perkins. “The first trial of its kind, it will help shape the future
Northern Ireland politician backs experts’ call for HEMS doctors Jim Allister, leader of the Traditional Unionist Voice party and a member of the Northern Ireland Assembly, has welcomed the intervention of a number of medical experts who have called on the province’s health minister to ensure that Air Ambulance Northern Ireland carries doctors onboard when it launches this year. Allister commented: “I greatly welcome this intervention by world experts in the provision of a helicopter emergency medical service. The gravity of the concerns about this issue is reflected in the fact that leaders in their field from Australia, Norway, England, Scotland, Slovenia, France, Wales, Austria, Hungary and the US have spoken out.” He continued: “Off the back of my question to the health minister, which asked if the service in Northern Ireland would be doctor-led and staffed, they have expressed concerns that the staffing model may be paramedic rather than doctor-led. The letter highlights that this would leave Northern Ireland in a uniquely short-changed position in a UK context as all other UK air ambulances are physician-staffed or moving towards that model.”
It is particularly noteworthy, said Allister, that the experts stated in their recent letter to Michelle O’Neill of the Northern Ireland Executive: “We fear the service will not be capable of providing the best life-saving care possible to the people of Northern Ireland from the outset if a doctor is not onboard the helicopter. Placing a combative, agitated, head injured or bleeding patient in a helicopter without a general anaesthetic is unsafe, both to the patient and the crew. The ‘golden hour’ is then lost as these patients will have to be transported on sometimes lengthy journeys by road to the trauma centre. Sedating head injured patients without a general anaesthetic is a ‘solution’ from the 1970s and has been shown to cause harm. This is what would happen without a doctor onboard.” Allister call on the minister to take notice of what he called a ‘highly unusual intervention’, saying: “It is imperative that the necessary funding is discovered for this vital service.” Read the full letter via www.airmedandrescue. com/story/1721.
PHI to share safety resources
Having been awarded the Airbus Helicopters Vision Zero award for its safety initiative at the US Air Medical Transport Conference (AMTC) Awards Show on 13 December, PHI Air Medical has announced that it will be using the $10,000 prize money to help bring its safety programme to the rest of the industry. PHI’s new programme, called Life-Saving Thinking, carries on from Life-Saving Behaviours, the initiative the company started in 2015. The aim was to improve
David Motzkin (centre), PHI Air Medical president, who collected the award, with Rick Sherlock (left), AAMS president and CEO, and Jennifer Hardcastle (right), Airbus Helicopter air medical sales manager
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human performance by addressing behavioural actions employees should take to ensure their safety. Life-Saving Thinking takes this a step further, said PHI, and challenges employees to understand how their brain works so they can adapt a conscious, hyper-vigilant mindset when performing critical tasks. David Motzkin, president of PHI Air Medical, said: “Through Life-Saving Thinking, PHI has stepped outside the bounds of traditional safety practices to really understand and address the challenges and barriers that exist within the human brain. By delving into this subject, we are challenging our employees to work through each and every task with real mindfulness and attention.” For a full list of AAMS Awards winners, see www.airmedandrescue.com/story/1727.
waypoints A cargo plane carrying close to 40 tons of emergency supplies landed in Erbil, Iraq, on 12 December, marking the ﬁrst of several operations organised jointly by the European Commission and Member States of the European Union (EU), said the organisations. Christos Stylianides, EU commissioner for humanitarian aid and crisis management, said: “These airlifts, ﬁlled with urgently needed help, are a tangible expression of European solidarity with the Iraqi people.” INAER, an aviation emergency and aircraft maintenance provider in Spain, has changed its name to Babcock Mission Critical Services Spain. The company said rebranding is the ﬁnal step in the acquisition process of the company by Babcock International Group that began in 2014. Vighter Medical Group has been awarded NAAMTA Accreditation for its commercial medical escort service, which was launched in 2015. This came after a comprehensive audit of Vighter’s administrative documentation, medical practices and facilities, said NAAMTA. The Greek Air Force released footage from 11 January showing the rescue of residents on the island of Skopelos left stranded by heavy snows. After taking off from the island of Chios, a Super Puma located a number of poeple and winched them to safety including a family of four. AirMed International has opened a new base at Cincinnati Municipal Lunken Airport, US, in order to serve air medical transportation, and organ procurement and recovery ﬂights. A Beechjet 400 plane will be housed in the Signature Flight Support ﬁxed-base operation facility at the airport, said AirMed International. After the opening of a new case, it can take anywhere from 12 hours to 33 days to repatriate a patient to their native country, according to new research by French ﬁxedwing air ambulance provider Medic’Air International. On average however, says Medic’Air, it takes 3.5 days to repatriate a patient from southern European and 6.25 days from Asian countries.
Dear AMR I read with interest the checklist supplied with Issue 81 (Dec 2016/Jan 2017) of AMR. It is a good start, but you could have a long running debate with the order of actions in the checklist; however, there is one important omission. Select 7700 on the IFF. This will get people’s attention on the ground and alert someone you are in trouble (important if you hit something or the procedure goes wrong). This will not only draw ATC’s attention to you, but could also be essential if your emergency pull-up is into controlled airspace. Being an ex-RAF helicopter pilot we were taught: 1. Aviate. Get the aircraft going up by rolling wings level (very important) and then pulling power. Ensure the speed is pegged (see later point). Trim the stable attitude and engage auto-pilot functions to help you. 2. Navigate. What safety altitude are you going to and do you need to turn to avoid high ground/controlled airpace etc., get out of icing or regain VMC? 3. Communicate. Tell somebody you have a problem. Pan call if all under control but Mayday if going up into controlled airspace, going into icing conditions or you are not instrument rated. I have a slight problem in the check list just nominating the best rate of climb speed. This in most helicopters is going to be around 60 kts, but you get forward penetration. In certain circumstances, like a steep sided valley, selection of the best angle of climb might be wisest (40-50 kts), but do not go below minimum speed on instruments for the aircraft. I can think of many things that should be included, like a check of the outside air temperature. You might just get to MSA, but if you then ice up you may into an uncontrolled descent scenario. Two RAF Sea Kings suffered this, but luckily ended up in valleys as they thawed out. The whole issue is a four-page article in itself and is best thought about in the crewroom and not after it has happened in flight. Tim Fauchon Chief executive, British Helicopter Association Response from Stacy Fiscus, Chair, Vision Zero Some interesting points have been raised by Mr Fauchon. But with his comments and critique I believe he has inadvertently hit upon the main point of the checklist. As was stated in the covering explanation, the whole purpose of sending this out was to raise awareness and create a base format for CRM to take place, be discussed and practised among EMS crews (predominantly those without the luxury of ﬂying two-pilot aircraft). It would have been extremely long and complex if every option for every scenario was listed. His observations are well founded, but the purpose of the checklist remains the same – however much an individual or crew wishes to change the actual items or sequence, if it enables them to deal with the emergency, ensuring minimal distraction to the pilot ﬂying the aircraft, while ensuring nothing critical is missed and minimising his workload to land safely, then it will have achieved its purpose. As Vision Zero discovered when researching a generic base format, if you ask 10 different pilots, you will get 10 different opinions.
Dear AMR I discovered the article US Coast Guard helos turn yellow (which was published on 19 January 2016) through the Internet (www.airmedandrescue.com/story1274). I have some information that you should learn. The article notes that the HO3S-1G helicopter was used by the US Coast Guard from 1946 to 1955. That is incorrect information. The HO3S-1G was used from 1946 to 1959; for example, HO3S-1G number 237 (which was based at Air Station Traverse City, Traverse City, Michigan) was used with The Mackinaw WAGB-83 [an icebreaker ship] for the spring ‘breakout’ on the Great Lakes in 1958, and HO3S-1G number 235 (which was at Air Station Traverse City) was used with the famous icebreaker in the spring of 1959 (after which it was seen on the fantail of the icebreaker by visitors touring the icebreaker at several cities in the late spring). By the way, ‘235’ exists at a museum in Pensacola, Florida. Also, I can report that the HO3S-1G was not yellow from 1946 to about 1950. I have photograph information that shows that that style of helicopter was yellow from about 1950 to 1959. It looks as if the first yellow paint appeared in 1950, but not all the units may have been yellow (with the big ID numbers on the front at roughly the feet of the pilot) till 1951. Number 232 is now on display in Arizona (the Pima Air and Space Museum) and is roughly in the form that it was from 1946 to 1950, and number 233 (which has a number of restoration flaws) is on display in Oregon (note: one flaw is a panel, sort of like an airvent panel, that is upside down up near the rotor blades). Sincerely Victor Swanson, historian Thank you for bringing this to our attention. We have corrected the online article and alerted the US Coast Guard. Ed NB Mr Swanson seeks a radar historian to help identify unknown radar systems based on records of the antennas on the The Mackinaw WAGB-83. If you can help, please contact AMR and we’ll put you in touch.
USCG Sikorsky HO3S-1G number 235 at Mackinaw City State Dock in 1959
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Tim Messer, project director for Watts Group Limited, said: “To achieve UK CAA compliance, we had to increase the water storage tanks from 8m3 to 20m3. The system also required new foam mixing equipment, larger pumps and associated controls. The CAA certification gives assurance that HEMS operations at Kings College Hospital can operate safely and best serve patients in time-critical conditions.” When the helipad opened in October, the Hospital said it would save thousands of lives, helping the centre to serve its trauma population of 4.5 million people across south east London and Kent. Built on top of the hospital’s 10-storey Ruskin Wing, the
CAA International (CAAi) has reported that it has certified the UK’s first onshore elevated helipad with a deck-integrated firefighting system to the UK CAA CAP 1264 standard. Located at Kings College Hospital, London, the helipad was formally opened late last year. The aviation consultancy, which forms part of the UK Civil Aviation Authority, noted that the construction phase of the helipad was managed by Watts Group Limited during a period when UK best practice was transitioning from Health Building Note (HBN) 15:03 to UK CAA CAP 1264, the latest UK design and operational standards for helicopter landing areas at hospitals. Following an in-depth review of the helipad drawings, the feasibility study and comprehensive onsite inspections by UK CAA Regulators, the Bayard’s-built helipad was given the green light for helicopter emergency medical services (HEMS) and air ambulance operations, said CAAi. To meet the design requirements of ICAO Annex 14 (Volume II) and the latest CAP 1264, the helipad’s physical characteristics (surface, tie-down points, safety net, and access points), environmental and operational factors, visual aids and firefighting systems all had to be assessed, said the organisation.
Photo courtesy of Bayards
helipad was made possible thanks to a multimillion-pound donation from the County Air Ambulance HELP Appeal. In addition, more than 2,600 patients, staff, and members of the local community generously donated £500,000 to the Hospital’s Time is Life Appeal. The majority of the cost of the project was due to adaptations made to the building as part of the project. The helipad’s deck integrated firefighting (DIFF) system automatically sprays foam from a series of nozzles installed into the helideck in the event of a fire, instead of relying on a team of firefighters to manually extinguish it. The Hospital said that using the automated fire system will save it £300,000 each year compared to employing firefighters. The new helipad has been built to speed up the time it takes helicopters to transfer critically ill patients to King’s and reduce ‘landing-to-resus’ transfer times to just five minutes. Previously, helicopters had to land in nearby Ruskin Park and patients faced a transfer of up to 25 minutes by road.
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Beechcraft Corporation has said that it is now offering Pratt and Whitney Canada PT6A-67A engines for improved performance on its King Air 350HW and King Air 350ER turboprops. During the announcement, made at the Middle East and North African Business Aviation Association (MEBAA) conference in Dubai, the company also stated that it is offering an increased gross weight option for the planes, increasing the maximum take-off weight to 17,500 lbs (8,000 kg). Both enhancements are FAA and EASA certified said Beechcraft, and will be offered as factory options for new aircraft or as aftermarket modifications. “The King Air 350 platform is renowned
as a worldwide mission enabler and these optional enhancements will offer customers added performance and payload for special mission operations,” said Bob Gibbs, vice-president of special mission aircraft. “We have successfully modified a fleet of NATO air force-operated King Air 350ER aircraft with these upgrades, and we are excited to offer these options to provide more value to our special mission customers.” The Pratt and Whitney Canada PT6A67A will provide ‘superior field and climb performance’ added Beechcraft, and the increased gross weight option provides operators greater flexibility between payload and fuel.
Police in Wisconsin use UAV in SAR mission Police in Lincoln County, Wisconsin, US used a drone to assist in the search for the body of a missing hunter, according to local news source WJFW Newswatch 12. The police department said that the body was found in 45 minutes, significantly less time than it would have taken a ground search and rescue team. A 76-year-old hiker was thought to have drowned whilst out in the Lincoln County area. He had left his house at 12:30 hrs on 16 16
AIRMED & RESCUE
30 November and was reported missing by his family at 16:00 hrs. After finding the carcass of a deer the hunter had killed, the police decided to use its drone to search for the man. Due to bad weather, a police request for a helicopter was turned down, reported WJFW Newswatch 12, meaning that the drone was launched. The incident was the first in which the Lincoln County Sheriff ’s Department had used the drone.
waypoints The German Federal Police has announced a new contract with Airbus Helicopters for three H215 helicopters. The Super Pumas will be equipped for both maritime emergencies and police missions, including search and rescue and disaster relief missions. Airbus said the helicopters are scheduled for delivery in early 2019. The Bundespolizei already operates 19 aircraft from the Super Puma family. Luxembourg Air Rescue (LAR), which also operates as European Air Ambulance, has announced that it will be acquiring another Learjet 45XR plane. The company recently sold a Learjet 35A, so the new jet, which is the fourth of its kind that the service owns, will be a direct replacement. The acquisition is part of a larger fleet restructuring that LAR began in 2011.
