Presented by Capt Iefan Blake Senior Helicopter Pilot Air Mercy Service

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3 Minimum Requirements for a Helicopter Rescue Program Including Hoist vs. Short Haul Rescue Operations based on the South African Red Cross Air Mercy Service Model Presented by Capt Iefan Blake Senior Helicopter Pilot Air Mercy Service

4 AMS MODEL The AMS model works for our specific set of conditions and is subject to: Mandate given to us by our Provincial Partners Resources-Aircraft, Crew (volunteers), Equipment Geographical Location-Mountain Heights, Wx, Terrain Nature of incidents-very few vertical face/cliff rescues May Not Be Applicable, Insight-establish safe, efficient heli rescue serv. Share thoughts, comments and experiences, all learn

5 CONTENTS AMS History and Helicopter Introduction Progression to Fully Fledged Rescue Service Minimum Requirements based on AMS Model Considerations, Hoist vs. Short Haul AMS Model Conclusion

6 AMS HISTORY AND HELICOPTER INTRODUCTION Established 1966 by Red Cross Society, non profit basis, C205 Primary Focus transport critically ill & injured patients Remote and under resourced areas In collaboration with Prov. Dept of Health Western Cape first to introduce Helicopter Service, BO

7 AMS HISTORY AND HELICOPTER INTRODUCTION CONT. Now we operate a fleet of 15 Aircraft 7 X PC 12 3 X EC 130 B4 4 X AW119MKII 1 X A109S Providing Flying Doctor, Air Ambulance, Rescue services

8 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE History Catalyst for Change Hoist Introduction Short Haul Introduction

9 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HISTORY Western Cape Dep. of Health 2000-BO105 MVA, IFT and assist with rescue where possible

10 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HISTORY

11 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HISTORY

12 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HISTORY Where landing not possible and due to not having a hoist-toe in and single skid landings were carried out

13 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HISTORY Dangers of toe in and single skid landings. Proximity to terrain and rescuers/patients, self induced pressure, not trained high error rate

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16 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - CATALYST FOR CHANGE To Mitigate Risk Improve rescue capability Ultimately to try and save more lives

17 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HOIST INTRODUCTION Introduce Alouette-2002 fitted with hoist Provided the capability to access patients without the high risk of toe in and single skid landings. Patient could be hoisted in harness or stretcher

18 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HOIST INTRODUCTION

19 PROGRESSION TO FULLY FLEDGED RESCUE SERVICE - HOIST INTRODUCTION

20 AMS MOUNTAIN RESCUE SERVICE- SHORT HAUL INTRODUCTION 2004-AloIII replaced with AS350 Permitted HEMS and Rescue at same time Hoist and Dual Cargo Hook fitted Allowed development of Short Haul Rescue technique Possible to extract patient with medic Back up when hoist u/s

21 AMS MOUNTAIN RESCUE SERVICE - SHORT HAUL INTRODUCTION

22 MINIMUM REQUIREMENTS AS PER THE AMS MODEL Legal, Policy, Planning and Control Matters Dispatch Equipment Crew Requirements Currency System Procedures (SOPS) Quality System Safety System

23 LEGAL, POLICY, PLANNING & CONTROL MATTERS Operator responsible-licensing Local Regulatory Body (CAA) Flight Operations Manual (FOM) endorsed by CAA Operator must be properly insured again aviation risks under the hull and third party liability insurance of the aircraft.

24 LEGAL, POLICY, PLANNING AND CONTROL MATTERS Key Role Players and responsible persons involved Regular meetings Overall Policy Control of Operations Integrate helicopter in established EMS system

25 LEGAL, POLICY, PLANNING AND CONTROL MATTERS Monthly Meeting Training arrangements, Venue, Permissions, Team Future Developments, Techniques, Equipment Review and Debrief Rescue Missions Unresolved, elevate to Policy & Control Meeting

26 DISPATCH Any organization can request through EMS Control Delay in dispatch significantly impacts chances of survival/recovery. Injury in Mountainous terrain, dispatch to: Locate patient and assess If safe, deploy Mountain Medic Provide situation report to Control, inc Patient condition and additional resources required Fly in additional support if required Extract to Hospital expediently

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28 EQUIPMENT HELICOPTER Modern Helicopter with the following specifications Reliable and proven engine Engine, Gearbox and Main Rotor Exceedence Monitoring and recording Dual Hydraulics Radar Alt Moving Map GPS Satellite tracking System Performance capabilities to provide sufficient payload to accommodate Rescue Equipment, Pilot, Hoist Operator, Medic and Tech Rescuer and enough fuel to be operationally effective. HOGE for the area the helicopter is based in

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30 EQUIPMENT HOIST

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32 EQUIPMENT HOIST Operational working load of at least 200kg s (450Lbs) Hoist cable length of at least 50m s (164ft) Useful to have hoist cable payout display for pilot and hoist operator Ability to allow the pilot to hoist the cable in or out in case of an emergency, the pilot s input must override the hoist operator s input Ability to allow the pilot to jettison the cable in case of emergency by use of a cable cut switch.

33 EQUIPMENT HOIST Recommended that the operation of the hoist master switch must activate an advisory on the aircraft indicating system so as to prevent inadvertent lowering of the cable during flight. Hoist must have an over temperature sensor to inform operator when he/she needs to stop hoisting to allow the hoist motor to cool down to prevent hoist motor burn-out. Hoist to have a cable foul sensor to prevent incorrect role up on hoist drum and possible failure of entire cable.

34 EQUIPMENT DUAL CARGO HOOKS

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38 EQUIPMENT DUAL CARGO HOOKS Dual Cargo hook load limit of at least 500kg s. Must have a dual cargo hook system installed and certified by manufacturer consisting of a main cargo hook and a safety cargo hook. When Flying HEC dual cargo hooks must be independently connected to separate release mechanisms which require two separate actions by the pilot to release the load.

