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YOUR ONE STOP SAR SHOP Commercial Helicopter Operators, Para public Safety Agencies, and Defense Forces need proven, cost effective, and innovative training capabilities that are speciically relevant to performing their mission mandates. Training thousands of Search & Rescue and Tactical students worldwide, on 26 different aircraft types, and having experience operating in diverse environments around the globe, Priority 1 Air Rescue meets the demands of our customers by offering the most comprehensive mission training solutions in the industry. O ur Search & Rescue and Tactical Training Academy (SART/TAC) is setting a new standard for mission training performance and safety by employing synthetic hoist/aerial gunnery virtual simulators, hoist and fast-rope training towers, and modern classrooms that utilize cutting edge technology to provide our universally adaptable and standardized multi-mission training and operational SAR programs. Whether you are looking for Civil Aviation Authority (CAA) compliant and certiied basic to advanced hoist mission training, new aircraft type SAR role conversion, or complete turn-key Air Ambulance/HEMS and SAR/LIMSAR program implementation with operational Paramedic and Rescue Specialist Aircrew staffing, we deliver proven solutions. Priority 1 Air Rescue is dedicated to providing unparalleled capability, safety, and service to perform lifesaving missions.
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AIRMED&RESCUE
Issue 97 | June 2019
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ISSUE 97 JUNE 2019
IN THIS ISSUE: After-action review – US National Guard management of SAR assets during Hurricane Florence Introducing the Cyclone CH-148 to Canada’s SAR fleet Cable care – making sure your cable doesn’t let you down
Military SAR Edition
Some times, using a rescue sling strop may be the only and last way of saving a life. We have all learned, however, that a traditional rescue sling strop is not always the best option. In many situations, Lite Flites safe and comfortable Rescue Wrap may turn out to be a better solution. You should try it. Three point suspension Head, back and thigh support No risk of slipping Safe, comfortable, sitting position Assisted or unassisted winching Conscious or unconscious victim Easy to pull victim in to helicopter No unneccessary options, just plain and simple, unless you want a • Custom Design • • • • • • • •
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EDITOR’S COMMENTS You can hardly fail to have noticed that this edition of AirMed&Rescue is focused on the Military SAR arena, although it’s not exclusive – we still have our News pages, Medical Insight and opinion pieces from industry experts too. For civilian SAR operators, insights into how military organisations such as the National Guard organises their assets during an emergency such as a hurricane makes for interesting reading. In this issue, we also learn about the value of after-action reviews, and find out about lessons learned for these organisations. In Canada, bidding farewell to the Sea King was the end of an era last year, but welcoming in the new generation with the CH-148 Cyclone will bring many benefits – these are detailed on p36. Sticking with Canada, I got in touch with the Royal Canadian Air Force recently to find out about what it takes to be a member of its elite SAR Tech force – you can find all the info on p20. Editor
Mandy Langfield
Enjoy this issue!
CONTRIBUTORS
Amy Gallagher Amy is an internationally published journalist covering aviation, rescue, medical and military topics, including evidence-based research articles. Amy has worked in both agency and corporate communications for aviation companies such as SimuFlite Training International, K-C Aviation, Chrysler Pentastar Aviation, and McKinney Aerospace.
James Paul Wallis Previously Editor of AirMed&Rescue Magazine from launch up till issue 87, James Paul Wallis continues to write on air medical matters. He also contributes to AMR sister publication the International Travel & Health Insurance Journal.
Sami Ollila Following his conscription with the Finnish Navy as a mine clearance diver, Sami was accepted for the helicopter rescue swimmer training program at Finnish Border Guard - Air Patrol Squadron in 1996. Sami graduated with a Bachelor of Healthcare in 2018 and now holds a dual-role position as a Rescue Swimmer and a Paramedic, in the five-man crew of H215-Super Puma helicopter. Sami currently volunteers as the Vice -President of Rescue Swimmer Association and as an instructor at Finnish Swimming Teaching and Life Saving Federation.
Dino Marcellino Known around the world for his aviation photography and reports, Dino Marcellino has been fascinated by aircraft since his childhood, and has spent his life combining his passion for aircraft with that of photography. Flying on more than 25 different types of helicopters, he has worked with the Italian Navy, Army and Air Force, as well as police and rescue organisations.
Adam Kaplan Adam is Co-Founder and CEO of Edgybees, a world leader in visual intelligence technology. Edgybees’ software platform enhances drone video footage to provide customers across various industries the ability to understand any complex scene instantly. Prior to Edgybees, Adam co-founded and served as an executive at multiple technology companies, including Xennex Inc. (acquired by Biotime Inc.), Athoc (acquired by Blackberry), Digital Guardian and Tonian (acquired by Primary Data).
Front page image © Staff Sgt Marcus Butler www.airmedandrescue.com
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Editor-in-Chief: Ian Cameron Editor: Mandy Langfield Sub-editors: Robyn Bainbridge, Lauren Haigh, Stefan Mohamed, Sarah Watson Advertising Sales: James Miller, Kathryn Zerboni Design: Rosi Yip, Tommy Baker, Will McClelland, Robbie Gray Web: Tom Reed Marketing: Isabel Sturgess, Kate Knowles Finance: Elspeth Reid, Alex Rogers, Kirstin Reid
IN THIS ISSUE... 6
Helijet renews contract with BCEHS
6
2019 Tim Hynes Award recipient announced
8
FLIR’s Black Hornet 3 PRS to be delivered to the British Army
9
Rotorcraft Asia Review
Contact Information: Editorial: tel: +44 (0)117 922 6600 (Ext. 3) email: editor@airmedandrescue.com Advertising: tel: +44 (0)117 922 6600 (Ext. 1) email: jamesm@airmedandrescue.com Online: www.airmedandrescue.com @airmedandrescue www.airmedandrescue.com/facebook www.airmedandrescue.com/linkedin www.vimeo.com/airmedandrescue Subscriptions: www.airmedandrescue.com/subscribe subscriptions@voyageur.co.uk Published on behalf of Voyageur Publishing & Events Ltd Voyageur Buildings, 19 Lower Park Row, Bristol, BS1 5BN, UK The information contained in this publication has been published in good faith and every effort has been made to ensure its accuracy. Neither the publisher nor Voyageur Publishing & Events Ltd can accept any responsibility for any error or misinterpretation. The views expressed do not necessarily reflect those of the publisher. All liability for loss, disappointment, negligence or other damage caused by reliance on the information contained in this publication, or in the event of bankruptcy or liquidation or cessation of the trade of any company, individual or firm mentioned, is hereby excluded.
Printed by Pensord Press Limited © Voyageur Publishing & Events 2019
AIRMED & RESCUE ISSUE 97 ISSN 2059-0822 (Print)
ISSN 2059-0830 (Online) Materials in this publication may not be reproduced in any form without permission.
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MEDICAL INSIGHT
NEWS FEATURE
14 10
Cable care How to make sure your cable doesn’t let you down
Feeling the pressure Physiological effects of winching
INDUSTRY VOICE 38
Tech success The vital role that technology plays in SAR
MILITARY SAR 20
Dare to be extraordinary What it takes to be a SAR Tech
24
Spotlight: 15th Wing Italian Air Force’s dedicated SAR unit
28
Always there, always ready US National Guard reviews Hurricane Florence
36
Taking the crown from the Sea King The Royal Canadian Air Force’s fleet upgrade
INTERVIEW 40
Building a sustainable future Meredith Staib, RFDS Queensland CEO
www.airmedandrescue.com
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NEWS
Helijet renews contract with BCEHS Effective 1 April, Canadian air ambulance service provider Helijet has renewed its dedicated air medical contract with British Columbia Emergency Health Services (BCEHS) for an additional four years, which will allow BCEHS to continue to provide air ambulance services for patients around the country’s westernmost province 24/7/365. The renewed contract dictates that Helijet will continue to supply four Sikorsky S-76 model helicopters for the British
Columbia Ambulance Service (which is operated by BCEHS). The British Columbia Air Ambulance Service currently uses a Sikorsky S-76A helicopter as a backup aircraft, but the new agreement will have this model replaced with a Sikorsky S-76C. Two of the helicopters, as well as the backup model, will be based at Helijet’s Vancouver International Airport facility, while the other helicopter will remain at Helijet’s Seal Cove, Prince Rupert facility, from
Sikorsky S-76 helicopter © Helijet
where it will operate. BCEHS also has another contracted helicopter based in Kamloops,
in addition to seven fixed-wing aircraft in its air ambulance fleet, to serve British Columbians.
2019 Tim Hynes Award recipient is announced This year, the International Association of Flight and Critical Care Paramedics (IAFCCP) has awarded the 2019 Tim Hynes Award to Steve Whitfield of Griffith University School of Medicine – Paramedicine in Queensland, Australia. The IAFCCP is an independent paramedic association focusing on specialty care paramedicine. The Tim Hynes Award was previously known as the ‘Flight Paramedic of the Year Award’, but changed its name after founding member of the IACFCCP, Tim Hynes, lost his life, along with his crew, when their helicopter crashed during a mission in 1998. The award honours Hyne’s spirit and contribution to the profession, while recognising exemplary abilities in leadership, education and safety within the paramedic profession. Whitfield has been a paramedic involved in ground and flight transport in Australia and internationally for over eight years – currently, he works as a clinical 6
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educator, lecturer and clinical advisor to several emergency prehospital organisations. He has spent much of his time volunteering as a relief flight paramedic in Fiji and a humanitarian medic team leader in Nepal, Mongolia, Sinai, Botswana, Vanuatu and the Arctic. Whitfield founded the Wild Medic Project following the 2015 earthquakes in Nepal. The project provides frontline medical and educational clinics in remote areas where access to basic healthcare is limited and provides shared experiences between local communities and humanitarian medical teams. The clinics are now all self-sufficient and employ local staff through the educational programmes that Wild Medic teams offer. Whitfield has also contributed to a number of paramedic publications, and, in addition to his many other degrees, diplomas and certificates, he is currently completing a Masters of Public Health (remote and polar medicine).
Steve Whitfield of Griffith University School of Medicine – Paramedicine in Queensland, Australia, winner of the 2019 Tim Hynes Award
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NEWS
FLIR’s Black Hornet 3 PRS to be delivered to the British Army FLIR Systems Inc. (FLIR) has recently announced that it has been awarded a US$1.8-million contract by the British Army to deliver the FLIR Black Hornet 3 Personal Reconnaissance System (PRS), which will support platoon- and troop-level surveillance and reconnaissance capabilities, as well as being used in part for a test and evaluation of nano Unmanned Aircraft System (UAS) capabilities to enhance warfighters’ situational awareness on the frontlines. The Black Hornet 3 is a pocketsized high-definition live-video transmitting device that sends information back to the operator. It weighs 32 grams, has a flight time of up to 25 minutes, and is almost completely silent. The still images and video feed provide soldiers with immediate covert situational awareness to help them complete their mission
FLIR’s Black Hornet 3 - May 2018. © FLIR Systems
more effectively. David Ray noted that, back in 2013, the British Army was one of the first military forces to deploy the technology, which aided troops operating in an active combat zone in Afghanistan. “We are pleased they have again chosen FLIR for its nano UAS solution and we are proud to provide the Black
Hornet 3, our latest version of this revolutionary, lifesaving technology, to soldiers on the battlefield,” he added. Having distributed over 7,000 Black Hornets to military customers worldwide, this new contract with the British Army further expands use of the Black Hornet PRS for military surveillance and reconnaissance
programmes. The order is for an experimental procurement of the combat-proven Black Hornet PRS and part of the UK Ministry of Defence’s Transformation Fund Rapid Procurement Initiative. FLIR will manufacture the systems in Hvalstad, in Norway, and the deliveries, which are to begin immediately, are expected to be completed within six months.