Search drone joins LASD fleet In a press conference on 12 January, Sheriff Jim McDonnell announced that the Los Angeles County Sheriff ’s Department (LASD) has received approval from the US Federal Aviation Administration (FAA) to use an unmanned aircraft system (UAS). He said the LASD can now use its drone aircraft in specifically defined roles, which include: search and rescue (SAR), explosive ordnance detection, hazardous materials response, disaster response, arson fires, hostage rescue, and barricaded, armed suspects. The remotely-controlled, camera-equipped quadcopter has been assigned to the Special Enforcement Bureau, which includes the Emergency Services Detail, Special Enforcement Detail, Arson/Explosives Detail, and the HazMat Detail. A number of deputies have been trained to operate the machine and received remote pilot certificates with a small unmanned
Beechcraft announces new King Air 350 modiﬁcations
aircraft system (sUAS) rating from the FAA. The LASD commented that deputy personnel also trained as tactical medics can use the UAS to remotely assess injured patients and provide them with rapid medical care. Sheriff McDonnell said: “We are continuing to raise the bar as a leader in law enforcement and always looking for ways to do the job better.” SAR personnel respond to over 500 SAR operations each year, many in treacherous terrain, said the LASD. The UAS will be
Thales LifeFlight Simulation Centre, based at Brisbane International Airport, Australia has received a further qualification for its new Reality H AW139 helicopter Full Flight Simulator (FFS). The FFS is now a Level D Full Flight Simulator under European Aviation Safety Agency (EASA) regulations, and becomes the first simulator in Australia to receive this qualification.
used in places too small or dangerous for manned aircraft to access, such as between large trees and in canyon areas, to locate and remotely assess injured patients. The cost of Implementing the system was around $10,000, said McDonnell. The announcement has sparked anger in some quarters, with protests calling for a ‘drone-free LASD’ and hundreds of concerned residents signing a petition against the use of UAVs by the police force. A post on the Drone-Free LAPD (sic) – No Drones LA! Facebook page argued: “The use of drones signify a giant step forward in the militarisation of local law enforcement that is normalising continued surveillance and violations of human rights of our communities.”
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The UK National Police Air Service (NPAS) has announced that the last of its six MD Explorer helicopters will be taken out of service by the end of March, with the models being replaced with EC135s. The service said that this is part of its wider streamlining process. Redstar Aviation, based in Turkey, has selected Spectrum Aeromed to equip its new Bombardier Learjet 45XR for medical use. Spectrum Aeromed has previously equipped another Bombardier Learjet 45 and a BAe Jetstream 32 EP for Redstar Avaiation in dual-patient configuration. Swiss air rescue provider Rega has announced that it has signed a new contract for six new H145 helicopters. The new vehicles are set to replace the service’s EC145 lowland fleet and will be ready to go into operation in 2018, said Rega.
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A Christmas miracle from Devon Air Ambulance
Christmas 2016 was very different for one family in Exwick, UK, but, fortunately, with a very happy ending. With all the excitement of being on school holiday and Father Christmas due in just a few days, eight-year old Harry Tansley was happy to be out scooting and skating along Exmouth seafront with his dad, a friend and his older brother Ben (pictured). When Harry lost his balance and fell, the handlebar of the scooter caught his throat the effect was immediate – he had a tear in his windpipe causing air to form under his skin with every breath he took. First responders were quickly on scene and administered an IV drip, but called for back-up from local HEMS charity Devon Air Ambulance (DAA), which sent an
emergency car with two aircrew paramedics and the helicopter with two further paramedics and a doctor onboard. Despite Harry’s face, chest and stomach swelling rapidly, he and his dad remained calm and Harry was able to answer questions coherently. Paramedic John Shaddick explained: “When we arrived, Harry looked like an eight-year old body builder: he was swollen from his head to his groin. But he and his dad were both amazingly calm – Harry really was a ‘perfect patient’, particularly considering what was happening.” Treating Harry in the back of the ground ambulance, Dr Reed administered an anaesthetic and Harry was intubated to stop throat swelling shut and to keep him
Longest EMCO-assisted medical ﬂight completed
breathing. Shaddick continued: “The teamwork of everyone working together was brilliant. Everyone, land crew, rapid response crew and aircrew, all knew what needed to be done, both inside and outside the ambulance.” While Harry was being looked after, paramedic Nick Ratcliff advised Harry’s dad and brother what was happening and spoke to Harry’s mum, who was at work in Torquay, on the phone. Harry was flown in the air ambulance to Bristol Children’s Hospital and his care was taken over by specialist children’s doctors. His dad, who flew with Harry in the aircraft, said he was impressed by the speed with which they covered the distance of around 80 miles (130 km), arriving at the hospital in just 30 minutes. As he was gradually woken up from his induced coma on Christmas Eve, Harry’s family at his bedside were relieved to realise that his windpipe had ‘healed itself’ and there was no longer the need for surgery. Christmas Day was made all the better with a visit from Santa Claus in the morning and, amazingly, a discharge from hospital in the afternoon. Back home in Exwick, the remaining Christmas holidays remained fairly calm as Harry recovered from his ordeal. His mum, Justine, called DAA to say thank you: “We are just so grateful to everyone who helped Harry on 20th December. Without the skills of all the paramedics and Dr Reed and the helicopter getting him to Bristol so quickly, things could have been so different. My husband and I have decided that we are going to run a half marathon this year to raise funds for DAA, so that the service remains available to help others when they need it. We can’t thank you all enough.”
A patient evacuation from Ho Chi Minh City, Vietnam, to Brussels, Belgium, has become the longest air ambulance flight featuring extra corporal membrane oxygenation (ECMO), according to the company in charge of the operation, Medic’Air International. The company said the patient, who was suffering from a heart failure with septic shock, was evacuated after a local physician requested the patient receive specialised treatment. The flight featured a team of four medical attendants including a cardiovascular surgeon and intensive care team. During the 18-hour flight, the patient benefitted for EMCO as well as French lyophilised plasma, onboard ultrasound and blood analyser, inotropic support and mechanical ventilation. Medic’Air said that the operation was co-ordinated from its ops desks in Shanghai, China, and Paris, France. It also said the mission was ‘complex’ but went smoothly.
Air Alliance announces second long-range air ambulance Air Alliance has announced the acquisition of a second Challenger 604. The company first entered the long-range air ambulance market in November 2016 when it bought its first Challenger 604. The new aircraft will be housed in the company’s base in Cologne, Germany. The company reported that the plane has a range of 7,000 km (4,300 miles) and will allow for non-stop flights from Europe to the east coast of the US or southeast Asia with one stop. Patient loading takes place via an electrical ramp that can be carried in the vehicle during the flight. The company also noted that the space inside the plane allows for three stretchers. It also allows for the carrying of two ventilated intensive care patients and one non-intensive care patient. Medical equipment within the aircraft includes a monitoring device, ventilator and perfusion pumps. The plane also has an integrated electric and oxygen supply. The crew is catered for with enough room for standing and an auxiliary power unit to keep the cabin at a comfortable temperature, said Air Alliance.
Plane crash attended by HEMS services
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The Cirrus SR22 single-engine aircraft was located at around 11:00 hrs in an area that was only accessible via boat or aircraft. Bundaberg RACQ LifeFlight Rescue was tasked with the treatment of the pilot, a male in his 60s. He was transported to Bundaberg Base Hospital suffering from multi-trauma injuries. RACQ Capricorn Helicopter Rescue Service
airlifted two passengers, a 29-year-old female with suspected head injuries and a possible fractured lower leg, and a 13-year-old male with a suspected fractured lower limb. Both were taken in a stable condition to Rockhampton Base Hospital. Sadly, the forth occupant was pronounced dead at the scene.
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Australian helicopter services RACQ LifeFlight Rescue and RACQ Capricorn Helicopter Rescue Service were both called upon to attend to the scene of a light plane crash at Bustard Head, Queensland, on 10 Januray. RACQ Capricorn Helicopter Rescue Service reported that the aircraft had been carrying four occupants onboard.
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Home for Christmas
A lifetime of service that has flown by
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For LifeFlight’s Dr Allan MacKillop, it all began more than 35 years ago with frequent phone calls in the middle of the night to attend the scene of horrific road accidents. Almost every week, the Gold Coast-based doctor was called to help save the life of a severely injured driver who had crashed on the Burringbar Range in northern New South Wales, at the time the most dangerous 50 kilometres of highway in Australia. This is how LifeFlight’s chief medical officer was introduced to the charity formerly known as CareFlight. Dr Al, as he’s affectionately known, has been pivotal in shaping the advanced medical care provided by LifeFlight’s medical team, including critical care doctors, intensive care nurses and Queensland Ambulance Service flight paramedics. Back in the early 1980s, he was one of the only anaesthetists in the Gold Coast and Byron Bay area, and one of a few doctors who volunteered their medical services to the community rescue helicopter service. He was well known in the region and was often called by ambulance staff to assist at the scene of serious accidents. “At the time, I would travel with my own rescue medical equipment in the car, so I started my own advanced medical care service by default because I was asked to do it so often,” he said. “It got to the point where the ambulance gave me a flashing red light on a magnet to put on the roof of the car, which was very unusual in those days.” Soon Dr Al’s mode of transport became a helicopter as he took to the sky with LifeFlight to help patients who had been involved in a serious accident to get emergency medical treatment faster. “It became obvious to us that having a rescue helicopter service to come to these towns and take patients to the hospital would be much better,” he said. “At my call and request, LifeFlight would, for example, fly the helicopter from the Carrara base to the Mullumbimby hospital where I had someone injured from a highway accident. I would then get onto the helicopter with the patient and fly to the Gold Coast, Tweed or Brisbane hospital and then I’d get a taxi back home.
The Helm of Awe
muster even a small amount of the reticence that marked his initial journey, although I’m afraid I’ll hug him and embarrass him with my enthusiasm – I’m so happy for him that it’s difficult to even write this without the bane of exclamation marks! And although I’m part of a profession that recognises death as a natural stage of life and comes face to face with it often, I still feel an inordinate amount of defeat when battles are lost. And I feel an equally inordinate amount of triumph when they’re won. Because of that, taking a victorious Henry home to his family in time for Christmas will be one of the most incredible gifts this season. Names and other identifying information have been changed. Reprinted with permission from AJN Off the Charts, the blog of the American Journal of Nursing. All rights reserved. https://ajnoffthecharts.com/home-for-christmasflight-nursing-and-the-symbols-of-hope.
Marcy Phipps, RN, BSN, CFRN, CCRN is chief flight nurse at Florida, US-based Global Jetcare, Inc. Her time off is spent running, writing and enjoying her family.
RACQ LIFEFLIGHT RESCUE
AUTHOR MARCY PHIPPS
RACQ LIFEFLIGHT RESCUE
Flight nursing and the symbols of hope
As nurses, we all have patients who stick with us. I’ve thought of Henry many times since we transferred him six months ago from Dublin to an American hospital to undergo groundbreaking treatment for acute lymphocytic leukaemia. His prognosis was poor – a fact he was well aware of. He’d told his father he wanted to ‘be done’. He’d had enough of hospitals and the medicine that didn’t cure him and only made him feel worse. He was ambulatory and stable from a medical standpoint, but had the drawn and haggard look of the chronically ill. Most disturbing was his reticence. There was none of the enthusiasm I’d expect from a 12-year-old riding across the Atlantic in a Learjet – he couldn’t even be coaxed to lean into the cockpit. The only time he perked up was when we landed for fuel in Keflavik, Iceland. He sat up and gazed out of the window on our approach, looking interested in his surroundings for the first time. I found out from his dad that he’d missed a school trip to the island due to his cancer, and I started telling him all I knew of Iceland, which wasn’t much. At that time, I had never left the airport. My Icelandic experience was not much more worldly than Henry’s. I’d seen some geothermal pools from the air and wondered at a landscape that looked lunar. The airport gift shop, though, was wonderful. Besides the usual airport kitsch, it was filled with handmade sweaters, pottery and references to Iceland’s folklore and the mystical – statues and paintings of the elves and gnomes believed to make mischief at night, and jewellery and etched rocks featuring Nordic symbols from Viking times. I had read up on and grown to love the Viking legends, and so acquired a good number of gift shop treasures – pricey polished lava rocks with Nordic symbols on them. I collected several each time we stopped for fuel, until the gift shop supply dwindled and then there were none. I gave one of these stones to Henry as we sat on the tarmac, bundled with blankets and watching the trucks fill the wings with jet fuel. He gripped the smooth rock for most of the journey. It bore the Helm of Awe, a symbol meant to convey strength in battle and invincibility. When I got home I sent him a book of legends. My own superstitions aside, I hoped the tales would shore him up and give him hope. And now half of a year has passed, and we’ve been called to take Henry back to Dublin in time for Christmas. He’s 100-per-cent cancer free at this moment and won’t require much medical care, but we’ll be keeping a close eye on him, making sure he’s cosy on the stretcher, not letting him feel one bit of discomfort as we speed him home. The joy I feel in his recovery is overwhelming and possibly unprofessional, but I can’t help it. I’ve been buying him gifts since I learned of this trip – a puzzle, a soccer ball, and another Nordic symbol, this one a pendant on a black leather cord. This time it’s the Vegvisir, a symbol used as a signpost or compass, guaranteeing safe passage in storms and bad weather, even when the way is not known. In a few days now I’ll see him. I hope to hold myself in reserve and perhaps
We did the best we could.” In the early years, one single-engine helicopter performed around 150 airlifts a year. Now LifeFlight doctors perform about 4,000 patient transfers or rescues each year across its fleet of helicopters and jets, as well as with other aeromedical rescue organisations. “The first helicopter was very small, the patient’s head was always sitting between the doctor’s knees and feet – it was very, very cramped. We had a single pilot and an ambulance officer. However, we all enjoyed the work because we did everything as a medical
Australia’s RACQ LifeFlight Rescue looks back on the chief medical officer Dr Allan MacKillop more than three decades spent providing care in the air
crew. We did a lot of ocean water rescues in those early days and did a lot of training in lakes and waterfalls,” he said. Fast forward 35 years and LifeFlight has expanded from five volunteers into a dedicated team including more than 130 doctors, nurses and paramedics on 12 rescue helicopters and three air ambulance jets. “It’s been a very, very significant change over 35 years. We have gone from performing one mission every couple days with a volunteer doctor, to now having a LifeFlight doctor on almost all aircraft. We have now flown 44,000 critical rescue missions in 35 years. So that’s more than 10 to 12 call-outs a day throughout the state,” he said. While the organisation has begun a new chapter under a new name, Dr Al who has been chief medical officer for the last 14 years, is adamant LifeFlight’s main objective remains the same. “Right from the very beginning, it’s been about providing the best outcome for our patients who are often in a terrible situation and far away from emergency medical services,” he said. “It’s about getting emergency medical services quickly to the patient, stabilising them at the scene and moving them quickly with sophisticated monitoring and medical services to a place where they can have definitive care.” When Dr Al reflects on what has been a remarkable few decades, he said: “In the 35 years LifeFlight has been operating, Queensland’s population has almost doubled. I must say it’s been an absolute pleasure to see us extend into rural and remote areas where obviously the need has always been great. It’s been an interesting trip of 35 years and it truly has flown by.”
