Planning for the Utilization of Air Medical Resources for Large-Scale Incidents

     It would be remiss of the emergency response community to overlook the necessity for air medical resources in the event of a large-scale natural or technological disaster. In this modern era of potential destructive threats to national security, it is essential that emergency response teams realize the imperative need for helicopters and the fundamental functionality they provide.

     The benefit of air medical response resources during large-scale incidents is monumental in comparison with ground-based EMS transport entities. These resources cannot only complete rapid response and transport requirements, but can also provide on-site triage and treatment teams, in addition to the shuttling of on-scene field surgical groups.

     To begin the path of preplanning, several aspects must be addressed. As a starting point to support a regional outlook, you need to identify every air medical response program within a 150-nautical-mile radius of your jurisdiction. By contacting your state emergency management office, military air response resources can also be identified, which should be included within your disaster plan. Certain initial questions must be answered to provide you with a detailed outlook regarding the development of your air medical response plan. After identifying each air response program, contact each flight program to ascertain the following:
?   Number of helicopters
?   Specific response radius
?   Helicopter type and weight
?   Patient transport capabilities
?   Landing zone requirements
?   Available first responder training
?   24-hour emergency contact numbers.

     Every flight program in the country has established a response radius for each of its aircraft. In most cases, the response radius is a fluid number and can be lengthened for extenuating circumstances. This initial radius identifies the outermost destination that a specific helicopter can fly to, pick up a patient and transport to its destination without refueling. Most helicopters have a response radius from 120 to 200 nautical miles, with larger aircraft boasting a radius of well over 250 nautical miles. Contact each flight program within your area to verify its specific aircraft radial. This information can then be plotted to be referenced during your potential activation and/or preplan.

     When identifying your regional flight resources, it is important to identify their specific transport capacities. These capabilities can range from single patient transport to multiple patient transport. This carrying capacity is specific to aircraft type and medical staffing. In addition to the patient transport amount, the helicopter’s weight needs to be taken into consideration. Rooftop hospital helipads are specifically weight-rated to identify the amount of weight allowed to land upon them. Your transport officer should have a list of area helipad weight ratings, in addition to area flight program helicopter weights, which should be cross-referenced prior to making a patient transport destination decision.

     While most helicopters are capable of landing in small spaces, the preferred landing zone dimension is usually 100' x 100', free and clear of all obstacles and hazards such as poles, wires, vehicles and people. While each flight program across the country has specific dimensions for landing its helicopters, the main concept here is safety. Think of it as large, free and flat-a large area, free of obstacles and a level surface.

     Before allowing field responders to work around helicopters, certain safety precautions must be considered. Basic helicopter operations and helicopter safety training must be provided to ensure all safety requirements are met and all scene personnel are properly trained to function around these vehicles. Flight programs are more than willing to provide this essential training to area first responders, if requested.

     Emergency response companies around the globe have developed an array of patient-tracking forms, checklists and computer programs that are available to assist your transport officer with patient tracking. These resources encompass generalized accountability regarding arrival locations, transporting entities and destination facilities. Regardless which method is used, a comprehensive patient-tracking system must be in place to facilitate coordinated movement and accountability.

     In addition to providing rapid transport capabilities, air medical programs can also deliver essential medical supplies directly to the scene of a mass-casualty or large-scale incident to supplement on-scene efforts during incidents that completely overwhelm local response supplies.

     Some air medical programs have established critical-incident dispatchers, who are capable of flying to the scene with the medical crew and assisting the incident commander with controlling multiple incoming aircraft. These specialized air medical dispatchers can be heavily relied upon to coordinate and control a large-scale air medical response, in addition to providing on-scene communications assistance.

     At times, severe weather prevents the use of air medical operations. In these instances, ground-based critical-care resources can often be used to facilitate patient movement. The concept takes the medical team (from the helicopter) and places them into an ambulance, creating a ground-based critical-care response asset. Considering these response assets as a mini emergency room on wheels, their capabilities are similar (if not identical) to those available on the helicopter. Remember to allow additional activation times when requesting these resources.

     The air medical industry has much to offer. By using proper preplanning measures, the resulting outcome will only enhance your response efforts.

Michael B. Judy is the mass-casualty coordinator with Flight For Life in Denver, CO, and is certified as a WMD technician with the Department of Homeland Security-National Medical Response Team (NMRT-Central).