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ATC Services & Medivac Flights?  
User currently offlineMr Spaceman From Canada, joined Mar 2001, 2787 posts, RR: 8
Posted (11 years 2 weeks 4 days 3 hours ago) and read 3938 times:

Hi guys.

Here's a question about certain Medivac Flights that I've been wondering about for years.

I learned from paramedics on medivac flights when I worked on an FBO ramp at Toronto Intl (CYYZ) back in the early 90's that a human heart has only 4 hours to stay good (I think it's increased to 5 hours these days due to better technology) from the time it's removed from the donor to when it's transplanted into the recipient patient. Only 4 to 5 hours!!! Then when you minus the travel time from the hospital to the airport & vise versa (hopefully by helicopter & not an ambulance), that increases the rush of the medivac flight even more.

My questions are .....

For example: Would ATC give a medivac flight such as a bizjet carrying a heart from Tampa to Toronto a #1 priority flight status? (for lack of a better phrase). Would ATC services give a medivac flight like this a direct route (if weather allowed it), as well as priority sequencing during it's arrival & approach including taxiing at both ends?

Could some airliners be given an altitude change or vectored off their course a bit by ATC, or when near the arrival airport find themselves in a brief holding pattern to provide a clear flight path for a very rushed medivac flight like this one?

Would the medivac flight's airspeed be handed over to the pilot's discretion?

Would ATC notify the military if a medivac needed to fly through a Military Operating Area (MOA), or would the pilots do it?

I know these questions may seem stupid because the obvious answer would be YES .... ATC services would do everything they could to help get the flight from point A to B as fast as possible, but, what I'm really hoping to learn about is some detailed info on what special procedures/rules are actually implemented by ATC during an emergency flight like this.

I'm wondering for example .... does the information block on a radar screen that follows the target of a medivac flight that's in a really hurry have any special markings or colour added to it to help remind controllers of the flight's emergency status as its handed off from controller to controller?

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Chris  Smile

"Just a minute while I re-invent myself"
10 replies: All unread, jump to last
User currently offlineATCisgreat From Germany, joined Apr 2004, 103 posts, RR: 0
Reply 1, posted (11 years 2 weeks 4 days 1 hour ago) and read 3834 times:

I can only speak for the airspace I work in but hospital or ambulance flights have priority. The least we do is pick up the phone and try to arrange the best possible direct route for them with the next sector. There is a priority of service laid down for each airspace, and with us it is:

  • flights for which the pilot declared an emergency or which are threatened by unlawful interference
  • security flights of air defense
  • flights on search and rescue mission
  • hospital or ambulance flights, these include flights carrying transplants, blood or medicaments as well as flights on their way to pick those up
  • governmental flights

If necessary, we talk to the military units involved to ask for permissions to fly anywhere more direct than usual. We in upper area control don't vector other planes around to create "free way" for the ambulance/hospital flight, nor do we climb or descend traffic specially. Once en-route they are treated as any other flight. What is an issue is that depending on what the flight is carrying, it might alter its descent profile, i.e. more shallow. I have no idea how the colleagues in approach handle it, whether they let other aircraft fly an extra pattern or so.

I hope this explains it a bit, although I cannot speak for Canadian airspace of course!

All the best

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User currently offlineTwinCommander From United States of America, joined Apr 2005, 195 posts, RR: 1
Reply 2, posted (11 years 2 weeks 3 days 23 hours ago) and read 3762 times:

With Lifeflight Network, they use the appropriate call signs I.E. Lifegaurd 290 papa fox or Lifeflight 1.

During one runway operations, the fixed wings get to use the runway ASAP, and the rotor gets immediate departure clearance. Depending on traffic, the fixed wings may even get to "play through". Its all matters as to what's going on during the time of activation.

Most of the destinations we fly to are filed direct GPS. Makes for quick turn around times at the patients pick up point.

User currently offlineN766UA From United States of America, joined Jul 1999, 8723 posts, RR: 23
Reply 3, posted (11 years 2 weeks 3 days 22 hours ago) and read 3706 times:

ATC does give priority to aircraft transporting people and/or organs needing medical attention. They tag on "Lifeguard" to the callsign so everyone knows. TWA 800 was a lifeguard flight, I believe carrying corneas in the cockpit.

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User currently offlinePilotpip From United States of America, joined Sep 2003, 3173 posts, RR: 9
Reply 4, posted (11 years 2 weeks 3 days 19 hours ago) and read 3661 times:

Yes, the only thing that gets priority over an air ambulance service is an emergency. They are pretty high up on the chain. One thing to point out though, a heart wouldn't go from Tampa to Toronto because of the mentioned time constaints. I get a number of organ flights at STL and a STL to TOL is stretching it for a heart.

User currently offlineMr Spaceman From Canada, joined Mar 2001, 2787 posts, RR: 8
Reply 5, posted (11 years 2 weeks 3 days 19 hours ago) and read 3657 times:

Hi guys.

Thank You, for your replies. I appreciate it.

OK, so ambulance flights do have priority over other normal flights in Germany & the USA (as I would expect), thus I'm sure the Canadian ATC system where I live uses similar rules when controlling an ambulance flight.

>> ATCisgreat, Thanks for explaining that ATC does indeed try to arrange the best possible direct route for an ambulance flight from sector to sector and that you guys will also ask the military for permission - if needed - to allow an ambulance flight to fly anywhere more direct than usual. I understand that once the flight is en-route they are treated as any other flight, as ATC won't create a "free way" for the flight.

Also, Thanks for explaining the 5 levels of the "Priority of Service" for each airspace. That's interesting to know about.

>> TwinCommander, Thanks for explaining that when activated, Lifeflight Network's helicopters get immediate departure clearances, and their fixed wing aircraft will get the active ASAP or maybe even get to "play through".

