Airvans and patient transport

[SJFedor]

Have you ever seen the litter arrangement in the Bell 206 jet ranger.....patient on one side, feet up next to the pilot, the back is not much roomier than a 182.....

mk

http://rds.yahoo.com/_ylt=A0WTb_mH9ndH2wIAzkijzbkF/SIG=126dmrcgk/EXP=1199130631/**http%3A//www.pantonov.com/gallery/biaf-1999/P0001224

AirEvac Lifeteam uses that configuration. IMHO, it's horrible. God forbid the patient gets rowdy and starts kicking the pilot.

I've been on the pad more then a few times helping AE crews get patients out, etc. We had one that was CPR in progress, and I was baffled how they even managed to do it in the aircraft. You actually have to move the airway seat just to extricate the patient out. Real cumbersome.

[flyerthom]

Have you ever seen the litter arrangement in the Bell 206 jet ranger.....patient on one side, feet up next to the pilot, the back is not much roomier than a 182.....

mk

http://rds.yahoo.com/_ylt=A0WTb_mH9ndH2wIAzkijzbkF/SIG=126dmrcgk/EXP=1199130631/**http%3A//www.pantonov.com/gallery/biaf-1999/P0001224

AirEvac Lifeteam uses that configuration. IMHO, it's horrible. God forbid the patient gets rowdy and starts kicking the pilot.

I've been on the pad more then a few times helping AE crews get patients out, etc. We had one that was CPR in progress, and I was baffled how they even managed to do it in the aircraft. You actually have to move the airway seat just to extricate the patient out. Real cumbersome.

The A Star 350B is similar. Friday night the patient grabbed the pilots charts! The word for today is sedation...

[SJFedor]

The A Star 350B is similar. Friday night the patient grabbed the pilots charts! The word for today is sedation...

*cough* DeathStar *cough* 

Our flight service uses EC-145s and BK-117s, so the patient has no access to the "flight deck", even if they manage to flight off the two Flight RNs in the back. But our flight nurses usually intubate before they even get in the chopper if they think there's any chance of the patient getting rowdy.

[/topic drift]

But yeah, we could transport walkie talkies. Where we'd come into the fold a lot better would be a isolated, cut off town with only a small airport. NOLA and Katrina type stuff, 130s and bigger did the job a lot better then we ever could have, though, if we did it, I wouldn't have minded getting the hours doing that.

Besides, since we're doing transport, the pilots doing so would more then likely need to be Comm rated. With the Airvan, that's not such a big problem, since Comm was a requirement (no more), but they still kinda prefer Comm rated people, or people getting there quickly.

[sardak]

Have you ever seen the litter arrangement in the Bell 206 jet ranger.....patient on one side, feet up next to the pilot, the back is not much roomier than a 182.....

Here's how our local Air Life does it with their 407s.  The platform swings out and their litter is attached/detached to the platform, then it swings back in.  A backboard or full body vacuum splint can be strapped directly to their litter.  Only one patient per flight.

The patient's feet are alongside the pilot, but there is "kick guard" that is about as high as the pilot's shoulder.

Back to topic.

Mike

[BillB]

The USAF Surplus L-5 aircraft that went into the CAP inventory in the late 1940's and early 50's were all capable of carrying strecher patients. the left side of the aircraft swung down and a litter could be installed. This played hell with weight and balance until pilots got used to the tail heavy effect. I remember several instances in Florida when the L-5's were actually used for patient transport from small airports/ grass strips to major airports and hosiptal areas. So in the dim-dark past CAP was used for emergency patient transport. (these were the L-5's with inline engines, not the radial engines)

[O-Rex]

Patient transport is not really part of our mission.  Besides the liability issues previously mentioned, patient transport requires enroute patient care, which we are simply not geared for: There are other orgs better suited for the task.

[BillB]

When the L-5's were in use by CAP they were all USAF aircraft and so marked. The liability was USAF's, not CAPs. At the time the aircraft were in use there was no other air lift capability from the small airports or grass fields. Helicopters were not yet in civilian use. The next smallest aircraft for air transport were twin engine Beech's. While rarely used, CAP did furnish the air transport of patients when required. During this period the military and CAP did not have on-board medic personnel for air transport (see the old MASH TV shows for an example)

[afgeo4]

So it seems to me that there are two major things that are staring us in the face with this: Liability and Number of Aircraft.  The first issue can only be handled by national; so I won't touch that one beyond a simple suggestion:  perhaps we could partner with the US Public Health Service on this one: we fly and maintain the aircraft, and they supply and maintain a sqdn of flight nurses and/or paramedics.  Thus, we avoid the health liability and burden an already-licensed organization with that. 

However, the aircraft issue is easily solvable through the purchase of additional aircraft.  If this were to happen, I would suggest we not use the airvan.  Although standardization is excellent, an aircraft such as the Pilatus PC-12 is more suited to CAP's needs.  In addition to the 'sexy' factor that it would add to our fleet (face it, the reason fighter aircraft are the stars of the armed forces is because they look so gosh darn cool!) the Pilatus has the capacity to carry 2 liters plus the nurses and medical equipment.  Additionally, (depending on winds, fuel costs and other uncontrollable values) the aircraft only requires abou $600/hr to operate.  (figures taken from http://www.pilatus-aircraft.com/media/Pilatus-PC-12-Just-The-Facts.pdf sec. 2.9)

Pilatus won't happen.

1. It is a platform that isn't useful for SAR duties with its wing under fuselage and high speed.
2. CAP regulations specifically state that CAP will not use aircraft rated for more than 8 passengers. It is strictly prohibited. The Pilatus seats 9.

