Air medical services are the use of aircraft, including both fixed-wing aircraft and helicopters to provide various kinds of urgent medical care, especially prehospital, emergency and critical care to patients during aeromedical evacuation and rescue operations.
122-620: The Royal Flying Doctor Service ( RFDS ), commonly known as the Flying Doctor , is an air medical service in Australia . It is a non-profit organisation that provides emergency and primary health care services for those living in rural, remote and regional areas of Australia who cannot access a hospital or general practice due to the vast distances of the Outback . John Flynn had worked in rural and remote areas of Victoria and
244-446: A "body chart" (1951). The chart was an anatomical representation of a human being, with areas clearly numbered. With such a chart, a remote doctor can ask the patient "where is the pain felt?" and receive a comprehensible reply. The medicines contained in the chest are similarly numbered for ease in communicating medical instructions. The service is still heavily reliant on community support for funding, particularly through events such as
366-406: A Nyamal language speaker) and makes reference to the three reliable fresh water soaks that can still be seen in and around the town, or as the town council's website says "refers to the hand like formation of the tidal creeks coming off the harbour (marra - hand, pikurri - pointing straight and nya - a place name marker)". According to Dreamtime legend, there was a huge blind water snake living in
488-462: A business enterprise, or funded by public donations. It may also be reasonable to differentiate between dedicated aircraft and those with multiple purposes and roles. Finally, it is reasonable to differentiate by the type of aircraft used, including rotary-wing , fixed-wing , or very large aircraft. The military role in civilian air ambulance operations is described in the History section. Each of
610-533: A centralised medical base. The pedal radio was the first result of this collaboration. These were distributed gradually to stations , missions and other human residences around Cloncurry , the base site for a 50-watt transmitter . Experimental aerial medical services commenced in 1926 and an injured miner was transported by air from Mount Isa to Cloncurry in November 1927. By 1928, Flynn had gathered sufficient funds through fundraising activities to launch
732-468: A combination of these roles. In almost all cases, the government provides guidelines to hospitals and EMS systems to control operating costs—and may specify operating procedures in some level of detail to limit potential liability. However, the government almost always takes a 'hands-off' approach to the actual running of the system, relying instead on local managers with subject matter (physicians and aviation executives) expertise. Ontario's ORNGE program and
854-692: A consideration in some contexts, in the United States, the primary measure of effectiveness is patient outcomes. Improvements in ground ambulance prehospital care have created uncertainty as to whether helicopter emergency medical services transport is associated with better patient outcomes compared with ground transportation. A U.S. study using 2014 data found that after adjusting for age, Injury Severity Score, and gender, trauma patients who were transferred by helicopter were 57.0% less likely to die than those transferred by ground ambulance (95% CI 0.41 to 0.44, p<0.0001). A retrospective review study reached
976-459: A federated structure and each of the seven entities has its own Board and Management. Each entity operates independently, both financially and operationally. The Flying Doctor operates from numerous bases, health services and other facilities (including marketing, fundraising and public relations as well as the national office) across Australia. RFDS bases are operated by: Bases at Carnarvon , Geraldton , Derby , and Wyndham have closed, while
1098-622: A great deal of experience in piloting their aircraft because the conditions of air ambulance flights are often more challenging than regular non-emergency flight services. After a spike in air ambulance crashes in the United States in the 1990s, the U.S. government and the Commission on Air Medical Transportation Systems ( CAMTS ) stepped up the accreditation and air ambulance flight requirements, ensuring that all pilots, personnel, and aircraft meet much higher standards than previously required. The resulting CAMTS accreditation, which applies only in
1220-684: A higher level of care at the scene of a trauma and faster transport to a trauma center. They can also provide critical care when transporting patients from community hospitals to trauma centers. Air ambulance transport is expensive, and if utilised poorly is therefore not cost effective. When inappropriately deployed to a patient close to a hospital, an air ambulance may add delay to the patient reaching hospital. In research from 1996, air ambulance services in England and Wales demonstrated no evidence of improvement in vehicle response times (i.e. time from 999 call to an ambulance vehicle being on-scene with
1342-966: A local business or even a multi-national company may choose to fund local air ambulance service as a goodwill or public relations gesture. Examples of this are common in the European Union , where in London the Virgin Corporation previously donated to the Helicopter Emergency Medical Service, and in Germany and the Netherlands a large number of the 'Christoph' air ambulance operations are actually funded by ADAC , Germany's largest automobile club and DRF Luftrettung. In Australia and New Zealand , many air ambulance helicopter operations are sponsored by
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#17327808732061464-489: A mix of de Havilland DH.50s , DH.83 Fox Moths , DH.84 Dragons , DH.104 Doves and the de Havilland Australia DHA-3 Drover . From the 1950s to 1970s, the fleet included the Beechcraft Baron , Beechcraft Travel Air , Beechcraft Queen Air , Beechcraft Duke , Cessna 180 , Cessna 182 , Cessna 421 , Piper Cherokee and Piper PA-31 Navajo . Aircraft were provided by contractors until the 1960s. Subsequently,
1586-421: A non-medically equipped and staffed aircraft simply transports patients without care in flight. Military organizations and NATO refer to the former as medical evacuation (MEDEVAC) and to the latter as casualty evacuation (CASEVAC) . Air Traffic Control (ATC) grants special treatment to air ambulance operations, much like a ground ambulance using lights and a siren, only when they are actively operating with
1708-433: A not-for-profit mutual insurance company, specifies the circumstances in which costs for air medical services are covered. The medical personnel of a helicopter ambulance has historically been a Physician/Nurse combination, Paramedic/Nurse, or a Nurse/Nurse combination. The need for a Physician/Nurse combination has diminished with more protocol and evidence-based applications for care by nurses and other clinicians and so
