Accidents, disasters, emergencies occur without warning and often in locations not accessible by road. It is here that helicopter has a distinct advantage over all other modes of transport as it provides the quickest and the easiest means of transportation to and from the location of the disaster.

The term medical evacuation (medevac) refers to the timely, speedy and efficient conveyance of an individual or individuals in need of urgent medical attention, by a motor vehicle, fixed-wing aircraft or helicopter, modified as an ambulance with the wherewithal to provide definitive medical supervision and care en route. The aim of the exercise is rapid transportation of seriously ill or injured persons, particularly trauma patients, from their location or from the accident site to a medical facility such as a hospital. This term also covers the transfer of patients from the battlefield to a treatment facility or from one treatment facility to another by medical personnel such as from a ship to a shore-based hospital. The practice has its origin in the Australian Royal Flying Doctor Service established in 1928 to bring the doctors to the patients and the patients to the hospitals from remote outback. The immense potential of the practice was truly realised with the development of the helicopter.

In the US military terminology, medevac is often differentiated from casevac (casualty evacuation) which generally refers to the wounded being evacuated from the battlefield. The essential difference between the two is that in the case of casevac, medical equipment on board the vehicle is limited and hence medical care en route, if available, may only be at a significantly lower level. The US Army pioneered this lifesaving technique using Sikorsky R-4 helicopters in Burma towards the end of World War II. Wounded soldiers were able to receive complete medical treatment after only a short helicopter flight. In this context, the helicopters employed are essentially combat aircraft capable of landing in “hot zones” in hostile conditions in which medevac helicopters would normally not operate.

Helicopter Emergency Medical Services

The helicopter modified as “air ambulance” has proved its versatility in the medevac role time and again, being a life-saver. Accidents, disasters, emergencies occur without warning and often in locations not accessible by road. It is here that helicopters have a distinct advantage over all other modes of transport as these provide the quickest and the easiest means of transportation to and from the location of the disaster. Analysis of data related to disaster management around the world indicates that swift response with helicopters has proved to be the most effective. Over 1,800 helicopter sorties were flown during the Chernobyl disaster; and during the earthquake in Los Angeles, helicopters were deployed within minutes. In both these instances, countless lives were saved. However, more effective and efficient response to emergency is possible if the helicopters employed are appropriately equipped for such a role.

In the developed world, there are organisations dedicated to this task and are designated as helicopter emergency medical services (HEMS). A machine employed for HEMS is in the nature of highly sophisticated “air ambulance”. It has on board, an intensive care unit (ICU) as also specialised equipment to care for trauma patients. To be certified for HEMS, the machines need to conform to the protocol laid down by the regulatory authorities of the country it is operating in. In the US, over the last two decades, the number of helicopters dedicated to HEMS has trebled reaching nearly 900.

HEMS help save lives, permanent disabilities and long medical treatment in the case of stroke or heart attack, if appropriate action is taken in the “golden hour”. As said by Dr G. Sairamanan, critical care expert from Chennai, “The golden hour is the first hour of the medical event wherein the human body system goes haywire and immediate reversals are required to prevent irreversible damage, and in case of trauma to prevent irreparable damage maiming or disability.” Thus timely evacuation and medical attention can enhance the chances of preventing fatality. “Time saved is a life saved”, is therefore, the credo of air ambulance services.