Clarification In response to an article published by AirMed&Rescue in April 2019, ‘Analysis: USFS/DOI Helmet Standard’, James Wegge, Director of Gibson & Barnes, has asked for clarification and corrections of some points made, telling AirMed&Rescue: • “Relevant to the legitimacy of claims made, Helicopter Helmet LLC and Government Sales Inc. attempted to sue Gibson & Barnes and Gentex in federal court alleging a multitude of wrongdoings; this lawsuit was dismissed with prejudice. HHL and GSI have appealed the dismissal. • Gentex manufactures both military and civilian versions of its HGU-56/P and SPH-5, and HGU-84/P helmets under different part numbers, not the same part number. It makes both military and commercial versions of each helmet from the same materials using the same manufacturing processes. The only difference between the military and commercial helmets is the colour. Gentex is currently testing its HGU-56/P to the DOI Aviation Helmet Standard.” AirMed&Rescue wholly agrees that the adoption of performance standards for civil aviation helmets, and the requirement of government aviation standards that helmets purchased for employees meet those standards, is both fair and reasonable. 8
AIRMED&RESCUE
Rotorcraft Asia Review Between 9 and 11 April, the second Rotorcraft Asia event was held at the Changi Exhibition Centre in Singapore. The event saw technological innovation announcements from companies including Bell, Leonardo, Sikorksy, StandardAero, Dallas Automotive and more.
AEROMETALS is to focus its growth efforts on the Asian market for its flat filter upgrade kit for the AS350 helicopter. The upgrade enables increased service intervals and is lighter than its previous iteration.
SUBARU made its debut at Rotorcraft Asia this year to showcase the 412EPX, on which it was worked with BELL. The helicopter will be manufactured in parallel production lines in Japan and Canada and is aimed at SAR, firefighting, police and coast guard operators.
BELL is showing cautious optimism about the Asian market, having experienced solid growth in 2018, with David Sale, Asia Pacific Managing Director, saying that the market hasn’t ‘recovered fully from the downturn, but it’s starting to turn in the right direction’.
Japan-based AUTONOMOUS CONTROL SYSTEMS LABORATORY has reached an agreement with the JAPAN GROUND SELF-DEFENSE FORCE under which unmanned systems will be used in disaster relief operations.
BUCHER is keen to exploit the opportunities available in the emerging HEMS market in China, while admitting that certification issues can be a lengthy process. It will soon be installing medical equipment onto 95 H135 aircraft for a Qingdaobased consortium.
LUMINATOR AEROSPACE showcased its LS-400 system for the first time at Rotorcraft Asia. The LED technology results in increased luminosity and longevity compared to incandescent bulbs.
KAMAN AEROSPACE’S optionally-piloted K-Max is undergoing a redesign that includes flight control software. The company said that in its unmanned version, it offers great promise as a fire-fighting platform.
STANDARDAERO is investing in the Asia Pacific market, building up its regional presence with MRO facilities in Singapore and Australia.
LEONARDO HELICOPTERS is hoping to extend its reach in the Asia Pacific through increased use of the AW139, supported by its popularity in the parapublic and police sectors. Three AW139s have been ordered by the Victoria Police Air Wing as part of its fleet modernisation programme. PATRIA exhibited its Compact Airborne Networking Data Link system for the first time in the Asia Pacific; the company is keen to support civil markets and applications. The system enables air-to-air and air-toground networking, as well as facilitating beyond-visual-lineof-sight capability.
Two AIRBUS H125s are to be assembled and tested before being accepted by the Philippine National Police force.
RUSSIAN HELICOPTERS views China as the most promising market for its KA-32 helicopter, where it will mainly be used for fire-fighting missions.
SAFRAN has reported increased demand from China and is hoping for certification from local aviation authorities for its Ardiden 3D/WZ16 engine by September this year.
Cable Care How to make sure your hoist cable doesn’t fail during an airborne rescue mission
James Paul Wallis examines what can go wrong with neglected helicopter hoist cables and the signs winchmen need to watch out for As the rescue swimmers rise to the safety of the helicopter, the cable from which they’re suspended begins to unravel. Veteran Ben Randall judges that the frayed cable isn’t strong enough to hold both him and rookie Jake Fischer, so he unclips and falls into the dark waters below. This nightmare scenario was, thankfully, filmed in 10
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front of a blue screen for Hollywood movie strands of wire is vital to mission success The Guardian and no actors were harmed, and safety. but it illustrates how important the hoist A typical hoist cable is a stainless-steel rope cable is in the helicopter rescue system. attached to the hoist at one end and a hook Beyond the loss of a rescuer or casualty, at the other. Individual wires are twisted into strands, and the past incidents have shown strands are twisted to that a cable that a damaged cable is best make an inner core and an outer wrap. separates can be replaced, not repaired a danger to the Together, these wires whole crew if share the load of it whips up and impacts the main or tail rescuers and casualties and must withstand rotor. Despite all the technology onboard being wound and unwound from hoist an aircraft, the condition of just a few drum and exposure to sometimes harsh
FEATURE
environments. Any defects can lead to a reduction in strength and premature failure. Care of cables includes inspection, cleaning and lubrication, depending on the cable type, all following guidelines laid out by the original equipment manufacturer (OEM). Inspections Cables are regularly inspected by operators and repair centres. Swiss air rescue service Rega, for example, inspects its hoists and cables every month or after one operating hour. The Royal Canadian Air Force (RCAF) uses authorised contractors alongside its
own technicians to maintain its cables. repaired, said Davis: “There As well as daily checks, there are more was a time when, if a hoist detailed inspections based on the frequency cable was damaged and it of usage. At Travis County STAR Flight, was not too far above the maintenance staff inspect the cable after hoist hook, they would consider, based every use as soon as is practical. Casey on the type of damage, cutting the cable Ping, who spoke to AirMed&Rescue just and re-swaging the end, but, fortunately, ahead of his retirement as Programme that does not happen anymore. For the Director, said the organisation goes beyond most part, the industry operates a zerothe inspection schedules prescribed by tolerance policy regarding hoist cables. OEMs: “At a minimum, we follow the OEM Meaning if they are damaged in any way, guidelines. We also perform additional they are replaced.” However, Mitchell told inspections, both in frequency and type.” AirMed&Rescue that his testing shows that if At Priority1Air Rescue (P1AR), Manager properly installed, the connection to a new SART/TAC Adam Davies detailed that both ball end is stronger than the cable itself. hoist operators One complexity and rescue despite all the complicated of performing specialists should an inspection is technology onboard the take the time that the cable to do user level should be kept aircraft, the condition of inspections of under tension their cables after just a few strands of wire as it’s unwound hoisting flights rewound is vital to mission success and to ensure they onto the hoist are still in good drum. Zephyr condition. Common signs of damage or International’s maintenance stations excessive wear include flattening, bends, include capstans that keep the cable kinks, broken strands and ‘milking’, said under tension while being wound onto a Davies, as well as bird caging, where the drum. Air Rescue Systems’ Cable Buddy outer strands stretch and open out. P1AR offers a more manual solution, comprising crews use a cable dimensional checker a pulley attached to the helicopter’s tool in the field to identify any necking or floor anchors or skids that allows a crew bulging that will need further investigation. member attached to the cable to apply Air Rescue Systems, which sells hoisting tension by leaning back as they walk away equipment and cable care tools, advises from the aircraft. users to also check for off-coloured deposits or powder that may indicate Cleaning and lubrication superficial or internal corrosion, as well as Other than checking for damage, necking (sections of narrowed cable that the other main aspects of cable indicate broken internal strands). maintenance are cleaning and lubrication. Inspections should be both visual and A spokesperson for Breeze Eastern tactile, said a representative of hoist-maker commented that users should pass the Breeze Eastern. And there are more cable through a clean cloth in order to hi-tech approaches such as MagSens, a remove debris or other contaminants, non-destructive inspection system that and should also perform a fresh-water uses magnetic flux leakage to spot potential rinse if the cable has been exposed to salt defects in the cable, which is offered by water or high-humidity environments. Zephyr International. Michael Mitchell, Adam Davis commented that lubrication President of Zephyr, explained: “The is typically performed by the maintenance MagSens provides a simple repeatable department during their maintenance and method to inspect the cable and it provides inspections on the hoist. A common and a means of standardising the inspection, simple method, he said, is to slowly reel so anyone with basic training can inspect the cable in while letting it pass through the cable better than a trained individual, an oiled towel in your gloved hand. Rega because it can sense and detect damage on uses a similar approach, a representative the inside of the cable.” explained: “We use a lint-free cloth, put oil A damaged cable is best replaced, not on it and, during reeling in, we lubricate the
www.airmedandrescue.com
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cable. We refresh the cloth every seven metres with new oil so that the whole cable is lubricated thoroughly.”
explained Mitchell. The RCAF is among operators whose cable maintenance routines do not include lubrication due to the type of cables used, a if properly installed, the spokesperson confirmed. connection to a new ball end is Breeze Eastern told AirMed&Rescue why its stronger than the cable itself guidelines do not include lubrication: “The oils Zephyr’s RHGSE mobile cable within the cable are intended to remain maintenance station features an assembly within the interior for the life of the that uses compressed air to dry the cable as cable. In general, our position is that no pads clean it and apply lubricant (if required) additional lubricant should be added to as the cable is retracted into the hoist, the cable on top of the existing lubricant, 12
AIRMED&RESCUE
especially to the cable’s exterior, since doing so may interfere with the action of the tensioning system.” There are, however, circumstances when lubrication may be appropriate, the representative added: “Some usage, cleaning, and maintenance processes end up stripping the lubricants from the cable’s interior and re-lubrication may be considered as anti-corrosion measure. In this case, thin lubricants which are applied in contact with the cable should be removed from the cable’s exterior with a clean cloth.” As for the choice of lubricants, for the cables that come with Goodrich hoists,
use of OEM-prescribed lubricants ‘is a necessity’, said Marty Sezack, Manager of Aftermarket Technical Services, Hoist and Winch, at Collins Aerospace, which owns the Goodrich brand. He continued: “Offthe-shelf products such as WD40 may aid in water removal and cleaning, but do not provide the level of lubrication required to attain full cable life.” Mitchell commented: “The lubricants used are many but the most common is a thin film corrosion preventative, many commercially available products are available. I prefer the thin-filmed CPCs over the turbine oil that Goodrich calls out.” He explained that the oil penetrates the cable through capillary action, displacing any water inside. Service life and replacement Even if no damage is identified, the cable will need to be replaced when it reaches the end of its service life. The OEM sets the replacement criteria, explained Ping, which is usually a combination of age and usage cycles. Davis gave ballpark figures of 1,500 cycles or 55 hours of actual use. In Davis’ experience, it’s rare that a cable lasts to the end of its life cycle, though: “They are most commonly replaced due to common wear that occurs from regular hoisting.” Ping added: “Since it is a life safety product, we may replace in any significant event (shock load, cable strike and so on) without meeting replacement criteria. It is a small price to pay for confidence in the equipment.” A shock load is a rapidly applied dynamic load that can damage a cable, even though it could safely take the same load if gradually applied (a static load). This can occur if, for example, the cable suddenly gets caught on the skids. Cables installed and delivered with new hoists are properly tensioned and conditioned by the manufacturer, noted Sezack. If a cable reaches the end of its life and is replaced, the new cable should be conditioned following the same procedure. Using the term cable ‘seasoning’, Davis explained that the cable must be tightly wrapped to the hoist drum. In-flight emergency Returning to our example of Kevin Costner’s heroics in The Guardian, what is the procedure if a cable fails during operations? Crews on a helicopter with a dual-hoist system can simply switch to the backup, but
for those without that luxury, Davis explained that one option is to cut the cable above the damaged area and apply a splice, which traps the end of the cable and creates a temporary attachment point. This can be a traditional slotted plate or a more advanced option such as the Quick Splice offered by Lifesaving Systems. Davis said: “[This] allows you to … perform one recovery to get your rescuer back to the helicopter. This is, however, considered an emergency procedure, so if there are other safer or more viable options for that recovery, those options should be exercised first.” Prevention Cable care is a matter of flexibility and vigilance. Cable servicing, both care and conditioning, should be driven by a planned programme, but this should adapt to any changes in operational tempo, said Sezack: “Operational safety driven by a regular inspection programme, inclusive of post-mission inspections, remains the best course of action … these inspection and maintenance practices also help assure full operational life of the cable and thus a lower cost of ownership.” As a final thought, let’s remember that prevention is better than cure. Davis highlighted that good cable management extends to the care you take during missions: “When hoisting you want to ensure that you are managing the cable with an expert level of finesse to ensure that the cable is not contacting surfaces that it should not, as well as ensuring that you are not shock-loading the cable.” Zephyr International was founded from our expertise gained from 37 years of rescue hoist engineering experience. With our exceptional quality and our product support culture, Zephyr provides: • Rescue Hoist Ground Support Equipment that extends the life of the cable using the capstan effect vs using a free weight in flight. • MagSens Cable Inspection quickly finds internal and external anomalies. • Turnkey Rescue Hoist Test Stands at Intermediate and Depot Levels, keeping assets mission ready. • AxelCut, QuickSplice, Darklight, and Shock Absorbing Weight Stacks to enhance safety. Zephyr products are in service at major Aircraft OEMs, Military and Civil SAR Rescue Organizations worldwide.