[chiles]

While I understand there are other organizations better suited, the entire reason this was even broached was that the number of people requiring evacuation overwhelmed those very organizations. Putting walkie/talkies into an airvan with a nurse seemed like a possible extension of the CAP ES mission. Does CAP incur too large a liability if they transport a walkie/talkie with a nurse responsible for them (who is not a CAP member). It seems to me like it'd be the same as any other transport mission. I'd also like to point out I'm not talking about demented or otherwise mentally unstable patient either. Just those elderly in nursing homes who require too much assistance to live on their own but not so much that they are bed bound or require locking up.

[RiverAux]

I would suggest that if we were to do evacuations, we would probably be able to handle more patients using our vans (of which we have twice as many as we do airplanes).  Since we're talking genrally about ambulatory people our capacity in the vans is also much higher.  Could take at least 2 stetchers without the seats were it necessary. 

[FW]

My original request was the feasibility of transporting ambulatory patients. That is, patients not requiring litters or stokes or anything like that. They're nursing home/assisted living patients that have no other way to evacuate and maintain the level of care they need. This may include simply being on oxygen or a bag of pills a day. If they can sit down in a seat, can't you transport more than just the one you mention?

One problem with providing patient airlift is our current FAA exemption.  I don't think we're allowed to transport anyone other than a CAP member or government official from point A to B; even during a declared emergency (CAPR  60-1).  Also, there are organizations like "Mercy Airlift",  "Angel Flight",  and the "Corporate Angel Flight Network" doing this mission every day at no expense to the taxpayer or patient(the pilot or corporation donates time/aircraft/fuel).  These organizations have thousands of volunteer pilots and aircraft at their disposal 24/7.  It is the mission of these bodies to transport anyone in need;  including, during emergencies.  
BTW: if anyone is interested in volunteering, go to www.angelflightne.org, or any of the other angel flight sites for more info.

[afgeo4]

My original request was the feasibility of transporting ambulatory patients. That is, patients not requiring litters or stokes or anything like that. They're nursing home/assisted living patients that have no other way to evacuate and maintain the level of care they need. This may include simply being on oxygen or a bag of pills a day. If they can sit down in a seat, can't you transport more than just the one you mention?

One problem with providing patient airlift is our current FAA exemption.  I don't think we're allowed to transport anyone other than a CAP member or government official from point A to B; even during a declared emergency (CAPR  60-1).  Also, there are organizations like "Mercy Airlift",  "Angel Flight",  and the "Corporate Angel Flight Network" doing this mission every day at no expense to the taxpayer or patient(the pilot or corporation donates time/aircraft/fuel).  These organizations have thousands of volunteer pilots and aircraft at their disposal 24/7.  It is the mission of these bodies to transport anyone in need;  including, during emergencies. 
BTW: if anyone is interested in volunteering, go to www.angelflightne.org, or any of the other angel flight sites for more info.

Where did you get that from?

[BillB]

The regulation allows flights for members of the news media with permission from National.

[afgeo4]

A few months ago I saw an article in the Volunteer about a CAP aircrew flying a family out of Louisiana or Mississippi as an evac flight. The pic was on the front cover too.

[FW]

CAPR 60-1 Attach. 2 is where the FAA exemption is listed.  We can provide transport for non members or property provided the mission is an AFAM "A" or non reimbursed mission B or C.   So, I stand corrected.  However, I still think the other orgs. are better able to handle this mission unless we have a large scale disaster.  

[sarmed1]

...sorry bored at reserve duty..... (its an Aerovac squadron so appropriate)
It would be interesting to have some one look at what the contingency capability of using the GA-8 airframe for litter evacuation.   ie its an airframe immediately available at a disaster site available for tasking, it might be nice to know what can be done so it doenst have to be invented on the fly, or outright declined becuase no one knows if it is or isnt really feasible.

The web site shows a 2 litter configuration? 
But what if (and yes I realize thats a very big if) CAP was called upon to do such a mission.
-How would you do it?...are there hard points on the floor you could cargo strap a litter to?
-How much space does the archer take up and there by decreasing the patient capability (space)  & weight load (and crew beyond pilot) can it be removed..if so how long does it take and/or does it require special technician type capabiliyty. (or to put it back afterwards)
-How about seat removal?
-Could you safely secure oxygen beyond a bunch of D-type tank bottles?
-Is there any power options that you could run 110VAC, how much...ie medical equipment....cardiac monitor, ventillator, IV pump. suction? or are you limited to device battery power?

mk

[PHall]

You can pretty much cross the Airvans off your list, period.

The ARCHER equipment can not be removed unless ordered by the NOC.
It's not a decision that an IC can make.

The Airvans are a National asset and they're the ones calling the shots.
And with all the money that they've thrown at this project, they're not going to want to damage the systems by putting them in and taking them out all the time.

[SAR-EMT1]

If this was listed above I missed it...

When was the last time CAP transported a pt in an aircraft?

What about organs or blood?

I imagine (but have no info to back this up) its been years maybe decades since we moved an actual patient. (Alaska might be the exception)

Second question: (semi related)
Anyone think Clinic Augmentation for EMTs/PAs/Nurses/MDs etc might be possible under VSAF? ... What about serving on C-130 medevac teams?

[RiverAux]

I think the volunteer had an article about blood transport last year.  That slacked off quite a bit after the 1980s when commercial services started doing it. 

[SAR-EMT1]

Exactly. Pt transport by CAP does not exist anymore.
Blood or organ maybe but not pt. transport.