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I recently had the privilege of spending some time with the flight crews at the King Shaka International Airport base and used this opportunity to find out more about a "day in the life of the flight paramedic".
It is an early start – before 7am the paramedics are already at the base. The main point of concern is the weather. There have been a few days of bad weather, with almost no flying.
There are still dark clouds inland, but at least there are patches of blue sky over the sea. The pilots and the flight coordinator are checking weather reports and the consensus is that it was going to clear and that it will be a good flying day.
The flight paramedics for the day are Calvin Bridjbal and Soneel Sookoo, both experienced Advanced Life Support paramedics, with many hours of flight experience. They complete their documentation before checking the helicopter.
The pilot Kevin Donellen has already done his checks. The paramedics are responsible for checking the medical equipment on the helicopter. Kevin checks the helicopter with jet aircraft rumbling in the background. The checks are vitally important as there is no room for error. Everything needs to be in working order.
The helicopter we are using is a Eurocopter EC 130 B4 with a medical conversion, which allows a patient to lie flat on a specialised stretcher, with several other adjustments including, oxygen connections and brackets to hold other equipment.
When all the checks are done, the crews gather in the crew room. They tell me stories from their previous missions, which range from landing in confined landing zones to how they hate watching movies about aeroplane crashes.
Image: Paramedics getting ready to board the Eurocopter EC 130 B4 in the hangar at King Shaka International Airport base
The call comes
The relaxed atmosphere changes suddenly as the flight coordinator informs us that there's going to be a flight. An ICU patient needs to be transferred. The paramedics listen carefully to the flight coordinator as she informs them about the patient. The paramedics start discussing what equipment they will need while the pilot checks weather reports for the Pietermaritzburg area, where the patients is situated.
After a few minutes the authorisation for the flight is given. The paramedics go over additional information about the patient and they decide that they need additional equipment. The patient is a critically injured man, still undergoing an operation.
He was hit by a vehicle the previous night. The pilot wants to know the patient’s weight to make sure the weight limit of the helicopter is not exceeded.
Read: What to do at the scene of a car crash
The helicopter has skids and is rolled out of the hanger on a specialised set of removable wheels, which can be attached and detached from the skids.
All operations on the helicopter are safety orientated. Kevin gives us a refresher on safety precautions before we get in. The flight crew sit in the rear section of the helicopter cabin, but that doesn’t mean they can relax because the mission’s safety is everyone's responsibility and everyone has a role to play during the flight.
All items and equipment in the aircraft need to be secured as loose items can become projectiles during turbulence or a crash.
Kevin performs safety checks and makes sure that we are buckled up in our four point safety harnesses. He starts the helicopters turbine engine and the blades start turning, slowly at first but soon becoming a blur, then invisible as they turn at several thousand RPM.
We take to the air
We are ready to take off and we can hear Kevin talking to the air traffic controller over our headsets.
The Kevin confirms our call sign, helicopter make and destination with the controller before gently taking off. The aircraft feels weightless in the air on our 25 minute flight to Pietermaritzburg.
During the flight Kevin is in contact with air traffic control, which directs our height. During the fight we are all on the lookout, checking for other aircraft and large birds that circle and soar on the hot air thermals. We manage to spot a pair of microlights, a small helicopter and a large brown eagle on the flight.
Image: Our helicopter casts a tiny shadow on the ground
As we approach Pietermaritzburg air space, the Durban air control hands us over to the Pietermaritzburg air traffic controller, who directs us to fly higher to allow a jet to land.
We fly over Pietermaritzburg and circle the hospital several times on a downward spiral as we decrease height and speed. The landing zone is clear and Kevin skilfully lands on the landing zone. With the blades still turning and engine running the paramedics get out.
After the aircraft has been shut down and secured, an ambulance crew meets us and drives us to the other side of the hospital at the main block where the intensive care unit is situated.
Meeting the patient
The patient has come out of the operating theatre during our flight up and is in a critical but stable condition. The paramedics get a report about the patient from the doctors before preparing to move him. Before the patient can be transferred, all the equipment needs to be changed over to the equipment that we have brought on the helicopter. This includes the ventilator, vital sign monitors and infusion control devices.
Once all this has been changed, the patient is moved onto the stretcher to load him into the helicopter. Once the patient is secured to the stretcher and the paramedics are happy that he can be transferred, they wheel the patient to the ambulance to drive us back around to the helicopter.
The ambulance crew help the flight paramedics to load the patient into the helicopter. The stretcher the patient is lying on is secured, as well as all the equipment. The helicopter has a large oxygen cylinder but no auxiliary power to connect the infusion devices, ventilator and monitors to. These are battery powered.
We take off and circle the hospital while Kevin confirms with the air traffic controller that we have permission for our direct flight path to Inkhosi Albert Luthuli Central Hospital in Durban. The flight path is confirmed and we start flying in the direction of Durban.
Kevin’s tablet has a flight map with a white line between the hospitals. A blinking helicopter icon flashes, moving along the white line, indicating that we are on a direct flight path to the hospital.
With the patient now on board, our altitude is lower, which meant greater danger from objects like power lines, terrain and birds. Fortunately the flight is uneventful. A large bird sees us before we see it and swoops down to the left of us.
Image: Soneel Sookoo, an experienced Advanced Life Support paramedic, takes notes
Read: First aid for emergencies
Landing at Albert Luthuli Central Hospital
The landing zone at IALCH is on the roof. We land safely on the large diameter zone and are met by the receiving team of doctors. They check the condition of the patient before helping to offload him onto a stretcher.
When down in the trauma casualty, the flight paramedics formally hand the patient over to the team of doctors and help to attach to the hospital's equipment. The patient is in good hands, continuing his care at the level one trauma facility.
The patient is handed over but the mission is still not complete. The equipment is returned and secured in the helicopter.
Going back to base
Again Kevin performs his safety checks before starting the engine and confirming our flight route with air traffic control. We take off, flying over Durban to the coast, where we turn north, back to the airport.
We pass the iconic Moses Mabhida stadium, with its large towering arches. The beaches below us are packed with hundreds of people enjoying the warm afternoon summer weather, most of them oblivious to us, 800 ft above them.
The air traffic controller slots us in to land between a jet liner taking off and another landing. After a sharp banking turn into the wind, Kevin skilfully manoeuvres the helicopter sideways while hovering to land on the apron in front of the hanger.
Another successful mission is completed, helping to save the life of a man the paramedics never knew and whom they will probably never meet again. The paramedics unpack the medical equipment they need to clean and charge while the pilot waits for the fuel truck to refuel the helicopter.
It is late afternoon and this is the last mission of the day – a shift where the pilot and paramedics helped to save a life. A shift which most people don’t even know about. Just another “day in the life of a flight paramedic”.
Read more:
A day in the life of a paramedic with KZN Emergency Medical Services
A day in the life of a rural doctor in South Africa
A night on call with the Netcare 911 crew