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Feeling the pressure Sami Ollila, a rescue swimmer and paramedic with the Finnish Border Guard’s Air Patrol Squadron, shared his thesis with AirMed&Rescue, offering valuable insights into the physiological effects of winching equipment Having worked as a helicopter rescue swimmer for 22 years, I applied for paramedic studies in 2015 at the Metropolia University of Applied Sciences and graduated as a Bachelor of Healthcare with a degree in Emergency Care in 2018. Finalising my studies with a thesis, I was permitted to work on a topic relating to my current profession and one that would benefit my employer. At the time, I discovered an inspiring article by Dr Alan Garner from Careflight (Australia): Physiology in the Winch. The article referred to related research and to a fatal accident that occurred in Australia while winching 14
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with the single-sling method. The accident in Australia raised some personal concerns in my own working environment and the current standard operating procedure
sudden vertical suspension, without support to the legs, challenges the blood circulation regarding the use of a rescue sling. The Air Patrol Squadron has over 35 years of experience in operating with SAR helicopters and winch rescue operations, and during that time, operational procedures have evolved to make the current procedures and equipment as practical and safe as possible. In this article,
I want to view the physiological effects of winching equipment according to related research so that one can understand the physiological effects of the winching equipment most commonly used in helicopter rescue. I predicted the collection of sources to be challenging, but I soon realised that there was more than enough for a reliable thesis. Many of the research papers are relatively old, going back to the late 80s and 90s, but most can still be seen as scientifically relevant. The latest research relating directly to the physiological effects of winching equipment in helicopter rescue was conducted in 2011 (Australia). No related researches of Finnish origin could be found on this topic. The equipment used in winch rescues can roughly be divided into four types of devices: the rescue sling, the harness or the vest, winch stretcher and the rescue basket. Patients or survivors are
Rescue sling The use of a rescue sling with the single-sling method is one of the most traditional ways to lift a survivor from water in helicopter rescues. The sudden vertical suspension, without support to the legs, challenges the blood circulation where natural compensation mechanisms aim to uphold efficient arterial blood pressure. An increase in heart rate is one of the initial compensation responses when predisposed to vertical suspension. How these normal compensation mechanisms are able to work efficiently enough is dependent on the overall rescue scenario and on the health of the individual. Static vertical suspension reduces the central blood volume, and can lead to inefficient circulatory compensation despite the body’s best efforts, and in this case, the circulatory system is unable to maintain arterial pressure at a level where the brain gets enough oxygenated blood flow. The compensatory process is further complicated in patients suffering from chronic or underlying heart problems. The normal compensatory mechanisms occurring in vertical suspension such as elevated heartrate can have devastating effects for a patient with an alreadyweakened heart. The physiological effects are more complex when rescuing from water. The Circum
Rescue Collapse hypothesis is widely quoted and is also one of the sources in my thesis. It describes the physiological responses that lead to collapse prerescue, during rescue or post-initial rescue from water. Hydrostatic pressure and
cold water are the main factors affecting the physiological responses when lifted to vertical suspension. After prolonged immersion, especially in vertical position, the hydrostatic pressure causes an increase in the central blood circulation and a decreased blood flow in the extremities. The theory describes the physiology behind pre-rescue as being caused by
MEDICAL INSIGHT
affected physiologically in different ways depending on the rescue equipment. These physiological mechanisms and effects should be understood by the rescue personnel.
decreased sympathetic activity. Normally, when a person is under stress or, for example, in survival mode, the sympathetic nerve system is active due to a high production of hormones that activate the sympathetic tone. The arteries squeeze into a smaller diameter and heart rate increases to uphold the arterial pressure. According to the hypothesis, when a rescue is perceived as imminent, the sympathetic activity may decrease, causing the arterial pressure to drop dramatically and the collapse is possible due to inefficient or failed compensation mechanisms. During rescue, when lifted to vertical suspension, the effects of hydrostatic pressure changes as per the effects of gravity. Blood starts pooling back to the extremities, generating a decreased central circulation, which reduces the preload of the heart leading to decreased arterial pressure. A collapse during rescue is a possibility because the compensation mechanisms may fail or be inefficient to uphold the arterial blood pressure at the required level. After collapsing in vertical suspension, victims may wake up when placed horizontally. Post-rescue problems relate more to hypothermia, where central blood volume increases to uphold the core temperature and to protect the vital organs from hypothermia. During rescue,
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the coronary perfusion. A sudden vertical suspension triggers the compensation response by raising the heart rate, which may result in cardiac arrest. It’s also notable that defibrillation of a severely hypothermic heart turned into ventrical fibrillation (VF) is likely not to be successful. Effective and continuous CPR en route to a hospital with ECMO (Extracorporeal Membrane Oxygenation) treatment available are the main elements affecting the survivability in this case. The single-sling method also affects the respiratory system more than any other device used in winch rescues. Suspension in a single sling causes a thoracic squeeze, which induces a mechanical respiratory
when a rescue is perceived as imminent, the sympathetic activity may decrease, causing the arterial pressure to drop dramatically when predisposed to physical activity, the heart of a hypothermic victim calls for more cardiac work and therefore more oxygen supply to the myocardium. Elevated heart rate decreases the time for coronary filling and this may not be tolerated by a cold weakened heart. Increased blood viscosity caused by severe hypothermia further increases the workload of the heart, which reduces
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strain. The squeeze also increases intrathoracic pressure, which may induce a decreased preload of the heart. Vertical suspension without support to the legs causes pooling of blood in the legs, which may further compromise the preload phase. Decreased preload, on the other hand, may cause a vasovagal response, leading to a slow heart rate and lowering of the arterial pressure, further compromising efficient blood flow to the brain. The most prominent indication of failed or inefficient compensation mechanisms during winch rescue is a collapsing survivor. Losing consciousness during vertical suspension in a rescue sling causes the loss of muscle tone and can result in slipping out of the sling and eventually to a fall, even if the victim is escorted on the hook. Such an occurrence
was demonstrated in a fatal winching accident in Australia, 2013. Winch stretcher Winching equipment that is used to lift a patient in a horizontal position can pose a risk to the respiratory functions. Lying supine is known to increase the workload of the respiratory system. The pressure against the upper abdomen increases, inducing a decreased residual capacity in the
categorising the winching equipment according to their physiological effects should not exclude any method available lungs. A patient locked in with straps is unable to move or change position and sometimes even turning the head is limited. Vomiting caused by nausea during stretcher winch poses a risk of aspiration where the airways are at risk of becoming blocked. Double sling Compared to vertical suspension in a single sling, the probability of losing consciousness in suspension with elevated legs is greatly decreased. Elevated legs prevent the pooling of blood to legs. Pooling of blood is one factor that causes the reduced central blood volume and decreased preload in the heart. All sources referred to come to the conclusion of favouring the double-sling method instead of single sling. The physiological benefits of using the double-sling method instead of a single sling may not be related only to rescuing a hypothermic victim, but to all victims winched from water. However, according to Tolerance to Head-up Tilt and Suspension with elevated legs (Madsen et al. 1998), being suspended with elevated legs does not totally eliminate the possibility of losing consciousness.
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Rescue basket, ARV and AVED Respiratory Function in Hoist Rescue (Murphy, Garner, Bishop, 2011) describes the physiological effects of rescue baskets as minimal, especially to the respiratory functions. The downside of the rescue basket relates to its functionality, mostly due to size. The basket takes up a lot of space in the cabin, and with many helicopters operating as a multirole platform, it can
Lying supine is known to increase the workload of the respiratory system be difficult, if not impossible, to equip the aircraft with a rescue basket. Putting an unconscious victim in a rescue basket poses a risk to airway management due to the sitting position and the victim being unattended during the winch operation. The victim should be cooperative when using a rescue basket. Operators with heavy SAR helicopters with enough cabin space should consider the option of having the rescue basket in the toolbox due to the advantages offered from a physiological point of view. Harness-type lifting devices represent the newest generation in helicopter winching
devices. The sitting position in the so called AVED (Ambulatory Vertical Extrication Device) or ARV (Airlift Rescue Vest) is similar to the position in the double-sling method. AVED/ARV can be seen as safer compared to the double-sling method because the victim is strapped in in such a way that it’s practically impossible to slip through the device. This device is designed for dry operations and may be too complex to work with in water rescues. Potentially, the development of a water rescue version of an AVED/ARV could be worth consideration by the industry. Summary Much of the research concludes favouring rescue equipment and methods that allow the survivors or patients to be lifted horizontally rather than vertically with a single sling. As the vertical lift with a single-sling method poses the highest risk for safety, it should be considered as the last resort when choosing the right rescue equipment for the job. However, categorising the winching equipment according to their physiological effects should not exclude any method available. Helicopter rescue scenarios can be challenging and complex, and sometimes the rescue method posing the highest physiological risk may be the only practical option. It´s equally easy to justify the use of a single sling in time-critical multi-
casualty scenarios due to the simplicity and effectiveness of the rescue device. Rescue swimmers, winchmen and flight paramedics have primary responsibility for the safety of their patients or survivors during the winch operation. It is vital, therefore, that they are prepared for any known outcome possible during winch rescues. It is as such equally important to understand the physiological strains the victims get exposed to, especially those with some form of preexisting medical condition. Experienced rear crew members should also be granted with a major role in the development processes of rescue equipment in their organisation.
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Adisesh, A – Robinson, L – Codling, A – HarrisRoberts, J – Lee, C – Porter, K 2009. Evidencebased review of the current guidance on first aid measures for suspension trauma. Research Report, RR708. Health and Safety Laboratory. University of Birmingham. Health and Safety Executive. United Kingdom. Australian Transport Safety Bureau ATSB. Aviation Occurrence Investigation. AO-2013-136. Helicopter winching accident involving Bell Helicopter Co. 412EP VH-VAS. 2013. Golden, F. St. C – Hervey, G. R – Tipton, M. J 1981. Circum-Rescue Collapse: Collapse sometimes fatal, associated with rescue of immersion victims. Journal of the Royal Naval Medical Service, Vol 77 (winter) 1991: 139–149. Madsen, Per – Svendsen, Lars Bo – Jørgensen, Lisbeth G – Matzen, Steen – Jansen, Erik – Secher, Niels H 1998. Tolerance to head-up tilt and suspension with elevated legs. Aviation, Space and Environmental Medicine 69(8):781-784. Murphy, David – Garner, Alan – Bishop, Rod 2011. Respiratory function in hoist rescue: Compairing slings, strecher and rescue basket. Aviation, space and environmental medicine 82 (2):123–127. Physiology on the winch <https://careflightcollective. com/2016/09/15/physiology-in-the-winch/> Rollink, JD – Witt, K – Hänert, W – Rix, W – Schwindt, M 2001. Rescue Lifting System (RLS) Might Help to Prevent Death After Rescue from Immersion in Cold Water. International Journal of Sports and Medicine 22:17–20. Seddon, Paul 2002. Harness suspension: review and evaluation of existing information. Contract research report 451/2002. Health and Safety Executive.
