Ireland's Emergency Aeromedical Service
The National Ambulance Service (NAS) saw a huge leap forward in their rapid response capabilities with the launch of the Emergency Aeromedical Service (EAS in 2012. The service, a joint project between the HSE and the Defence Forces, means that NAS paramedics now have the assistance of a dedicated military helicopter for the rapid transfer of critical patients to the most suitable hospital.
Initially set up in 2012 for a 12-month trial period, the aim was to assess the level and type of dedicated helicopter emergency medical service (HEMS) required in Ireland in light of recent closures of regional facilities such as Roscommon Hospital. The joint helicopter crew includes a NAS Advanced Paramedic, who leads the clinical care and is assisted by a military paramedic.
The EAS is a new venture for the Defence Forces that builds on the inter-hospital air ambulance service it has offered the State since the 1960s. To date the Air Corps has carried out over 3 000 inter-hospital air ambulance missions utilising its aircraft. The inter-hospital service is still available from Casement Aerodrome, Baldonnell.
The EAS got off to a great start with its first successful callout on the first day of the service, followed by 11 aeromedical missions in the first two weeks of its launch. However, the service suffered a temporary setback when a helicopter had a heavy landing after striking a wire during a callout. Since then the service has recommenced using another helicopter type.
Augusta Westland 139 (AW 139)
The Defence Forces has invested heavily in recent years in the equipment it uses to complete air ambulance missions and now utilises the state-of-the-art ‘Lifeport’ system.
When configured for Emergency Medical Services (EMS) operations, it can accommodate an array of medical equipment, including oxygen, suction and defibrillator, several attending medics and a patient. It is the fastest helicopter in its class, capable of travelling at 315 kilometres per hour. The EAS can be anywhere in the country and deliver patients to an appropriate hospital in minutes.
The EAS is based at Custume Barracks in Athlone, where the helicopter remains on immediate call to the NAS seven days a week, 365 days a year. The helicopter is known by its call sign MEDEVAC112 reflecting its military and medical nature with ‘112’highlighting the standard European Emergency contact number.
The EAS is an element of the Health Service Executive (HSE) which, in conjunction with the National Ambulance Service (NAS) manages the air transport of patients within the state and abroad. Command and control is in the National Aero-medical Coordination Centre (NACC); the NACC co-ordinates requests for air support and assigns air assets as appropriate. It is co-located with ambulance control at Tullamore regional control centre.
How the Service Works
Any paramedic who believes that time critical treatment or transport is required for their patient and this is unachievable by ground transport may request the support of MEDEVAC112. The guideline is that the estimated time taken from leaving the scene to being at hospital should be greater than 45 minutes.
In such an example, the paramedic simply requests MEDEVAC112 from Regional Control. They in turn pass the request to the NACC who assess the situation and then task the helicopter. The crew is ready to launch in moments and will quickly make their way to a suitable Helicopter Landing Site (HLS) to collect the patient. (See ‘Activation Criteria Table’) MEDEVAC112 is available from 0800hrs to 1800hrs but it has the ability to continue a mission after 1800hrs should it be requested. In all cases, the service is in daytime hours.
Crew and equipment
MEDEVAC112 brings an AP with a full range of NAS equipment in addition to the LIFEPORT system. Equipment includes, inter alia, paramedic bag, drugs bag, Entonox, resuscitation bag, defibrillator (Zoll type), spinal board, paediatric bag, vacuum splints, spare medical equipment bag, suction unit, medical cabinet and contents.
How will the MEDEVAC112 know where I am?
The NACC should be able to locate your position using the AVL system in the ambulance or the address of the call and pass it on to MEDEVAC112. You can also pass this information to the crew by radio as the aircraft approaches. The aircraft can be contacted, when in range, using a designated channel on the ambulance radio. This channel will be allocated by the NACC.
Where can the helicopter land?
Helicopters can land almost anywhere but currently the service makes use of any location that meets military planning guidance for a Helicopter Landing Site (HLS). Potential sites are constantly being planned and developed with the NACC. Any site that is clear of wires, loose objects (such as rubbish) and is relatively clear of obstacles can make a good HLS. It should have good road access to link up with the local ambulance. A good example of a HLS is any local football field.
Sources: Ireland Pre-Hospital Emergency Care Council, Vertical Mag