1830-575: A paramedic provided from whichever fire department rescue unit has responded. Sometimes the air ambulance may be run as a dual concern with another governmental body - for example, the Wiltshire Air Ambulance was run as a joint Ambulance Service and police unit until 2014. In other cases, the paramedic staffs the aircraft full-time, but has a dual function. In the case of the Maryland State Police, for example,
1952-430: A patient. When this happens, air ambulance aircraft take the call sign MEDEVAC (formerly LIFEGUARD) and receive priority handling in the air and on the ground. As with many Emergency Medical Service (EMS) innovations, treating patients in flight originated in the military. The concept of using aircraft as ambulances is almost as old as powered flight itself. Although balloons were not used to evacuate wounded soldiers at
2074-520: A similar conclusion: "Patients transported by helicopter to an urban trauma centre ... had improved survival than those arriving by other means of transport." Patient survival is not the only possible measure of patient outcome. In the case of stroke patients, for instance, various outcome measures could be used. There are many considerations in determining whether to dispatch air medical services. Availability, distance and flight conditions are primary considerations. Even when available, an air ambulance
2196-525: A single rotor-wing aircraft based in Toronto. An important difference in the Ontario program involved the emphasis of service. "On scene" calls were taken, although less commonly, and a great deal of the initial emphasis of the program was on the interfacility transfer of critical care patients. Operating today through a private contractor ( ORNGE ), the system operates 33 aircraft stationed at 26 bases across
2318-892: A standing air ambulance system, as did Siam (Thailand). In 1928 the first formal, full-time air ambulance service was established in the Australian outback . This organization became the Royal Flying Doctor Service and still operates. In 1934, Marie Marvingt established Africa's first civil air ambulance service, in Morocco. In 1936, air ambulance services were established as part of the Highlands and Islands Medical Service to serve more remote areas of Highland Scotland . Air ambulances quickly established their usefulness in remote locations, but their role in developed areas developed more slowly. After World War II ,
2440-827: A typical paramedic, so medical control permits them to exercise more medical decision-making latitude. Assessment skills tend to be considerably higher, and, particularly on inter-facility transfers, permit the inclusion of functions such as reading x-rays and interpretation of lab results. This allows for planning, consultation with supervising physicians, and issuing contingency orders in case they are required during flight. Some systems operate almost entirely off-line, using protocols for almost all procedures and only resorting to on-line medical control when protocols have been exhausted. Some air ambulance operations have full-time, on-site medical directors with pertinent backgrounds (e.g., emergency medicine); others have medical directors who are only available by pager. For those systems operating on
2562-440: A warm but humid sea breeze. Port Hedland is very sunny, averaging over 10 hours of sunshine per day annually and being in the sunniest region of Australia, receiving around 218.9 clear days annually. Dewpoint in the warmer months typically ranges from 19 to 22 °C (66.2 to 71.6 °F). Annual rainfall (falling almost exclusively between December and June) averages 311.5 mm (12.26 in) but because of erratic cyclones
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#17327808732062684-422: A wider coverage area than a land ambulance. This makes them particularly useful in sparsely-populated rural areas. Air medical services have a particular advantage for major trauma injuries. The controversial theory of the golden hour suggests that major trauma patients should be transported as quickly as possible to a specialist trauma center . Therefore, medical responders in a helicopter can provide both
2806-499: Is 30% higher than the Western Australian average. The Blackrock Stakes was a 122 km race from Goldsworthy to Port Hedland in which competitors, either in teams or as individuals, push wheelbarrows weighed down with iron ore . It was first run in 1971, and competitors pushed a wheelbarrow full of iron ore from a remote mine site into Port Hedland. After that the race grew to raise more than $ 1 million for charity as
2928-410: Is a specially outfitted helicopter or fixed-wing aircraft that transports injured or sick people in a medical emergency or over distances or terrain impractical for a conventional ground ambulance . Fixed-wing aircraft are also more often used to move patients over long distances and for repatriation from foreign countries. These and related operations are called aeromedical . In some circumstances,
3050-739: Is able to accommodate ships over 250,000 tonnes. In 2013, finance was being raised for yet another iron ore mine, railway and port, this time for the Roy Hill project. It requires a 344 km railway. With the neighbouring ports of Port Walcott and Dampier , Port Hedland is one of three major iron ore exporting ports in the Pilbara region. On 31 December 1968, a Vickers Viscount operated by MacRobertson Miller Airlines crashed at nearby Indee Station . The plane had flown from Perth without incident until about 10 minutes before landing at Port Hedland. The aircraft suffered catastrophic failure of
3172-425: Is an increasing trend as state health services agencies address the issues surrounding the safety of emergency medical services flights . Some examples are the states of Colorado, New Jersey, New Mexico, Utah, and Washington. According to the rationale used to justify the state of Washington's adoption of the accreditation requirements, requiring accreditation of air ambulance services provides assurance that
3294-477: Is managed by the Pilbara Ports Authority, a state government instrumentality. The Port Authority's headquarters, control tower and heliport are at Mangrove Point, just to the west of The Esplanade at the western end of Port Hedland. The tugboat pen, customs office and public jetty are at nearby Laurentius Point. The harbour's wharves are located on both sides of the harbour: Finucane Island to
3416-673: Is more than the mean annual rainfall. The high summer temperatures experienced in Port Hedland mean that most tourists to the area choose to visit in the cooler months between May and September. According to the Bureau of Meteorology , the Western Pilbara , including Port Hedland is the sunniest place in Australia; being the only place to record an annual average of more than 10 hours a day of sunshine. Port Hedland's harbour
3538-458: Is not always the faster choice in comparison to ground ambulances. Ground ambulances are more numerous and more ubiquitous, so will often be closer to the scene. Ground ambulances can depart their base almost immediately, while air medical services must complete preflight routines prior to departure. A nearby suitable landing site may not be available due to trees, wires, etc. Air medical services tend to have an advantage where ground access routes to