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EXTRAO R What does it take to be a Canadian SAR Tech? AirMed&Rescue reached out to the Royal Canadian Air Force (RCAF) to find out more about the unique role of a SAR Technician Where does the opportunity to be a SAR Tech start? SAR Technicians must have served a minimum of four years in the Regular Forces or in the Reserve Force prior to applying for a Voluntary Occupational Transfer (VOT) to attend the SAR Tech selection and Land Survival Course. Military background and training will vary from individual to individual. Both male and female Canadian Armed Forces (CAF) members apply for VOT and those with the strongest personnel files will be offered the opportunity to attend selection. The file review is the first phase of selection conducted at the BPSO level. 20
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CAF members apply from the Army, Navy and Air Force and are generally top performers in their respective branch / occupation. Highest levels of physical fitness are an expectation of all candidates that volunteer. SAR Technician candidate occupations range from Infantry, Medic, Combat Engineer, ACS Technician, Boatswain to Construction Engineers and Special Operations. Further file review for selection is conducted by D Air Pers and the SAR Tech CWOs. This is the second phase of the selection process. Stronger personnel files will include specific skill sets that mirror SAR Tech prerequisites of training such as parachuting, mountaineering, diving and medical. The CAF has about 140 SAR Techs; why only 140? Occupation total numbers are set by the RCAF in support of the National SAR Mandate. A limiting factor to the total number of SAR Techs in the occupation is the
specialised training that they must receive. The Canadian Forces School of Search and Rescue (CFSSAR) trains SAR Techs, specifically the Restricted Team Member (RTM), Restricted Team Leader (RTL) and Team Leader courses. Due to the specialised training requirements, a maximum course load of 16 is recommended, thus limiting increased outputs. How long does the initial training phase last? The selection and land survival course totals 17 days. Those deemed suitable and successful during selection will be courseloaded on the SAR Tech RTM course. The RTM course is 11 months long. What does initial training involve? Initial training on the RTM course consists of: • In clearance – four administrative days • Aeromedical training – four days • Ground Search Operations Phase – five days
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O RDINARY • Paramedic pre-studies • • • • • • • • • • • •
– 10 days R2MR – two days Paramedic Phase – 80 days RUET – five days HPMA – two days Dive Phase – 29 days (includes CSRD) Arctic Survival Operations Phase – 12 days Winter Mountain Rescue Operations Phase – nine days Sea Survival / Rotary Wing Operations Phase – eight days Parachute / Fixed Wing Operations Phase – 35 days Summer Mountain Rescue Operations Phase – 10 days Final Operations Phase – 10 days+ Graduation week – 10 administrative day
SAR Techs are trained to a primary care paramedic national standard – what exactly does this mean in terms of the care they are able to provide and drugs they can administer? SAR Techs are trained to treat trauma injuries at the Primary Care Paramedic Level – performing triage in multiple casualty situations; assessing the medical condition of casualties; maintaining adequate airways; initiating and maintaining oxygen therapy; ventilating a patient; performing cardiopulmonary resuscitation; providing emergency treatment; treating hypovolemia utilising IV therapy; stabilising and extricating casualties from wreckages; evacuating personnel by loading and unloading patients from the evacuation platform; recognising and treating trauma injuries on an ambulance and in an ER setting over a five-day period; and initiating, maintaining and transferring patient medical documentation. They are also trained to treat medical
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emergencies, providing treatment for respiratory conditions; cardiac conditions; chest pain; unconscious patient not yet diagnosed (NYD); cerebral vascular accidents (CVA); seizures; diabetic conditions; acute abdomen; allergic reactions; anaphylaxis; alcohol and narcotic overdose; neurological disorders; psychological emergencies including critical incident stress; obstetrical emergencies; paediatric emergencies; environmental emergencies; high-altitude emergencies; and diving emergencies. SAR Techs are land and sea survival experts â&#x20AC;&#x201C; what training do they 22
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undergo in order to achieve the right level of expertise in these disciplines? SAR Techs will survive in a land environment by applying survival pattern; operating survival / personal equipment; performing first line maintenance on survival / personal equipment; constructing international / improvised ground signals; navigating on land using orienteering techniques; navigating on land using a GPS; performing first-line maintenance on SAR tents; erecting SAR tents / improvised shelters; and utilising field craft tools and woodsman skills. For Arctic survival, SAR Techs survive by operating survival stoves and / or
improvised heat sources to provide heat, food and water; erecting survival tents and constructing snow walls to provide shelter for an indefinite period of occupancy; constructing a multi- and one-man snow cave and fighter trench to provide shelter for an indefinite period of occupancy; contributing to group survival ability and morale; constructing improvised signals particular to the arctic; operating signal devices; and navigating. For sea survival, the SAR Tech will train by parachuting into the water, practising egress from an aircraft, and completing the RUET training course.
WO Rob Coates spoke to AirMed&Rescue about his experiences as a SAR Tech in the RCAF: What made you want to become a SAR Tech? I had wanted to become a SAR Tech for many years during my time in the Army, prior to doing SAR Tech selection. What the trade did, both in training and in operations, appealed to me because it was more what I wanted to do with my military career and was similar to what I enjoyed doing in my personal life. I liked the fact that the skill sets
that were taught and maintained throughout your career as a SAR Tech were transferable to life after SAR. What is the most challenging part of the role? The most challenging part of the job is maintaining not just your currencies, but proficiency in all of the many skill sets that SAR Techs possess.
What is the most satisfying part of the job? The most satisfying part of the job is being able to return to safety those victims of disaster entrusted to your care by the assignment of the mission to which you have consented! Being able bring loved ones home to their families or provide closure to families in some cases.
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Spotlight: 15th Wing Dino Marcellino details the development of the Italian Air Force’s primary air rescue asset
An HH-101A on Cervia AB At the beginning of the new century, two events happened that prompted significant changes in the organisation of 15th Wing, the Italian Air Force’s (IAF) unit devoted to air rescue. The first was the rise in international tension that began with the tragic 9/11 attack on the Twin Towers in New York, and the subsequent geo-political instability that spread rapidly around the 24
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globe. Wars – declared or not – terrorism, migratory movements and asymmetric conflicts resulted in a complex situation for military organisations to face, which didn’t fit in with traditional approaches to war fighting, and also brought new challenges in the case of rescue missions. The second event was that the main helicopter model – the ageing Sikorsky HH-3F Pelican – was
coming to the end of its life. It had been in service since 1977 and had accrued more than 186,000 flight hours and rescued over 7,000 people. A new era To face the new scenarios around the world and the replacement of the HH3F, it was obvious that the organisation of
and overseas, and are equipped with stateof-the-art machines: the HH-139A and HH-101A. Locations The headquarters of 15th Wing is on Cervia Pisignano Air Base (AB) in northern Italy, which is also home to the 81st Crew Training Centre CAE, the 83rd SAR Centre,
15th Wing is the biggest IAF unit, with detachments over five bases that cover all Italian territories
23rd Flying Group, 915th GEA Aircraft Efficiency Group, 615th Squadron and 387th Squadron. The helicopters operating from the base are the HH-139A and HH-101A Caesar. Elsewhere, Decimomannu
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15th Wing had to be re-thought. So, for the first time, 15th Wing had a base dedicated to it in Cervia-Pisignano, and it planned to acquire two new helicopter models, which together would cover both national SAR and combat SAR / medevac / personnel recovery for missions abroad. Today, 15th Wing is the biggest IAF unit, with detachments over five bases that cover all Italian territories at home
on Sardinia is home to the 80th SAR Centre, and is the only one equipped with an elderly HH212 helicopter. Trapani-Birgi AB on the island of Sicily is home to the 82nd SAR Centre, equipped with an HH-139A; Gioia del Colle (southeast Italy) is home to the 84th SAR Centre with an HH-139A; and Pratica di Mare (central Italy) is home to the
85th SAR Centre, which also operates an HH-139A. Each base provides 24/7/365 SAR cover for any emergency in Italy and its islands, with each base having one or two helicopters ready to take off at short notice (HH-139As on four bases and an HH-212 in Sardinia). The crew is made up of two pilots, a winchman, and one or two rescuers.
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On Poggio Renatico AB, not far from Cervia AB, the IAF houses the European Personnel Recovery Centre, which was established by seven founding nations (Belgium, France, Germany, Great Britain, Holland, Italy and Spain) to develop doctrines in order to train leaders and specialists to act as a focal point for all international personnel tasking in Europe.
Dedicated aircraft With the HH-139A being used mainly for national SAR, the HH-101A has been bought by the Air Force to ensure it can respond to the new scenarios it is facing abroad – there is a definite need to face emerging threats overseas, namely providing support as part of an international coalition effort, and they can also perform CSAR missions in hostile territory, whether for military or civilian personnel. To accomplish those missions, the HH101A has been acquired in 12 units (six have already been delivered and six are slated for delivery). For its wide mission profile, on long distances, the HH-101A is qualified to perform helicopter air-toAn HH-101A on special forces training
the HH-101A has been bought by the Air Force to ensure it can respond to the new scenarios it is facing abroad
An HH-212 winching in Sardinia
© Images by Dino Marcellino
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air refuelling, and is equipped with an ‘up / down-link system’ called Vortex, which allows dialogue in real time, with an advanced reconnaissance system; each one of the special forces operators on board the HH-101A has a data link connection at their disposal, so they can receive images and re-plan the mission during the flight, if necessary.
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‘Always Ready! Always There!’ Amy Gallagher explains the primary assets that the National Guard used during Hurricanes Harvey and Florence, including aircraft types, personnel from multiple states, and multiple modes of communication, to manage the mobile matrix of required resources, as well as the after action review (AAR) assessments conducted by the Texas Army National Guard (TXANG) and the North Carolina Army National Guard (NCANG) Regardless of the mission, it is the humanitarian services that the US National Guard have been called upon to serve in greater numbers during the past two hurricane seasons. While the National Guard serves as a reserve component of the US Armed Forces, the guard members must always be ‘ready’ and ‘there’ when called upon by their government to support state emergency managers. The National Guard has a variety of assets and capabilities to assist in life-saving efforts during any disaster, whether man-made or organicallymanifested by Mother Nature herself. In order to battle the kind of hurricanes that hover for days – like Harvey and Florence – the National Guard conducts an AAR assessment to determine the appropriate assets and training programmes required for the next hurricane season. The 2017 hurricane season ensured that Texas-bound Harvey earned the title as the ‘most destructive natural disaster in the US’. The 2018 hurricane season delivered a similar disaster along the eastern US coast, where loss continues to compound as a result of Hurricane Florence. Hurricanes Harvey and Florence proved to be quite the pair, leaving their indelible mark on thousands of Americans, their homes and work lives. A perilous pair of natural disasters with similarities, there’s no doubt, circling and hovering above the ground, generating massive flooding.
