18 AUgust :In order to give boost to the Helicopter Industry in the country, Ministry of Civil Aviation has declared 2008 as year of Helicopter. Number of activities have been planned to popularize the usage of helicopters in the year of helicopter. One of the activities planned is the conduct of a National Seminar on Helicopter Emergency Medical Services (HEMS) and Heliport Development .
The event is being organized under the aegis of Ministry of Civil Aviation by the Rotary Wing(Helicopter) Society of India, at India Habitat Center, New Delhi on 20 Aug’08.
The aim of the Seminar is to bring to the fore the concept of Helicopter Emergency Services (HEMS) and how these services can be institutionalized for the benefit of the public in the country. Development of heliports in major hospitals, in and around metros as well as State and District Head Quarters in support of Helicopter operations is another essential requirement which will be discussed during the seminar.
Mr. Ashok Chawla, IAS, Secretary, Ministry of Civil Aviation will inaugurate the Seminar.
The genesis of the use of helicopters for air evacuation is traced to the Korean War in 1950-54. It is said that the "air ambulance" helicopters reportedly transported 100 casualties each day from the battle field to the field hospitals. According to Major Booker King, M.D, who served in a Korean MASH Unit air evacuation undoubtedly contributed to a dramatic reduction in the death rate of wounded soldiers?"
In the early days when helicopters were used for air evacuation, the primary objective was to move the patient to a hospital quickly — within the "Golden Hour. Even in India, the helicopters of the IAF air evacuated hundreds of wounded soldiers from hostile terrain during the Indo-China conflict of 1962.
Success of Aero Medical Evacuation
Today, aero medical specialists provide advanced life support for the patient in-flight or at the scene of an accident. The helicopters are converted as mini ICUs and provide effective trauma care to individual/mass casualty event. As a result, the concept of providing advanced life support for the patient in-flight or at the scene of an accident has become very popular in the West.
The success of most of the air evacuation companies in the USA have been attributed to providing fast, reliable and safe helicopter transportation for patients from outlying areas who need advanced health care services. The Indian hospital Industry feels that it is time to introduce the concept of Helicopter Emergency Services (HEMS) with helicopters equipped with full emergency room capabilities and paramedics. Once we build the number of such helicopters in civil, it could be very useful in times of mass casualty event. Why Helicopter Emergency Medical Services are popular in USA?
Saving time saves lives – Trauma (Golden Hour), Cardiac (Time is muscle), Strokes (Time costs brain cells), High Risk OB/Neonatal and Organ transplants. Currently in the USA over 792 dedicated private medical Helicopters are used in air evacuating 300,000 patients per year. Around 50% of the cases were evacuated from the scene and 50% of the cases were related to transfers from lower medical facility to higher medical facility. Since 95% of the population in the United States lives within a 30 minute response time for a dedicated medical helicopter, these air evacuations are done well with in the Golden Hour.
How can a Medical Helicopter be funded
The funding of medical helicopters is carried out by any of the following agencies or by a combination of agencies; (1) Government,(2) Hospital Marketing Tool,(3) Corporate donations (flying billboard),(4) Fee for Service,(5) Membership Programs and (6) Combination of any of the above
Helicopter Evacuation provides larger economic benefits ;(1) Less need for more specialized hospitals,(2) Less need for high level ground ambulance services and (3)Better patient outcomes including Back to work faster and Less expensive inpatient care.
For providing quick response during a mass casualty event with in the golden hour, it is recommended to preposition helicopter resources close to the location of the event. State Govts especially of those disaster prone states such as Uttaranchal, Orissa, Andhra Pradesh and Gujarat should therefore consider integrating helicopter resources available within each state into their Disaster Management Response system.
It is also proposed that Insurance Regulatory and Development Authority (IRDA) encourage Insurance companies to extend insurance cover that takes care of air evacuation in medi claim policies. With the economy growing, many citizens and corporate would certainly avail such cover. Once there is a demand for air evacuation private hospital groups would synergize with helicopter companies to commence providing air ambulance/HEMS cover for such personnel.
Presently, many of the foreign nationals who visit India avail the air evacuation clause when they are in need. Many non scheduled helicopter operators have handled such air evacuation requests. In India, there are some air charter companies who handle elective air transportation of patients to hospitals mostly by fixed wing aircraft. Some of the hospitals such as Apollo & Escort in Delhi have started using helicopters. Comprehensive Trauma Consortium at Bangalore has already started using helicopters from Deccan Aviation for air evacuation. There is already a heavy demand from Industries /Institutions located in the outlying areas of Metros for organized air evacuation of their personnel in case of a requirement to Specialty Hospitals in Metros.
Like the Home Ministry has subsidized helicopter operations in the states of Himachal Pradesh, Arunachal Pradesh, Meghalaya and Sikkim, Health Ministry and National Disaster Management Authority should take initiative to launch air evacuation schemes with assistance from concerned state governments to save public lives in the case of mass casualty event. There are numerous examples of such initiatives in the West.
London’s Helicopter Emergency Medical Service (HEMS) is one such example. It has pioneered pre hospital care since 1989, taking an experienced trauma doctor and paramedic to the scene of serious incidents in the Greater London area to give patients the best chance of survival.
Their helicopter flies seven days a week in daylight hours, flies approximately 1000 missions a year, and can reach anywhere within the London city within 12 minutes. The majority of incidents are road traffic accidents and falls from heights. A trauma car operates five nights a week providing the same high-level service.
It is operated with funds raised from Corporate. Approximately Pounds 1,00,00,00 are raised every year to keep the service operational.
Heliports & Staging Areas Needed
For effective use of helicopters in EMS role during mass casualty event, heliports and staging areas should also be developed simultaneously. Heliports Committee convened by Ministry of Civil Aviation has already identified two sites, one in Rohini and the other in near DND in Delhi area for heliports and staging areas. Other State Govts should also take similar initiative. It is time that Authorities concerned create suitable heliport / roof top facilities at Metros that would facilitate HEMS operations in case of mass casualty event.
Many More lives could be Saved
In the decade 1990-2000, an average of about 4344 people lost their lives and about 30 million people were affected by disasters every year. The loss in terms of private, community and public assets has been astronomical. Over 16000 lives were lost in the Bhuj earthquake in Gujarat in January, 2001 and a similar number during Tsunami in Dec’04. In such disasters, helicopters have saved thousands of lives. Many more lives could have been saved if we have air evacuation resources in every state.