3660-499: Is one pilot and two medical crew is: "3 to go, 1 to say 'NO'". If one flight member is not comfortable with the flight for whatever reason, the flight is cancelled. Some have questioned the safety of air medical services. While the number of crashes may be increasing, the number of programs and use of services has also increased. Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, and postcrash fires. An air ambulance
3782-482: Is sometimes better to wait for air medical services with a specialized team to transport a patient even though a local land ambulance and an ad hoc local medical team may be able to transfer a patient from a remote hospital to definitive care faster than air ambulance. In the United States, insurance coverage may be a factor. For example, the Coverage Policy Manual for Arkansas Blue Cross BlueShield,
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3904-423: Is subject to some of the largest variations in annual precipitation in the world. As an illustration, in 1942, 1,040 millimetres or 40.94 inches fell, but two years later in 1944 only 32 millimetres or 1.26 inches fell and the town went for over 300 days with no rain. The town received record daily rainfall on 27 January 1967 when a total of 387.1 millimetres or 15.24 inches of rainfall was recorded for 24 hours, which
4026-402: Is the single most important factor to be considered when deciding whether to transport a patient by helicopter. Weather, air traffic patterns, and distances (such as from the trauma scene to closest level 1 trauma centre) must also be considered. Another reason for cancelling a flight is based on the comfort of the flight crew with the flight. The general rule of safety is upon the crew, when there
4148-540: The Great Depression of the 1930s. During its first few decades the service relied heavily on community fundraising, volunteer support and donations. Nowadays, the service is supported by the Commonwealth, State and Territory Governments, but still relies heavily on fundraising and donations from the community to purchase and medically equip its aircraft, and to finance other major capital initiatives. Until
4270-470: The Korean and Vietnam wars. Later, helicopters were introduced to civilian health care, especially for shorter distances, in and around large cities: transporting paramedics or specialist doctors as needed and transporting patients to hospitals, especially for major trauma cases. Fixed-wing aircraft remained in use for long-distance medical transport. Air medical services can travel faster and operate in
4392-552: The Learjet 35 and 36 , Learjet 31 , King Air 90 , King Air 200 , Pilatus PC-12 & PC-24 , and Piper Cheyenne . Due to the configuration of the medical crew and patient compartments, these aircraft are normally configured to only transport one patient but some can be configured to transport two patients if so needed. Additionally, helicopters have stricter weather minimums that they can operate in and commonly do not fly at altitudes over 10,000 feet above sea level. Beginning in
4514-745: The Q150 celebrations, the Royal Flying Doctor Service was announced as one of the Q150 Icons of Queensland for its role as an iconic "innovation and invention". In 2011 the Royal Flying Doctor Service of Australia (Queensland Section) was inducted into the Queensland Business Leaders Hall of Fame in recognition of its contribution to rural health and rural community building in Australia. Air medical services During World War I , air transport
4636-664: The Second World War . The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by a US Army Sikorsky R-4 in Burma during WW2 , and the first dedicated use of helicopters by U.S. forces occurred during the Korean War , between 1950 and 1953. The French used light helicopters in the First Indochina War . While popularly depicted as simply removing casualties from
4758-744: The Siege of Paris in 1870, air evacuation was experimented with during the First World War . The first recorded British ambulance flight took place in 1917 in Ottoman Empire when a soldier in the Camel Corps who had been shot in the ankle was flown to hospital in a de Havilland DH9 in 45 minutes. First Recorded Aeromedical Evacuation in the British Army The same journey by land would have taken some 3 days to complete. In
4880-619: The Simpson Desert Bike Challenge , and is well respected across the country as an organisation that has contributed much to rural, regional and remote communities. Its services include: The service also uses not just aircraft but also four-wheel drives and other utility land vehicles to aid in transportation and communications. The RFDS is made up of seven legal entities – RFDS of Australia, Central Operations, Queensland Section, South Eastern Section, Tasmania, Victoria and Western Operations. The RFDS operates in
5002-944: The United States Air Force , the German Luftwaffe , and the British Royal Air Force . The Swedish National Air Medevac - SNAM is an exception to the military only rule where the system is owned by the Swedish Civil Contingencies Agency Myndigheten för samhällsskydd och beredskap and the 737-800 aircraft is provided under contract when so required by Scandinavian Airlines. Each operates aircraft staffed by physicians, nurses, and corpsmen/technicians, and each can provide long-distance transport with full medical support to dozens of patients simultaneously. However, in recent years, exceptions to
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5124-652: The Westpac Bank . In these cases, the operation may vary but is the result of a carefully negotiated agreement between government, EMS, hospitals, and the donor. In most cases, while the sponsor receives advertising exposure in exchange for funding, they take a 'hands-off' approach to daily operations, relying instead on subject matter specialists. In some cases, air ambulance services may be provided by means of voluntary charitable fundraising, as opposed to government funding, or they may receive limited government subsidy to supplement local donations. Some countries, such as
5246-520: The "military-only" rule have grown with the need to quickly transport patients to facilities that provide higher levels of care or to repatriate individuals. Air medical companies use both large and small fixed-wing aircraft configured to provide levels of care that can be found in Trauma centres for individuals who subscribe to their own health insurance or affiliated travel insurance and protection plans. In most jurisdictions, air ambulance pilots must have
5368-526: The 1920s several services, both official and unofficial, started up in various parts of the world. Aircraft were still primitive at the time, with limited capabilities, and the effort received mixed reviews. Exploration of the idea continued, however, and France and the United Kingdom used fully organized air ambulance services during the African and Middle Eastern Colonial Wars of the 1920s. In 1920,
5490-487: The 1960s the service predominantly hired aircraft, pilots and service technicians from contractors. After this point, the service moved on to purchasing its own equipment and employing its own pilots and mechanics. In 1932, the success from its operations in Cloncurry, and the increasing public awareness to this vital rural service, resulted in a push for a national network of flying doctors, hopefully with sponsorship from
