Flying Ambulances

The government is finally taking some action on HEMS

New Delhi: If all goes well then in about a year’s time India will have its own Helicopter Emergency Medical Service (HEMS). Even though certain private sector hospitals in India have been offering the services of air ambulances, and in the event of natural disaster, military aircraft, including rotor wings, have been plied into the role of air/ heli ambulances, there is no dedicated helicopter ambulance service in India.

Airbus Helicopters' air ambulance

This is slightly ironical because statistically, India has amongst the fastest growing population of billionaires. It is frequently touted as the emerging market for business jets, and according to the most recent figures, Indian wealth has increased by 211 per cent in the last 15 years alone. Moreover, a certain class of Indians have been using helicopter services, provided by both private and public-private companies, for pilgrimage and tourism. So clearly, there exists a market for dedicated helicopters in the emergency medical role.

Yet, in the absence of policy-making, this has remained a grey area, despite the fact that a Bengaluru-based company Aviators Air Rescue Ltd has put in place a model for running heli-ambulances in collaboration with the US-based Air Medical Group Holdings Inc. Of course, the company can only operationalise its model once the government guidelines are in place. And at least, in this direction, there seems to be a forward movement. The Directorate General of Civil Aviation (DGCA) put out a draft operations circular on HEMS on its website in September 2015. As of now it is a draft because the DGCA has invited comments from people and stake-holders to be submitted by 6 November 2015, before policy guidelines are formulated and issued.

Once this happens, it will be a huge leap of faith, because a helicopter ambulance cannot be a multirole platform. To qualify for HEMS, the platform would have to be configured specifically for this role. In addition to the ability of carrying a stretcher for the patient and seats for the medical personnel, it will have to be fitted with emergency medical equipment like oxygen supply, blood pressure stabiliser, heart rate monitor and an array of emergency medicines. It will also need to have enough space for the paramedic or the doctor to perform emergency non-surgical procedures like cardiopulmonary resuscitation (CPR) in-flight if required. Hence, once configured in this role, the helicopter will have to remain dedicated to it. This will obviously bring in the issues of making the service profitable to make it sustainable.

However, despite the fact that 2,100 helicopters are flying in the HEMS configuration around the world, almost 55 per cent in the United States alone, the concept is not as simple as converting a helicopter into an ambulance and air-lifting emergency patients. In terms of operations alone, heli-ambulances are different from fixed-wing air ambulances, which fly patients from one airport to another, and hence operate like any other private jet with DGCA and air traffic control’s clearance.

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