Frequently Asked Questions: Forest Service Emergency Medical Short-Haul
What are Forest Service Emergency Medical Short-haul helicopters? They are first and foremost firefighting resources to be used in support of fire suppression. They are exclusive use aircraft that are helitack configured and perform all the functions other Type 3 helicopters provide. In addition, they are trained and equipped to assist in emergency medical response when one of our employees, cooperators or contractorsbecomes critically injured or ill. Short-haul is considered a last resort option when other means of medical support andtransportation are unavailable or cannot respond in a timely manner to extract a critically injured or ill employee.
What is “Short-haul”? Short-haul is a method of inserting or extracting personnel from a location, using a helicopter. It is used where other methods of insertion or extraction are not feasible or not available, such as in heavily timbered areas, steep slopes or roadless terrain where landing an aircraft is not possible. Personnel who are being inserted or extracted are attached to the helicopter by a rope, the length of which can vary but is typically greater than 150’.
What is “Emergency Medical Short-haul”? The purpose of Emergency Medical Short-haul is to facilitate rapid and effective access to medical care in the field for critically injured or ill employees, as well as extraction of patients for transport to definitive medical care.
What are the risks involved with Emergency Medical Short-Haul? There is risk associated with every aviation mission and Short-haul is no exception. For personnel being carried on the end of the line outside of the helicopter the consequences of a mechanical failure could be fatal. Helicopters have survivability built into the structure of the airframe for the aircrew;there is no similar protection for the employee or patient on the end of the line. Risk assessments are designed to evaluate if the risk to emergency responders is justified by the need of the patient. Short-haul missions are intended to be short duration flights for the purpose of getting a patient to better medical care.
Is Short-haul the same as Hoist? No. Helicopters with hoist capability can raise and lower personnel and equipment at the end of a cable while hovering, using an onboard hoist system. This allows for the employee and patient to be brought into the cabin of the helicopter during transport, lessening exposure to both. The rope used in a Short-haul mission is an approved fixed length linethat cannot be raised or lowered.
How is an Emergency Medical Short-haul mission performed? After a thorough recon is accomplished an Operational Risk Assessment is completed. If risk mitigations cannot be established, the mission is not performed. If risk mitigations can be established, at a minimum an Emergency Medical Technician (EMT) is inserted into the incident site and the patient is packaged for transport. The patient and the EMT are lifted from the site together. They are then transported an appropriate distance to a location where other medical transport (air ambulance or ground based ambulance) and higher-level medical care can intercept the patient and move them to definitive medical care for treatment.
What is the Forest Service’s history conducting Short-haul missions? The Forest Service has conducted numerous Short-haul missions associated with Law Enforcement and Investigations activities in the Pacific Southwest Region for a number of years. 2015 is the first year that the Forest Service is prepared to conduct Emergency Medical Short-haul missions.
Do other agencies perform Short-haul? Yes. A wide variety of agencies perform Short-haul missions in a variety of operational contexts. In terms of federal natural resource management agencies, the National Park Service (NPS) has conducted a Short-haul program for several decades. NPS performs Short-haul missions for the purposes of search and rescue, providing medical aid, and law enforcement. Many state and local government agencies also perform Short-haul missions for a variety of public safety and law enforcement functions.
Does the Forest Service use the Short-haul capabilities of other agencies? Yes. Traditionally the Forest Service has used cooperating agencies’ Short-haul capabilities in the same way that it makes use of other cooperator capabilities. For example, seriously injured firefighters have been extracted from Forest Service fires using the Short-haul capabilities of other agencies such as the National Park Service.
Is the Forest Service developing an Emergency Medical Short-haul capability to replace air ambulances or cooperating agency capabilities such as the National Guard? No. It has long been recognized that cooperating agency resources are not always available or cannot always respond in a timely manner to a Forest Service medical emergency in a remote location. Development of a Forest Service Emergency Medical Short-haul capability will supplement existing extraction capabilities, not replace them; when used, the goal will always be to transfer patient care to Advanced Life Support (ALS) capable resources such as ambulances or Life Flight as soon as possible.
What level of Emergency Medical Services (EMS) will a Forest Service Short-haul helicopter be equipped to provide? Forest Service Short-haul crews will carry Emergency Medical Technicians, or EMTs. These personnel will be trained and equipped to provide Basic Life Support-level EMS, with the primary goal of patient stabilization and transport. Forest Service Short-haul helicopters will not be equipped to provide Advanced Life Support (ALS); the goal of the Forest Service Emergency Medical Short-haul mission is to facilitate the delivery of a patient to ALS as rapidly as possible.
Should the availability of an Emergency Medical Short-haul helicopter justify the acceptance of a higher level of risk in an operation? No. An Emergency Medical Short-haul helicopter is not risk mitigation; it is a means for extracting a patient who has already become critically injured or ill. Hazards should be identified and risks assessed for all operations, prior to engagement. Accepting more risk because a Short-haul helicopter is available is akin to accepting more risk because you’re carrying a fire shelter. As with all aviation operations, there is no guarantee that a Short-haul mission will go as planned. There are times when an Emergency Medical Short-haul helicopter cannot respond due to reduced visibility caused by smoke, weather or darkness, or due to mechanical issues. This resource should not be considered a “safety blanket” that enables more risk to be accepted. Short-haul missions themselves involve some level of risk to aviators; risk should not be transferred from ground operations to aviation operations.
Under what circumstances would Forest Service Emergency Medical Short-haul be used? When the following circumstances are all present:
- When an EMT or highest qualified medical provider on scene assessesan injury or illness to be serious enough (e.g., life threatening)to warrant prompt evacuation, and
- When a conventional ground rescue operation would expose rescue personnel and/or patient to an unacceptable level of risk, and
- When no other viable means of getting thecritically injured or ill patient to medical treatment in a timely manner exists(including air ambulance, National Guard Hoist, ground transport, etc.).
Will the Forest Service perform Emergency Medical Short-haul for members of the public? The primary purpose of emergency medical short-haul capability is to provide life-saving transportation to definitive medical care for employees, cooperators and contractors performing agency work. Participating in emergency medical short haul for a member of the public would be rare and should only be considered when aformal request has been made from the local agency with jurisdictional responsibility for search and rescue. Transporting injured members of the public is a local responsibility of county sheriffs, local search and rescue organizations, etc. Risk assessments and other protocols used for dealing with all such cooperator requests must be followed.