5612-399: The 1990s, the number of air ambulance crashes in the United States, mostly involving helicopters, began to climb. By 2005, this number had reached a record high. Crash rates from 2000 to 2005 more than doubled the previous five year's rates. To some extent, these numbers had been deemed acceptable, as it was understood that the very nature of air ambulance operations meant that, because a life
5734-661: The British, while suppressing the " Mad Mullah " in Somaliland , used an Airco DH.9A fitted out as an air ambulance. It carried a single stretcher under a fairing behind the pilot. The French evacuated over 7,000 casualties during that period. By 1936, an organized military air ambulance service evacuated wounded from the Spanish Civil War for medical treatment in Nazi Germany ; this service continued during
5856-456: The CQC together ensuring fundraising, air and clinical operations are in line with national regulation and best practice. The code goes further with an expectation of mutual support and working within its policy and best practice guides. The nature of the air operation frequently determines the type of medical control required. In most cases, an air ambulance staffer is considerably more skilled than
5978-510: The De Grey River. Wedge encountered difficulties in his efforts, as he was hampered by heavy rain and the tidal creeks around Mangrove Harbour and was unable to reach the proposed port site to survey its suitability. In 1891, exploration of the area by Tom Traine, John Wedge (son of Charles Wedge) and Syd Hedley identified two landings and described the harbour as "pretty as well as safe". In September 1895, Cossack residents requested
6100-581: The District Surveyor survey the headland at Port Hedland in order to establish a town and requested that the Government build a jetty. In 1896, the Port Hedland town site was surveyed by government surveyor E.W. Geyer, who named the grid of streets after the pastoral pioneers, including Richardson, Withnell, Wedge and McKay streets, and in October 1896, the town site was gazetted. By 1905,
6222-466: The European Union, almost all air ambulance service is on a fee-for-service basis, except for systems that operate by private subscription. Many jurisdictions have a mix of operation types. Fee-for-service operators are generally responsible for their own organization but may have to meet government licensing requirements. Rega of Switzerland is an example of such a service. In some cases,
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#17327808732066344-569: The Franco-German model, the physician is almost always physically present, and medical control is not an issue. Most aircraft used as air ambulances, with the exception of charter aircraft and some military aircraft, are equipped for advanced life support and have interiors that reflect this. The challenges in most air ambulance operations, particularly those involving helicopters, are the high ambient noise levels and limited amounts of working space, both of which create significant issues for
6466-643: The German system in 1983 when Christophorus 1 entered service at Innsbruck. Also in the year 1975 Hans Burghart, one of the inventor of the civilian air rescue in Germany, presented at one Academic conference in the US the concept "Rescue Helicopters in Primary and Secondary Missions" which had impact for the aviation training at Fort Rucker , Alabama . The first civilian, hospital-based medical helicopter program in
6588-494: The John S. Dunn Helistop, one of the busiest helipads in the world, with space for four helicopters. A final area of distinction is the operation of large, generally fixed-wing air ambulances. In the past, the infrequency of civilian demand for such a service confined such operations to the military, which requires them to support overseas combat operations. Military organizations capable of this type of specialized operation include
6710-858: The Polish Lotnicze Pogotowie Ratunkowe (LPR) are examples of this type of operating system. The Polish LPR is a national system covering the entire country and funded by the government through the Ministry of Health but run independently, there is no independent HEMS operator in Poland . In North East Ohio, including Cleveland , the Cuyahoga County -owned MetroHealth Medical Center uses its Metro Life Flight to transport patients to Metro's level I trauma and burn unit. There are 5 helicopters for North East Ohio and, in addition, Metro Life Flight has one fixed-wing aircraft. In
6832-623: The Port Hedland to Marble Bar rail service is now preserved at the Kalamunda Historical Village in the south of the state. Located between Port Hedland and South Hedland are the large salt hills of Dampier Salt , a subsidiary of Rio Tinto . These large mounds have almost become a tourist attraction in their own right. Port Hedland is known by the Indigenous Kariyarra and Nyamal people as Marapikurrinya, which either means "place of good water" (as told by
6954-953: The RFDS had received their 4 Pilatus PC-24 jets, replacing their Hawker 800XP jet. They are based at Jandakot Airport and Broome in WA and Adelaide SA. The PC-24 can fit 3 stretcher beds and two seated patients. The aircraft can cruise at 45,000 feet (14,000 m) and halves the time of flight compared to the existing propeller driven fleet. The PC-24 can also operate out of paved and unpaved runways. In 2022, The Western Operations started operating its own helicopters. Two Airbus EC145 were imported from Germany and reconfigured at Jandakot Airport into hospital retrieval platforms. The aircraft are operated single pilot IFR with NVIS (NVG). The service provides retrievals up to 200 kilometres (120 mi) from Perth, landing in sports ovals or helipads. Patients are then flown directly to rooftop helipads located on all
7076-721: The RFDS owned its own aircraft and employed its own pilots and engineers. In the 1970s and 1980s the RFDS base at Broken Hill operated the Australian-made GAF Nomad . From the 1980s to the 2000s, the fleet included the Cessna 404 and Cessna 441 . For a time in the mid-2000s the aeromedical evacuation aircraft used were either the Pilatus PC-12 or the Beechcraft King Air 200 series . The internal configuration of these two aircraft varies in
7198-608: The Roads Board had made considerable improvements to the roads and streets. In 1909 port facilities were built, and in 1911 a rail link to Marble Bar commenced operation. On 30 July 1942 the town was bombed by the Japanese, killing one soldier at the local airfield. By 1946, approximately 150 people lived in the area. The population of the town in 1968 was about 3,000 people. Goldsworthy Mining developed an iron ore mine approximately 100 kilometres east of Port Hedland in
7320-780: The Saskatchewan government in Regina, Saskatchewan, Canada, established the first civilian air ambulance in North America. The Saskatchewan government had to consider remote communities and great distances in providing health care to its citizens. The Saskatchewan Air Ambulance service continues to be active as of 2023. J. Walter Schaefer founded the first air ambulance service in the U.S., in 1947, in Los Angeles. The Schaefer Air Service operated as part of Schaefer Ambulance Service . Two research programs were implemented in
