Doctors in the blue sky

When mankind was waging the first meat grinder war with might and main in 1918, people thought about how to save a wounded soldier (and even more people of higher rank / importance) in a better way, rather than rip a horse over bumps to a nearby hospital. Then they came up with the idea that you can use the fastest and most straightforward medium of movement for this – air. After all, an airplane, if equipped with the appropriate equipment, will be able to land in a field a hundred meters from the victim, and take him back at an amazing speed, and not shake anything out of him on the way. Solid profit. These ideas led to the creation of the aviation industry called “Air ambulance”

During the First World War, as we all know, aviation not only received a huge explosion in development, but also for the first time received a real application, in addition to tests and demonstration flights. Before the war, no one believed in the amazing capabilities of aircraft, but the war proved the opposite to everyone, and, what is most important for us, not only as a means of killing our own kind. In 1917, in the Sinai desert, one of the soldiers was seriously wounded – an enemy bullet pierced and completely crumbled his knee. The orderlies who caught him suggested the usual way – to take a camel and take a camel to the nearest railway, where the train would already pick him up and he would calmly reach the hospital. However, such a path would take 2.5-3 days, because it was about 120 km to go to the nearest railway. Therefore, one of the orderlies proposed a brilliant and, most importantly, innovative solution – to transport him in a bomber. The DH.9 aircraft, which was located nearby, had two seats – one for the pilot, and the second for the observer (since the aircraft also performed a reconnaissance function). And therefore there was an opportunity to place a second person there – albeit in a sitting position, but still better than on a camel. And, to everyone’s surprise, they did just that. They placed our kneeless comrade in the observer’s seat and flew to our hospital. The entire journey from the place of selection by military doctors to the hospital took about an hour and left the soldier intact, albeit not completely safe (alas, a shot in the knee deprived him of his leg; but at least it didn’t take his life) – the journey through the familiar land would take 60 times longer , with a high probability of leaving the fighter dead.

The Airco DH.9 was a bomber that could, in principle, carry both bombs and casualties, and also carry out reconnaissance.  In general - a master of all wings
The Airco DH.9 was a bomber that could, in principle, carry both bombs and casualties, and also carry out reconnaissance. In general – a master of all wings
The very description of this case.  Caution, English
The very description of this case. Caution, English

Since then, people have thought about transporting the wounded by air. This is a simple matter, and modifications to the aircraft should be made to a minimum, but the attitude of survivors to the wounded has increased significantly. Already in the 1920s, separate units appeared that were engaged in the rescue of the seriously wounded (at first they appeared with the army, simply because they already had aviation, but then they moved to civilian service), and even individual modifications of aircraft. For example, the DH.9 aircraft mentioned above was modified by the French, who installed a stretcher instead of a bomb bay and an observer position. It was already possible to transport wounded people in them without any problems. Using these aircraft, the French were able to evacuate more than seven thousand wounded from various remote places in just 10 years, and, most importantly, almost all of these people survived.

After that, ambulance aviation, on a par with all other aviation in the world, began to develop rapidly: many transport and passenger aircraft were modified into medical ones, even separate models were built, intended exclusively for transporting the wounded by air. For example, the Danish aircraft SAI KZ III, created in 1944, had in its hull not just a stretcher, but a full-fledged bed.

I agree, the conditions are not ideal - you can't look out the window, you can't talk to a beautiful nurse.  However, it is still much better than any alternatives at the time.
I agree, the conditions are not ideal – you can’t look out the window, you can’t talk to a beautiful nurse. However, it is still much better than any alternatives at the time.

A real revolution in this matter was made, oddly enough, by helicopters. It is logical, because even an airplane, with all its mobility, cannot land in the middle of the mountains or in a field 150 m long. And the helicopter, although it has a shorter range, easily bypasses these problems. They were first used back in the Korean War, where they proved to be extremely successful. And since then, they have been the main means of rescuing the wounded and sick people from the most inaccessible places on earth. As with airplanes, there are a large number of modifications to existing models, as well as a large number of helicopters, originally built to rescue people from a variety of situations. But here’s the thing … There are three times more of these helicopters than airplanes. And this is an indicator of their usefulness, versatility and relevance in the current world.