>> N766UA, Thanks for your info about ATC giving priority to aircraft with a medical situation onboard, and that the word "Lifeguard" is tagged onto their callsign to let everyone know. Eight years ago, I flew on an American Eagle Saab 340 from Tampa to Miami and there was a stack of 8 white coolers with eyes/corneas inside them straped into the last seat across from me. That was cool to know.

The pilots of all the ambulance aircraft (both fixed & rotary wing) that I hear talking to Toronto ATC say the word "Medivac" after their callsign.

Well guys, I'm sure that when a midnight man/ramper calls a standby flight crew at 03:00 hrs (like I used to always do) to let them know they have a Medivac Flight to retrieve an organ, and their Learjet is ready to be fueled, they really appreciate all the help they can get from ATC.

Chris  Smile

"Just a minute while I re-invent myself"
User currently offlineMr Spaceman From Canada, joined Mar 2001, 2787 posts, RR: 8
Reply 6, posted (11 years 2 weeks 3 days 19 hours ago) and read 3653 times:

Hello Pilotpip.

Quoting Pilotpip (Reply 4):
a heart wouldn't go from Tampa to Toronto because of the mentioned time constaints.

I understand what you mean. I was just using Florida as an example because of the 2+ hours of flight time it would take to fly a heart to Toronto in a bizjet, thus the very tight window of time.

I remember having a cooler with lungs in it sitting on my desk at my FBO for about an hour on many occasions before leaving on a bizjet or in an ambulance because the time frame for lungs was 11 hours back then .... if I remember correctly. Although when it came to a heart, I would always see the medical team running by me in a blur with the small cooler as they switched from a jet to a chopper or vise versa. Those were always powerful moments to witness, and I was always proud to be a little part of it. Especially when I was the only ramper on duty after midnight!

Chris  Smile

"Just a minute while I re-invent myself"
User currently offlineTwinCommander From United States of America, joined Apr 2005, 195 posts, RR: 1
Reply 7, posted (11 years 2 weeks 3 days ago) and read 3580 times:

Last week our Lear was called to take a heart from BFI to BIL. At 3pm we were activated, and by 4pm the Lear was up in BFI. At 11pm, they were back at HIO. No word on how the patient did, but it was weird seeing a lifeguard designation next to that Lear on the tracker.

User currently offlinePilotpip From United States of America, joined Sep 2003, 3173 posts, RR: 9
Reply 8, posted (11 years 2 weeks 2 days 19 hours ago) and read 3547 times:

It's a gratefying moment until you have somebody die on your ramp like I did last summer. The guy was being transported cross country to his home after having a massive heart attack. They stopped here to fuel up and continue, when they got up to about 6000 feet he destabilized. The plane turned back and the CFR crews and an ambulance were waiting but he didn't make it. Between that and a guy who stopped breathing while I was fueling two years ago I really don't like dealing with air ambulances any more. I do agree with you about organ flights though. While it's sad to know that somebody has died, their gifts may save 5 lives.

What's really fun is getting a 300lb plus man out of the door of a Lear while on a stretcher when it's raining. I've had to help with that a couple times too.

User currently offlineTwinCommander From United States of America, joined Apr 2005, 195 posts, RR: 1
Reply 9, posted (11 years 2 weeks 2 days 17 hours ago) and read 3535 times:

While I haven't had a patient die yet while IM working with the plane, I do get to help carry pretty banged up people. The worst are the panda flights with the pre-mature babies and sick infants.

What's sad is that half of the kids that get sick could have been prevented, according to the flight nurses with the panda teams.

User currently offlineMr Spaceman From Canada, joined Mar 2001, 2787 posts, RR: 8
Reply 10, posted (11 years 2 weeks 2 days 4 hours ago) and read 3511 times:

Hi guys.

Well, I believe we're all on the same mental wave-length regarding the emotions you can experience when involved with a medivac flight on your ramp.

Organ retrieval & exchange flights did give me mixed emotions because I new someone had died which is sad (never knew how or why though), but the nice feelings were that someone was about to receive a gift of life & hope.

I've helped carry dozens & dozens of incubators from aircraft to ambulances. It's a pretty strange sight to see a pre-mature new born's legs under a layer of bubble wrap that are as thick as your index finger! I always wondered if they survived.

I never had a death occur on the ramp either (Thank God!), My crew and I did carry a few coffins out of Learjets though, with family members watching. I would bend company rules under those circumstances and allow family members to be on the ramp or in a hangar while their loved one was being transferred from a jet to a hurst.

Regarding injured patients, the hardest/trickiest one for me to help carry out of a bizjet was a really big guy who was in a lot of pain and could feel every inch his stretcher needed to be tilted sideways to get him out of the jet. He was para-sailing in Florida and the rope snapped! Unfortunately that occurred while close to the beach, and the wind blew him into the side of a hotel at the fifth floor level. He was a real visible mess.

The sadest medivac experience for me happened on a beautiful Saturday afternoon in 1990. My partner & I carried a young 21 year old guy on a stretcher out of a dedicated Learjet while a nurse had to breath for him with one of those respirator bottles you squeeze .... until he was hooked up to the respirator machine in the ambulance (there was a respirator in the jet too). He was on his honeymoon in the Dominican Republic having a great time I'm sure ..... until he dove into the hotel swimming pool and broke his neck! He was paralyzed from the neck down and could only communicate by blinking his eyes. His head was in a metal halo. Now that was tough to handle. He was only 3 years younger than me .... which really made his situation sink in. Very sad!

I think it's great that ATC controllers will help out medivac flight crews as much as possible. I'm glad they don't have to experience what the pilots, line crew, and medical teams experience though.

Chris  Smile

"Just a minute while I re-invent myself"
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