7442-559: The U.K., use a mix of such systems. In Scotland, the parliament has voted to fund air ambulance service directly, through the Scottish Ambulance Service. In England and Wales, however, the service is funded on a charitable basis via a number of local charities for each region covered. Great strides have been made in the UK, with the 'Association of Air Ambulance (AAA)'. This organization is widely credited for having created
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#17327808732067564-474: The U.S. to assess the impact of medical helicopters on mortality and morbidity in the civilian arena. Project CARESOM was established in Mississippi in 1969. Three helicopters were purchased through a federal grant and located strategically in the north, central, and southern areas of the state. Upon termination of the grant, the program was considered a success and each of the three communities were given
7686-540: The United Kingdom, the Scottish Ambulance Service operates two helicopters and two fixed-wing aircraft twenty-four hours per day. In some jurisdictions, cost is a major consideration, and the presence of dedicated air ambulances is simply not practical. In these cases, the aircraft may be operated by another government or quasi-government agency and made available to EMS for air ambulance service when required. In southern New South Wales, Australia,
7808-540: The United States began operation in 1972. Flight For Life Colorado began with a single Alouette III helicopter, based at St. Anthony Central Hospital in Denver, Colorado. In Ontario, Canada, the air ambulance program began in 1977, and featured a paramedic-based system of care, with the presence of physicians or nurses being relatively unusual. The system, operated by the Ontario Ministry of Health, began with
7930-517: The United States, includes the requirement for an air ambulance company to own and operate its own aircraft. Some air ambulance companies, realizing it is virtually impossible to have the correct medicalized aircraft for every mission, instead charter aircraft based on the mission-specific requirements. While in principle CAMTS accreditation is voluntary, a number of government jurisdictions require companies providing medical transportation services to have CAMTS accreditation to be licensed to operate. This
8052-634: The battlefield (which they did), helicopters in the Korean War also moved critical patients to hospital ships after initial emergency treatment in field hospitals. Knowledge and expertise of use of air ambulances evolved parallel to the aircraft themselves. By 1969, in Vietnam , the use of specially trained medical corpsmen and helicopter air ambulances led U.S. researchers to determine that servicemen wounded in battle had better rates of survival than motorists injured on California freeways. This inspired
8174-416: The beach front, was formerly a single-men's quarters for Mount Newman Mining Co. The centre was privatised by the first Howard Ministry in the late 1990s. It was closed in 2004 due to the falling number of asylum seekers arriving by boat in Australia's north-west. The town mayor called for the federal government to allow the town to use the detention centre to accommodate the many new mine workers needed for
8296-415: The church's newsletter. Peel died in combat in September 1918, probably not even knowing the impact he had in the creation of an Australian icon. Along with motorised flight, another new technology was being developed that could replace the complicated means of communication by telegraph. Together with Alfred Traeger , Flynn began experiments with radio in the mid-1920s to enable remote outposts to contact
8418-450: The different RFDS sections. Typically they are configured with two rear-facing seats which look onto two stretchers. In some aircraft, one stretcher can be removed quickly and two seats slipped into place instead. The PC-12, PC-24 and King Air are pressurised and so can safely transport patients who would not otherwise tolerate the decreased air pressure in a in non-pressurised aircraft. The internal cabin pressure can be maintained throughout
8540-426: The early 1960s and built the towns of Goldsworthy and later Shay Gap as mine sites. A rail line was then built to Port Hedland, where dredging was undertaken to deepen and widen the port's channel, and a wharf was built opposite the township of Port Hedland on Finucane Island. Shipment of ore began on 27 May 1966, when the Harvey S. Mudd sailed from Port Hedland to Japan with 24,900 tonnes of ore. In 1967, iron ore
8662-439: The establishment of hospitals in bush communities, but this did not help those who lived far from any major community. In his public speaking he would often retell the tragic circumstances that had befallen several bush settlers. The fate of Jimmy Darcy, in 1917, was one of these stories. It was from stories such as this that Flynn, and his following at the AIM, became inspired to develop a route of communications that could solve
8784-726: The evolving Emergency Medical Services. As the concept was proven, dedicated civilian air ambulances began to appear. On November 1, 1970, the first permanent civil air ambulance helicopter, Christoph 1 , entered service at the Hospital of Harlaching , Munich, Germany. The apparent success of Christoph 1 led to a quick expansion of the concept across Germany, with Christoph 10 entering service in 1975, Christoph 20 in 1981, and Christoph 51 in 1989. As of 2007, there are about 80 helicopters named after Saint Christopher , like Christoph Europa 5 (also serving Denmark), Christoph Brandenburg or Christoph Murnau am Staffelsee . Austria adopted
8906-590: The experiment of the AMS on 15 May. Its supporters included industrialist HV McKay , medical doctor George Simpson and Hudson Fysh , one of the founders of Qantas . Qantas supplied the first aircraft to the fledgling organisation, VH-UER a De Havilland DH.50 , dubbed "Victory". On 17 May 1928, two days after inception, the service's first official flight piloted by Arthur Affleck departed from Cloncurry, 85 miles to Julia Creek in Central Queensland , where
9028-498: The feasibility of using military helicopters to augment existing civilian emergency medical services. These programs were highly successful at establishing the need for such services. The remaining challenge was in how such services could be operated most cost-effectively. In many cases, as agencies, branches, and departments of the civilian governments began to operate aircraft for other purposes, these aircraft were frequently pressed into service to provide cost-effective air support to
9150-499: The first experiments with the use of civilian paramedics in the world. The US military recently employed UH-60 Black Hawk helicopters to provide air ambulance service during the Iraq War to military personnel and civilians. The use of military aircraft as battlefield ambulances continues to grow and develop today in a variety of countries, as does the use of fixed-wing aircraft for long-distance travel, including repatriation of