Indeed, Harvey and Florence were true to their names: ‘blazing iron’ and ‘ruffled wrench’ respectively. The inside track Maj. Jordan A Boyd, US Army, Deputy, State Aviation Office (SAO) TXANG, served as a pivotal point of contact navigating assets, resources and communications during Hurricane Harvey. Brett Dixon, Programme Manager, Texas Task Force One (TTF1) and the Helicopter Search and Rescue Technicians (HSART) rescue swimmers, explained how, surprisingly, a hurricane like Harvey served to strengthen the TXARNG crew and the HSART teams. Meanwhile, while Hurricane Florence hovered like a helicopter on the eastern coastline of the US, Lt Col Michele Harper of the NCANG explained the protocols applied during Hurricane Florence, along with CW5 Todd Woodard, Deputy SAO, NCANG, US ARMY NG who assisted in both Harvey and Florence SARs. Aircraft and equipment assets According to subject matter experts, noted Maj. Boyd, the 13-day siege on the Texas Gulf during Hurricane Harvey was the first time the National Guard used the Lakota for night-time rescues in Texas: “During Harvey, the National Guard crews flew both the Blackhawk and the Lakota, with
each aircraft type serving specific purposes.” Maj. Boyd continued: “Traditionally, the National Guard deploys UH-60 Blackhawks for SAR missions, while the Lakota proved to be a valuable asset during Harvey as well, notably during nighttime missions.” The night rescues during Harvey validated the value of the Lakota, with respect to the aircraft’s night vision system, he added. “We’re very proud of
MIL SAR that. It was a great success.” According to Dixon, the rescue hoist hooks used on all TXANG aircraft were recently upgraded to an ‘auto-locking design that is now safer and easier to manipulate’. And Maj. Boyd added that, although the UH-60 ‘Mike’ does not currently have a hoist system, the aircraft is currently in the Airworthiness process to ultimately retrofit the hoist system as an upgrade. “The UH-
60M hoist process is a long-term solution,” explained Boyd. “This is an NG-specific responsibility, not an Active Duty issue. As such, the installation of any upgrades comes with staffing and emphasises challenges.” Maj. Boyd added that the process includes a hoist Airworthiness Release (AWR), followed by testing and modifications of current fleet based upon priority (probably starting with the coastal states that will be
hardest hit by the next hurricane season). “Both the Blackhawk and Lakota will continue to be utilised during state-wide SAR operations day and night, knowing each airframe brings its own strengths and limitations to the fight,” he added. “We are currently maintaining NVG qualifications for our rescue personnel in both aircraft.” Boyd further explained that light-utility helicopter (LUH) crews that have counterdrug experience, and UH60 medevac
crews with overseas operational experience, bring extensive hours of ‘goggle flying’ to the SAR mission. “Spreading our capabilities over numerous airframes provides the flexibility to diversify our Defense Support of Civil Authorities (DSCA) response,” said Maj. Boyd. Adapting to emergent needs One National Guard member experienced both Harvey and Florence. “Each and every hurricane requires a specific approach based on the circumstances at the time,” said Woodard. He told AirMed&Rescue that every hurricane operation demands an ‘art and science’ approach in order to meet the requirements of the current emergency situation. “Operational plans are created to synchronise such operations, but leaders must be able to adapt to the situation as it develops,” he said. “All National Guard aviation platforms provide capabilities distinctive to their particular area of operation, which become extremely valuable tools.” During both hurricanes, both the TXANG and the NCANG crews used UH-72s, UH-60s and CH-47s to implement the specific operational plan, including SAR, Woodard added. “Wide-area searches, critical needs assessments, and flights and commodities movements into stricken areas were conducted,” he said. Similar to the Texas TTF1HSART, North Carolina’s HART consists of aircraft from the NCANG and NC State Highway Patrol, along with other aviation partners. “These teams train consistently throughout the year, honing their skills to prepare for any and all hurricane operations, as well as additional rescue missions, such as mountain and river rescues,” said Woodard. 30
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“Our J3 Domestic Operations section ensures preparedness throughout the year by updating force packages, conducting AAR and coordinating domestic training for
all guard members,” he explained. Knowing when to modify assets One area that will always be a challenge is knowing how and when to increase and reduce forces, and it is always a discussion point during every event, noted Col Harper. “Florence was the first event that required the need to employ a Joint Task Force (JTF) during emergency conditions, so the Aviation Task Force piece of the puzzle was
a challenge,” said Col Harper. “Each state employs aircraft differently. Some states give aviation operations more latitude, while other states are more restrictive.” She
explained that having parameters in place before they arrive means that they can stay within those and are therefore not going outside of state norms, nor what is considered acceptable usage of a highdollar reimbursement. “The ability to expand and contract operations exponentially requires a complete understanding of the situation and the ability to address critical needs in a timely manner,” said Col Harper, who
A look at the numbers Col Harper, with the North Carolina National Guard, provided a detailed account of the assets applied during Hurricane Florence. To effectively manage SAR operations during a Cat 4 hurricane like Florence – which soon became a flooding event – the assets of one state alone cannot meet the demand, stated Harper, who explained that North Carolina utilised a variety of aircraft from a variety of states during Hurricane Florence, including the following aircraft response totals: • North Carolina: NC ARMY National Guard: 7 x UH-60 Blackhawk (4 HART/3 GS), 2 x LUH-72 Lakota (1 HART/1 MEP) • United States Coast Guard: varied daily, but normal set was 6 x MH-60T, 4 x MH-45, 1 x HC-130J • NC State Highway Patrol: 1 x Bell 407 HART, 1 x B206, 3 x OH-58 • Civil Air Patrol: 6 x Cessna 172 and 11 x Cessna 182 • Other state ARNG support: CT: 1 x UH-60 and 1 x CH-47 NE: 2 x HH-60 IL: 1 x UH-60 and 1 x CH-47 IN: 2 x UH-60 MD: 2 x UH-60 and 1 x CH-47 MN: 1 x CH-47 NY: 2 x UH-60 WI: 2 x UH-60 OK: 1 x UH-60 MS: 2 x CH-47 TN: 3 x UH-60 MI: 1 x HH-60 NJ: 1 x UH-60 • NY AIR National Guard: 4x HH-60 Blackhawk and 1 x C-130 • US Customs and Border Protection TX: P-2 Omaha for C2 and 5 x UH-60 According to Harper, TXANG provided aviation brigade level personnel to support the JTF, KYANG provided personnel to support the Aviation Task Force, and National Guard Bureau sent some additional aviation personnel to support the JTF, so 16 states plus Washington, DC in all supported Hurricane Florence. The total numbers that provided support during Hurricane Florence is approximately 400 aviation/support personnel and at the peak, approximately 80 aircraft total (rotary and fixed wing).
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added that pre-planning aviation operations requires constant adjustments due to the ever-changing environment of a natural disaster. “Training in the area of expanding
and contracting operations can be conducted during scenario-based hurricane training exercises, which we plan to do and expand into a SAREX, similar to prior training we attended in support of TXANG last summer,” she explained. These exercises can be tailored to the trainees and modified to ensure maximum training effect for all involved, said Col Harper. After action review The ‘after’ phase of any mission requires the analysis of data. “For the aviation team, we capture all the data – files, trackers, forms, org charts, admin – and digitally clean and store the information for historical purpose. More importantly, we conduct a thorough AAR with all ‘players’ in order to prepare for the next event,” noted Col Harper. “Secondly, we prepare future trackers, forms, etc. and 32
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have a new folder drafted within weeks, in preparation for the next event.” Ground crews take a pivotal role in the ‘after’ phase for all disasters. Col Harper details that
Ground crews take a pivotal role in the ‘after’ phase for all disasters ground troops assist with the moving and the cleanup to restore a sense of normality, ‘as much as is possible’. “Our state effectively manages all resources,” she added, “so as soon as all roads are open for moving food, water, and people, then all aviation operations cease at that point.” Drones as future assets Unmanned Aircraft Systems (UAS) are increasingly prevalent in disaster response, said Dixon. According to the Federal
Aviation Administration (FAA) Research and Development information (as cited on the agency’s website), research activities such as flight tests, modelling and simulation,
technology evaluations, risk assessments and data gathering and analysis provide the FAA with critical information in areas such as Detect and Avoid, UAS Communications, Human Factors, System Safety, and Certification – all of which enable the Agency to make informed decisions on safe UAS integration. “State and federal agencies are investing more in research, training, and certification,” added Dixon. “We have added a seat for a UAS Liaison Officer in the Air Operations Center to assist with subject matter expertise and coordination,” he added. Boyd commented: “With all the civilian UAS in the area of operations during a DSCA event, however, I do not foresee Texas integrating Ravens (SUAS) or Shadows (TUAS) in the near future.” Photography provided by the TXANG.
Communications systems With the onslaught of Harvey’s historical weather event, the need for more reliable communications became evident. “Some coordination personnel received public requests on social media platforms (Twitter, Facebook) for assistance; however, it was not and should not be the standard procedure for receiving, validating / triaging, and assigning those missions,” said Dixon. According to Dixon, group messaging apps such as WhatsApp were used by the civilian response personnel when cell service was reliable and radio communications were not feasible. “Chat groups could be created based on crews, sector assignments, and joint ops with boat squads,” Dixon explained. “Not that it was ideal, but, at the time, it was an efficient way to pass detailed information that could be quickly and easily shared or recalled (for privacy concerns, WhatsApp utilises end-to-end encryption).” According to Maj. Boyd, all Texas SAR aircraft have 800-MHz satellite radios, and more specifically, the Voice Interoperability Plan for Emergency Responders (VIPER 800), which will ideally negate the use of social media. The system will give public safety agencies the ability to talk to one another via radio communication systems – to exchange voice and/or data with one another on demand, in real time through all agency partners within the state, he explained. “The National Guard Bureau (NGB) recently funded the modification of all DSCA aircraft,” Maj. Boyd said. “We use a secure chat from the Accession Options Criteria (AOC) and Judge Advocate General Connecticut to aircraft swimmer for mission details. To ensure redundancy, we also send the information to the flight crew via text.” Additionally, Maj. Boyd said the TXANG is exploring a programme called Domestic Operations Awareness and Assessment Response Tool (DAART) for secure chat, aircraft tracking, and a common operational picture. DAART is a web-based mapping application system that pulls together geospatial intelligence assets from a variety of sources, including terrain and mapping. “The ideal situation is for all interagency partners to utilise the same radio equipment,” said Maj. Boyd.
The interagency network includes the Department of Public Safety (DPS), Texas Parks & Wildlife, Texas State Highway Department, local law enforcement and police departments and, of course, interstate National Guard units as resources are available. Hurricane Florence delivered similar challenges, as the NCANG conducted SAR missions that included the use of the Viper 800-MHz radio. While ‘VIPER 800 to Air Boss’ might sound like a radio call on a sci-fi show, according to NCANG’s Col Harper, the radio call was live and real during Hurricane Florence: “All forms of communication were used in order to ensure missions were executed in the timeliest manner in order to save lives and protect property.” Col Harper added: “Most communication took place over the VIPER 800MHz radio, which we are fortunate to have on all aircraft in North Carolina (NC). All NC assets were able to communicate with flight operations or the Air Boss’ State Emergency Response Team (SERT) Air Operations Cell when needed.” Most of the National Guard from other states that assisted in Florence also had Viper channels for communication, stated Col Harper. “If an out-of-state aircraft did not have a VIPER, the crews travelled in pairs with an aircraft that had VIPER, so communication would be easier,” she explained. Col Harper said that all calls from people affected on the ground were routed through the standard 911. “We then received the message in the SERT Air Ops Cell by phone or through a Web EOC request, a system used to process non-urgent EM requests,” noted Col Harper. Additionally, Col Harper said the NG had liaison officers in the SERT Air Ops cell from all agencies to establish communications within each respective organisation. “Because the NCANG had the 800-MHz radio, social media was not used to communicate during Florence,” she added. “However, we did have phone numbers for every aircraft crew if we needed to text or call if we were not able to contact them in other ways.”
