South Care

“The ACT and South-East NSW Aero- Medical Service determined that they wanted a pretty well high end ‘set and forget’ aeromedical helicopter service provision.

CHC fitted that with their worldwide helicopter knowledge and safety management systems, operations management structures and international standards accreditation,” Thomas said of the partnership.

“So from a government perspective, international standards accreditation meant that they [CHC] were providing instant, easy safety management of aviation into the operation…We offer a high degree of safety, a high degree of serviceability and we’ve got a good pool of aircraft spares for backup. We’ve also got a good pool of pilots, aircrewmen and engineering support. ” Funded by the NSW and ACT governments under a 90/10 split, the service is also supported by the Snowy Hydro SouthCare Helicopter Fund, which raises money through commercial sponsors and community donations. “It’s difficult describing to people the fact that it’s not totally government funded,” said Thomas.

“People are generally happy to give to Snowy Hydro SouthCare because they’re aware that they could need the service anytime themselves. They’re generally very proactive at giving, and sometimes the smallest communities are the best givers, the smaller rural communities. ” Snowy Hydro SouthCare often finds itself operating to those smaller rural communities to provide vital aeromedical support to those otherwise isolated from access to suitable medical facilities.

“It’s about 70 per cent secondary interhospital transfer,” Thomas said of South- Care’s missions. “But to put that into perspective, if you require hospital transport from one hospital to another, it means that you need a greater level of care, it’s quite a critical transfer that you’ve been involved in. So even though they [hospital transfers] appear to be maybe not so important, if you’re being transferred from one hospital to the next in a helicopter, it’s an important transfer. ” Tasking Snowy Hydro SouthCare for hospital transfers also means a local community’s ambulance is not unavailable for emergency response for extended periods.

“That way, they’ve got a medical response [capability]…and we’re not draining their resource. So we’re a supportive resource as well as an immediate emergency response resource. ” The balance of Snowy Hydro SouthCare’s missions are “what we would call primary responses, where we respond to a roadside accident, to a farm accident, to a bushwalking accident or a missing bushwalker or for beacon searches,” Thomas said.

Of a typical four member SouthCare crew, CHC provides the aircraft captain (pilot) and aircrewman (winch operator), while the ACT Ambulance Service provides an intensive care paramedic (ICP), and the CRSS the doctor. The ICP is dual qualified as a flight paramedic and down-the-wire crewman able to perform both sea and land rescues. Snowy Hydro SouthCare’s CRSS doctor is also qualified for down-the-wire land operations and stretcher rescues.

“We are the sole resident service of the ACT, but a high percentage of our work happens in New South Wales,” Thomas said, with SouthCare’s area of operations extending from the Snowy Mountains to the NSW south coast, and the regional NSW centres of Wagga Wagga and Albury.

Primary response missions are coordinated by the Ambulance Service of NSW’s Rapid Launch Trauma Coordinator (RLTC) within the Medical Retrieval Unit (MRU) in Sydney. The RLTC prioritises high category medical emergencies requiring possible aeromedical support, and will task the appropriate helicopter rescue service, such as South- Care, to respond.

“They have a rapid launch desk system where they monitor radio communications all around this region, and they determine if a job has high priority and if it might need a helicopter. They will respond us even maybe without getting a triple zero call so we have an aircraft underway quickly,” Thomas explained.

Meanwhile, for inter-hospital transfers, consultation between Canberra Hospital and regional hospitals is important in determining whether Snowy Hydro South- Care gets tasked. “All the outlying regional hospitals rely on Snowy Hydro SouthCare’s consultant doctor to determine whether our vehicle is the right vehicle for them,” Thomas detailed.

“There’s a category one to four system where they’ll determine if a patient is critical and needs to be moved to the Canberra Hospital or to Sydney.

“The MRU in Sydney has its own consultant doctor for best use of the aviation assets, and we’ve got a consultant here [in Canberra] who’s assisting in the process, understanding the limitations of some of the regional hospitals because we work with them closely, so we know when they do and don’t need assistance. ” Ready to answer that call for assistance is Snowy Hydro SouthCare’s Bell 412.