9272-507: The first nurses, known as "Flying Sisters", to join the service. She was key in the New South Wales Section operations during the 1940s and 50s, even though Flying Nurses didn't actually become regular until the 1960s. Many patient transports are conducted with an RFDS nurse and pilot only on board. Nurses have been responsible for many innovations to the service, including an addition to the RFDS medical chest to incorporate
9394-436: The flight at that of sea level. This is important for patients critically sensitive to pressure changes. Also, pressurised aircraft can fly at high enough altitude to be above turbulent weather. This is of great benefit in providing an environment safe for the patient and staff, and also limits complications of aeromedical transport such as motion sickness and exacerbation of injuries such as unstable fractures. In October 2009
9516-621: The flight paramedic is a serving State Trooper whose job is to act as the Observer Officer on a police helicopter when not required for medical emergencies. In many cases, local jurisdictions do not charge for air ambulance service, particularly for emergency calls. However, the cost of providing air ambulance services is considerable and many, including government-run operations, charge for service. Organizations such as service aircraft charter companies, hospitals, and some private-for-profit EMS systems generally charge for service. Within
9638-520: The government. In 1934 this was realised with the new Australian Aerial Medical Service opening up "Sections" across the nation. Bases were set up in Wyndham, Port Hedland , Kalgoorlie , Broken Hill , Alice Springs and Meekatharra . The Queensland experiment was expanded with two additional bases opening in Charters Towers and Charleville . An official Federal Council for the organisation
9760-473: The ground responder's ability to determine whether the patient's condition warrants air medical transport. Protocols and training must be developed to ensure appropriate triage criteria are applied. Excessively stringent criteria can prevent rapid care and transport of trauma victims; relaxed criteria can result in the patient being unnecessarily exposed to the potential dangers of dangerous weather conditions or other aviation-related risks. Crew and patient safety
9882-651: The health impacts caused by dust levels generated by Port activities. On April 13, 2023, Cyclone Ilsa , a large and destructive category 5 tropical cyclone, made landfall just east of the port city. Port Hedland has a hot desert climate ( Köppen BWh ) although subject to the influence of tropical cyclones . Port Hedland is very warm to sweltering all year round, with mean maximum temperatures of 36.4 °C (97.5 °F) in January and 27.1 °C (80.8 °F) in July. Maximum temperatures in summer are usually moderated by
10004-589: The helicopter that responds as an air ambulance is actually operated by the local hydroelectric utility, with the New South Wales Ambulance Service providing paramedics, as required. In some cases, local EMS provides the flight paramedic to the aircraft operator as-needed. In the case of the Los Angeles County Fire Department, the helicopters are brush fire choppers also configured as air ambulances with
10126-399: The hospital are congested and for locations more distant from hospitals. In some situations, it may be desirable to dispatch a ground ambulance that can arrive on the scene first to provide immediate patient care, and an air ambulance to transport the patient(s) to a trauma center. It also should be borne in mind that faster may not always be better. In the context of interhospital transport, it
10248-428: The improvement of government standards and CAMTS accreditation. Whilst some air ambulances do have effective methods of funding, in England, they remain almost entirely charity funded, as improved cost-benefit ratios are generally achieved with land-based attendance and transfers. Health outcomes, for example from London's Helicopter Emergency Medical Service , remain uncertain. Although cost-effectiveness may be
10370-404: The inclusion of respiratory therapists in all modes of air transport is becoming more prominent. Port Hedland Port Hedland ( Kariyarra : Marapikurrinya ) is the second largest town in the Pilbara region of Western Australia , with an urban population of 15,298 as of the 2021 census , including the satellite town of South Hedland , 18 kilometres (11 mi) away. It is also
10492-597: The increased number of car accidents in 1979 on highways , the Yugoslavian government made a decision to buy new or redistribution of use of old helicopters. Air ambulance service, sometimes called Aeromedical Evacuation or simply Medevac , is provided by a variety of different sources in different places in the world. There are a number of reasonable methods of differentiating types of air ambulance services. These include military / civilian models and services that are government -funded, fee-for-service, donated by
10614-473: The landlocked area of water known as Jalkawarrinya. This landlocked area is now the turning basin for the ships that enter the port and as the story goes, "the coming of the big ships meant it was unable to stay". The coastline in the area was seen by European mariners as early as 1628, when the Dutch merchant ship Vianen , captained by Gerrit Franszoon de Witt visited. Swedish-born mariner Peter Hedland
10736-433: The main beach front. Several lookouts along the beach front path allow views of marine mammals including Indo-Pacific bottlenose dolphins , Indo-Pacific humpbacked dolphins and Australian snubfin dolphins . The Port Hedland Saltworks Important Bird Area is a 103 km tract of originally intertidal land, now containing a saltern, about 20 km east of the port of Port Hedland. The site regularly supports over 1% of
10858-539: The major hospitals in Perth. The RFDS uses a wide range of contemporary emergency medical equipment to provide aeromedical retrieval services. These include transport ventilators , critical care monitors, infusion devices, point-of-care testing , portable diagnostic ultrasound and a range of other splints and devices. According to the RFDS of Australia 2015/16 Annual Report the service owns 67 aircraft, and operates 23 bases with 1,225 employees. Each day, on average,
10980-598: The master of Mystery . Ridley located a firm landing place above the mangroves, and a practicable stockroute from there to the De Grey River . In 1866, the Government Resident at Roebourne , Robert John Sholl , directed Charles Wedge to re-examine Port Hedland as an alternative port, because the distance from Tien Tsin Harbour (later known as Cossack) was discouraging settlement in areas such as
11102-489: The medical profession. Other U.S. states require either CAMTS accreditation or a demonstrated equivalent, such as Rhode Island, and Texas, which has adopted CAMTS' Accreditation Standards (Sixth Edition, October 2004) as its own. In Texas, an operator not wishing to become CAMTS accredited must submit to an equivalent survey by state auditors who are CAMTS-trained. Virginia and Oklahoma have also adopted CAMTS accreditation standards as their state licensing standards. While
11224-735: The opportunity to continue the helicopter operation. Only the one located in Hattiesburg, Mississippi did so, and it was therefore established as the first civilian air medical program in the United States. The second program, the Military Assistance to Safety and Traffic (MAST) system, was established in Fort Sam Houston in San Antonio in 1969. This was an experiment by the Department of Transportation to study