DAART is a web-based mapping application system that pulls together geospatial intelligence assets from a variety of sources, including terrain and mapping
AAR training drills post-Harvey The TTF1 and the Helicopter Search and Rescue Technicians (HSART) teams, along with TXANG aircrews, conduct annual training on helicopter hoist rescues in realistic and timed scenarios, involving simulated floodwater, according to Dixon. In May 2018, the teams conducted a one-week SAREX, involving multiple state national guard units who travelled to Texas, joining civilian partners such as the Border Patrol, Parks & Wildlife, and Police Departments, Dixon explained. “We recreate the scenarios during Harvey while exercising critical thinking and decision-making skills to access and apply multiple equipment options on the aircraft using specific techniques,” said Dixon. “The goal is to identify the most efficient strategy to support the operational plan.”
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FIGHTING FLORENCE
Managing a mobile matrix
The following timeline is a narrative of events prepared by Lt Col Michele Harper, NCANG, covering the aircraft rescue operations in Kelly, North Carolina during Hurricane Florence. “This was a SAR event that occurred due to an unpredicted levee breach that led to a church (that was being used as a shelter) and the surrounding area needing to be evacuated,” explained Harper. “As the ‘Air
Boss’, I sent assets to the area to perform SAR, but the greater success was that of the aircrews and their ability to assess the situation to create a course of action that was successful for all involved.”
3 Killdevil 277 conducted the initial recon of the levee, confirmed the breach and hoisted three persons from a residence and delivered them to a fire station across from the Centenary Church. Initially, there was no further immediate need, so Killdevil 277 departed for fuel and Killdevil 663 picked up the mission until relieved and returned to base.
20:15
AIRCRAFT & CREW
1 On 20 September, the North Carolina Emergency Management Eastern Regional Coordination Center (RCC) notified North Carolina (NC) Emergency Operations Center (EOC) of 150-200 residents gathering at Centenary Church at approximately 20:15 hrs (local time) that required rescuing.
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2 SERT Air Operations diverted aircraft Killdevil 277 which was departing Wilmington Airport (KILM) en route to Salisbury Airport (KRUQ), to recon a levee in the Kelly, NC, area due to initial indications that there might be a breach or impending breach to the levee.
4 Raven 83 then entered the location and began reconnaissance of the area to determine if any additional rescues were required and to establish locations for potential landing zones (LZ), if required. At that time, Raven 83 determined the surrounding water was rising and relayed, via radio, that the Centenary Church would need to be evacuated.
KILLDEVIL 277
KILLDEVIL 663
RAVEN 83
KILLDEVIL 347
(NC National Guard Helicopter Aquatic Rescue Team (HART) UH-60 Helicopter)
(North Carolina National Guard HART UH-60)
(Maryland National Guard HART UH-60)
Crew – CW2 Jay Moon, CW2 John Masseria, Sgt Brian Smith, Sgt Greg Sherrell, HART Tech Josh Johnson, HART Tech Stacey Rooks, HART Tech Mike Morley
Crew – CW3 Justin Evans, CW2 Mark Chambers, Sgt Christopher Raynor, Sgt Joseph Leight, HART Tech Michael Stream, HART Tech Andrew Hays
(North Carolina National Guard HART UH-60 Night Crew) Crew – CW3 Jimmy Suggs, CW3 Bruce Scharbius, SSG Donald Money, SPC Anthony Green, HART Tech Doug DeJonge, HART Tech Will Sanburg, HART Tech Omar Kasso
Mission Totals – 3.0 hrs flown
Mission Totals – 6.0 hrs flown, five persons rescued
Mission Totals – 6.7 hrs flown, 12 persons and six animals rescued
Crew – CW4 Brandon King, WO1 Wesley Powell, Sgt Jacobe Moore, SPC Monty Ingle, HART Tech Bobby Cooper, HART Tech Jay Bettencourt, HART Tech Brad Holmes 6.1 hrs flown, three persons rescued
8 Two CH-47 aircraft, Guard 818 and Guard
9 CG 6030 landed at the Centenary Church
827, were launched from Kinston Airport and Raleigh-Durham International Airport to assist. Guard 818 landed at the Centenary Church LZ and rescued 42 persons and 15 dogs. Guard 827 then landed at the Centenary Church LZ and rescued 24 persons and seven pets. All persons and animals were taken to the Kinston Airport for triage and shelter.
LZ and rescued six persons and one dog. CG 6038 then landed at the Centenary Church LZ and rescued 10 people and four dogs. CG 6038 then diverted to another location to confirm a second possible rescue position.
20:44
10 CG 6030 and CG 6038 then transported all persons and animals to the Kinston Airport for triage and shelter.
7 During this time, the United
11 Raven 83 was then diverted to a motorhome in the area and landed at an LZ nearby to rescue five additional persons. Raven 83 then transported all persons to the Kinston Airport for triage and shelter.
12 Raven 11 was also diverted to two additional locations in the area and rescued five persons in one location and four in another location.
13 Killdevil 347 returned to the scene and assisted in rescuing two more persons and three pets. Killdevil 347 and Raven 11 then transported all persons and animals to the Kinston Airport for triage and shelter.
States Coast Guard (USCG) launched CG 6030 and CG 6038 at approximately 20:44 hrs and 20:45 hrs (local time) to support rescue efforts in the Kelly, NC area.
6 Once Killdevil 347 departed Kelly, NC area, Raven 11 replaced Killdevil 347 on station.
5 Killdevil 347 reported on station in the area of Kelly, NC and performed a recon of the area. At that time, Killdevil 347 rescued 10 people and three dogs at Centenary Church and transported them to the Kinston Airport (KISO) after a fuel stop at the Wilmington Airport (KILM).
06:15
It should be noted that all operations (both rescue and transportation) were conducted under Night Vision Goggles (NVG) in an extremely austere environment. Totals for all aircraft involved: 111 persons and 33 animals rescued.
End of Mission for last aircraft involved (Killdevil 347) was 06:15 hrs on 21 September 2018.
Photography provided by the NCANG CW5 Todd Woodard Photography provided by the TXARNG Brett Dixon
RAVEN 11
CG6030
CG6038
GUARD 818
GUARD 827
(Maryland National Guard HART UH-60)
(United States Coast Guard)
(United States Coast Guard)
(Minnesota National Guard CH-47)
(Maryland National Guard CH-47)
Crew – Lt Anthony Phillips, Lt Kyle Johnson, AMT2 Jonathan Miller, AST2 Mark Fulgham
Crew – Lt Christopher Pulliam, Lt Ian Sibberson, AET2 David Franklin, ASTC Bradford Fitzpatrick, AST3 John Fuller
Crew – CW3 Tom Knutson, CW2 Shad Romans, Sgt Brandon Stafford, Sgt Jon Neilsen, Sgt Derek Vollmer
Crew – CW3 Steven Howell, CW2 Jonathan Noble, Sgt Thomas Woolford, SPC Scott Eaton
Mission Totals – 4.7 hrs flown, 42 persons and 15 animals rescued
Mission Totals – 2.5 hrs flown, 24 persons and seven animals rescued
Crew – CW3 Gregory Turner, CW2 Roger Rippeon, SFC Matthew Gwin, SSG Steven Lucas, HART Tech Shane Sierakowski, HART Tech David Gouak Mission Totals – 6.5 hrs flown, nine persons rescued
Mission Totals – 4.1 hrs flown, six persons and one animal rescued/assisted
Mission Totals – 4.3 hrs flown, 10 persons and four animals rescued/assisted
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Taking the crown from
© Leading Seaman Dan Bard, Formation Imaging Services
the Sea King
The Royal Canadian Air Force (RCAF) has officially retired its ageing fleet of Sea King helicopters, and is ushering in a new era of combat and SAR helicopter with the introduction of the CH-148 Cyclone 36
AIRMED&RESCUE
Recognising past contributions The CH-124 Sea King was a ship-borne maritime helicopter with unique capabilities. The aircraft’s compact design, with a fold-up rotor and tail, meant it fitted on even the smallest warship’s deck, while its amphibious hull enabled it to perform emergency water landings. Powered by two turboshaft engines and equipped with subsurface acoustic detection equipment and homing torpedoes, the Sea King lifted off from destroyers and frigates to locate and destroy submarines. Capable of flying day or night, the CH124 was a versatile surveillance aircraft. Although originally procured for anti-
submarine warfare (ASW) in 1963, it expanded its role to include: • SAR operations • Disaster relief • Counter-narcotic operations • Fisheries and pollution patrols. The helicopter also played a vital role in international peacekeeping operations. It was heavily committed to the international campaign against terrorism, conducting hundreds of missions to transport troops and locate suspicious vessels. CH148 Cyclone – the new generation The CH-148 Cyclone is replacing the CH-124 Sea King as Canada’s main shipborne maritime helicopter, providing air support to the Royal Canadian Navy. The Cyclone will serve a number of key roles and participate in a variety of activities. It will
MIL SAR Wing Commander (retired) Ian Lightbody, former commander of 12 Wing Shearwater, Nova Scotia, commented on the retirement of the Sea King, and its value to the RCAF as its role changed over the years Originally delivered in August 1963 to then Her Majesty’s Canadian Ship Shearwater, just outside Halifax, Nova Scotia, the Sea King finished its service to Canada at the end of 2018 in Patricia Bay, just outside Victoria, British Columbia. During its 55 years of employment in Canada, the Sea King has been used by multiple services, and has changed significantly from its initial 1963 configuration. Originally procured by the Royal Canadian Navy to operate from aircraft carrier HMCS Bonaventure in anti-ASW roles, it was on the leading edge of rotary wing technology at the time, with two turbine engines and the then-revolutionary capability to automatically transition to a hover with the push of a button. This allowed a great leap in night and all-weather operations, permitting anti-submarine searches with an active dipping sonar. Additionally, the automatic transition equipment permitted SAR operations in bad weather. The end of the Cold War saw the Sea King change with the times. After the invasion of Kuwait by Iraq in 1990, the Sea King was modified from an obsolete ASW platform to a multi-mission helicopter specialising in surface surveillance and control. The addition of a forward-looking infrared sensor, a door-mounted machine gun and infrared anti-missile defences opened the door to expanding its presence in roles that weren’t emphasised during the Cold War. A decade later, the Sea King reached a new peak of deployed operational activity after the attacks on the US on 11 September 2001. In 2010-11, for example, the Sea King was deployed in combat operations off Libya, humanitarian relief operations in Newfoundland and after the Haiti earthquake, and domestic security operations during the Olympics and the Toronto G7/G20, where the Sea King performed air intercept operations. While there is no doubt that the Sea King’s retirement was long overdue, it was a bittersweet moment for many. The East Coast ceased Sea King operations early in 2018; in August, the Shearwater Aviation Museum inducted two Sea Kings into its inventory, one in the original RCN configuration and one in the final configuration.
conduct surface and subsurface surveillance and control, utility and SAR missions, and provide tactical transport for national and international security efforts. This twinengine helicopter is compatible with the latest high-tech naval frigates and includes several new safety features. Its aluminium and composite airframe, for example, is built with lightning-strike and high-intensity radio frequency pulse protection. The aircraft also incorporates flaw tolerance and engine burst containment. The Cyclone can conduct its operations day and night and in most weather conditions. It is approximately 10-per-cent faster than a Sea King. The Canadian Government approved initial operational capability of the CH148 Cyclone helicopter in June 2018. Sikorsky and Canada’s Department of National Defence have designed, built and
configured the CH-148 Cyclone for ASW, anti-surface warfare (ASuW), maritime SAR, overland operations and utility missions. As Canada’s first true intelligence, surveillance and reconnaissance (ISR) helicopter, the fly-by-wire Cyclone is equipped with a fully integrated mission system, modern sensors and a multi-mission cabin. Entry into service with the Royal Canadian Air Force occurred in mid-2018 aboard one of the Royal Canadian Navy’s Halifaxclass frigates. By 2021, with delivery of all 28 Cyclone helicopters in full mission configuration, the RCAF’s 12 Wing will base the aircraft at Shearwater, Nova Scotia, and Patricia Bay, British Columbia. Key features:
• Fully integrated mission systems and
sensors, featuring multi-mode radar,
•
•
• •
HELRAS dipping sonar, ESM/radar warning receiver, aircraft survivability suite, dual torpedoes. Dual-station tactical console with ASW/ASuW full mission suite; or 22 passengers (utility configuration), or multiple medical litters. Fly-by-wire controls enable exceptional handling qualities, folding tail and main rotors, C-RAST deck handling system demonstrated to Sea State 6, CT7-8A7 marinised engines, shipboard maintainable, helicopter in-flight refuelling. Maximum takeoff weight: 29,300 lb (13.3 t); designed to lift 7,000 pounds on the cargo hook. Significant increase in useable cabin space, mission performance and speed compared to the CH-124 Sea King.
