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Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 265-266

Helicopter emergency medical services in India: An augean task at hand

Emergency Unit, Department of Emergency Medicine, Pacific International Hospital, Port Moresby, Papua New Guinea

Date of Submission19-Feb-2020
Date of Decision13-Mar-2020
Date of Acceptance29-Mar-2020
Date of Web Publication10-Jul-2020

Correspondence Address:
Dr. Gautam Didla
Emergency Unit, Department of Emergency Medicine, Pacific International Hospital, Port Moresby
Papua New Guinea
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_17_20

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How to cite this article:
Didla G. Helicopter emergency medical services in India: An augean task at hand. Curr Med Issues 2020;18:265-6

How to cite this URL:
Didla G. Helicopter emergency medical services in India: An augean task at hand. Curr Med Issues [serial online] 2020 [cited 2021 Sep 16];18:265-6. Available from: https://www.cmijournal.org/text.asp?2020/18/3/265/289408

Dear Editor,

The first aeromedical evacuation services date back to the turbulent times of theFirst World War in Serbia in 1916. More than a century later, the convenience and versatility of air transport have been extended beyond the needs of medical evacuation at the battlefield to airlifting people in emergency medical needs from unreachable terrains.[1] An aeromedical evacuation was performed in Israel in 2005 during a train collision which injured 289 passengers.[2] In spite of the advances made by most developed countries in Helicopter Emergency Medical Services (HEMS), it is unfortunate that the scene in India and other developing countries appears to be in sputters and largely in the quiescent stage.

India, with the Himalayas sprawling from the snow-covered northwest, to the rugged terrain of the foothills along the Northeast, with flash floods ravaging vastly unique geographical spaces such as Uttarakhand and Kerala and a large northwestern region under constant threat from tectonic movements, presents both a challenge and an opportunity at the same time. The rapid urbanization of our cities, with the ever-increasing traffic densities, prolonging the site-to-hospital and hospital-to-hospital time also calls for a revamp of our air medical transport services. However, a clear line of distinction has to be drawn between HEMS and the evacuation services provided by our armed forces during times of calamities and natural disasters.[3]

Despite HEMS accounting for the major share of the market for helicopters across the world, the bleak scene in India can be attributed to a spectrum of obstacles, ranging from the tight government grip on low-altitude airspaces to the lack of helicopters armed with personnel and equipment for the resuscitation and stabilization of patients on the ground or in the helicopter. The last month of 2016 saw a private startup from South India initiating HEMS services with a fleet of three helicopters. However, the fortunes have dwindled since then, with the choppers being used for purposes outside the intent for which they were designed for. The company ended its foray in 2019 after receiving neither incentives nor airspace for their services, in spite of not having to endure competition in the field.

My experience in HEMS comes from working in Papua New Guinea (PNG), which is an independent island nation in the Oceania, with a population only as large as Bengaluru, but has an aeromedical evacuation system owned and operated nationally as well as by commercial airlines. Operations involving airlifting patients from remote locations to centers within PNG are usually carried out with helicopters while the patients who need care outside PNG are often airlifted with commercial airlines to Australian cities such as Cairns and Brisbane. The aircrafts are equipped with qualified specialist aviation physicians, nurses, and paramedics who provide their service 24 h a day, 7 days a week. The model has been functioning quite efficiently for at least a decade and a half with a lot of success.

With opportunities galore, India needs investment by the private sector, ably supported by the government through incentives and relaxation of civil aviation norms and airspaces, with training for physicians and paramedics equipped to operate and oversee the services aboard the HEMS. Operational regulations need to be formulated and safety needs to be ensured. This is important when we forage into the untapped potential of providing prompt emergency services to hinterlands otherwise unapproachable by road ambulance services, on the expressways threading the Golden Quadrilateral and even on our territorial waters, should an urgent medical need arise. This could be a timely move, but a grueling and rutted ride till fruition.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Teichman PG, Donchin Y, Kot RJ. International aeromedical evacuation. N Engl J Med 2007;356:262-70.  Back to cited text no. 1
Johnson MS. Editorial comments: Role of air-medical evacuation in mass-casualty incidents-A train collision experience. Prehosp Disaster Med 2009;24:277-8.  Back to cited text no. 2
Ranjan CK, Renjhen P. Casualty air evacuation: Sine quo non of combat casualty. Med J Armed Forces India 2017;73:394-9.  Back to cited text no. 3


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