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PETROLEUM DIRECTORY: Aeromed’s vital air ambulance service Speed and efficiency become of paramount importance in life-threatening situations Alan Bailey Petroleum Directory contributing writer
In Alaska’s vast territory the air ambulance has become a critical component of health services — if someone falls seriously ill or suffers a major injury, air travel often provides the only means of timely access to hospital care. Anchorage-based Aeromed International has built a successful business to meet this vital air ambulance need, with critical-care air ambulance services in Alaska and between Alaska and the rest of the world.
Aeromed was formed in 1997 and is a department of the Yukon Kuskokwim Health Corp., a member of the Alaska Native Tribal Health Corp. Origins The formation of Aeromed stemmed from the need to transport patients from the Yukon Kuskokwim Delta region to hospital in Anchorage.
“What we did prior to 1997 was we used Alaska Airlines (from Bethel) for a lot of our patient transfers — we would buy three rows of seats (in a scheduled flight),” Brooks Wall, director of Aeromed, told Petroleum News.
In 1997, as a consequence of the ValueJet Crash in Florida, the FAA tightened the rules for carrying oxygen on aircraft. Consequently the Yukon Kuskokwim Health Corp. found that it could no longer transport patients on scheduled passenger flights. So, to ensure that patients could continue to fly from Bethel to Anchorage and to provide air ambulance services within the Yukon Kuskokwim Delta, the corporation decided to establish its own air ambulance service — Aeromed came into existence. Steady growth Since its creation Aeromed has expanded into a major operation handling about 550 missions per year in the Yukon Kuskokwim Delta and about 950 missions per year to and from Anchorage.
The company’s Aeromed Delta branch uses a dedicated Cessna Grand Caravan, operated by Grant Aviation, for ambulance services between Bethel and rural villages in the Yukon Kuskokwim Delta. The Grand Caravan can easily operate in and out of the small gravel airstrips in the villages.
“That’s how we usually evacuate seriously ill patients out of the villages and get them into Bethel,” Wall said.
If there’s a medical condition that the hospital in Bethel can’t handle, Aeromed’s Anchorage branch transfers the patient by jet aircraft to Anchorage or elsewhere — the Anchorage branch uses two Lear 35A jets and one Citation II jet operated by American Air Network Alaska Inc.
“We staff two of the jets 24 hours a day, seven days a week year round, with the capability of staffing the third jet when we need to,” Wall said.
As well as flying patients from Bethel, Aeromed’s Anchorage branch provides service for other tribal health regions throughout Alaska.
“There is a contract that we have with the Alaska Native Tribal Health Consortium to provide service to all the other members of the consortium,” Wall said. Specialized aircraft Aeromed has equipped all of its aircraft as fully operational air ambulances with the life-support technology that is needed for a successful patient transfer.
“What we provide is critical care — you’re talking about an intensive care unit type setting ... in the aircraft,” Wall said.
Specially trained nurses and paramedics attend to patients during flights.
“We have eight full-time flight paramedics, eight full-time flight nurses and then we have backup people ... that we keep with us,” Wall said. Backups consist of five additional nurses and four or five paramedics, he said. Rapid response With speed being so critical to saving a patient, Aeromed takes great pride in launching its missions rapidly. As an independent operator, Aeromed can muster its crews without having to pull people from other duties — that gives the company a great advantage in achieving optimum response times.
“Everybody says that they have the doors sealed in the aircraft in 45 minutes (from a call) — our door seal times are averaging ... about 38 minutes,” Wall said. “Our medical crews and flight crews are totally dedicated 24 hours a day, seven days a week ... our medical staff doesn’t work in a hospital. The pilots aren’t on call to do anything else — they’re totally dedicated to this service.”
And Aeromed isn’t tied to one particular hospital, so that the company can ferry a patient to any hospital in Alaska or in the Lower 48, Wall said. A challenging business Achieving rapid response times in the unpredictable world of medical emergencies does bring some business challenges — it’s necessary to balance the need for adequate service capacity at peak demand with the need for cost efficiency.
“In our business it’s usually either feast or famine,” Wall said. “We’ll maybe sit around for a couple of days and do absolutely nothing and then all hell will break loose,” Wall said.
The jet aircraft, for example, require enough pilots for a day-and-night shift system and to ensure that pilots are always available.
“It’s much different from a corporate type of operation where your pilots are on call and you may have (just) ... a captain and a co-pilot for a corporate jet,” Wall said. “... for these (air ambulances) you’re basically four captains and four co-pilots per aircraft.”
Ensuring payment for services when dealing rapidly with a medical emergency presents another challenge. Emergencies can’t usually wait for insurance and other payment arrangements to be completed but the company does need to be paid so that it can continue in business.
“Everything happens after the fact,” Wall said. “It’s very rare that you can get everything agreed and approved beforehand because it’s an emergency situation when people call and need help.”
The vagaries of Alaska weather add to the difficulties of operating an air ambulance service in the state. Although a medical emergency may generate pressure to conduct a flight, safety must take priority when weather conditions make access to an airport dangerous.
“We depend on our pilots to make really good decisions about whether you can or you can’t perform a mission,” Wall said. “We work very hard with them to divorce them from the medical situation ... if it’s not safe then we don’t do the patient or ourselves any good to go out and try to land somewhere.” International operations In addition to providing services within Alaska and from Anchorage to the Lower 48, Aeromed has expanded into international medevac services for a variety of customers.
“We’ve done some transports from Russia and some from Japan and Korea,” Wall said.
Wall sees opportunities to further expand these international operations, including the potential to partner with air ambulance operators in the Lower 48 — Anchorage provides an ideal location for an international medevac hub.
“If a call came in we could launch almost immediately out of Anchorage and in the meantime the (partner) company would be en-route up to Anchorage,” Wall said. “We could pick the patient up and bring them back here and ... transfer the patient (to the other carrier) right here in Alaska. It would save time for the patient and save expense.” Business expansion Wall also sees opportunities to support new industrial customers, perhaps from the Alaska oil and mining industries.
“We are interested in contracting with some of these companies ... to take care of their medical transportation,” Wall said.
Aeromed’s extensive Alaska experience, efficient services and worldwide reach can really help industrial customers, Wall thinks. But Wall’s positive outlook on Aeromed doesn’t just stem from the company’s flourishing business. He finds the air ambulance business very satisfying because it involves saving or improving people’s lives.
And perhaps this impact on people is what really matters.
Editor’s note: Alan Bailey owns Badger Productions in Anchorage, Alaska.
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