11346-463: The original base at Cloncurry was moved to Mount Isa in 1965 and the early base at Charters Towers moved to Cairns in 1972. The most recent new base was opened in Broome in 2016. The first aircraft operated by the "Aerial Medical Service" in 1928 was a de Havilland DH.50 hired from the fledgling Qantas . It was replaced in 1934 by a DH.83 Fox Moth . During the 1930s and 1940s the fleet consisted of
11468-644: The original intent of CAMTS was to provide an American standard, air ambulance services in a number of other countries, including three in Canada and one in South Africa, have voluntarily submitted themselves to CAMTS accreditation. In the UK, the AAA has a Code of Conduct that binds one of the most regulated areas of operation together. It brings the Fundraising Standards Board, CAA / EASA and
11590-509: The patient) for air ambulance attended patients compared to those attended by a land ambulance. The same review found patient did not arrive at hospital any quicker when attended by an air ambulance. When the same authors looked at health outcomes in Cornwall and London they found no evidence that the attendance of an air ambulance (HEMS) service improved survival in trauma patients. Effective use of helicopter services for trauma depends on
11712-464: The plane was met by over 100 people at the airstrip . Qantas charged two shillings per mile for use of the Victory during the first year of the project. Within the first year of operations, the service flew approximately 20,000 miles in 50 flights, becoming the first comprehensive air ambulance service in the world. The service persisted through difficult first years, dealing with postwar Australia and
11834-529: The political climate that made the helicopter industry and National Health Service recognise the enormous contribution charities make to trauma care in the United Kingdom. In 2013, the AAA published the "Framework for a High Performing Air Ambulance Service" which details many of the developments from 2008 to 2013. In recent years, the service has moved towards the physician-paramedic model of care. This has necessitated some charities commissioning clinical governance services, however many air ambulances operate under
11956-531: The port was initially regarded as unusable, due to a sandbar that frequently sealed the entrance and thick mangroves around the shore; further, the narrow entrance made the harbour difficult to enter in bad weather. Later in 1863, government surveyor Joseph Beete Ridley examined Mangrove Harbour while exploring the country between Nicol Bay and the Fitzroy River, describing it as "an excellent anchorage and perfectly landlocked". He named it Port Hedland after
12078-431: The primary means of transportation between communities is by boat. Early in aviation history, many of these communities began to rely on civilian "bush" pilots, who fly small aircraft and transport supplies, mail, and visiting doctors or nurses. Bush pilots probably performed the first civilian air ambulance trips, albeit on an ad hoc basis—but clearly, a need for these services existed. In the early 1920s, Sweden established
12200-463: The problem of remoteness, but no feasible technology seemed apparent. Victorian pilot Lieutenant (John) Clifford Peel had heard Flynn's public speeches, and on being shipped out to France for World War I in 1917, sent Flynn a letter explaining how he had seen a missionary doctor visiting isolated patients using a plane. Assisted by costing estimates by Peel, Flynn immediately took the idea of using aircraft to begin his idea, and published Peel's idea in
12322-423: The province, performing both interfacility transfers and on-scene responses in support of ground-based EMS. Today, across the world, the presence of civilian air ambulances has become commonplace and is seen as a much-needed support for ground-based EMS systems. In other countries of Europe, like SFR Yugoslavia , first air ambulance appeared in the 1980s. Most of the fleet was previously used in military service. With
12444-660: The provision of ongoing care. While equipment tends to be high-level and very conveniently grouped, it may not be possible to perform some assessment procedures, such as chest auscultation , while in flight. In some types of aircraft, the aircraft's design means that the entire patient is not physically accessible in flight. Additional issues occur with respect to pressurization of the aircraft. Not all aircraft used as air ambulances in all jurisdictions have pressurized cabins and those that do typically tend to be pressurized to only 10,000 feet above sea level. These pressure changes require advanced knowledge by flight staff with respect to
12566-552: The remaining models is explored separately. This information applies to air ambulance systems performing emergency service. In almost all jurisdictions, private aircraft charter companies provide non-emergency air ambulance service on a fee-for-service basis. In some cases, governments provide air ambulance services, either directly or via a negotiated contract with a commercial service provider, such as an aircraft charter company. Such services may focus on critical care patient transport, support ground-based EMS on scenes, or may perform
12688-428: The same aircraft may be used to search for missing or wanted people. Like ground ambulances, air ambulances are equipped with medical equipment vital to monitoring and treating injured or ill patients. Common equipment for air ambulances includes medications , ventilators , ECGs and monitoring units, CPR equipment, and stretchers . A medically staffed and equipped air ambulance provides medical care in flight—while
12810-429: The service meets national public safety standards. The accreditation is done by professionals who are qualified to determine air ambulance safety. In addition, compliance with accreditation standards is checked on a continual basis by the accrediting organization. Accreditation standards are periodically revised to reflect the dynamic, changing environment of medical transport, with considerable input from all disciplines of
12932-612: The service: The School of the Air , which links outback students with centralised teachers, until recently used the same radio equipment as the RFDS. This has been superseded with the availability of internet services. Notable people associated with the RFDS include: The First and Second Australian Inland Mission Hospitals in Birdsville are listed on the Queensland Heritage Register . In 2009 as part of
13054-542: The site of the highest tonnage port in Australia. Port Hedland has a natural deep anchorage harbour which, as well as being the main fuel and container receival point for the region, was seen as perfect for shipment of the iron ore being mined in the ranges located inland from the town. The ore is moved by railway from four major iron ore deposits to the east and south of the Port Hedland area. The port exported 519,408,000 tonnes (1.1 trillion pounds) of iron ore (2017–2018). Other major resource activities supported by