European Air Ambulance
When European Air Ambulance (EAA) scooped ITIJ’s Air Ambulance Provider of the year award at the end of last year, it was a well-earned reward for a company that had a successful and exciting 2016. Christian Northwood spoke to director of sales and marketing Patrick Schomaker about how EAA operates Last year was always going to be special for EAA as it marked the company’s 10th year of operation. Though its parent company, Luxembourg Air Ambulance has been operating for 28 years, EAA was formed only in 2006. “Originally DRF Luftrettung and Luxembourg Air Ambulance were founding members and part of EAA,” Schomaker explains. “But DRF left in 2014 to focus on their own members and do not offer medical repatriations to thirdparty companies any more. Luxembourg Air Ambulance is now the only operator behind EAA.” The year ended up being one of the company’s most successful and impressive ever, and one that saw it named as Air Ambulance Provider of the Year by AMR’s sister publication, the International Travel & Health Insurance Journal (ITIJ). Over the course of 2016, EAA completed moving into its new state-of-the-art base at Luxemburg Airport, meaning that all its staff can be under one roof. From there, the firm says it can operate ‘in all countries worldwide, except warzones’. During 2015, for example, EAA flew 792 missions in 117 countries, ranging from Afghanistan to Zimbabwe. “We are especially strong in the 22 22
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Mediterranean area, Africa, Middle East, Russia and CIS, and are developing Asia and North America,” adds Schomaker. Fleet 2016 also saw EAA replace one of its Learjet 35s with a new Learjet 45. This has been part of the service’s ongoing fleet renewal project. EAA currently has four Learjet 45s and one remaining Learjet 35, though the service plans to upgrade it to a Learjet 45 over the coming year. Using these vehicles, the service is able to complete a number of different repatriation services, ‘from intensive care patients, to double-stretcher, incubator, paediatric, obese patient, infectious disease’. The Learjet 45s improve on the Learjet 35s in several ways, including shorter take-off and landing capabilities, a larger and more flexible cabin and the ability to travel longer distances. “The upgrade brings many advantages to our operations, and most importantly to the service we can provide our clients and the patients in our care,” says
in 2015, EAA flew 792 missions in 117 countries, from Afghanistan to Zimbabwe
Schomaker. “All of our aircraft are dedicated to medical flights and are in effect in-transit hospitals, offering a level of service and medical care that is simply not possible on commercial charter transfers for patients.” The flexible cabin interior allows EAA to run a more cost-effective service, says the firm, allowing the carrying of either two intensive care patients, or an incubator and a mother on a stretcher, or a single patient with their family
of up to four passengers. It also allows EAA to carry out its specialist services, which include an infectious disease isolation module, a new stretcher system for overweight patients and a neonatal-paediatric unit. Schomaker explains EAA’s plan for the future of its fleet: “We will not dramatically expand our fleet, but prefer to grow organically and maintain our high level of service; our focus is not to be the biggest, but to offer the best possible level of medical care in the air. We will continue to modernise our fleet and sell our last remaining LJ35 [in 2017] to invest in a LJ45.” The infectious disease programme, created by the company’s in-house scientists, is unique to Europe, says EAA. Helped by EAA’s partnership with the UN and NATO for relief and rescue operations, the module has ‘a standard of MEDEVAC capability usually only seen in military operations’. Looking forward to 2017, Schomaker asserts that this unit will develop further: “The infectious disease module was originally developed for Ebola, but we want to adapt it to other kinds of highly infectious diseases to be able to serve the international community in case of a new outbreak.” Crewing The air ambulance provider currently employs 125 full-time staff and about 40 freelance physicians. Schomaker explains: “EAA missions are always crewed with a specialised medical team of one physician and one flight nurse other specialised medical crew can be called upon, depending on the patient’s medical requirements.” EAA staff must be qualified to a required level before they can work for the company. Flight nurses, for example, must have a ‘minimum of four years of experience as a registered nurse working in intensive care and/or anaesthesia and/or emergency room’ and a ‘continuous medical education’, while physicians must have ‘specialist status in anaesthesiology, internal medicine or general/trauma surgery or emergency medicine’ and ‘at least one year of full-time intensive care experience and practice in an ICU’ whilst also having ‘continuous medical education’. Mission control The process EAA follows to treat patients balances the strengths of its staff with the needs of every individual case. Schomaker details how a patient transport is handled and organised: “The logistics of an international air ambulance flight are based on the needs of the patient, and most important is that for every mission all medical details are clarified. When it is alerted, the Mission Control Centre (MCC) collects patient and hospital data and consults a physician. The physician communicates with the patient’s doctor to discuss various medical aspects, such as what kind of illness or injury the patient is suffering and whether the patient is in a position to be transported.” If the patient is given the all clear to be transported, the MCC assembles the crew: “The MCC informs the appropriate medical crew who will accompany the flight, as well as the pilots on call about the upcoming mission. The MCC also organises the complete transport of the patient from hospital bed to hospital bed, including ground transportation. At the same time, the MCC prepares all flight details including over-flight rights, landing permission, fuel stops and other extensive information.” This thorough approach to the process has allowed EAA to complete outstanding, and for Schomaker memorable, missions such as the longdistance patient transfer that was completed in March 2015. A patient contacted the organisation
from Seoul, South Korea, with a request to be repatriated to the UK. EAA calculated that the mission would require two crews. As the second crew was to be positioned in Siberia, Russia, both crews required Russian visas. They also required overflight permits for Belarus, Russia and China, as well
the service plans to upgrade its remaining Learjet 35 to a Learjet 45 in 2017
as landing permits for Russia, South Korea, Mongolia and the UK. EAA accepted the mission five days after the request was made, and within 36 hours had all the required permissions. An EAA Learjet 45XR started its journey towards the patient two days before the scheduled transfer, with the patient reported to be in a stable condition after being diagnosed with myocardial infarction. The patient was brought onboard the aircraft under mild sedation in Seoul, and after a refuelling and crew swap in Serbia, was flown back to the UK. He was even said to have shown signs of respiratory improvement when he landed. Despite the successes and growths of 2016, for Schomaker his highlight of the year is obvious: “Winning the ITIJ provider of the year award!”
PETER TEN BERG
Wadden Islands medevac ANWB-MAA Director Petra van Saaze
New aerial ambulance service for Dutch islands operational At the same time, the nurse maintains radio contact with the emergency room Noord Nederland. Once on site at the pick-up location, the HCM supports the nurse in taking care of the patient. Gepco Ruitenberg, chief pilot for ANWB-MAA’s base in Leeuwarden, explains that after the announcement of the contract award to ANWBMAA in mid-August, immediate action was undertaken to acquire the two helicopters and to have tailor-made medical interiors fitted by Bucher of Switzerland. In total, eight pilots received type rate training at LifeFlight in Bonn-Hangelar, Germany, for visual flight rules (VFR) qualification including instrument rating (IR), and two of them were additionally trained to become type rate instructors (TRIs). Although the flights will be mostly over open water, there are no additional requirements needed according to the European Aviation Safety Agency (EASA). The fact that one of the H145s is equipped with inflatable floats is only due to the fact that they were already fitted to an available helicopter, rather than having been required by the customer. Despite the short turnaround, the operational launch date in November was achieved and the coast guard, who had taken over the service temporarily due to the delayed tender, was stood down. From November to mid-February, the service could be called upon between 08:00 and 16:00 hrs as RAV crew training continued on the job, while the coast guard was on standby at night. From 16 February, the ANWB-MAA helicopters and crews are fully operational on a 24/7 basis. Gepco Ruitenberg stated that after this period, further training will begin in preparation for beginning night flying using night vision goggles (NVGs) on 16 November 2017. Without NVGs, the helicopter will only land by night at predetermined and illuminated spots. ANWB-MAA director Petra van Saaze sees the five-year contract with RAV Fryslan as a new milestone for her company. With the two new helicopters, the fleet grows to seven. Van Saaze explains that the choice of the larger H145 was taken due to customer requirements with sufficient space for patients as well as an accompanying parent or partner to join the flight to the hospital.
The Dutch Wadden Islands have a new helicopter rescue service, as Peter ten Berg reports
not urgent, but the time to travel by ferry is assessed as unacceptable. Originally, Royal Netherlands Air Force AB412 helicopters on search and rescue duty at the Vliehors fighter aircraft weapons range took care of this role as a side job. With the withdrawal of these defence helicopters in January 2015, the Air Force could no longer offer these public ambulance services for the islands. RAV Fryslan director Tjerk Hiddes is excited that after some delay in the tender process, the desired helicopter service is finally running. In addition to 17 nurses, the organisation supplies 10 ground ambulance drivers who have received additional training to become HEMS crew members (HCMs). The HCM is primarily responsible for assisting the pilot during the flyingphase with, for example, navigation tasks and observation of landing zones.