Equipped with long range fuel tanks, Nitesun searchlight, a forward looking infrared sensor (FLIR) with camera, and Goodrich rescue hoist capable of carrying approximately 272kg, there’s no doubt CHC’s 412 is a capable rescue machine, suited to the ACT and southern NSW’s often harsh winter conditions.

Having flown with Snowy Hydro SouthCare for over nine years, Thomas, a 15 year CHC veteran, highlights the importance of having local knowledge of the region’s unique weather conditions in being able to maintain safe flight during EMS and SAR operations.

“The aircraft captains inside CHC are well aware of the dangers of the weather in this local region. . . All pilots are educated in local geographical and meteorological conditions, but it typically takes a couple of years of aviating around the Canberra region for pilots to experience all the weather conditions,” Thomas said.

“The Bell 412 is not allowed to fly in known icing conditions…So at the beginning of each day and at the beginning of any mission, we determine whether we can aviate safely in the present weather, and typically this time of year [winter] the weather’s more dangerous,” he cautioned.

A key example of that challenging weather can be seen when Snowy Hydro SouthCare undertakes a snow or mountain rescue, requiring the aircrew to pay particular attention to variables such as wind, turbulence and altitude, and if harsh terrain below requires the use of the rescue winch.

“A snow or mountain rescue often takes more planning than a ‘simple’ roadside vehicle crash. The mountains have their own brand of weather. . . So the aircraft performance is something that needs to be determined before we leave here, and we often plan that at the beginning of the day,” noted Thomas.

“If we’re responding to a mountain rescue, there may be enough time if the patient is not critical to reconfigure the aircraft to take fuel and other equipment out to enhance performance and safety. But there may also be times where we need to add safety equipment, survival equipment for ourselves. It may be that there could be some delay because there’s difficult weather passing through the mountains, and that we need to wait. We may arrive on scene and have to. . . incrementally approach the rescue in stages, due to the impact of surrounding weather factors. ” While the preference is to use the 412’s hoist as a “last resort”, Thomas notes that there are times when the situation calls for such a rescue to be performed. For a winch operation, the pilot will bring the 412 into a hover about 20m off the ground for reference, before the winch is deployed.

“We prefer not to winch but that’s not to say we avoid it. We consider the best outcome for the patient. And it’s continually evaluating risk to be as low as reasonably practical, and the risk is not only for the aircraft and its occupants, but it’s for the person who we’re saving or we’re rescuing. ” In such scenarios, Thomas stresses that crew safety is of paramount importance for the aircraft captain, who attempts to mitigate the associated risk factors by adhering to the ALARP (As Low As Reasonably Practical) principle.

“Often, whilst we don’t…let patient safety condition blur our vision, we determine that we either can or can’t aviate safely in the limitations of the aircraft and the crew.

And our operations manual supports our decision making and provides us with black and white rules based on [CHC’s] historical knowledge of operating helicopters all around the world,” Thomas said.

Categorising Snowy Hydro SouthCare as an “essential emergency medical service in the community”, Thomas also hinted there could be a possible fleet modernisation and expansion review in the near future, with the regional helicopter ambulance contract up for renewal in 2012.

“The 412 has performed solidly during its history, it’s a very safe aircraft. However, we’ve [CHC] identified that the Ambulance Service New South Wales have moved to more modern aircraft, and we’re expecting that in the future CHC will look to its fleet as well,” said Thomas, suggesting a move towards the AgustaWestland AW139 as one possibility.

In the meantime, Thomas is confident that CHC will continue to play an important role in supporting Snowy Hydro SouthCare’s future operations.

“We aviate within the abilities of this aircraft [412], and that is one thing that you could identify about CHC pilots, or CHC crews, is we’ll only aviate inside the boundaries of our strict safety regimes and the abilities of the machine. You can extend your mission focus with better performance, but we aviate safely with the tools that we have for today. ”