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Tech
Success
From cutting-edge tools transforming medical care to emerging public safety solutions, augmented reality (AR) is enabling significant strides in industry and society. Adam Kaplan, CEO and Co-Founder of Edgybees, discusses the advantages of implementing AR technology in SAR missions Nowhere is AR’s game-changing potential more evident than in SAR and military scenarios. Drones equipped with AR software, for instance, play crucial roles in generating deeper situational awareness and actionable information for first responders
and platoon members in SAR scenarios. Drones not only offer perspectives unavailable to the naked human eye, but can actually save lives – especially when they’re outfitted with state-of-the-art software. Envision an AR-equipped drone that feeds video to control rooms in realtime, complete with overlaid geospatial information on the locations and statuses of key personnel and infrastructure during critical missions. This isn’t a scenario from sci-fi or the distant future: thanks to rapidly advancing AR technology, it’s increasingly a reality of modern public safety operations, and it’s allowing for more effective collaboration and communication among first responders and military personnel in even the most complex SAR scenarios.
Drones not only offer perspectives unavailable to the naked human eye, but can actually save lives
Ensuring a successful outcome What can AR-equipped drones achieve when deployed in SAR operations? First, they deliver rapid and accurate actionable insights that enable first responders and
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military personnel to better and more efficiently understand their surroundings. Rather than having to cross-reference maps and piece together information from siloed sources, these drones provide all vital information – even that which isn’t necessarily visible to the human eye – in one place. In high-risk scenarios – be they
At the heart of any efficient and successful SAR operation is full situational awareness forest fires or military rescue operations – the geographic and situational data these drones generate can not only help accelerate operations, but also prevent decisions that could lead to further tragedy. Take military reconnaissance missions:
INDUSTRY VOICE
in these cases, AR can pinpoint key population centres and identify civilians, enabling militaries to avoid unnecessary casualties. Drones with AR are also being used to allow the delivery of humanitarian aid in remote areas and disaster zones, where itâ&#x20AC;&#x2122;s crucial for responders to have as much information as possible about the local terrain, the state of infrastructure, and the damage to business and population centres. In these difficult-to-navigate environments, AR can mean the difference between a successful and a failed mission. Notably, the same technology can also be harnessed by other aircrafts to ensure accurate deployment of military personnel and first responders. Utilising AR drones, officials can monitor any situation and track vital metrics â&#x20AC;&#x201C; a crucial capability in often fast-changing
AR can mean the difference between a successful and a failed mission emergency SAR scenarios. With controlroom dispatchers able to keep their eyes on their people at all times, thanks to features like AR-projected geospatial information, the technology helps keep personnel from ever being in the dark. The bigger picture At the heart of any efficient and successful SAR operation is full situational awareness. From tracking beacons used to find those trapped in the aftermath of avalanches, to drones like those deployed during the 2018 California wildfires, to military use cases, technology carries life-saving potential that simply cannot be ignored. Given the spectrum of public safety challenges confronting police and fire departments domestically and militaries abroad, technology like AR will soon become a must-have for public safety organisations as they seek to generate detailed views of their environments and safely accomplish their missions while mitigating damage to life, property, and infrastructure. With the SAR equipment market projected to reach US$125.66 billion by 2022, the coming period is set to witness a drastic spike of innovation â&#x20AC;&#x201C; and the payoff will be more lives saved.
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Building a sustainable future
AirMed&Rescue spoke to Meredith Staib, CEO of the Royal Flying Doctors (RFDS) Queensland Section, about joining an iconic Australian organisation and embracing new technology to ensure 40 AIRMED&RESCUE 40 sustainable a future
HALO stands for Health, Aviation and Logistics Online … The system is intuitive, and this frees up our clinicians so they can give Queenslanders greater levels of direct care What has your experience in the international medical assistance business allowed you to bring to your new role with the RFDS? I have clinical experience, which helps me understand the business and operational needs, and also means I keep the people at the receiving end of our service in mind. Over 15 years’ experience in the business of international medical assistance
also means that I’m no stranger to the challenges of combining health and aviation. Before the RFDS, I was CEO of World Travel Protection (WTP), which is Zurich’s Global International Emergency Medical Assistance business. WTP coordinates urgent medical care and repatriations for travellers in over 200 countries. This means I’m used to leading people who are the best at what they do in health and aviation across large distances. I’m skilled at working with a diverse and geographically-dispersed workforce that delivers its service across multiple operational platforms. Lastly, I come from a sector that has embraced technology to improve its service delivery, and I have significant experience in championing the introduction and use of new technologies. What does the role of CEO involve on a day-to-day basis? Day to day it’s never the same! But you can guarantee that I’m learning and understanding more about the business every day. As I’m responsible for driving the strategy for the business, which we’ve called ‘Towards 100: Getting future ready’, I am always on the lookout for ways to future-proof our business and respond to many challenges in our environment. Our strategy is focused first and foremost on our people, as well as innovation to sustain and fund operational excellence. On a day-to-day basis, I collaborate with different stakeholders and our partners who help us deliver health care to the furthest corner of Queensland. Plus, I’m in regular contact with my counterparts in the rest of Australia to share ideas and problem-solve challenges. Risk management is an important part of my day to day. I hold the AOC licence for the business with the Head of Flying operations, so ensuring we’ve an appropriate risk management process in place is a daily part of my role. RFDS QLD has been pushing hard for innovation in healthcare technology, starting its Drones in Healthcare Think Tank in April, as well as other initiatives. Why is this such an important part of the organisation’s work? The RFDS was started by Reverend John Flynn just over 90 years ago to provide
INTERVIEW
You’ve been working for the RFDS since mid-2018; what first attracted you to the organisation? The RFDS has always appealed to me. It’s such an iconic and trusted Australian brand with a long, proud history. When I started my career as a registered nurse, I conducted emergency retrievals and got to know and admire what the RFDS does for people in remote and rural Australia. I saw an organisation that aligned with my own values and desire to make a difference in the world. Of course, back then, I never imagined that one day I’d be in a position to influence the organisation’s future. Instead, I pursued a career in international medical assistance and loved it. One of my highlights was leading the retrieval team who flew into Nepal to retrieve customers impacted by the earthquakes in 2015. With RFDS, I feel like I’ve come home to use this experience and passion to help Queenslanders, and I feel very privileged and honoured to be here.
‘a mantle of safety for the people of outback Australia’. He was a true innovator before we were all talking about it. I feel acutely responsible for carrying on his vision. Part of the reason I’m so passionate about pushing innovation is that I have seen the success of doing this in my previous work and because I strongly believe it’s key to future-proofing the RFDS and making sure that we’re still around for another 90 years and more. Our Drones in Healthcare Think Thank, which was created in partnership with World of Drones Education at Queensland University of Technology, brought together some of the best and most experienced minds in unmanned aerial vehicles to discuss how this technology could be used in the future to help us to overcome the tyranny of distance. We found that the possibilities for this kind of technology to supplement the great work that we already do were endless. Potentially with drones, we could deliver
We’re in the process of rolling out the technology that will allow our staff to train virtually on vital pieces of equipment like the Hamilton Ventilator
blood, vaccines, antivenom and other medical supplies to remote and rural areas – either to hospitals, our team or directly to the injured or sick person, their workmate or family member. In some circumstances with a drone, we could reach people who need help faster and offer them initial assistance or assess them before a team flies out. This has the potential to make a significant difference to our service delivery model.
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In general, if you think of how far we’ve come in healthcare with the use of technology – from telemedicine to wearable devices to AI – you can also see there’s enormous potential and I think our next decade will be defined by great change. We need to ensure the RFDS is at the forefront of that change in every part of our organisation. Your HALO program was recently the recipient of the Australian Information Industry Association iAward and Australia Computer Science Gold Disruptor Award for NFP; could you tell us more details about the program, and the difference it is making to the care delivered by RFDS? HALO stands for Health, Aviation and Logistics Online. It’s a new multifunctional digital platform, which was created for the RFDS to address an ongoing issue we had. Previously, clinicians were documenting important clinical data on paper, which was later manually entered into a secure database. The delay and inefficiency 42
AIRMED&RESCUE
in transposing hand-written notes was leading to an unacceptable error rate. We also had an ‘integration problem’ because of poor data transfer between the various ICT systems. Today, HALO helps our team deliver services more effectively business-wide. We can use it to effectively log staff activity;
match and dispatch teams in accordance with patient needs; simply and easily record diagnosis, observations, treatments and interventions; and complete and record safety checks and inspections. The system also integrates with a wide range of current and legacy systems. All of which means we can demonstrate compliance with legislative requirements and best practice.
For the people we’re looking after, it means they get the help they need faster, and we have accurate clinical information to work with. The system is intuitive, and this frees up our clinicians so they can give Queenslanders greater levels of direct care. Training of medical personnel is another area where technology is improving learning; what has the RFDS done in this regard, and what are the plans for the future? Yes, this is really exciting! At RFDS, we maximise technology and innovation when it comes to clinical training. I’ll give you an example. We have just opened a new, state-of-the-art training facility at our Brisbane base, called the Traeger Clinical Innovation and Learning Centre, which our teams across Queensland can use via remote access. The facility uses immersive technology, which transports our team to any of our nine bases, any hospital around Queensland, paddock, or anywhere they may find themselves when they’re out and about on the job. We achieve this simulated
learning environment through projectors, surround sound and interactive sensors. We also have an incredible high-fidelity mannequin that can interact with and react to our clinicians to really suspend their disbelief and make our training scenarios as realistic as possible. This is so important because the work that we do is so wideranging. Our clinicians have to be fully prepared for hundreds of challenging and complex scenarios. They have to be the best at what they do and using technology, we can train them to the highest standard. We also plan to roll out a suite of these training facilities across the state so remote staff will have equal access to training, without taking time away from their base and their families. The other technology we’re implementing is virtual reality (VR). We’re in the process of rolling out the technology that will allow our staff to train virtually on vital pieces of equipment like the Hamilton Ventilator, even if they don’t have access to it where they are based. This allows staff to train on expensive and complicated pieces of kit, without us
having to take the equipment out of action. Eventually, we also hope to use VR to run simultaneous training sessions across the state allowing people to train with their colleagues, no matter where they are. Just like Flynn and his invention of the pedal radio, we’re working hard to
with drones, we could deliver blood, vaccines, antivenom and other medical supplies to remote and rural areas innovate and overcome the tyranny of distance. My next step for this innovation is using VR in other areas of our business for training such as in engineering. Medical outreach programmes are a key part of what the RFDS does, bringing healthcare to remote aboriginal communities; what are
the main challenges that are faced in delivering care to these communities, and how has telemedicine changed the way in which medical assistance can be delivered to remote areas? Roughly 46 per cent of the people we care for are Aboriginal and Torres Strait Islander people. As part of our commitment to helping improve health outcomes and access to services for them, RFDS’ research and policy team published a report that made aeromedical retrieval data available for the first time in 2016. This helped to provide evidence around the main illnesses and injuries impacting remote Aboriginal communities. It also reinforced that holistic and collaborative health approaches, established with the community, lead to better outcomes. We continue to build on this knowledge. The RFDS is not just an aeromedical business. We provide 25,000 primary healthcare consultations across Australia each year and we deliver care, such as our mobile dental service, in places where there are no local services. Our care reaches
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SAVE THE DATE 2019 some of the most remote communities in Australia. We know that Aboriginal and
Sustainability is a big focus of mine, not just for funding, but for recruitment, staff wellbeing and all other areas of the organisation
RFDS Medical Chests, this means patients can be sometimes be treated without having to travel hours for medical attention. While telemedicine has enhanced the RFDS’ delivery model, we can see there is still a strong need in communities for onthe-ground support and for our clinicians to be seen as part of the community. We hear time and time again how much people value the face-to-face model, and how it can help to prevent more serious health conditions.