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PETER TEN BERG
PETER TEN BERG
With two brand new H145 helicopters, a new Dutch helicopter ambulance service covering the northern Wadden Islands (also known as the Frisian Islands) became operational on 16 November. As of that date, the Regionale Ambulance Voorziening (RAV) Fryslan, the regional ambulance service, became responsible for aerial patient transportation from the Wadden Islands to hospitals on the mainland. The helicopter service, flying under the call-sign MEDIC01, is operated from Leeuwarden Air Base by ANWBMedical Air Assistance (MAA), which has for many years operated the so called Lifeliner EC135 helicopters in Holland. There is now one H145 for immediate deployment and another helicopter as back-up to guarantee the continuity of the ambulance service. MEDIC01 can reach all island destinations from Leeuwarden within 15 minutes. The helicopter is deployed when requested by a local island general practitioner or the ground ambulance service where a patient is considered to need medical treatment not available on the island. This includes where the patient’s condition is not life-threatening and treatment is
AIR AMBULANCE REVIEW 2017 OUT IN APRIL
Instrument helicopter anyone? IFR for safety, not just a last resort
US pilot Mike Biasatti discusses how IFR proficiency can improve HEMS safety In 2009, I wrote a paper entitled Rule #1: go home at the end of your shift. The previous year, 2008, was the deadliest year on record for US HEMS operations with eight fatal accidents and 29 fatalities, so the article’s intent was to start a discussion among air medical crews on what we could learn from these tragedies in order that we never have another year like that again. There have been a lot of changes in the air medical industry since that fateful
Rule #1: go home at the end of your shift
year: standardisation across the industry, new equipment requirements and several new helicopter air ambulance (HAA) specific FARs (Federal Aviation Regulations) geared toward improving safety, including FAR 135.603, which goes into effect on 24 April 2017. FAR 135.603 establishes that ‘no certificate holder may, nor may any person serve as the pilot-in-command of an HAA operation unless that person holds a helicopter instrument rating’. In reality, most HAA operators in the US already require an instrument rating as a condition of employment; however, this impending regulation sets a benchmark for current and future air medical pilots as a minimum rating requirement for entry. What FAR 135.603 doesn’t do is speak to the topic of instrument currency or proficiency of operating a helicopter in the IFR (instrument flight rules) system. It is a start though. “A superior pilot uses his superior judgment to avoid situations which require the use of his superior skill.” – Frank Borman When I began pursuing my first helicopter pilot’s certificate back in 1989, the idea of an instrument rating was nowhere on my to do list. I assumed the road to a successful career in the commercial helicopter world involved a commercial certificate with a rotorcraft rating, and, as a civilian pilot, a CFI (certificated flight instructor) rating. I can remember as if it were yesterday gazing across the ramp at the Oakland International Airport, standing next to an Enstrom F28A (for my private pilot training) and then later next to an R22 (commercial and CFI training) and looking longingly at a Bell 206 that was 2626
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used by the local news stations. Inside that beautiful airframe was a LORAN (long range navigation) that, compared to the wet compass I navigated by, looked to be the coolest thing I’d ever seen on a helicopter radio panel. I thought to myself that the Bell 206 equipped with the LORAN represented the absolute pinnacle of the commercial helicopter pilot’s career path and upon reaching that peak, I would have arrived professionally. A few years later, it became apparent that an instrument helicopter rating was no longer a luxury, but an absolute necessity to career advancement. The Robinson Helicopter Company had produced an instrument helicopter package (not certified for flight in IMC, instrument meteorological conditions) that allowed flight training under the hood to simulate flying the aircraft with sole reference to the instruments. Even during this training I expected that I would never see the inside of a cloud while operating a helicopter and never did I think that I would one day be piloting both a twinengine and a single-engine HAA under IMC. Fast forward many years and the air medical programme I worked for operated three Bell 412s SPIFR (single-pilot IFR) and a Bell 206L3 SPIFR as a back-up aircraft. Yes, you read correctly, we flew a single-engine helicopter
it became apparent that an instrument helicopter rating was no longer a luxury
under IMC. Now, the fuel range on the Bell 206 wasn’t substantial, so it wasn’t useful for longer-range flight requests, but it allowed for safe acceptance of flights that might not otherwise be accepted because of our ability to enter the IFR system, complete instrument approaches at hospitals as well as airports and, perhaps more importantly, it gave us the freedom to resist the temptation to push forward into deteriorating conditions safely, versus descending into unknown circumstances as ceilings lowered and visibility reduced. It may surprise many to know that it is still possible to certify a single-engine helicopter for flight into IMC – it’s possible but far from practical, with cost and weight providing significant obstacles. CFR Part 27 lists the certification requirements for helicopters in instrument flight, although it relies heavily on Advisory Circular (AC) 27-1. AC27-1 is a policy paper of over 1,000 pages that while like all ACs isn’t regulatory, is however generally accepted as the benchmark requirement edict for manufacturers looking to engineer
many pilots have no interest in utilising their instrument rating for anything other than recovery
or augment a new or existing rotorcraft airframe for IFR certification. In 1999, AC27-1 was revised and then revised again in 2001, each time making the standard for a helicopter to receive IFR certification much more difficult to meet. Interestingly, while the FAA was making it more difficult for helicopters, it was making it easier for singlxe-engine airplanes to receive certification, recognising that ‘most aircraft accidents are caused by something other that equipment failures’. The pilot’s failure to identify and arrest the helicopter’s descent, which resulted in its impact with terrain – NTSB Would flying an IFR-certified helicopter, whether a single-engine or a
twin, reduce the number of helicopter encounters with IIMC (inadvertent instrument meteorological conditions), thereby leading to a reduced number of CFIT (controlled flight into terrain) accidents? Would the industry embrace the ongoing training requirements to keep pilots proficient? When the time came to make the decision to punch in and commit to putting their aircraft in IMC, would enough pilots make that decision, or would there be a significant number who would continue to try and duck under (scud run) in the hopes of improving conditions, only to fall victim to spatial disorientation and loss of aircraft control? NTSB 2011 ﬁgures show that 45 of the 52 IIMC accidents occurring that year were fatal … that is 86 per cent, giving you a 14-per-cent survivability rate if you go IIMC!1 Of course, there’s no way to know the answer for certain, but when I talk with visiting pilots, many express disbelief that our programme not only routinely flies under IFR, not as a last resort to get out of trouble or sneak back into town, but rather for a good part of the year, files and flies from departure to destination planned IFR. Many of these pilots convey that they have no interest in qualifying and then utilising their instrument rating for anything other than recovery. They welcome the opportunity to fly an instrument-equipped helicopter under VFR, but the pilots I spoke to rejected the idea of intentionally entering IMCs in the furtherance of HAA operations, citing a lack of real-world experience, comfort level and confidence. >>
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“The inadvertent encounter with inclement weather, including snow, freezing rain, and reduced visibility conditions, which led to the pilot’s spatial disorientation and loss of aircraft control.” NTSB “The pilot’s improper decision to continue visual flight into night instrument meteorological conditions, which resulted in controlled flight into terrain.” – NTSB There is a huge difference between being legal to file and fly IFR and being proficient, comfortable and safe to do so. It is a very perishable skill and one that requires frequent practice and training, particularly in a single-pilot configuration. Would an increase in the number of air medical helicopters certified for instrument flight reduce these accident numbers? If a more affordable single-engine IFR helicopter were available, would the HAA pilot population welcome this opportunity if given the initial and equally important, ongoing training? At one time, a large majority of air medical helicopter pilots came from the military ranks and had the opportunity to acquire flight in actual instrument conditions, even though their IFR experience was in a dualpilot configuration in larger, multi-engine helicopters. They had the
IFR is a very perishable skill that requires frequent practice and training
axis autopilot. The autopilots being installed allow pilots to select a specific altitude and heading, freeing up the pilot’s hands: the aircraft will maintain level flight, and a specific heading, while allowing the pilot to assess the situation, contact air traffic control and formulate a plan. By reducing pilot workload, particularly during the heightened stress of an IIMC encounter, he or she is able to allow the autopilot to aviate and navigate in the selected flight profile, freeing the pilot to communicate, enlisting the assistance of air traffic control, the onboard crew and his/her dispatch centre. Even in VFR conditions, the ability to set the autopilot reduces pilot fatigue and requires
even in VFR conditions, the ability to set the autopilot reduces pilot fatigue
very little in the way of training. Today’s HAA crews operate in challenging environments, often to unimproved areas at all hours of the day and night with only minutes to prepare. Using good, sound judgement to avoid VFR flight into IMC is crucial. Complementary to that judgement are the enhancements to cockpit instrumentation, advanced navigation, night vision imaging systems, and terrain avoidance warning systems, and now an autopilot adds another in a growing line of safety related technologies that give the air medical pilot, whether in a single-engine, multi-engine, IFR or VFR helicopter, an incredible collection of resources to assist as they and their crew strive to continue to provide exceptional care in the air and, above else, to always follow Rule #1. REFERENCES 1 International helicopter Safety Team - Training Fact Sheet – Inadvertent Entry Into Instrument Meteorological Conditions (IIMC) 2. Elan Head, Cultural Barriers (Article), October/November, Vertical Magazine 2015
opportunity to develop proficiency and comfort with operating in the instrument environment and then bring those skills to the civilian air medical industry. The civilian pilot world, however, doesn’t possess many of these opportunities for pilots. As the industry grew, more and more VFR bases opened, and civilian-trained pilots began to fill the ranks established with the expansion of the industry. Civilian-trained pilots with instrument ratings have likely completed the bare minimum training to achieve that rating and in all likelihood never once acquired any flight time in actual instrument conditions. Would the industry embrace the idea of training a predominantly VFR pilot community to IFR currency and then commit the resources to bringing a more expensive IFR helicopter online, as well as provide the pilots an opportunity to maintain their newly acquired proficiency? From 2001 to 2013, the International Helicopter Safety Team reported that there were 194 accidents worldwide involving single-engine helicopters, IIMC or CFIT and low-level flight to avoid weather (fifty-seven occurred in the US). Of the worldwide total, 133 were fatal accidents that killed 326 people. None of the accident helicopters were IFR-equipped.2 Perhaps a more practical idea, and one that will be more feasible in implementation, is what industry giants Air Methods and Air Evac Lifeteam are incorporating into their light single-engine turbine helicopters: a two2828
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AUTHOR MIKE BIASATTI A helicopter air ambulance (HAA) pilot in the US for over 15 years and a certificated helicopter pilot since 1989, Mike Biasatti continues to enjoy all things helicopter. In 2008, the deadliest year on record in the US HAA industry, he founded EMS Flight Crew, an online resource for air medical crews to share experiences and learn from one another with the goal of promoting safety in the air medical industry. He continues to write on the subject of aviation safety, particularly in the helicopter medical transport platform with emphasis on crew resource management and communication.
Diploma in Retrieval and Transfer Medicine A paramedic’s summary
Jeff Proctor an advanced retrieval practitioner in the UK’s Emergency Medical Retrieval Service, discusses what’s involved in preparing for and achieving the DipRTM qualification DipRTM is awarded by the Royal College of Surgeons of Edinburgh (RCSEd), UK, through its Faculty of Pre Hospital Care and was conceived by a multidisciplinary group of clinicians who work in retrieval medicine internationally. The exam’s main focus is the retrieval of patients from one hospital facility to another. An increasing number of paramedics and nurses are now involved in prehospital critical care and retrieval medicine. Due to the multidisciplinary nature of retrieval medicine, it is prudent that a recognised examination exists that allows candidates to demonstrate a safe, robust and proficient approach to retrieval medicine. Launched in 2012, the DipRTM offers candidates the opportunity to apply themselves to the comprehensive syllabus and then undertake a written exam and OSPE (Objective Structured Practical Examination) stations over a two-day period. The DipRTM is open to doctors, nurses and paramedics as retrieval medicine is rarely a solo undertaking. Often, the most cohesive and efficient retrieval teams will draw on clinicians from a range of backgrounds and experience. Since its inception, a variety of nurses and paramedics working in retrieval and transfer medicine have successfully completed the DipRTM. Syllabus The DipRTM syllabus is a comprehensive document from which the exam questions and OSPE scenarios are derived. There is a strict adherence to this policy, therefore candidates can expect only to be tested on material they will have previously covered in the syllabus. There are six sections including: 1. clinical; 2. environmental; 3. operational; 4. equipment; 5. communication; 6. management and leadership. Candidates will be expected to already have experience of working within the retrieval and transfer environment. There are several core texts that will assist the candidate with working through the syllabus. These core texts are augmented by additional suggested reading material. This, along with the candidate’s practical skills, knowledge and experience, will assist with the successful completion of the DipRTM. Written exam The written paper is divided into two parts with one being single-best-answer questions and the other following a multi-source-answer format. Both written papers are completed on day one of the exam. Attention to what is being asked in each question as well as focused timekeeping is important to making sure the candidate has the opportunity to answer all the questions. OSPE The OPSE circuit takes place on day two of the exam. Each candidate will rotate though a dozen or so scenarios designed to test their skills and knowledge of retrieval medicine. All OSPE stations address elements of the syllabus to ensure that as much subject matter as possible is presented to each candidate.
“The pilot’s failure to maintain terrain clearance as a result of fog conditions. A contributing factor was inadequate weather and dispatch information relayed to the pilot.” – NTSB
A still from an RCSEd video with advice for undertaking the OSPEs
Personal thoughts The author is from a paramedic background and spent several years working on ground ambulances prior to becoming involved with aeromedical retrieval. After two years working within a retrieval service, I considered the DipRTM as an attractive development opportunity and consequently applied for and sat the exam. The syllabus for the exam covers a wide range of material related to retrieval medicine. When studying, I found it increasingly important to make sure I had a good grasp of each syllabus section and the content within it. The core texts are invaluable learning aids as are the associated reading materials. I was part of a study group where we practised equipment familiarisation, drills and Q&A sessions as much as possible in order to polish our skills for the OSPE stations, again considering the content of the syllabus. Reading all questions thoroughly and keeping to time were the two main learning points from the written paper. For the OSPE stations, having a structured and systematic approach was found to be very useful. This, coupled with pre-existing experience, allowed me to proceed with each OPSE topic in a safe, competent and logical manner. This technique is what examiners are looking for. Although I was studying for an exam, the process of learning for the DipRTM allowed me to gain a significant amount of new knowledge that I may otherwise not have had. Broadening my understanding of retrieval and transfer medicine has certainly allowed me to better understand the challenges and requirements for safely conducting patient care in the retrieval environment. Becoming an examiner for the DipRTM has now allowed me to support and contribute to its continued delivery. As highlighted before, it is a systematic and safe approach along with good timekeeping and attention to detail that will produce a successful DipRTM candidate. I would strongly encourage other paramedic and nursing colleagues, working in retrieval medicine, to consider the DipRTM as an achievable and desirable adjunct to their professional practice. For more information, visit https://fphc.rcsed.ac.uk/examinations/diploma-inretrieval-and-transfer-medicine.
AUTHOR JEFF PROCTOR Jeff Proctor worked as a paramedic in London and Glasgow, UK, before joining the Emergency Medical Retrieval Service. He now works as an advanced retrieval practitioner based at Glasgow Airport.
