The benefit for air medical response resources during large-scale incidents is monumental in comparison to ground-based EMS transport entities. These resources can not only complete rapid response and transport requirements, but can also provide onsite triage and treatment teams, in addition to the shuttle of on-scene field surgical groups.
To begin our journey along the path of preplanning, several aspects must be addressed. As a starting point to support a regional outlook, one needs to identify every air medical response program within a 150 nautical mile radius of your jurisdiction. By contacting your State Emergency Management Office, military air response resources can also be identified, which should be included within your disaster plan. Certain initial questions must be answered to provide you with a detailed outlook regarding the development of your air medical response plan. After identifying each air response program within your 150 nautical mile radius, contact each flight program to ascertain the following:
- Number of helicopters
- Specific response radius
- Helicopter type and weight
- Patient transport capabilities
- Landing Zone requirements
- Available first responder training
- 24-Hour emergency contact numbers
Every flight program in the country has established a response radius for each of their aircraft. In most cases, this response radius is a fluid number and can be lengthened for extenuating circumstances. This initial radius identifies the outer most destination that a specific helicopter can fly to, pick up a patient, and transport to its destination without refueling. Most helicopters have a response radius from 120 to 200 nautical miles, with larger aircraft boasting a radius of well over 250 nautical miles. Each flight program within your area must be contacted to verify its specific aircraft radius. This information can then be plotted, to be referenced during your potential activation and/or preplan.
When identifying your regional flight resources, it is important to identify their specific transport capacity. These capabilities can range from single patient transport abilities, to multiple patient means of transport. This carrying propensity is specific upon aircraft type and medical staffing. In addition to the patient transport amount, the helicopters' weight needs to taken into consideration. Rooftop hospital helipads are specifically weight rated which identifies the amount of weight allowed to land upon it. Your transport officer should have a list of area helipad weight ratings, in addition to area flight program helicopter weights which should be cross-referenced prior to making a patient transport destination decision.
While most helicopters are capable of landing in small spaces, the preferred landing zone dimension is usually 100' x 100', free and clear of all obstacles and hazards such as poles, wires, vehicles and people. While each flight program across the country has specific dimensions required for landing its helicopters, the main concept here is safety. Think of it as large, free and flat... a large area, free of obstacles and a level surface.
Before allowing field responders to work around helicopters, certain safety precautions must be considered. Basic helicopter operations and helicopter safety training must be provided to ensure all safety requirements are met, and all scene personnel are properly trained to safety function around these vehicles. Flight programs are more than willing to provide this essential training to area first responders, if requested.
Emergency response companies around the globe have developed an array of patient tracking forms, checklists and computer programs, available to assist your transport officer with patient tracking. These resources encompass generalized accountability regarding arrival locations, transporting entities and destination facilities. Regardless which method is used, a comprehensive patient tracking system must be in place to facilitate coordinated movement and accountability.
In addition to providing rapid transport capabilities, air medical programs can also deliver essential medical supplies directly to the scene of a mass casualty or large-scale incident to supplement on-scene efforts to incidents that completely overwhelm local response supplies.
In addition to medical re-supply, some air medical programs have established Critical Incident Dispatchers that are capable of flying to the scene with the medical crew and assisting the Incident Commander with controlling multiple incoming aircraft. These specialized air medical dispatchers can be heavily relied upon to coordinate and control a large scale air medical response, in addition to providing on-scene communication assistance.
At times, severe weather sometimes prevents the use of air medical operations, in these instances, ground based Critical Care resources can often be utilized to facilitate patient transport movements. The concept takes the medical team (from the helicopter) and places them into an ambulance, creating a ground-based critical care response asset. Considering these response assets as a mini emergency room on wheels, their capabilities are similar (if not identical) to those available on the helicopter. Remember to allow additional activation times when requesting these resources.
In conclusion, the air medical industry has much to offer, and by utilizing proper preplanning measures, the resulting outcome can enhance response efforts.
Bio
Michael B. Judy is the Mass Casualty Coordinator for Flight For Life Colorado, an emergency transport service affiliated with Centura Health and St. Anthony Hospitals.
