Air ambulances Russia
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Air ambulances Russia

Air ambulances Russia

 

Stages of development of air ambulance coincide with the history of aviation in general. The advent of air "emergency" due to the First World War. Already in 30-ies of the last century in the Soviet Union paid attention to the creation and equipment of special types of aircraft, which could be used in air ambulance.

The next stage in the history of sanitary aviation falls at the time of the Second World War, and the peak of development - already in the postwar period. Then for medical purposes, helicopters began to use more and more. Unlike an airplane, an aircraft with vertical take-off and landing can be used in many hard-to-reach places; Since there is no need for a long runway, it is possible to equip heliports near hospitals. But the planes also do not leave the arena: their payload increases, the salon becomes closed. At the beginning of 1968, there were 164 hospitals in the Soviet Union, in which sanitary aviation teams were established. They were served by planes like An-2, An-28, L-410, Tu-104, and Mi-2 became the main helicopter of the country's doctors.

 

Air ambulances Russia 343

Air ambulances Russia

 

At one time the air ambulance in the Soviet Union was engaged in the Ministry of Civil Aviation, in the second half 20 century this question again transferred to the Ministry of Health. In 1994, the formation of the fleet of air ambulance took over the Ministry of Emergency Situations of the Russian Federation. Now used for medical purposes Ka-226, there are several Eurocopter EC-145, Eurocopter Bo-105, but not so much.

The main problems faced by sanitary aviation Russia Today, for the high operating costs of ships flying. There are difficulties in obtaining permission to fly (in some areas of strategic importance it is problematic), acute lack of infrastructure. Noted lack of coordination in the work of various departments, which are responsible for those or other issues related to air ambulance (No single service that would unite doctors and rescue workers), as well as red tape.

 

Air ambulances Russia

Air ambulances Russia

 

There are technical difficulties with organizing flights in the dark: for example, in Moscow and in the Moscow region at this time, ambulance helicopters do not fly. 

 

- The doctor come, I feel bad.

- I can not, my friend to come myself badly.

 

No, of course, with the doctors in Russia, everything is in order. Our doctors are very good, but there are big problems with the delivery of doctors to the sites of accidents, disasters and simply patients in need of urgent medical care.

We will not touch the ground delivering emergency teams on this subject much has been said, written and illustrated. Referring to the problem of urgent air delivery of Aesculapius to the needy. Flying doctors at specially equipped boards in our country is quite rare, if not easier: with such flights have just trouble.

Sanitary Aviation: look into the past.

- Aircraft designed to provide emergency medical care in poor transport accessibility and remoteness from large medical institutions, in search and rescue aircraft and passengers in distress, as well as for the rapid transport of sick and injured, as required by the severity of their condition.

Immediately after the end of the Civil War, have been paying great attention to the development of remote areas, due to the vastness of the territory which we have quite a lot (it is now hard to reach areas in the Russian enough) in Soviet Russia. The planes were often the first general view of art, which saw the locals.

Since the country was a priority for the development of aviation as a whole, its various components also developed: polar aviation, naval aviation, and, of course, ambulance aviation. Moreover, already in the 30s, they did not try to follow the simple path, that is, to adapt the aircraft already being produced for specific needs, but to design special ambulance aircraft. There are enough examples of this: recall at least the famous flying boats of the designer V. Shavrova. The development of the K-3 aircraft designed by A.N. Gratsiansky. He developed it with the direct participation of doctors, back in 1927. "Nurse" - as the aviators dubbed the plane, was developed by order of the Russian Society of the Red Cross and Red Crescent. The requirements for the aircraft were quite stringent: the provision of urgent medical care to the patient and his evacuation to the nearest medical centers.

With the development of the helicopter industry in our country, sanitary aviation has acquired what is called a "second wind". After all, there were aircraft that do not need specially prepared landing area. Helicopter could sit almost anywhere.

Aircraft became sealed, their load capacity is steadily increasing, which means that in the cargo can be positioned a growing number of stretchers and special equipment.