MILITARY SAR SPECIAL EDITION
MILITARY SAR SPECIAL EDITION
Task Force Gunfighters rewarded for medevac
US pararescue chief retires
US Forces Afghanistan has reported that a team from US Task Force Gunfighters was recently honoured for an evacuation that they completed on 21 September in Khost Province, Afghanistan. Task Force Gunfighters is comprised of 1st Combat Aviation Brigade pilots, crews, and teams from the 1st Infantry Division, Fort Riley, Kansas. It conducts attack, assault and medical evacuations in support of Train, Advise, and Assist Command
Chief Master Sgt Davide Keaton, superintendent of 26th Special Tactics Squadron in the US, has retired after 30 years of service as pararescue chief. During his service, Keaton won many accolades, including major command pararescueman of the year, Pitsenbarger Award valor under fire, AF pararescue senior NCO of the year, and the AF Lance P.Sijan senior NCO of the year. “It’s not just retiring a Special Tactics Chief,” said Col Michael Flattern, vice-commander
– East, Special Operating Forces, and Afghanistan National Defence Security Forces (ANDSF). Captain Cody Sneed and his UH-60 Blackhawk flight crew were called to action after an ANDSF team was pinned down by enemy machinegun fire. One of the ANDSF soldiers received a gun wound to the head and so needed to be medically evacuated. “We were executing a patient transfer when we were dynamically re-tasked to respond to an urgent nine-line MEDEVAC request,” recalled Sneed. The crew quickly completed the patient transfer, landing at FOB Dahlke to refuel the helicopter. After taking to the air again, the team pinpointed the location after picking up radio traffic from the 1-1 ARB Attack Weapons Team (AWT) that was then directly supporting the ANDSF Chief Warrant Officer Craig Bakies, Sg. Michael Charles, Chief Warrant Officer ground forces. Matthew Seiber, Staff Sgt Kathryn Asurmendi, Sgt Joshua Steveson, Spc. Justin “The pilots were taking Couvitier, Staff Sgt Trevor Thompson, Capt. Cody Sneed, Sgt Chad Carmichael, and Chief Warrant Officer Kerry Hall Credit: Capt. Cody Sneed the information and
the radios were going crazy,” said Sgt Michael Charles, crew chief. “Staff Sgt Thompson (flight paramedic) was prepping all the medical gear that he might need for the patient.” Whilst under enemy tracer fire, the helicopter manoeuvred above the designated medevac site. As ground forces and the supporting Apache helicopters cleared the landing site, the Blackhawk hovered at an altitude of around 10,000 ft, waiting to move in. The intended pick-up zone was changed three times before finally it was safe for the medevac chopper to land. “We landed in a riverbed,” said Thompson. “The patient had been shot in the head. It was a very fast transfer to our aircraft and we departed immediately for Chapman Theater Hospital.” “Staff Sgt Thompson and Sgt Charles worked seamlessly together to start lifesaving interventions for the 10 to 15 minutes flight to the hospital,” added Sneed. “Undoubtedly, this saved that soldier’s life.” Sneed, Charles and Thompson were each presented with the Air Medal for their achievements on 18 December 2016 by Gen. Mark Milley, chief of staff of the US Army, and Sgt Major of the Army Daniel Dailey.
of the 24th Special Operations Wing at a special ceremony on 12 January. “It’s retiring a close friend, a brother in arms, one of my heroes… and one of the best men Special Tactics ever produced.” Keaton originally joined the US Army as part of the Security Forces before transferring to the pararescue service in 1992. Over the course of his career, Keaton attained paramedic, static line and freefall jumpmaster and dive medical tech qualifications.
“In every annual report, Dave’s maturity, drive, professionalism, pursuit of training, selfless service and focus on the team is high,” added Flattern. “He continued to save people, on the battlefield and off… including two military working dogs.” Keaton was deployed over 15 times throughout his career. He said at the ceremony: “I love pararescue; I loved my career, I love the men I served with and the ST community as a whole. That’s why I stuck around it for so long: it was home for me.”
Combat Squadron (HSC) 25 in the US
The ‘Island Knights’ of Helicopter Sea
An MH-60S Sea Hawk Helicopter assigned to the Island Knights of HSC-25
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completed their first rescue operation of 2017, assisting with the recovery of two small vessels that were in distress off the coast of Guam on 23 January. A distress flare was first spotted by HSC-25 aircrew members when out on a training exercise. Two MH-60S Sea Hawk helicopters were then dispatched to find the source of the flare using their infrared cameras and night vision goggles. Both boats were located approximately 10 miles (16 km) southwest of Cetti Bay. The boats were without power, having to cope with 10 to 12-ft high waves. The Island Knights marked their location, waiting for Guam Fire and Rescue to arrive. Last year, HSC-25 aided the US Coast Guard and Guam Fire and Rescue in over 60 SAR missions throughout the Northern Mariana Islands.
SENIOR AIRMAN RYAN CONROY
First SAR mission of 2017 for Island Knights
Chief Master Sgt Davide Keaton wearing his maroon beret for the last time
MILITARY SAR SPECIAL EDITION
MILITARY SAR SPECIAL EDITION
US Air Force A-10s receive CSAR upgrade US Air Force (USAF) A-10C Thunderbolt II planes assigned to active duty fighter squadrons at DavisMonthan Air Force Base, Arizona, US, are in the process of being upgraded with new lightweight airborne recovery systems controllers. The USAF said the new LARS V-12 systems will allow the A-10Cs to communicate more effectively with individuals on the ground, through the system’s speech or text communication functions. It will also provide the pilot
with the individuals’ GPS co-ordinates. The upgrades are being installed by the 309th Aircraft Maintenance and Regeneration Squadron (AMARG). “This urgent operational need arose in August (2016),” said Timothy Gray, the 309th AMARG acting director. “Air Combat Command and the A-10 Program Office asked me if AMARG could complete 16 aircraft by December. I said, ‘Absolutely!’ It was awesome to see Team AMARG take on this massive logistical challenge, build a production machine,
find facilities, manpower, equipment, tools, and make material kits (to) execute the requirement.” As of 6 January, 19 aircraft had received the LARS upgrades which will provide ‘pilots and ground personnel downrange with a valuable search capability’. Lt Col Ryan Hayde, the 354th Fighter Squadron commander and A-10 pilot, added: “A-10 pilots take the combat search and rescue role very seriously. While this is just one tool, it can assist us in bringing them back to US soil safely.”
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2nd SAR group trains in snow
The Polish Air Force’s 2nd Search and Rescue Group recently held a trained on finding survivors by homing in on personal locator beacon signals. A crew onboard a PZL W-3WA helicopter was tasked with locating one of the unit’s
Polish Air Force
most experienced pilots, who made every effort not to be discovered, forcing the crew to rely on a thermal camera and the beacon signal. Once the pilot was found, medical crew members were lowered from the aircraft in order to prepare him for winching onboard. The Air Force reported that the exercise was repeated several times, despite the severe cold and reduced visibility caused by snowed whipped up by the helicopter’s downwash, saying: “It’s very important to maintain the greatest possible effectiveness of the Group in the event of an aircraft accident or emergency situation, where every minute is important for saving human life.”
Attack victims airlifted in Mali A Portuguese Air Force C-130H Hercules from 501 ‘Bison’ Squadron, working as part of the MINUSMA mission (United Nations Multidimensional Integrated Stabilization Mission in Mali), was involved in the response to an attack on the Mécanisme Opérationnel de Coordination (MOC) military base in Gao, Mali.
On 18 January, the aircraft and personnel from the Força Nacional Destacada were engaged in logistical support in the theatre of operations, transporting MINUSMA medical teams as well as a Portuguese military medical team. Two days later, the plane was utilised to transport 11 people left wounded in the attack from Gao to Mali’s capital Bamako.
Brazilian SAR team takes course in Spain The Brazilian Air Force (FAB) sent six of its crew members to Seville, Spain, The team in the classroom at the beginning of January in order to complete a specialist course for the service’s new CASA C-295 search and rescue plane. The training lasts two months, said the FAB, and is offered by International Training Centre (ITC). The six airmen will learn to operate the systems onboard the new aircraft, including the mission support centre (MSC), which allows real-time data from the mission, including video and audio, to be transmitted to an operations room. 34 34
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Once the current six students finish the course in March, another six will fly out in their place. The course teachers, said FAB, are all either Airbus employees or former Spanish Air Force personnel. “They are highly experienced in the area of operation of the mission system,” said Sgt Ednei Jones de Carmo, one of the six course attendees, of the instructors. FAB’s CL-X2 programme, under the management of the Coordinating Commission for the Combat Aircraft Programme (COPAC), has laid out plans for the purchasing of two CASA C-295 aircraft for search and rescue purposes. The first is expected to be delivered in mid-2017, said the FAB.
Helicopter Tactics Synthetic Training
waypoints In a video published in December, Commander Scott Sanborn of the US Coast Guard (USCG) has explained what being a Coast Guard aviator means to him in a new video for the force’s YouTube channel. The video is in honour of the centennial anniversary of Coast Guard Aviation. www.airmedandrescue.com/story/1713 In December, the Chilean Ministry of Defence exhibited its SAR capabilities at Muelle Vergara in Viña del Mar, Chile. As well as exhibiting its rescue boat, the service performed a number of helicopter winch rescues in front of a gathered crowd to highlight the dangers that visitors to the beach may face. At the event, officials highlighted the 25 deaths that had taken place at the beach in the previous year, and the 300 call-outs that the service attended. www.airmedandrescue.com/video/1733 The German military (Bundeswehr) is relocating four of its MH90 transport helicopters to Mali, in order to assist in UN missions in the country. The helicopters will mainly be used for medevac missions, with the plan to have two of them ready to launch at all times. The helicopters were flown to the country along with an AN-124 transport plane.
M134/M240/GAU21 Aerial Gunnery
V H IS el IT i E U xp S o AT 20 B 17 O O in TH D 2 al 4 la 17 s, T X
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Tactical Hoist Rescue
PR / Technical Rescue
PR / Tactical Medicine
PR / CSAR Mission Rehearsal Scenarios
Instructor-Led / Facility Dry Lease Options
A US Coast Guard Sector Columbia River MH-60 Jayhawk helicopter rescued an injured crewman off a ship near the mouth of the Colombia River, Oregon on 6 January. The injured man was hoisted off the ship’s deck safely and taken to Warrenton, where he was then transferred to Columbia Memorial Hospital in Astoria, Oregon, via ground ambulance. www.airmedandrescue.com/story/1757 The German Armed Forces has released a video profiling the role of the door gunner, which is essential to protect helicopters flying in combat zones for missions including search and rescue. The clip features scenes of a CH53 flying over Masari-Sharif, Afghanistan and an interview with doorgunner nicknamed ‘Wolle’ (‘Wooly’). www.airmedandrescue.com/story/1814
Your Partner for SAR-Tactical Mission Success
MILITARY SAR SPECIAL EDITION
A day in the life of a Canadian SAR pilot A Canadian Royal Air Force SAR unit has allowed a peek into what one of its members does on an average day. Captain Nicolas Bossé is a search and rescue (SAR) pilot with 424 Transport and Rescue Squadron, 8 Wing Trenton. As the pilot of a CH-146 Griffon helicopter, Bossé helps Canadian Armed Forces SAR units to respond to some 400 call-outs every year in central Canada. On 19 June, Bossé was called out to a jet skier incident. The man in question had been out in Inner Bay, Norfolk County, Ontario on Lake Erie, but had failed to return. Bossé was tasked to lead a team of two pilots, two SAR technicians and a flight engineer from the 424 Transport and Rescue Squadron out to locate the jet skier, but first the team gathered as much information on the man as they could. “Usually when we get a call similar to this, we want to know the sex and age of the person,” explained Bossé. “We ask for any medical conditions that the person may have – for example, cardiac conditions or diabetes – so before going out we know a little about the person we are looking for and can anticipate the type of treatment the SAR techs may have to administer. We also ask for the person’s last known location, the possible route he might have taken and
whether he was familiar with the area.” The weather on the night of the search was windy and dark, and due to mission taking place over water, Bossé decided to request the support of a CC-130 Hercules. The Hercules, noted the Canadian Armed Forces, can fly higher during night SAR missions than the Griffon and illuminate the ground with flares. It can also search for signs of distress, and if one is found, the Griffon can then fly closer to investigate. Around 15 minutes after the search started, Bossé’s Griffon received word from the Canadian Coast Guard that the local fire department, who had been helping with the search on ground, had heard shouting. Bossé explained what the team did next: “We asked for their position and we made our way towards that location. We started searching an area covered five to six feet tall in grass, with several narrow paths in the grass. After looking around for some time, we spotted somebody on the water. We investigated a bit more and we found the overdue person standing on his jet ski frantically waving.” After the man was located, a SAR tech was lowered down to him and he was then hoisted up into the Griffon. Despite it being 01:00 hrs, the man seemed in good shape, though was ‘visibly tired’.
“When we brought this person onboard the chopper, I turned around and saw him smiling and I could see a sign of relief on his face: ‘I’m onboard, I’m safe’. It was really, really rewarding,” said Bossé. The man was then flown to the nearest hospital, concluding an effective SAR mission. The mission took five hours to complete, from the moment the team was tasked to the moment the jet skier was brought to hospital. Bossé commented on what is most difficult about missions like these: “For us, the most challenging thing while flying the Griffon Helicopter is having to do a hoist sequence over the water with few hover references. That’s why when we do this type of mission over the water, we always ask for Hercules support so they can provide illumination, which helps with maintaining a steady hover.” One of the keys to a successful mission, according to Bossé, is making sure he and his crew are well rested. “As soon as we get a call, we’re supposed to be able to provide a 15-crew day. That means we could be tasked to work a 15-hour tasking.” Despite this, Bossé is glad he does the job he does: “For this mission and any mission where we save lives, it is extremely rewarding because we make a difference.”
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CANADIAN ARMED FORCES
From left to right: Master Corporal Jeff Beaudry, Master Corporal Terry Shanks, Sergeant Cory Cisyk, Captain Stephanie Pouliot, and Captain Nicholas Bossé
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MILITARY SAR SPECIAL EDITION
MILITARY SAR SPECIAL EDITION
CSAR pilot makes Air Force Reserve history but spends most her time looking after two young children. “Maj. Orton is a very professional aviator,” stated Lt Col David Underwood, CSAR pilot with the 39th Rescue Squadron. “She always comes well prepared and ready to execute whatever task we have. With over 20 years of experience as an enlisted crew member, and as an officer, she has a perspective that few in our community have.”