Torres Strait Islanders’ decisions about when and why to seek health services and the success of education programmes are strongly influenced by culture. Our challenges include how to review the cultural responsiveness of our services and programmes and how to keep building the capability of our workforce, so we provide culturally appropriate healthcare. Our telemedicine service is a 24-hour medical consultant service via phone and radio for people in remote Queensland locations. Through this service, we provide advice to rural doctors, nurses and Aboriginal and Torres Strait Islander health workers. Used in conjunction with the
What is your vision for the future of the RFDS QLD? Is there a way to future-proof such an iconic piece of Australian heritage? Yes, I strongly believe so! We’ve got a dedicated team that is certainly working hard to do so. Sustainability is a big focus of mine, not just for funding, but for recruitment, staff wellbeing and all other areas of the organisation. Key to achieving sustainability is having a great overall strategy. When I joined, the organisation had just formalised a five-year strategy, and we’ve just started on that journey. But my experience of strategy is that you can’t ‘set and forget’. You should be reviewing your strategy every six months because things change. It could be technology, it could be people, it could be regulations. You need to be ahead of the game strategically. It’s also important to check in with people regularly, to align their work to the wider strategy. Then every year, our board has an offsite strategic board meeting in one of our nine Queensland bases. This year we’re going to Cairns and again, that’s to review the strategy. To ask are we still on track? Is it still right for the business? I always keep in mind Flynn’s words – ‘if you start something worthwhile, nothing can stop it’, so I’m filled with optimism about the future of the RFDS Queensland and our ability to continue to care for the people of Queensland.
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JUNE
4-5
PAvCon Europe Schipol International Airport Amsterdam
6-7
International Conference on Urban SAR San Francisco US
14
Australian & New Zealand Search & Rescue Conference RACV Royal Pines Resort, Gold Coast Australia
World Maritime Rescue Congress 15-19 Vancouver Canada
JULY
15-20
APSCON CenturyLink Center Omaha US
AUGUST AAMS Safety Management Training Academy Pittsburgh US
4
OCTOBER
28-30
ITIC Air Ambulance & Medical Assistance Forum Malta
NOVEMBER
4-6
Air Medical Transport Conference Atlanta, Georgia US
5-7
Vertical Flight Expo & Conference Farnborough UK
Medic’Air International
Ace Air & Ambulance (Pvt) Ltd. 2 Mount Road, Avondale, Harare, ZIMBABWE
+263 (4) 302 141
AMREF Flying Doctors Dr Bettina Vadera Medical Director
Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA tel: +254
20 6000 090 fax: +254 20 344 170
email: emergency@flydoc.org website: www.flydoc.org
medic-air.com
+212 5 24 38 13 88
Asia Air Ambulance Asia Air Ambulance Co. Ltd., Bangkok599/59 Ratchadaphisek Road, Jatujak, Bangkok 10900, THAILAND
+668 9896 9000
asiaairambulance.com
EDS AVIATION PTE LTD 33 Ubi Avenue, #08-13, Vertex Tower B, SINGAPORE, 408868
+65 9836 3265
eds-aviation.com
+65 6483 5412
flyingdoctorsasia.com
Flying Doctors Asia A’Posh Bizhub, 1 Yishun Industrial St 1, #08-03, SINGAPORE, 768160
LifeFlight
Awesome Air Evac Hanger 104C, Gate C, Lanseria Airport, Lanseria, SOUTH AFRICA
Dar El Bacha - Tizougarine 5, 40000 Marrakech Medina, MOROCCO
ace-ambulance.com
(ASIA-PACIFIC)
AIR AMBULANCE (AFRICA)
SERVICE DIRECTORY
+27 11 430 1777
awesomeairevac.com
+61 7 5553 5955
LifeFlight.org.au
Medic’Air International 每递安国际
ER24 Cambridge Manor Office Park, Manor 1, Stone Haven Road, C/o Witkoppen & Stone Haven Roads, Sandton, Paulshof, SOUTH AFRICA
PO Box 15166, City East, QLD 4002, AUSTRALIA
+27 (0) 10 205 3100
er24.co.za
885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA
+86 2163 558289
medic-air.com
www.airmedandrescue.com
45
>>
Medical Wings 222 Don Mueang International Airport Office Building 3rd Floor, Vibhavadi Rangsit Road, Sanambin, Don Mueang, Bangkok 10210, THAILAND
+662 247 3392
medicalwings.com
Air Alliance Medflight GmbH SIEGERLAND AIRPORT, Werfthalle G1, 57299 Burbach, GERMANY
+49 170 366 4933
air-alliance.de
AIRLEC Air Espace airlecairespace.com
+335 56 34 02 14
Zone Aviation Générale, 33700 Mérignac Cidex 05 FRANCE
AIR AMBULANCE (EUROPE)
AIR AMBULANCE (EUROPE) (APAC)
SERVICE DIRECTORY
capitalairambulance.co.uk
+356 2703 4129
186 Ix Xatt Santa Maria Estate Mellieha MLH 2771, MALTA
Swiss Air-Rescue (Rega) +41 44 654 33 11
rega.ch
+49 7007 3010
drf-luftrettung.de/air-ambulance
EURO LINK GmbH Allgemeine Luftfahrt, D -85356 München Flughafen, GERMANY
FlyEuroLink.de
+49 89 6137 2103
European Air Ambulance
Aeromedevac Air Ambulance Gillespie Field Airport, 681 Kenney Street, El Cajon, CA 92020,USA
Director Sales & Marketing
Luxembourg Airport, B.P.24, L-5201, Sandweiler Luxembourg email: alert@air-ambulance.com
+(800) 462 0911
aeromedevac.com
+1 619 754-6755
aeiamericas.com
AirEvac International 8001 South InterPort Blvd., Suite 150, Englewood, CO 80112, USA
AMR Air Ambulance 001 South InterPort Blvd., Suite 150, Englewood, CO 80112, USA
Patrick Schomaker
taa.at
+43 512 22422 100
Fuerstenweg 180, A-6026 Innsbruck-Airport, AUSTRIA
AIR AMBULANCE (NORTH AMERICA)
+44 845 055 2828
DRF Luftrettung / German Air Rescue
26 26 00 fax: +352 26 26 01
Rescue Wings Malta
Tyrol Air Ambulance
Airport House, Exeter International Airport, EX5 2BD, UK
24hr tel: +352
quickair.de
+49 2203 955 700
Hangar 3, Cologne Airport, 51147 Cologne, GERMANY
Rega-Center, PO Box 1414, CH-8058 Zurich, SWITZERLAND
Capital Air Ambulance
Rita-Maiburg-Str. 2, D-70794 Filderstadt, GERMANY
Quick Air Jet Charter GmbH
+1 720 875 9182
AMRAirAmbulance.com
Global Jetcare, Inc. 15421 Technology Dr. Brooksville, FL 34604, USA
+1 352 799 7771
globaljetcare.com
Helidosa Aviation Group
website: air-ambulance.com
Karla Viñas
Air Ambulance Account Executive
FAI – rent-a-jet AG Flughafenstasse. 124; 90411 Nuremberg; GERMANY
+49 911 36009 31
fai.ag
Jet Executive International Charter Mündelheimer Weg 50, D-40472, Düsseldorf, GERMANY
+49 211 602 7775
tel: +1
46
AIRMED&RESCUE
email: k.vinas@helidosa.com website: helidosa.com
Jet-Rescue Air Ambulance
+49 221 98 22 333
malteser-service-center.de
Suite 100, 7777 Glades Road, Boca Raton, Florida 33434, USA
+1 786 619 1268
medjetsUSA.com
Skyservice Air Ambulance
North Flying a/s North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK
(829) 345-7219
jetexecutive.com
Malteser Service Center Malteser Service Center Kalker Hauptstr. 22-2, 51103 Köln, GERMANY
Hangar 1 10 & 14 La Isabela Airport Santo Domingo Dominican Republic
+45 9632 2900
northflying.com
Montreal/PE Trudeau Int Airport, 9785 Avenue Ryan, MONTREAL (Quebec), H9P 1A2, CANADA
+1 514 497 7000
skyserviceairambulance.com
Latitude Air Ambulance Diana Iaquinto
Director Sales & Medical Ops
John C. Munro/Hamilton International Airport, 9300 Airport Rd. Mount Hope. Ontario, L0R IW0, Canada tel: +1
ASSOCIATIONS
fax: +1
289 426 1133 289 426 1132
email: 24.7@latitude2009.com website: www.latitude2009.com
AAMS 909 N. Washington Street, Suite 410, Alexandria, VA 22314, USA
tel: +(703)
fax: +(703)
836-8732 836-8920
website: www.aams.org
MEDICAL ESCORT ON COMMERCIAL AIRLINES
AIR AMB. (N. AMERICA)
SERVICE DIRECTORY
AMREF Flying Doctors Dr Bettina Vadera Medical Director
Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA tel: +254
fax: +254
20 6000 090 20 344 170
email: emergency@flydoc.org website: www.flydoc.org
European Air Ambulance Patrick Schomaker Director Sales & Marketing
Luxembourg Airport, B.P.24, L-5201, Sandweiler, LUXEMBOURG 24hr tel: +352 fax: +352
26 26 00 26 26 01
email: alert@air-ambulance.com
website: www.air-ambulance.com
LIFESUPPORT Patient Transport
IAFCCP Monica Newman
Graham Williamson
4835 Riveredge Cove, Snellville, GA 30039, USA
VANCOUVER – TORONTO – HONOLULU
CEO
Executive Director
tel: +770-979-6372
GROUND TRANSPORT - MEDICAL
fax: +770-979-6500
website: www.iafccp.org
Gateway International EMS 600 Pennsylvania Ave SE, Washington DC, 20003, USA
+1-202-499-2294
gateway-ems.com
24hr Worldwide Ground Transports 3815 E Main St., Suite C St. Charles, IL 60174, USA
fax: +1
630 444 2100 630 823 2900
fax: +1
250 947 9641 877 288 2908
email: graham.williamson@LifeSupportTransport.com
website: www.LifeSupportTransport.com
Medical Wings
One Call Medical Transport
tel: +1
tel: +1
email: ops@ocmt.com
website: www.ocmt.com
222 Don Mueang International Airport Office Building 3rd Floor, Vibhavadi Rangsit Road, Sanambin, Don Mueang, Bangkok 10210, THAILAND
+662 247 3392
medicalwings.com
Prime Nursing Care, Inc. 1918 Harrison Street, Suite 215, Hollywood, Florida, 33020, USA
+1 754 999 0460
primenursingcare.com
To have your company listed in our service directory contact the sales department now: sales@airmedandrescue.com +44 (0)117 925 51 51 (opt.1)
www.airmedandrescue.com
47
ADVERT LEFT
ADVANCED MEDEVAC When time and distance are matters of life, Gulfstream aircraft can be uniquely equipped for medevac. High-speed, long-range flight speeds arrival. Payload capabilities allow for an array of critical-care equipment that sustains multiple patients during transport.
ALEX KOLAR | +1 703 841 7447 | alex.kolar@gulfstream.com