1963 year. Air ambulances was removed from the Ministry of Civil Aviation and transferred to the Ministry of Health. In many hospitals, in those years, it was established special teams of doctors for the air ambulance.

1968 year. In the USSR, there were 164 hospital, to which were attached specialized airplanes and helicopters: AN-2, 28-AN, L-410, 2-Mi, Mi-4, and later equipped Mi-8.

1992 year. Formed CAMD - central airmobile rescue squad. He submitted to the Ministry of Civil Aviation. It existed until 1994 years.

1994 year. MOE has started forming its own aircraft fleet which included sanitary and Aviation: helicopter unit TsAMO and 4 separate helicopter detachment Regional Emergency Center. There are Air Group and long time health care facilities.

Problems of air ambulance - common problems ANI

Currently, disaster medicine, airmobile brigade ambulance could use planes and helicopters AON general purpose aircraft. But as bureaucratic obstacles, interdepartmental conflicts, uncertain leadership position Rosaviation (IAC), the absence of state targeted support and common development strategy, do not allow to develop this necessary in the national economy as a civil aviation structure ANI suffers because of this and sanitary aviation.

In the current market relations in the economy as a whole, there was no place for the production of domestic light piston and turbine engine (gas turbine) engines for aircraft of small aviation. Accordingly, there is no large-scale release of light aircraft and helicopters for the national economy, including specially adapted to the needs of the air ambulance.

So there was no replacement of domestic veteran AN-2, who served as a huge amount of various activities for the national economy, including sanitary flights. Until now, no mass produced no light helicopter full national assembly. Performing all types of work, "wagon" Mi-8 (and its variants) is too heavy for many emergency situations, and most importantly, it is prohibitively expensive for many organizations flights on such a machine simply can not afford.

The lack of a domestic lightweight piston engine led to the fact that the market is filled with foreign engines, which means that there is total dependence on service and maintenance work, spare parts supply. Not to mention the fact that dealers, distributors Rotax, Subaru and other Western models, constantly jacking up prices, completely dependent on the dollar and the euro. All this led to the fact that all light helicopters and planes that are either already developed or produced in small batches, entirely focused on foreign equipment, engines and components.

All the problems of small aircraft impact and air ambulance. Not only there are no specially designed for medical purposes aerial means, but do not even have the basic technology that can be converted to modern flying points of emergency medical aid.

Of course, there are also domestic firms that develop medical aircraft, or create medical modules for re-equipping aircraft and helicopters for "flying doctors". But there are few such developments, and they are all expensive enough for a regional hospital to afford such transport.

For comparison: In the 70s of the last century, the number of aviation sorties for medical purposes was over 100 (!) Per year. Each region of the Soviet Union had its own fleet of ambulance planes and helicopters.

And as of May 2012, according to the practical conference "Air ambulance and medical evacuation - 2012", the number of air ambulance sorties was reduced to 15 a year. And it continues to decline steadily.

Order of the Health Ministry of Russia from August 15 2011 931, the number has been created working group on air ambulance in the Russian Federation. The basic expectations related to its organization, is to provide clear guidance on the structure and organization of the order of service.

Five years have passed, it seems that the created  working group It was not really working because the problems are not diminished, and even more increased.

In the west, unmanned medical aerial vehicles are already being tested. For example, the Israeli development of the UAV MedUAV and AirMule. So far, they are intended for the operational evacuation of servicemen who received moderate wounds from the battlefield. With the help of an escort, the wounded soldier is placed with the UAV medical module, in which he is connected to life support, and automatically sent to the nearest base. Variants of the development of air evacuation of the wounded on unmanned convertiplanes and quadcopters, which no longer require special take-off and landing sites, are being considered.

Is there a similar domestic developments?

Problems of development and operation of Sanitary aviation in Russia

(On materials of scientific-practical conference "Sanitary Russian aircraft and medical evacuation")

With the advantages of an air evacuation of casualties in traffic accidents or emergency situations people find it hard to argue.