Orton began her career as an aircraft loadmaster before gaining a bachelor’s of science in education degree and then completing flight school. She now flies the HC-130P/N King plane. Orton commented: “I love the variety of missions we fly. There are so many different things we do in the C-130, like refuelling, hauling cargo and dropping PJs [pararescuemen].”
Members of the US Air Force Reserve 315th Aeromedical Evacuation Squadron (AES) took advantage of a humanitarian aid mission being conducted by the 300th Airlift Squadron to carry out medical training inside the C-17 Globemaster III being used in the mission. The aircraft and its crew had been tasked with bringing six pallets of humanitarian aid to Ramstein Air Base, Germany, which were destined for northern Iraq. “Working with the flying squadrons creates
a unique opportunity for our medics to train in the air and still supporting the mission,” said Master Sgt Johnny Gomez, 315th AES medical technician. “Our job takes place in the air, from training to real world.” The opportunity to train in the air is priceless, said the unit, and offers the chance to train in an unstable environment, accounting for issues that can only occur when in the air. Although the reserve airmen’s civilian medical jobs assist them, being in an airborne environment can be
very different. “The stresses of flight, from changing altitudes to in-flight turbulence, provides real-world experiences for our medics,” said Tech. Sgt Maria Wesloh, 315th AES mission crew co-ordinator. “Many scenarios they’re facing while training is based on real-life events we’ve faced before.” She added: “Our hope is that the flying medics will learn what to do the first time within a training environment. That way, if the real thing happens… they’re ready.
SENIOR AIRMAN BRANDON KALLOO SANES
The US Air Force Reserve has reported that one of its pilots, Citizen Airman Maj. Jennifer Orton, recently found out she is the first female fixed-wing combat search and rescue (CSAR) pilot in US Air Force Reserve history. As part of the 39th Rescue Squadron, Orton has logged approximately 3,000 hours flight time, including deployments in Afghanistan, Iraq and the Horn of Africa,
US reserve air medics train onboard C-17
Orton in the cockpit of a HC-130P/N King
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autonomy to fly for four and a half hours, can take part in a range of operations on short runways, as well as unprepared runways or aerodromes.” There were a number of other representatives at the event, including the director general of the Air Force, Belsio González, assistant director general, Luis E. Ruiz E, members of the Aeronaval Board and the Canadian ambassador to Panama, Ana Karin Aslein.
SENIOR AIRMAN TOM BRADING
Panama’s Servicio Nacional Aeronaval (SENAN) has announced the launch of its new Twin Otter DHC-6, which will be entering into service to assist with humanitarian aid transport, search and rescue duties, and other missions. President Juan Carlos Varela attended the ceremony, which took place at Teniente Octavio Garrido Air Base, and said: “This aircraft, with state-of-the-art technology, fully integrated digital avionics and
SERVICIO NACIONAL AERONAVAL
Twin Otter takes flight in Panama
The US reserve airmen training in flight
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MILITARY SAR SPECIAL EDITION British Columbia, is expected to begin shortly. The final aircraft should be delivered in 2022. Slow approach The process has been a long one, spanning three governments and several delays. The Canadian government originally announced its intent in the spring of 2004 to buy a new fleet, but the project was temporarily shelved in 2006 followed by a litany of more delays blamed on reasons
A rendering of a C295W in RCAF colours
like higher priorities of equipment for Canada’s Afghanistan mission. As well, allegations were made by domestic aerospace firms and Airbus that the RCAF rigged the process to favour of the C-27J – which the RCAF denied, according to a CBC news report at the time. So the case was referred to the independent National Research Council, which agreed the RCAF’s demands were much too specific and needed to >>
“it was not the lowest cost-compliant bid, but the one providing the best value for Canadians”
The C-27J as proposed by Alenia Aermacchi
Graham Chandler reflects on the journey taken by the Royal Canadian Air Force to replace its veteran fixed-wing SAR fleet, and looks at how the new C295Ws will benefit the nation
aircraft. The C295Ws will replace Canada’s six CC-115 Buffalo and 13 CC-130H Hercules planes currently tasked with FWSAR missions at five bases across the country. It is a long overdue replacement: the RCAF’s Buffaloes were first delivered in 1964, and some of the Hercules arrived in the same decade. Many in the fleet have operational lives approaching In awarding a CA$2.4-billion contract to Airbus Defence and Space for 50 years. 16 C295W planes, the Government of Canada last December brought Under the contract, many of Canada’s top aerospace and defence firms to a close a 12-year odyssey searching for a replacement for the Royal will benefit. Engines will be manufactured by Pratt & Whitney Canada, Canadian Air Force’s ageing fleet of fixed-wing search and rescue (FWSAR) electro-optical systems by L3 Wescam, and other mission systems by Lockheed Martin Canada. CAE, Canada’s training and simulator manufacturer, will design, develop, and manufacture the training solution, including simulators. In-service support for the life of the programme will be provided by AirPro, a joint venture between Airbus Defence and Space and PAL Aerospace of St John’s, Newfoundland. The contract requires Airbus to provide 70-per-cent availability, so the RCAF can be sure to meet its SAR responsibility 24/7, 365 days a year. The RCAF will keep first-line maintenance and servicing, and Airbus will be responsible for all second and third-line maintenance. This will add an estimated $2.3 billion to the price tag over the life of the aircraft, which are to fly until 2043. The first aircraft will be delivered and training is to begin in 2019. Construction of the new training centre in Comox, The new C295Ws will be some 50-per-cent faster than the Buffaloes (example pictured) they replace 40 40
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MILITARY SAR SPECIAL EDITION and Space focused on the capability which included the requirement for modern and effective technologically advanced systems, and a robust comprehensive in-service support programme to ensure availability of aircraft when needed,” says Boucher. “The company also took into account the industrial and technological benefits policy in order to encourage highvalue jobs for Canadians and generate growth for Canada’s aerospace and defence sector.”
a new mission management system can record and track up to 200 search objects at the same time
Boeing suggested the game-changing V-22
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Adopting tiltrotor aircraft for SAR
Increased responsiveness Canada is the second-largest country in the world. To meet its challenging and diverse search and rescue environments, each C295W will be equipped with state of-the-art sensors including: • a search radar able to detect people and objects hundreds of kilometres away in all weather conditions (the current FWSAR aircraft use just weather radar);
be broadened. Finally, in 2011 a brand new ‘Statement of Operational Requirement (SOR) to acquire a modern, effective replacement FWSAR aircraft to provide the capability for the next 30 years’ was issued. In December 2011, the project management office was re-established, and in March 2012 expenditure was approved, allowing development of the request for proposal, which was finally posted in March 2015. The following January, bids were closed with three proposals submitted. In March 2016, aircraft were tested at the bidders’ facilities, and in June that year bid evaluations got underway. The three companies in the running were Alenia Aermacchi North America (now rebranded as Leonardo-Finmeccanica) for the C-27J, Airbus Defence and Space for the C-295W, and Embraer for the KC-390. They were asked to submit prices and aircraft numbers for a fleet that would operate out of at least four main bases across Canada: Greenwood, Nova Scotia; Trenton, Ontario; Winnipeg, Manitoba; and Comox, British Columbia; with a separate proposal using only three airfields. Current SAR squadrons operate out of these four bases as well as a fifth at Gander.
AgustaWestland (now Leonardo) and SAR provider Bristow announced signed a platform development agreement for the AW609 TiltRotor programme in 2015
Best value The winning bid wasn’t necessarily the lowest priced. “A best-value approach was used for the evaluation of bids,” explains Nicolas Boucher, of Public Services and Procurement Canada, the federal agency responsible. “It was not the lowest cost-compliant bid, but the one providing the best value for Canadians.” The contract was awarded on a weighted points basis: 65 out of 100 points on capability, 25 on cost, and 10 on economic benefits to Canada. “The winning proposal received the highest overall score – Airbus Defence
Full tilt, shared cost
Embraer’s choice, the KC-390
• an electro-optical/infra-red camera to detect and identify objects and to detect heat radiation for searches where vision is obscured, e.g. at night or in wooded area searches; • an automatic identification system to locate and identify ships; • a communication system compatible with other SAR assets (i.e. aircraft, ships, searchers on the ground, the rescue co-ordination centre, etc.); • and a new mission management system that can record and track up to 200 search objects at the same time. Compared to the aircraft models it replaces, the C295W is 50-per-cent faster than the Buffalo and about 10-percent slower than the Hercules, says Lieutenant-Colonel Jean-François Godbout, project director for the FWSAR Project in Ottawa, who completed two SAR operational tours – on the CC115 Buffalo in Comox, British Columbia and on the CC130H Hercules in Greenwood, Nova Scotia. He explains how they evaluated the C295W against the existing two types. “When we did the assessment we looked at the 13-hour crew day and the range, and based on the historical data of SAR missions that have taken place said can we fly to the scene with the required payload, can we stay on scene for an hour before we need to recover?” he explains. “When you combine all of the sensors and how they operate with other agencies, it definitely increases that level of responsiveness so you are getting the same level of comparison.” “It will be a great asset to the RCAF,” sums Godbout.
Tiltrotor aircraft have proven themselves a useful asset in the military sphere, and, although costly, boast novel capabilities that make them particularly suited to the rescue role. Femke van Iperen looks whether cost sharing could boost the hybrid aircrafts’ potential future in this type of mission The Bell Boeing V-22 Osprey has been marketed as benefiting from a ‘successful blend of the vertical flight capability of a helicopter, with the speed, range, altitude and endurance of an airplane’, and a ‘survivable and transformational platform in the most challenging environments on the planet.’ The world’s first production tiltrotor aircraft, it has been described as ‘the most in-demand aircraft with the U.S. Marine Corps’ and has seen action in combat operations in Iraq and Afghanistan*3. The Osprey also made an appearance for example during the Trident Juncture 2016 NATO exercise, when it was referred to by a Dutch Ministry of Defence magazine as a ‘very special bird’ after it had landed for the first time on the deck of the Dutch Landing Platform Dock (LPD)*4. A next-generation tiltrotor also aimed at the military is in development. A lighter, cheaper machine than the V-22, the Bell V-280 Valor (which has been marketed as having ‘twice the speed, twice the range of current helicopters’) has been designed for ‘warfighters’ strategic options*5’, and is described as ‘a Black Hawk that can adjust its thrust to fly like a fixed-wing aircraft once it’s airborne’. The V-280 could also have applications outside of combat missions. Frost & Sullivan aerospace and defence senior industry analyst Mike Blades noted in a report by National Defense Magazine in July 2015 that the aircraft ‘could also be marketed for medevac and search-and-rescue missions*7’. All in all, the high speed, long range and vertical lift capabilities of tiltrotors make them particularly suited to SAR missions.
A way to go However, the development of tiltrotors is early and whereas the Bell Boeing V-22 is in production and provided for military usage, the V-280 Valor is still in the testing phase and yet to make its first flight. Another model in development, the AgustaWestland AW609 (which started life as the Bell/Agusta BA609), is believed to be around two years out from certification, AMR was told.
the high speed, long range and vertical lift capabilities of tiltrotors make them particularly suited to SAR missions
There have been reports of tentative international interest in the V-22 (from for example Israel and India), but the high purchase and ongoing costs remain a barrier. In the previously-mentioned National Defense Magazine report, Blades warned that for the V-280 to be considered for medevac and SAR missions, its ‘operating costs would need to come down considerably’, despite its having been designed with particular attention to ‘manufacturing, assembly, and sustainability,’ thereby ‘greatly reducing the total cost of ownership’. In the same report it was also referred to >>
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MILITARY SAR SPECIAL EDITION ‘fertile soil’ for tiltrotor aviation. AIA through Project Thunderbird is seeking early sensible adoption of this technology for the clear benefits it will bring to patient care.” Referring to the issue of tiltrotors and cost, Adams said: “Capital expense largely looms as the most prohibitive feature of tiltrotor technology to interrupt Project Thunderbird and delay acquisition within Australasia. Cost
US AIR FORCE / SENIOR AIRMAN NESHA HUMES
there has also been interest in the use of tiltrotors in civilian SAR
efficiency will be achieved via approaches that capitalise on the tiltrotor’s capacity for ‘economy of scale’. As such, AIA supports any concept that permits early adoption for the clear benefits it will bring to patient care. AIA also has a vision for key facilities at Wellcamp Airport as a regional hub to support the emerging era of tiltrotor aviation in Australasia.” In November in 2015, there were also news reports on how the Joint Aviation Command (JAC) of the UAE had selected three AW609s for its SAR missions for future delivery. The decision had been based on the tiltrotor’s ‘unique speed and range characteristics, combined with its ability to hover,’ and an AW609 spokesperson from Italy-based manufacturer Leonardo confirmed with AMR that the company has a number of agreements on order from customers around the world, and firm contracts with the UAE for example, for a SAR variant of the aircraft. In fact, the Leonardo website, which attributes the SAR potential of its tiltrotor to its ‘pioneering combination of hovering flight, high speed, ability
Kenyan Defence Forces officers observe a CV-22 Osprey during a personnel recovery demonstration near Camp Lemonnier, Djibouti, 2015
Opportunities such as this may help pave the way to make tiltrotors more affordable for nations interested in employing them for their SAR needs.
the AW609 is around two years out from certification
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A US Marine Corps MV-22 at Fort Hood, Texas, during a 1,100-mile proof-of-concept raid exercise in 2013
‘so-called ownership cost’ of flying the V-22 (overall expenses divided by the number of hours the aircraft flies per year) as more than $83,000 per hour. However, V-22 Joint Program Office programme manager US Marine Corps Col Daniel Robinson has mooted a potential solution to reduce the overall life-cycle cost of tiltrotor aircraft. Nations could benefit from independent ownership of the aircraft, he explained, but share support such as repair, training, and aircraft modification capabilities: “A shared regional logistics support concept could be tailored to individual customer needs and include an allocation of service, with costs based on portion of fleet flying hours,” he said of a concept that he presented at the 2016 Farnborough International Airshow. “Host countries could stand up one or more of each of the support areas including fleet support; supplier repair programmes; integrated logistics; intermediate or depot maintenance; supply chain management; engine management and training,” he said. Clarifying further that there are many possible forms this concept would take, Robinson added: “As an example, it could include independent country aircraft ownership, but share a common regional support concept. The shared concept could leverage industrial participation in host countries and could use the NATO Sustainment and Procurement Agency (NSPA) for legal framework, authorities and agreements.” Although Col Robinson told AMR that at this time, nothing has been set in motion as far as the international sharing concept is concerned, there has been interest in it, and ‘discussions are ongoing with NATO and the US Government’.