I will show you several different models so that you have something to see: W-3 of the Polish Air Force
I will show you several different models so that you have something to see: W-3 of the Polish Air Force
One of the most beautiful, in my opinion, helicopters - Eurocopter EC-145
One of the most beautiful, in my opinion, helicopters – Eurocopter EC-145
Agusta A109 K2 Swiss Rescue Service
Agusta A109 K2 Swiss Rescue Service
MD902 lands to rescue a badly injured man right in the middle of London
MD902 lands to rescue a badly injured man right in the middle of London
ArgusWestland AW139, which can accommodate up to 5 casualties
ArgusWestland AW139, which can accommodate up to 5 casualties
Bell 412 taking off after the victim, despite the non-flying conditions
Bell 412 taking off after the victim, despite the non-flying conditions

However, of course, models and history are good, but …

What is he, this lifeguard of yours in the sky, equipped with?

In general, these flying hospitals can be equipped with anything – from ordinary stretchers, as it was at the dawn of their appearance, to entire resuscitation complexes. However, for now I will walk through the bare minimum of a modern rescue helicopter / plane.

First, let’s discuss conventional flying ambulances. Let’s say a man’s leg broke during a mountain hike. Of course, the case is unpleasant, but there is no need to send a whole resuscitation emergency helicopter there – just a helicopter will be enough to transport the patient from the mountains to the hospital, and, perhaps, to fix the limb. Only the most common flying ambulance will be needed here. Such helicopters provide quite simply – n-th number of beds for victims, one or several “first aid kits” – not what you have at home or in your car, but a dropper, various painkillers and other things that may be needed on the spot even if in a non-critical case – as well as a group of two or three doctors who are equal in qualifications to emergency doctors.

Emergency aircraft, on the other hand, is a completely different story. First, they make up the majority of the fleet of all companies / rescue units in the world. Secondly, they are already much more interestingly equipped than ordinary air ambulances. They have full-fledged life support systems for victims in a complete set: here you have a defibrillator, a ventilator, and many other devices that are both expensive and very difficult to use at the same time. As you can imagine, ordinary ambulance doctors are hardly suitable here either. Doctors should not only know and be able to provide emergency assistance, but also do all this in often very uncomfortable conditions. At the same time, there are very stringent requirements for the vessel itself and its structure. It must have strong noise suppression systems, especially if it is a helicopter. Also, any rescue craft should have a fully pressurized cockpit, ideally with the ability to vary the pressure inside the cockpit. In addition, there must be enough space in the fuselage in order to be able to access all the equipment that is on board – for this, some modifications of helicopters / aircraft have an extended fuselage in comparison with their conventional models.

“Interior” of the emergency helicopter. This is not all the equipment / medicines that are present on board.
But along with this - almost everything.  Underneath you can see the bunk.
But along with this – almost everything. Underneath you can see the bunk.
This is what the inside of an ambulance plane looks like (which is not an emergency)
This is what the inside of an ambulance plane looks like (which is not an emergency)
And so - at the emergency plane.  The difference is obvious.  Please note that the bed itself has complex systems in itself - they should help damp shaking in the cabin, as well as help on bends
And like this – at the emergency plane. The difference is obvious. Please note that the bed itself has complex systems in itself – they should help damp shaking in the cabin, as well as help on bends

Pilots have their own requirements. These should be people with extensive experience in aircraft control (which is quite understandable, because such flights are often much more difficult than ordinary civil flights). Many companies even require a higher class pilot’s license than that of private / civil pilots. Also, in the event of an unforeseen incident, pilots should also know and be able to provide first aid (if you are a civilian pilot, then you should be able to do this anyway, but the requirements for pilots of other aviation environments are much lower in this regard).

The price of such pleasure

Many countries, oddly enough, do not have official government systems for emergency rescue of people with air fleets. This whole task lies in the hands of private companies. Fortunately for us and you, there are not so few such companies around the world, often 5+ per country. However, even though most of these companies are non-profit, they still cost a pretty penny to fly out. For example, in the United States in 2008, a helicopter flight from a government clinic cost $ 1500-1800. In the UK at the same time – up to 2000 pounds (from a private, but non-profit company). And with all that all, it is still not expensive, in comparison with the fact that many commercial companies at the same time demanded up to $ 15,000 per flight. So for you and me, this is far from a cheap thing. This is understandable, because, in addition to the fact that the cost of an hour of flight for such aircraft / helicopters is not a drop lower than that of conventional models, the equipment also costs quite a lot of money, and you also need to keep the fleet ready 24 hours a day. , 365 days a year. Oh, yes, you also need to fly out in bad weather, and after that the service price increases by one and a half times.

In total, we can only thank all those people who came up with this field of flights – medical aviation – and also worked / are working in it. They have saved a huge number of lives in the most inaccessible places of the globe, while showing great skill in their work.

For a snack - a picture of the takeoff of a rescue helicopter, made from sequential footage
For a snack – a picture of the takeoff of a rescue helicopter, made from sequential footage

Author: Alexey Borzenkov

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