39 EQUIPMENT DUAL CARGO HOOKS Preferably a mirror must be fitted to allow the pilot to see the cargo hooks and confirm that they are open and free of the load when the load is jettisoned. The main cargo hook must have a load measuring system and readout indicator in the cockpit so that the pilot can check the weight being lifted by the hook and verify that it is within the hook loading limitations.

40 CREW REQUIREMENTS Rescue Pilots- Min Commercial Pilot, Hoist/Sling, Night, recommend IR, 1500 Hours, Mountain experience Hoist Operators- Have mountain rescue experience who have completed a Certified/CAA Endorsed Hoist Operator Course and passed the assessment. Mountain Medic and Technical Rescuers-Appropriatley skilled and experienced crews that have successfully undergone helicopter training and have been appointed to the helicopter program by the operator. Note: The total number of team members must not be more than what can be kept current by the system

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43 CURRENCY AND TRAINING SYSTEM One of the ways to mitigate some of the risk of Helicopter Rescue operations is to carry out regular training sessions in line with accepted Standard Operating Procedures (SOPs). The principle here is to operate as you train, in other words whatever you do during training is what you do during rescues. Training is to be prioritized over no urgent transfers Training is as important and requires a commitment from operator/client Training needs to be completed in full, including attending the briefing and debrief for currency to be awarded Pilots, Hoist Operators, Medics and Tech Rescuers are required to regain currency every 6 Months. A record of all training and currency is to be kept by the operator.

44 PROCEDURES (SOPS) AND QUALITY SYSTEM SOP s are there to provide the rescue team members with the necessary information for them to safely and successfully perform their specific function in the rescue environment The SOP's should be written using all the experience, expertise and knowledge in the system. The operators Quality Manager will ensure regular audits are conducted to ensure that this SOP is adhered to.

45 SAFETY SYSTEM The operator will need to implement a Safety Management System to identify hazards and control risks while maintaining assurance that these risk controls are effective

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47 CONSIDERATIONS: HOIST VS SHORT HAUL AMS MODEL

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50 CONSIDERATIONS: HOIST VS SHORT HAUL AMS MODEL General Information Capabilities Limitations Reliability Cost and Maintenance Training of crews

51 GENERAL INFORMATION Almost always an installed hoist system on a helicopter will be the fastest way to get rescuers to a patient side (dependent on hoist cable length) The extraction time between the two methods is normally very similar, although the short haul allows the medic to remain at the side of the patient during the extraction. Most cases power margins allow the technical rescuer to be extracted at the same time. Note: Hoist and Cargo Hooks are manufactured by third party vendors who sell them to Helicopter Manufacturers and operators.

52 CAPABILITIES Hoist Load limit 204 kgs Cable Length 50 m Short Haul (Duel Cargo Hooks) Load Limit 500 kgs Rope Length Limited only by Pilot & Crew capabilities and organization s SOP s

53 LIMITATIONS Hoist Aircraft stationary in hover during hoisting in or out Load limit of 204 kgs prevents Medic accompanying patient next to stretcher during hoisting Limited access gorges and vertical cliff faces due to hoist length limit of 50 m Hoist weighs 46 kgs Increased aircraft weight for all missions, not just rescue Short Haul (Duel Cargo Hooks) 100 Knots but limited to 40 Knots for Rescuer Comfort Duel cargo Hook weighs 20 kgs Increased aircraft weight for all missions, not just rescue.

54 RELIABILITY Hoist In excess of 10 malfunction of some kind or another, since introduction of brand new hoist into the system. We have 2 spare hoists in the fleet. Short Haul (Duel Cargo Hooks) Not one malfunction recorded since introduction of Short Haul in 2004.

55 COST & MAINTENANCE Hoist Short Haul (Duel Cargo Hooks) New Hoist US$ Overhaul required every 5 years, US$40 000, sent away to service centre Hoist Cable US$3000 Cable Tensioner US$3000 New Duel Cargo Hooks US$43000 Overhaul required after 5 years, can be overhauled by the In- House AMO No repairs required so no price available

56 COST & MAINTENANCE CONT. Hoist Maintenance required every 3 months / 200 cycles, 6 months / 400 cycles, annually, 1500 cycles, 5 years / 2000 cycles overhaul Geneva Wheel failure requires hoist to be sent to service centre causing weeks of delays for overhaul Short Haul (Duel Cargo Hooks) Annual inspection and cleaning required Overhaul required after 5 years, can be overhauled by the In-House AMO

57 COST & MAINTENANCE CONT. Hoist Typical Failures: Bird caging Milking Geneva Wheel Failures Self Tentioner R1 500 per hoist as calculated by AMS finance (R42000/Trng Session for 8 Crew, 28 Hoist, no Short Haul) Short Haul (Duel Cargo Hooks) Typical Failures: NIL

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59 TRAINING OF CREWS Hoist 18 flight hours for Hoist Operator training Short Haul (Duel Cargo Hooks) No exclusive training given yet but estimate 10 hours for crewman BUT if Pilot trained in Vertical Referencing no crewman required

60 RECOMMENDATIONS: HOIST VS SHORT HAUL AMS MODEL If budget and helicopter performance allows buy both! The reliability of the Short Haul makes it a good backup for the hoist. If budget/helicopter performance does not allow both but a rescue capability is required consider the following: Terrain, Crew Compliment, Altitude, Helicopter Capabilities - Vertical Face Rescues where a Hoist Cable cannot reach Short Haul High altitude, operating at engine limits Short Haul and Vertical Reference Low cloud base or excessively high winds Hoist Extracting more than 2 people at once Short Haul Medic required to treat patient during extraction Short Haul

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62 QUESTIONS