SAR interest In the meantime, besides its overall military success, there has also been some reported interest in the use of tiltrotors in civilian SAR (and related) missions in particular. In Australia for example, Aeromedical Innovation Australasia (AIA) has been running a campaign, AIA Project Thunderbird, which is described as an ‘initiative to improve clinical outcomes and increase efficiency of aeromedicine for rural Australians through the integration of tiltrotor aircraft’. AIA chairman Dr Paul Adams told AMR: “The AW609 Tiltrotor is a prodigy aircraft for Australian Aeromedicine. In fact, the whole of Australasia is
to fly in full icing conditions, and long-range capacity’, promises its tiltrotor to be ‘an unrivalled asset for government or private SAR operations’ amongst others, and assures this in ‘even exceptionally difficult emergency situations’. Said the Leonardo spokesperson: “The US continues to work in support of the industrialisation, certification, and assembly of the AW609. The company’s site in Philadelphia has been selected as the first final assembly line for the AW609, including deliveries for SAR-configured aircraft, such as in the case of the UAE. Work on all configurations of the AW609, including SAR, VIP, EMS, and offshore transport, continues as the programme moves towards certifications.” The AW609 is ‘ideal to support long-range surveillance and SAR operations up to 300 nm from shore, aiding in border patrol, maritime rescue and homeland security efforts,’ the spokesperson further explained. “Those operators requiring emergency medical capabilities will benefit from a pressurised cabin that allows for a broader range of treatment options and the ability to reach patients that were previously inaccessible, and travel faster to specialised and critical care medical centres,” she added. Meanwhile, it was reported in July 2015 that the first international contract for V-22s involved Japan’s Ground Self-Defence Force (JSDF), which would purchase some of the aircraft for its country’s ‘defensive and humanitarian operations’, as they would providing ‘an ideal platform for relief efforts in response to natural disasters’. A JSDF spokesperson confirmed with AMR that the Force ‘are planning to procure 17 V-22 Ospreys in total’, to be delivered at a later stage, and said: “These tiltrotor aircraft are expected to be extremely vital equipment in terms of maintaining Japan’s security and disaster relief operations.” The Bell spokesperson said: “At this time, our current in-production tiltrotor – the V-22 – is provided for military usage only. However, its platform along with the V-280 is something we see as viable options for military SAR.”
Concept image of a V280 on a humanitarian relief mission
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MILITARY SAR SPECIAL EDITION Joint PR Centre (JPRC) communicated with all of the departments. The colonel gave an example: “When a task force asked to have 15 minutes extra because they cannot make the boarding time, then the JPRC had to go co-ordinating with all those players. But they had to be looked up somewhere, because they moved around.” In order to prevent that from happening on the 2016 course, a smallscale air operations centre, or a course operations centre was established on the base. All the key players are present in the room and they don’t leave. “If the request comes to delay departure for 15 minutes, they can immediately ask if it’s possible,” said Holewijn. In this way, communication lines are now shorter. Information can immediately be communicated to the other players in the room. “Especially if it becomes clear that we cannot fly for any reason, then you immediately have everyone available. Every player can call his people to make them come back.”
Air Centric Personnel Recovery Operatives Course
Theory days The course starts with two days of theory. The first day focuses on what PR is, but attendees are expected to know a little about that already. In addition, information is provided about local regulations, about what the participants can expect, what the survivors’ roles will be in this course, and the capacities and capabilities of the various aircraft. The second day is focused on planning: how the planning process works, how to divide tasks, what steps to go through and how to use various tools.
Jeroen van Veenendaal spoke to Lt Col Bart Holewijn, director of the APROC course held at Lechfeld Air Force Base in Germany from 28 September to 12 October From 2002 to 2006, the European Air Group (EAG) conducted VOLCANEX Exercises with a heavy focus on combat search and rescue (CSAR). These exercises provided not only valuable training for the participating forces, but also threw up a variety of lessons learned. Through these, it became obvious that Force Integration Training was extremely valuable. As no other training opportunity of this kind was available in Europe, the EAG developed the Combined Joint Combat Search and Rescue Standardisation Course on the basis of the previous VOLCANEX exercises and their respective lessons learned. Later on, the need for this course became more pronounced. However, the naming of it lead to misunderstandings and distracted from its aims: CSAR is just a narrow subset of personnel recovery (PR). On 3 July 2013, the EAG chiefs of air staff decided to create a European Personnel Recovery Centre (EPRC). An interim EPRC was initiated and situated at RAF High Wycombe, UK, with eight staff officers under the control of the director of the EAG. The EPRC achieved initial operational capability on 8 July 2015 and an inauguration ceremony was held at its final location on Poggio Renatico Air Base in Italy. The 2016 event marked the first time that the EPRC had been sole 46 46
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organiser of the course – the 2015 version was still organised by the EAG and ultimately implemented by the EPRC. The name of the course has also changed to Air Centric Personnel Recovery Operatives Course (APROC) to provide more clarity. Course director We spoke to the course director, Lt Col Bart Holewijn. He has worked at the EPRC since it was founded and his main task is to organise APROC. The 2015 course would have still been organised by his predecessor who worked at the EAG, but due to health issues, 2016 was Holewijn’s second outing as a course director. Holewijn told us how he ended up with the EPRC: “I started in the Royal Netherlands Air Force in 1990 at the 299 squadron, and have flown the Bölkow Bo-105 [helicopter] there for several years.” When the Bölkow was phased out, he had to be retrained on the Alouette III, but due to practical considerations, he was moved to a desk-based staff role. Changes in the course In comparison to 2015, the 2016 iteration saw a number of changes in how the course was set up. The goals were the same, but the approach was very different to previous years. Holewijn explained: “The biggest discussion we had last year is: What is this? Is this an ‘exercise’, is it a ‘training event’, or is it a ‘course’?”
The EPRC concluded that they had to return to designing a real ‘course’. There had to be clear and explicit learning objectives, and a clear description of how to make the course incrementally more difficult during the two weeks over which it was held. Holewijn stated: “It has to be that on any given day, if we have three task forces, that they all perform the same mission. They have to have the same learning curve.” The course also started at a lower level to be more accessible, and in order to connect better with the participants. Globally unique Holewijn pointed out there is no other course like APROC. “The Netherlands has the Helicopter Weapon Instructor Course for example, the British have a comparable training [event], but internationally there is nothing like this, and other countries also have no similar training course.” The formation of the task forces also differed compared to previous years. For the first three days they now consist of the same personnel, making it easier to communicate and share what they have learned. Ops centre Another important change to the previous format was that a Course Operations Centre is now set up for the course. “Previously, there were several different departments, all of which were somewhere in the building, all of which had an owner, and they all walked around.” A
Mixed crews Crews and helicopters of various nations are mixed all the time. At the beginning of the course, when everyone arrives, a cross-training exercise takes place, to ensure safety. The purpose of this mixing is to see if attendants interpret the same text in the same way. A difference in interpreting certain things is common, and this kind of training is very useful to get clarification. Holewijn finds this element very interesting: “Normally, fighter pilots never talk with extraction forces. Fighter pilots and helicopter pilots talk to one another sometimes, but they don’t often co-operate. In between these groups, there’s also an AWACS flying for support. Fighter pilots, of course, communicate often with AWACS, but helicopter pilots never talk to AWACS, and nor do extraction forces. So there are all kinds of players who would normally never actually talk to each other who will be forced to work together.” All communication takes place in English, including in the planning area. Holewijn said: “If someone behind you suddenly starts talking Spanish, for example, [you may] have no idea what he’s talking about, when what they say can be very important for your role in that process.” Mission preparation Before starting a recovery mission, the group divides into a number of teams that prepare individual parts of that mission. The rescue mission commander (RMC) is there to keep control of the process. During the planning process, there are so-called mission mentors that supervise the entire planning process; they advise people and also watch the exercise. Following a few hours of planning, there is a group briefing. The RMC briefs the overall plan to make it clear to all participants, at which point the mission can begin. However, as Holewijn has experienced in the past, the mission can’t always begin without further clarification. He recalls saying one year: “I have no idea what you will do, but that cannot be safe, so the mission won’t be carried out like that.” A discussion then arose in the group on how to execute mission elements, and it was found that the preparations of various teams didn’t gel. “You have a conclusion at >>
Execution After the briefing, the task force goes to the ops centre, where they get the latest info on the weather and air traffic, and then the package flies in accordance with the route they have planned to reach the pick-up zone. The task force consists of fixed and rotary-wing assets, with an armed ‘rescort’ (rescue escort), recovery vehicles, and of course the extraction force. All these groups have to plan the mission together. They are given a location where someone is waiting to be rescued. Survivor roles At the pick-up zone there can be all kinds of survivors. It can be a pilot who ejected. It can be an infantryman with a radio, but no knowledge of evacuation procedures and, perhaps, speaks poor English. It can be a civilian who has a mobile phone and has made a call for help, but has no clue what kind of procedures even exist, and therefore cannot apply them, but can only make a call for help. These aspects have a major impact on mission planning. A pilot has a survival radio, is easy to communicate with and data can be exchanged so you can get the exact co-ordinates of where the pilot is located. If the survivor has a traditional radio, that is helpful but of limited use. And if the person on the ground cannot read a map, they might give unhelpful information. In the case of a civilian who can read a map, there is still the problem that the once in the air it’s often no longer possible to contact them. The bad guys To complicate the scenario, there are of course opposing forces (OPFOR) 48 48
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in the area. These teams add another dimension to the decision process regarding the tactics the extraction force chooses to use, and on the legal side, means that rescuers have to be mindful of the rules of engagement (ROE). In these scenarios, ‘extremists’ are also embedded, who look like civilians, but carry a rifle. Holewijn elaborated: “The angry farmer who comes at you waving a stick, is it an extremist or an angry citizen? If it’s an extremist, he falls under a different rule of engagement than a civilian does.” The challenge for the participants is to recognise a threat and act accordingly. Also deployed is a tactical radar threat generator (TRTG) from the Multinational Aircrew Electronic Warfare Tactics Facility (MAEWTF, but referred to as Polygone). The TRTG is a truck with various transmitters that can simulate all kinds of air defence systems. Placed somewhere in the training area where the task forces will pass en route to the survivor, it can simulate an air defence system of any type. The task forces must take countermeasures as though to avoid being shot down. The OPFOR almost always consist of host nation personnel. They know where the pick-up zones are, and are previously given very clear limits on what they can and cannot do in the exercise. The survivor knows there are OPFOR walking or driving around somewhere. When the extraction team sees a few people walking around, they could be hikers, or they could be OPFOR – this creates a more realistic scenario. Initial stages Italian AMX fighter planes provide the fixed-wing escort, and they participate in the planning. In most missions, the AMXs are the first to reach the survivor’s vicinity, and they are the ones that make initial contact. They also make certain that the person on the ground is who they say they are by using pre-arranged code words. After that, they will ask details about the survivor’s health and status and what they can see in the immediate area, for example. They can also prepare the survivor for pickup by advising them what to do.
the end of the discussion, but if you have three, four discussions during a briefing, does everyone still know exactly what’s really decided?” They had to repeat the briefing with all the corrections and additions, and that time it was clear.
MILITARY SAR SPECIAL EDITION
JEROEN VAN VEENENDAAL
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The second thing the AMX crews do is to eliminate threats on the ground. Because the helicopters also have weapons onboard, targets need to be well divided, and the helicopter and fighter pilots have to coordinate together.
make two Learjets available for this course. They both simulate the escort role, emulating the communications that fighter aircraft would make. One of the aircraft has a sensor onboard that can be used as on an A-10, which was one of the aircraft emulated during this course.
GFD Learjets There is always a shortage of fighter aircraft to perform the escort role, and a German company, GFD, has a contract with the German Air Force to
The future The course continues; in 2017 it will be held in Italy. In the future, the course will always take place in June, and the host nation must also provide the fixed-wing support. Holewijn clarified: “That should give us more assurance that we have more fixed-wing aircraft. Planning for the course can take place further in advance, even if there are no exact dates known.” There will be a seven-year cycle, rotating the destination between the seven countries behind the EPRC. Results and progress Reflecting on the 2016 course, Holewijn said: “I’m not completely satisfied. I think it is not good if you are completely satisfied, so that’s good. The course works better than previous editions, its set-up is more structured.” On the other hand, he is happy everything happened safely, and all participants agree on the importance of that aspect. “Taking it back to a course, we have made a step in the right direction. But we are not there yet.”