1. High speed the arrival of medical professionals at the scene.

2. Fast delivery in the next few specialized hospitals to provide first aid.

3. Evacuation of victims who urgently need highly qualified specialists, after first aid.

Disadvantages of domestic air ambulance:

1. The difficulties with the organization of flights over major cities. There are a number of objects, flights are prohibited. For this reason, it is difficult to obtain permission to take off and to agree on the flight route.

There are many other such restrictions, especially in the metropolitan area and other areas of central Russia. In many cases - to organize the transportation of the patient by road faster and easier.

2. Operation and maintenance of aircraft are extremely expensive. Most public emergency services who are interested in the use of air transport - do not have the money for it. Air ambulances urgently needed in liquidation of emergencies in rural areas (for example, a major accident on the road away from the settlements, a major fire in the village, the explosion of gas cylinders, many injured in serious condition), but for this reason it will not be there in the real foreseeable future.

3. The total lack of infrastructure for the use of helicopters - no platforms for the home, refueling and maintenance of helicopters, there are no areas suitable for planting. For example, in large cities the use of helicopters is almost impossible - there is no place to sit (all advertising, trolley and other wires, standing near tall buildings - landing distance required at least 100 meters from the nearest high-rise buildings, etc...).

There are no grounds for landing helicopters in most medical facilities.

4. The difficulties of interaction between the organizations. For the foregoing reasons, the aircraft is in the MOE property, the Interior Ministry, the military, civil aviation organizations. In medical institutions of their own aircrafts there. "Sharing" of any object - is always a large bureaucratic and financial difficulties.

5. Poor organization of operational radio communications in Russia and its complete absence between emergency services of various departmental affiliations. Poor organization of operational interaction between different services.  

6. Difficulties with flight organization in bad weather and at night. There is no necessary equipment and bureaucratic problems. In Moscow and the Moscow region in the dark ambulance aircraft does not fly.

7. In Russia, there is no service with rescuers and medics. Rescuers - Ministry of Emergency Situations, doctors - the Ministry of Health, subject to different organizations. Ideally, the place of emergency they have to come together as part of a single unit. For this reason, Russia is almost not carried out rescue work using air ambulance.

These options do detachment "Centrospas", but it is one for the whole country. Currently, the regional search and rescue team EMERCOM of Russia are beginning to be supplied and operated by medical helicopter units.

Regional TCMC (Territorial Centers for Catastrophe Medicine) are the most promising organizations for the creation of a modern air rescue service on their basis, with the joint work of the TCMC staff with search and rescue units of the Ministry of Emergencies. But the development of sanitary aviation is possible only if the relevant state program is adopted at the highest level. Because of the high complexity and cost, such a program needs strict control over execution and protection from theft, corruption and misuse of funds. Unfortunately, there are practically no real prospects for development.

Conclusion

From myself I would like to add: the best world experience necessary to adopt, in spite of political differences.

For example, Israeli disaster medicine, air ambulance is fully served by military aviation. The benefits of such cooperation are quite obvious. Military pilots fly more hours, practice their quick response skills and work in any difficult conditions (weather, urban, etc.)

In other countries, similar functions are performed by private companies, which are partially funded by the state or have preferences instead working out a certain number of flying hours for the needs of the emergency centers.

In some countries, in times of natural disasters, man-made disasters, major accidents, owners of private planes and helicopters necessarily drawn to help doctors and rescuers. And for this they are subject to special mandatory training.

In Australia and Switzerland, for example, in medical aircraft concentrated profit companies financed from the federal budget.

And there is another problem - the problem of financing. Since the beginning of the 90s, the obligation to finance air ambulance has been shifted from federal to regional authorities. This means that the regions will always have more urgent matters than the development of their own aviation facilities for emergency assistance to victims.

And, as always happens in Russia, there is no one-would be responsible for the state of affairs is in the air ambulance. And what is the demand, when there is nobody to ask?

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