MEDICAL EVACUATION BY HELICOPTER

1. MEDICAL EVACUATION BY HELICOPTER January 2012 CANADIAN COAST GUARD AUXILIARY - PACIFIC

2. Introduction

3. Introduction • This presentation describes generic medical evacuation procedures.

4. Introduction • When a vessel at sea requires a medical evacuation, lives depend on knowing the right procedure and on advance planning. • An oversight or poor planning can endanger the helicopter, its crew, the patient, and the crew of the vessel. • Knowing the right way makes everyone safer.

5. Introduction • Open or T Top rescue vessels are not to participate in helicopter medical evacuations, and should proceed to nearest area where the helicopter can safely land, and where the vessel can safely land the patient to the helicopter. • This landing site will be specified by the helicopter.

6. When Requesting Assistance

7. When Requesting Assistance 1.Give accurate position, time, speed, course, weather conditions (ceiling, visibility, wind direction and speed, and sea state). 2. If not already provided, give complete medical information, including whether or not the patient can walk. 3. Be prepared to change your course toward the helicopter if you are told to do so by the SAR mission coordinator.

8. Preparations Before Helicopter Arrives

9. Preparations Before Helicopter Arrives 1. Keep radio watch on 156.8 MHz (CH 16 VHF-FM or other frequency specified by the SAR mission coordinator.

10. Preparations Before Helicopter Arrives 2. Select and clear the hoist area, preferably aft in the stern. This includes securing loose gear, awnings, rigging and booms.

11. Preparations Before Helicopter Arrives 3. If the hoist is at night, illuminate the hoist area as well as possible. Do not shine any lights toward the helicopter that may blind the pilot. If there are obstructions in the vicinity, put a light on them so the pilot will be aware of their locations.

12. Preparations Before Helicopter Arrives 4. Point searchlights vertically to help the helicopter locate the ship, and extinguish them when the helicopter is on scene.

13. Preparations Before Helicopter Arrives 5. Advise SAR mission coordinator of location of hoist area before the helicopter arrives so the pilot can make the necessary approach.

14. Preparations Before Helicopter Arrives 6. There will be a high noise level under the helicopter, making voice communications almost impossible. Arrange a set of hand signals among the vessel crew who will assist.

15. Preparations Before Helicopter Arrives 7. Helmets with face shields or goggles are recommended due to the noise and spray generated by the helicopter.

16. Hoist Operations

17. Hoist Operations 1. Be sure patient is tagged to indicate what medications, if any, were administered and when.

18. Hoist Operations 2. Have patient's necessary papers in an envelope or package ready to transfer with them.

19. Hoist Operations 3. Have the patient ready to move as their condition permits. Time is important.

20. Hoist Operations 4. It will be necessary to hoist the patient in the rescue device, which will be lowered by the helicopter. Be prepared to do this as quickly as possible. Be sure the patient is strapped in, face up, with a life jacket if their condition permits.

21. Hoist Operations 5. Establish the procedure that if either rescue vessel or helicopter had to break off the manoeuvre for any reason, then one word would be called" Break”. Rescue vessel goes to starboard and helicopter goes to port .

22. Hoist Operations 6. Change course so the vessel rides as easily as possible with the wind on the bow, preferably the port bow. Reduce speed if necessary to ease the vessel's movement, but maintain steerageway. As the helicopter craft starts to hover above you there is a slight drop in speed in our vessel - compensate for that to maintain steerage but no sudden increase in speed without telling the helicopter.

23. Hoist Operations Once the hoist begins, maintain course and speed, and follow instructions from the helicopter. The vessel will be severely buffeted by the downwash of the helicopter so complete concentration is needed.

24. Hoist Operations 7. If you do not have radio contact with the helicopter when you are in all respects ready for the hoist signal the helicopter in with a “thumbs up" by hand, or at night by flashlight.

25. Hoist Operations 8. Allow the rescue device to touch the deck before handling it to avoid static discharge.

26. Hoist Operations 9. If the helicopter drops a trail line, guide the rescue device to the deck with the trail line. Do not tie the trail line or hoist cable to the vessel.

27. Hoist Operations 10. If necessary to take rescue device away from hoist point, unhook the hoist cable and keep free for helicopter to haul in. Do not attempt to move rescue device without unhooking it. Do not secure the cable to the vessel.

28. Hoist Operations 11. Place patient in rescue device, sitting with hands clear of sides or strapped in face up. Signal hoist operator when ready for hoist. Patient signals by nodding head if he is able. Deck personnel give "thumbs up" to hoist operator. Steady the rescue device to prevent turning or swinging.

29. Hoist Operations 12. If a trail line is attached to the rescue device use it to steady the rescue device during the hoist. Keep feet clear of the line.

30. Hoist Operations 13. The helicopter may elect to lower their crewman to your vessel to evaluate the patient and assist in the hoist evolution. Please assist the crewman and follow his instructions.

31. High Line Transfer Operations

32. High Line Transfer Operations Where the vessel may not be appropriate to take the direct landing of a crewman from a helicopter, the high line transfer technique may be used.

33. High Line Transfer Operations 1. As before make sure everything is tied down and secure. The down wash from a Sea King is 130 knots, the Cormorant more. Vessel heading and speed will be at the direction of the helicopter pilot, but generally with wind and sea on the port bow.

34. High Line Transfer Operations 2. The helicopter will be lowering a light weight line with a bag of lead shot on the end, down to the vessel. The weight on the end of this line can be increased with the speed of the wind. On board the vessel it is useful to have a bucket into which the weighted line can be coiled. The line must must not be secured.

35. High Line Transfer Operations 3. The high line is lowered to just above the water. The helicopter will then fly in, to allow the vessel crew to catch the bag. Avoid getting hit by the bag.

36. High Line Transfer Operations 4. The crew man starts being lowered on the winch of the helicopter. The high line is attached to the crewman by a light piece of line which is designed to break in case the pilot needs to make a sudden manoeuvre and break away.

37. High Line Transfer Operations 5. The high line is used by the vessel crew to guide the crewman onto the vessel.

38. High Line Transfer Operations

39. High Line Transfer Operations 6. Once on board the crewman will unclip himself, to allow the helicopter to fly clear and await further instructions.

40. High Line Transfer Operations 7. Once on board the crewman will unclip himself, to allow the helicopter to fly clear and await further instructions. Video www.youtube.com/watch?v=Q5bKb2jJ_N0

41. The End