Dino Marcellino gets to know the Italian Air Force’s new CSAR helicopters The first part of the new millenium has seen a period of increasing political instability all over the world. Wars, asymmetrical conflicts, terrorism, unregulated migration, revolutions and coups d’etat: a dramatic and unusual climate, described by Pope Francis in 2014 as the Third World War fought piecemeal. It’s an environment unlike a traditional conflict, more complex to interpret and deal with. The armed forces of many countries have been forced to revise their military doctrine, with the intention to better face this new challenge, becoming more flexible and reactive. In this regard, special forces units constitute an essential element of the military organisation, and the armed forces have to be able to project the special forces into enemy territory, giving them adequate support and ensuring their recovery. To meet these commitments, the Italian Air Force has begun a modernisation programme of its helicopter fleet providing search and rescue (SAR), combat search and rescue (CSAR) and air support to the special forces. SAR background The 15° Stormo (15th Wing) is the Italian Air Force Unit devoted to SAR. The Wing originated in 1946 when it was transformed from a World War Two assault wing to become a rescue unit, and one year later it became part of the SAR service. Various types of aircraft, both fixed and rotary-wing, have been utilised in the years following this change. In 1977, the Sikorsky HH-3F Pelican helicopter was selected, entering in service in 1979. From that year, 50 50
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RAIDERS the Pelican was assigned to the SAR centres operating across Italian territory, flying more than 185,000 hours and rescuing 7,000 people. The Pelican was flanked by a number of AB-212s. Deliveries of the Pelican’s replacement, the HH-139A, started in 2012, and the last HH-3F of the original 35 acquired was phased out in 2014. The Pelican was a machine in 10-ton class, a large aircraft with a number
the last HH-3F of the original 35 acquired was phased out in 2014
of special features, for example being able to float on water, a large cabin, a rear ramp, and firepower supplied by three hand-held machine guns. The Air Force thought of replacing each of the two helicopter models (HH-3F and AB-212) with heavier modern machines: the in-development AW149 in the over eight-ton class for SAR service and the heavyweight HH-101 for CSAR. However, the aged HH-3F Pelican fleet went out of operation sooner than expected, so the Air Force had to rent a fleet of 10 6.5-ton class HH-139s, initially intended as a ‘gap filler’ while waiting for the AW149s. In fact, the new machines gave such good performance on daily SAR duty that the decision was made to adopt them on a permanent
MILITARY SAR SPECIAL EDITION
The fuselage can accommodate a number of passengers and/or stretchers
basis, becoming a fundamental asset of the Air Force. The 15° Stormo today The 15th Wing is structured as follows: the Headquarters, the 81st Crew Training Squadron and the 83rd CSAR Group have their home at Cervia Air Base; the 85th CSAR Squadron is based at Pratica di Mare Air Base near Rome; the 84th CSAR Squadron is at Gioia del Colle Air Base near Bari; the 82nd CSAR Squadron is at Trapani on the island of Sicily; and the 80th CSAR Squadron is at Decimomannu on the island of Sardinia. The latter is the only squadron flying the AB-212; all the other squadrons are equipped with the new HH-139A. Together they provide a nationwide SAR service, operating round the clock. In 2015, the first two new HH-101A ‘Caesar’ helicopters joined the fleet at Cervia air base. These heavy machines are mainly devoted to CSAR, personnel recovery, interceptor and air support to special operations roles. The new HH-101A Caesar When I visited Cervia Air Base in July 2016, four HH-101As had been delivered and were in service at the base (two of them, before reaching Cervia, had been extensively used by the Italian Air Force’s Experimental Wing to test performance and equipment). Two more machines were set for delivery in 2016, while six more of the type will be delivered in 2017 (plus three further machines on option). 15th Wing’s Commander Col Pilot Giuseppe Massimetti explained: “The delivery of the 12 machines has been split into two stages; the first six machines are in ‘basic mission’ configuration – advanced equipment
(for example electronic warfare systems) are not installed. This equipment will be installed from the seventh machine, named ‘enhanced mission’, and then retrofitted on the first six machines. The time between the delivery of the first machine and the seventh machine is spent for the transition of the crews; to do that it is better to have the machines in basic configuration.” He continued: “We started training an ‘initial core team’, made up of eight pilots, four of them already instructors. The latter are also qualified on the HH-139A, so that they have a large spectrum of competence on the 85th Wing’s entire fleet.” In the future, due to the complexity of the HH-101As and the demanding nature of the CSAR role, the expectation is that crews will specialise exclusively on the type, said Massimetti. He added: “For crews qualified on the old HH-3F Pelican, the transition to the new machine is a big change. The Pelican has been a great aircraft, but was a decades old machine, with out-of-date avionics, logistics and performance. The fact that all the staff in the Wing have had
“the Caesar is the first Italian helicopter to have conducted air-refuelling” the opportunity to experience a new generation machine, in the form of the HH-139As, before the delivery of the new HH-101A, has
MILITARY SAR SPECIAL EDITION
The machine features a full glass cockpit
MILITARY SAR SPECIAL EDITION
MILITARY SAR SPECIAL EDITION for example a Predator drone, or with a satellite. Each Special Forces member onboard the helicopter can receive up-to-date images of the target transmitted by the Predator. This allows the Special Forces team to hold a rebriefing of the mission during the insertion flight. Commander Col Massimetti highlights these features: “The Vortex just mentioned is a new instrument for us: it is fundamental because the scenery changes very quickly, often within the hypothetical hour of flight to reach the target” He added: “Another new feature is that for out-ofarea missions, the helicopter can be equipped with a probe for air-to-air refuelling. The Caesar is the first Italian helicopter to have conducted air-refuelling and it is the first European helicopter to have done it by night under NVGs. We are training the crews in air-refuelling with the KC-130J
the weaponry comprises three sixbarrelled M134D machine guns
Rescuers and patient during a training mission
facilitated the transition.” The Caesar is the newest and advanced version of the 101 family. It is derived from the ‘international’ model, with modifications specified by the Italian Air Force. If the external shape is similar for all models, the Caesar is very different from a technological point of view compared with the models in service with the Italian Navy, or with the UK’s Merlins and others in service around the world. Norway has acquired 10 machines which are similar but more SAR oriented, which are estimated to be around 90-per-cent equivalent to the Caesar. The HH-101A has a take-off maximum weight of 15,600 kg. It is fitted with three engines, each producing 2,500 hp. To compare it with the previous machine, the old HH-3F was in the 10,000-kg class and had two
The pop-up hangar at Cervia Air Base
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1,500-hp engines. It’s not only power that marks the difference: a full glass cockpit, new avionics, new high efficiency blades, a new power transmission, an advanced Gabbiano radar by Selex, and comprehensive self-protection and electronic warfare systems (including identification friend or foe, laser warning receiver and missile launch detection system), weapons and armour (three Gatling M134 7.62-mm machine guns, armoured cockpit seats, and ballistic protection for machine gun operators). Primary roles: CSAR, Special Forces insertion/extraction/support The HH-101A is fitted with a data link system named Vortex. It connects the helicopter with an advanced reconnaissance system in real-time,
(Italian Air Force 40th Wing in Pisa).” For everyday operations, said Massimetti, the probe is removed along with other role-specific equipment: “This is another peculiarity of the HH-101A: equipment can be installed and removed as needed for the training or mission profile. A strong point of the HH-101 is that it has a lot of equipment available, utilisable depending on the specific activity required, but in any case the helicopter is always in flying configuration. So the Caesar is very flexible machine.” The weaponry comprises three six-barrelled M134D machine guns, one mounted on each side with the third on rear ramp. The typical set-up for forces around the world is that rear machine guns are mounted in the middle of the ramp and need to be removed to embark loads. However, on the HH-101A, the machine gun is hooked onto the roof of the fuselage and can be simply and easily rotated inside the cabin when needed to allow loading of bulky items such as quadbikes or zodiac tenders. The helicopter has three anchor points for fast-roping: one on each side and the third on rear ramp. Crew selection depends on the mission type. There are basic configurations that can be modified according to specific requirements: • Medevac mission. Two pilots, technician, air rescuer. Five doctors, six stretchers, one fast rope. • CSAR mission. Two pilots, technician, air rescuer. Eight Special Forces operators, three stretchers, two fast ropes. • Domestic SAR (land or sea). Two pilots, two technicians, one or two air rescuers. The all-black paintwork is prompted by the main type of mission foreseen for this helicopter: CSAR and Special Forces operations are mainly performed at night, so this offers the best camouflage. The paint is specially formulated to absorb infra-red. During Special Forces missions, landing in sandy or dusty areas is a common occurence. Sand raised by the down-wash generates a cloud around the helicopter, which is dangerous if the crew loses visibility. With the HH-101, this effect is limited thanks to the shape of the rotor blades, which are an advanced design. These blades allow a ring-shaped zone to form around the helicopter, within which there is greater >>
MILITARY SAR SPECIAL EDITION visibility compared to other heavy machines such as the old HH-3F Pelican or a CH-47 Chinook. Another benefit of the blades is the limited downwash under the helicopter during winching. With the helicopter hovering or taking off, the downwash is less severe under the machine than is the case for even light helicopters. However, this ceases to be true out of rotor diameter – just metres
a dedicated support system has been developed using a kit-form hangar outside this zone, the downwash is severe, making it difficult to stay on one’s feet. Secondary roles: domestic SAR, medevac, low speed interceptor, transport of patients in bio-containment During special events, for example G8 or G20 summits, the national authorities can require the deployment of helicopters as low speed interceptors. In this case, it is possible to equip the machine with the two side-mounted machine guns, or to embark one or more snipers. With all
not-essential equipment removed, the HH-101A can fly for four hours without air-refuelling, and the machine is very stable (even compared to other 101 models), ideal for sniper work. Since this helicopter will be used mainly for out-of-area operations, a dedicated support system has been developed using a kit-form hangar. The components are packed in a container that can be transported by medium/heavy cargo planes. The hangar, which can be assembled in 24 to 48 hours, is equipped with a generator and is air-conditioned. It can accommodate an HH-101 and allow for major maintenance tasks to be carried out, such as disassembly of the transmission. The hangar is water and windproof and can cope with extreme weather conditions. It’s also possible to add on external containers to serve as offices, toilets, etc. There is also a ‘fly away kit’, which is a container with spare parts needed to perform maintenance while on deployment. This allows for autonomy for three months. Conclusion Commander Col Massimetti observes that the HH-101A is an excellent machine, which is only now starting to develop its full potential. “The 15th Stormo and the Reparto Sperimentale Volo (Italian Air Force Experimental Test Wing) have been involved in all development phases; so we know the machine well, and when it arrived … we had already a lot of experience on it. With this helicopter, the Italian Air Force has very good prospects. I can affirm that the HH-101A Caesar is one of the best aircraft of the world.”
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Unmanned Technologies & Security Expo & Conference Nürnberg Messe Nuremberg Exhibition Centre www.utsec.de
LifeFlight mascot assists on call-out Bundaberg-based RACQ LifeFlight Rescue’s mascot and newest recruit, Drummer Bear, was taken along to one of the service’s call outs. The bear helped to pilot the helicopter, read all the safety instructions and generally provided support to the LifeFlight patient. To watch the full video visit www.airmedandrescue.com/ story1762.
Tutus and drag to the rescue
Trauma Care Conference
Trauma Care Yarnfield Park Conference Centre, Staffordshire, UK www.traumacare.org.uk
There’s nothing the AMR team enjoys more than hearing of civic leaders dressing up in fluorescent tutus and shower caps, especially when it’s for a good cause, as in the case of Peter Atkinson, mayor of Ferry Hill in the UK (pictured below). Atkinson has been engaged in various wheezes as part of a whole year of fundraising for local HEMS charity Great North Air Ambulance. The photo was taken as he and a team of 16 fundraisers prepared to take part in the Boxing Day Dip at Seaham Beach. Speaking of the challenge, he said: “We were nervous going into the North Sea in the middle of winter but it was an incredible day. Our volunteers were very brave and mad to take part. There was a parade and a crowd of around 900 people cheering us and all the other participants on and we got carried away with the atmosphere. We felt like superstars.” One participant’s comment on a photo posted on the Ferry Hill Mayor Facebook page underlined the swimmers’ courage: “Bloody hell, I look like I was slapped around the face with a wet kipper but it was freezing cold xx a fun day xx.” Other fundraising events Atkinson has been involved with include a Halloween quiz night, a wine and cheese evening, a Last Night at the Proms-themed charity concert, a Burn’s night fundraiser, and a performance by Miss Tess Tickle and the Dragettes, which no doubt had to be seen to be believed.
Critical Care Weekend ECHO Boston, Massachusetts, US www.eastcoastheliops.com
UAV & SAR workshop
Italian National Fire Service Istituto Superiore Antincendi, Rome, Italy www.vigilfuoco.it
Medical Transport Leadership Institute
AAMS Oglebay National Training Center, Wheeling, West Virginia, US www.aams.org
15th Airborne Neonatal & Pediatric Transport Conference
International Biomedical Sheraton Hotel at the Capitol, Austin,Texas, US www.int-bio.com/conference.php
Flight Medical Crew Study Day
CCAT Aeromedical Training Cumberland Lodge, Windsor, UK www.ccat-training.org.uk
In flight with rear ramp lowered
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