13176-679: The spar in the right wing. The wing suddenly separated from the fuselage. All 26 on board, including both pilots and two flight attendants, were killed. In 1991, an immigration detention facility, the Port Hedland Immigration Reception and Processing Centre, was opened to deal with the arrival of boat people seeking asylum. Port Hedland was seen as a good location, as it is in an area where many asylum seekers arriving by boat were entering Australia, and it had an international airport that would allow for easy deportations when required. The detention centre, situated on
13298-550: The specifics of aviation medicine, including changes in physiology and the behaviour of gases. There are a large variety of helicopter makes that are used for the civilian HEMS models. The commonly used types are the Bell 206 , 407 , and 429 , Eurocopter AS350 , BK117 , EC130 , EC135 , EC145 , and the Agusta Westland 109 , 169 & 139 , MD Explorer and Sikorsky S-76. Fixed-wing aircraft varieties commonly include
13420-400: The standardisation on the two aircraft types ended when two Cessna 208B Grand Caravans and a Hawker 800 XP joined the fleet. The South Eastern Section operates 18 King Airs (B200, B200C, B300C); The Queensland Section operates 20 King Airs (B200, B200C, B300C) and 3 PC-12s; The Western Operations operates 16 PC-12s and 3 PC-24; and Central Operations operates 19 PC-12 and 2 PC-24. By 2021,
13542-606: The tasking ambulances services clinical governance. The AAA now publishes Best Practice Guidance on a range of operational and clinical functions and provides a code of conduct that all full members, both ambulance services and charities must uphold. Memorial Hermann Life Flight is a not-for-profit hospital-based critical care air ambulance service in Houston , Texas , USA. As of 2023, it operates six EC-145 twin-engine helicopters. The service relies on community support and fundraising efforts. Memorial Hermann Life Flight operates from
13664-561: The town include the offshore natural gas fields, salt, manganese, and livestock. Major deposits of lithium are being developed and exploited south of the town as well. Grazing of cattle and sheep was formerly a major revenue earner for the region, but this has slowly declined. Port Hedland was also formerly the terminus for the WAGR Marble Bar Railway , which serviced the gold mining area of Marble Bar from July 1911 until closure on 31 October 1951. The locomotive from
13786-579: The town's mining boom. A lack of accommodation made it difficult for companies to operate efficiently, as they were unable to house staff or consultants within the town's small number of hotels. The centre is now operating as the Beachfront Village. In October 2019 the state government announced an Improvement Plan would be imposed over the West End of Port Hedland. The purpose of the plan was to prohibit all future residential development due to
13908-516: The west and Port Hedland to the east. Access by oceangoing vessels into and out of the harbour is via a narrow curved channel. The current control tower was opened in 2019. The area contains five primary schools (four government, one Catholic), along with Hedland Senior High School , Port Hedland School of the Air and the Cassia Education Support Centre. Port Hedland has a flatback sea turtle rookery, located on
14030-727: The world populations of red-necked stints and sharp-tailed sandpipers , as well as a population of the range-restricted dusky gerygone . Species that have strongly declined since the 1980s are broad-billed sandpipers , Asian dowitchers , curlew sandpipers , red-necked avocets , banded stilts , Oriental plovers , Oriental pratincoles and white-winged black terns . Other species present include Australian bustards , bush stone-curlews , western bowerbirds , painted finches and canary white-eyes . Estuaries such as Pretty Pool support mangroves , marine fish, and birds. Pollution from iron ore dust regularly exceeds national standards. The local hospitalisation rate for respiratory infections
14152-601: The wounded. Currently, a NATO working group is investigating unpiloted aerial vehicles (UAVs) for casualty evacuation. The first civilian uses of aircraft as ambulances were probably incidental. In northern Canada, Australia, and in Scandinavian countries, remote, sparsely populated settlements are often inaccessible by road for months at a time, or even year-round. In some places in Scandinavia, particularly in Norway,
14274-549: Was at stake, air ambulances would often operate on the very edge of their safety envelopes, going on missions in conditions where no other civilian pilot would fly. As a result, nearly fifty percent of all EMS personnel deaths in the United States occur in air ambulance crashes. In 2006, the United States National Transportation Safety Board ( NTSB ) concluded that many air ambulances crashes were avoidable, eventually leading to
14396-828: Was commissioned by the Presbyterian Church to look at the needs of people living in the outback . His report to the Presbyterian Assembly in 1912 resulted in the establishment of the Australian Inland Mission (AIM), of which he was appointed Superintendent. In 1928, he formed the AIM Aerial Medical Service, a one-year experiment based in Cloncurry , Queensland . This experiment later became The Royal Flying Doctor Service. Flynn's missionary work involved
14518-459: Was discovered at Mount Whaleback , and a mining venture was undertaken that included the establishment of a new town, Newman , 426 km of rail from the mine to the port and the development of processing equipment at both Newman and Port Hedland. In 1986, at a cost of $ 87 million, the existing channel was dredged to allow larger ships to enter the port. Prior to dredging, the port was only able to load vessels of less than 2,000 tonnes, but today it
14640-538: Was formed in 1936. In 1937, Dr Jean White became the first female flying doctor in Australia, and the world, when she started work at Normanton . In 1942 the service was again renamed as the Flying Doctor Service, with Royal being bestowed upon the service in 1955. On 22 October 1958, Holden car manufacturers donated its 500,000th vehicle to the service in Melbourne . Sister Myra Blanch was one of
14762-540: Was the first European to note the harbour's existence and the possibility of using it as a port. Peter Hedland arrived in the area in April 1863 on board his boat Mystery , which he had built himself at Point Walter on the banks of the Swan River . He named the harbour Mangrove Harbour and reported that it would make a good landing site with a well protected harbour, and that there was also fresh water available. However,
14884-739: Was used to provide medical evacuation – either from frontline areas or the battlefield itself. In 1928, in Australia, John Flynn founded the Flying Doctor Service (later the Royal Flying Doctor Service), to provide a wide range of medical services to civilians in remote areas; these included from routine consultations with travelling general practitioners , to air ambulance evacuations and other emergency medical services . Fixed wing military air ambulances came into regular use during World War II. Helicopters became more commonly used for such purposes during
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