The Dutch ‘Lifeliners’
As reported by Dutch hospital trauma centres over the last few years, their four Helicopter Emergency Medical Service (HEMS) helicopters made some 9700 emergency calls annually, providing urgent assistance. Considering the continuous annual growth trend, the Service is soon expected to reach 10K emergency call milestone.
The Dutch Trauma helicopters, also known as ‘Lifeliners’ have recently renewed their contract with the operator ANWB-Medical Air Assistance (part of the Royal Dutch Touring Club) for another six years with an additional extended option. The first two H-135s have been delivered and another two are expected to join the team this year (2020). The requirement for medical support by air in The Netherlands has been growing multiple fold after the arrival of an air ambulance in 2016 and the country is now running various programmes to include drones into the service.
HEMS
ANWB-MAA operates four Lifeliner HEMS helicopters from stations in Amsterdam VU hospital (Lifeliner1), Rotterdam Airport (Lifeliner2), Volkel Air Force Base (Lifeliner3) and Groningen Airport (Lifeliner4) and has two helicopters on reserve at ANWB-MAA HQ at Lelystad Airport. The reserve helicopters are used for pilot training and when an operational helicopter has to receive periodical maintenance. As Petra van Saaze, Managing Director of ANWB-MAA explained, the company is responsible for the availability of the helicopter and its pilots for each of the four stations, throughout the year on a 24/7 bases.
The hospital trauma centres are responsible for availability of the other crew, a nurse and a trauma physician. The nurse, having received additional training to become HEMS Crew Member (HCM), assists the pilot in the cockpit during flight with navigation and safety procedures. For night time operations, the pilot and HCM are trained to use Night Vision Goggles (NVG). The physician is in the cabin and is in contact with the emergency room being informed on the urgency and prepares equipment needed. In critical situations the physician joins the car ambulance, where the medics have more space compared to the helicopter, to give additional treatment when the patient’s condition requires as much.
Ms van Saaze explained that the final choice of the HEMS helicopter was an outcome of the customer’s required tender specifications, which appeared to be fulfilled at best by the H-135.
Organisation
To ensure that the Lifeliners are in 24/7 operation mode, more than 30 pilots are with the ANWB-MAA. Being based in The Netherlands, the company complies with European Aviation Safety Agency (EASA) demands where rules for single pilot Commercial Air Transport (CAT) HEMS flights apply to the organisation. Petra van Saaze stated that the helicopter pilots also go through a special Crew Resource Management (CRM) training programme, developed for medical helicopter crews, with an annual repetition course.
Because of the composite helicopter crew, all with different backgrounds, the ANWB-MAA observes this as a very important and essential training in order to maintain a high safety level during HEMS operations and avoiding misinterpretation in communication.
The ANWB-MAA, which owns the Lifeliner helicopters, are paid for their services by the trauma centres for whom they operate. The main hospital trauma centres (Amsterdam, Rotterdam, Nijmegen and Groningen) are funded for this task by the Dutch Ministry of Health, Welfare and Sports.
Ambulance service
Next to the HEMS flights, the ANWB-MAA also operates an H-145 ambulance helicopter service for the northern Dutch Wadden islands. Without hospital presence, the Ambulance Air Team (AAT) transports non-critical patients from the islands to mainland hospitals for further medical treatment. Operating under call sign Medic01, about 700 medical support flights are flown annually.
As Martin ter Haar, Manager of the Ambulance Helicopter unit, explained, the land based location of the AAT at Royal Netherlands Air Force Base Leeuwarden, is ideal as all the islands can be reached within 15 minutes flight time from there. A second H-145 is kept on reserve to guarantee the ambulance helicopter service. The H-145 crew is trained and certified for NVG operations as their ambulance service is also on a 24/7 base.
Now with the outbreak of COVID-19 virus, the reserve ambulance H-145 is operated to fly Intensive Care (IC) patients to other hospitals and taking of IC pressure of hospitals in highly affected regions.
Story and photos by Peter ten Berg