Air rescue capabilities in the UK

We frequently hear of reports where mountain rescue teams are assisted by air rescue services. Knowing how long we are going to be with a casualty can be vital information for the first-aider. If I know that rescue by the professionals is imminent, as a first-aider, I will be reluctant to intervene as much as I might if I knew that I was in for the long haul on a cold wet mountain.

HM Coastguard attending to a call out on Crib Goch April 2017

Background

Air rescue in the UK will be covered either by the HM Coastguard search and rescue services (SAR), or by the Helicopter Emergency Medical Services (HEMS). The SAR helicopters are typically large and come equipped with a winch which is necessary where the terrain won’t allow the helicopter to land. The winchman is a trained paramedic – so you can think of one of these SAR helicopters as being a bit like a flying ambulance that has the capability to get in to some tricky locations.

HEMS helicopters are typically smaller and won’t have the capabilities offered by a winch. If you’re on the side of a mountain, don’t expect a rescue from one of these. But HEMS helicopters generally carry Critical Care Paramedics (CCPs) and Pre Hospital Care Doctors, (but not always): pretty much as high a standard as you can have in the NHS. They are experts in pre-hospital care. CCPs can issue greater levels of anaesthesia without a doctor present. Having a doctor onboard brings greater surgical intervention to the road-side that a paramedic cannot accomplish at the moment. This is critical for such things as traumatic cardiac arrests and head injuries as examples. The idea of HEMS is to stabilise the casualty and get them to hospital ASAP.

Who can request air support?

If you can see that the location you’re in won’t be accessible to a vehicle you should always call 999 and ask for the police to coordinate the rescue.

You should explain to them that you would need a mountain rescue team, and you could advise that due to the casualty’s condition, as well as the remoteness of the location, that an air support may be needed. The final decision will not be yours however.

What happens once you request air support?

You make the request to the 999 coordinating authority (Police or Ambulance) and they process the information you give them and decide whether or not an air rescue is suitable. Your location and the severity of the casualty’s condition come into play here.

They contact the Aeronautical Rescue Coordination Centre (ARCC) to request helicopter support who then look to see which resource is the most appropriate and available. It may be that the local helicopter base is already tasked and so another aircraft is sent. Possibly (though unlikely) the nearest available aircraft is across the country, and so a flight time of around 90 minutes may need to be factored in to the overall timings.

Once a helicopter is scrambled they are expected to take off inside 15 minutes (during the day), although typically this may be faster – around 7/8 minutes.

When might we not expect an air rescue?

Helicopters are incredibly versatile and that’s why they are such a terrific resource as a means of casualty evacuation. But, they are not without their limitations.

As mentioned earlier the SAR helicopters have the ability to winch casualties out of some pretty precarious locations. Also the winching capability means that they don’t have to land and so can work in conditions of poor visibility such as at night time. That said if you’re in fog or dense cloud or triggered lightning then it may be difficult for a helicopter to get to your location.

The HEMs helicopters are funded locally in their various regions through charitable donations. Their capabilities therefore vary up and down the land accordingly and so you can’t expect these to operate in poor visibility or in locations where the helicopter can’t land. Some may have the capability to fly at night time.

As well as physical constraints, air rescue is also a finite resource. If there is another casualty whose condition is worse, then they will get the priority. Priority cases will include cardiac arrest, casualties going into hypervolaemic shock or those suffering with a stroke. Broken limbs are not always up there as a high priority.

Helicopters will be tasked to relevant jobs as appropriate. You can be lucky or unlucky in terms of what is available. A lot of HEMS units also run rapid response cars and SUVs instead of helicopters when the weather is too bad to fly or at night.