Helicopters save lives
The Dhruv ALH, in air ambulance configuration.
The air ambulance configuration of the Dhruv ALH provides a unique CASEVAC capability from inhospitable environments. The 202 Squadron’s unit doctor, says the idea is to pick up a casualty from a forward location, stabilize him in the air and either improve or maintain his current condition till the time he reaches a high medical center.
Evacuating by air has its own, different challenges in comparison to evacuation on ground, involving flights at different speed, temperatures and pressures. There are a lot of aero-medical issues that are involved in stabilizing the casualty,” says the doctor, adding, “There are certain casualties which require a certain amount of restrictions in terms of the altitude, in terms of the rate of ascent and descent.”
The air ambulance can carry four stretchers cases and two sitting casualties, attended by a medical attendant and a dispatcher, or simply eight sitting casualties at a time. Casualties are slid in an out of the aircraft through the clamshell doors in the back with the average time being 30 seconds each.
The doctor says the most crucial thing for a patient in the air is oxygen management. “When we’re carrying him in the air he should not be deprived – he should not deteriorate – especially since he’s coming from high altitudes. So we have the Independent Patient Oxygen System, which consists of two cylinders and four masks. So one cylinder takes care of two lying patients for a minimum of two to two and a half hours – continuous hundred percent oxygen.”
The air ambulance also carries a Multi System Monitor equipment for constant monitoring the four basis important parameters of casualties, pulse, blood pressure, body temperature and ECG. “We can shift up the monitoring system from one patient to another, as and when required,” says the doctor. The system can monitor the parameters of multiple patients simultaneously. “I can monitor the blood pressure of one patient the oxygen for the other the ECG for the third – so I can monitor multiple patients at a time, depending on the requirement,” he says.
Also onboard is a defibrillator for providing an electric shock in the event of a cardiac arrest. The system analyzes the status of the heart and also indicates if the electrodes are not properly connected. “The moment it says that shock has to be given I press the red button. Otherwise it will tell me ‘Please remove the leads shock not required’,” says the specialist in aviation medicine.
Both of these devices have independent batteries which have an endurance of around two and a half hours and do not require an external power supply, catering for long distance CASEVAC, as well.
They also carry special stretchers. The ‘Scoop’ stretcher can be disassembled, placed on the sides below a casualty with spinal injury and reassembled allowing the casualty to be picked up and moved. They also have a stretcher that can allow a casualty to be winched up, but this is still at a trial stage and would come into play only when there is absolutely no place for the aircraft to land.
And of course, the aircraft carries the ‘doctor’s bag’, which includes a standby oxygen system, ventilator system, suctions apparatus and essential drugs.
“Yesterday we had a gunshot wound at a forward area. It was stabilized initially by the personnel there. We took off the aircraft in the air ambulance role, reached that place, picked up the casualty,” he says. The casualty’s blood pressure dropped and he required a large vessel repair. The air ambulance stabilized the patient and brought him to the referral hospital in Srinagar where he is now stable.
Source:
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