Air Rescue Capabilities in the UK

We frequently hear of reports where mountain rescue teams are assisted by air rescue services. Knowing how long we are going to be with a casualty can be vital information for the first-aider. If I know that rescue by the professionals is imminent, as a first-aider, I will be reluctant to intervene as much as I might if I knew that I was in for the long haul on a cold wet mountain.
Image of an air rescue helicopter deployed in Snowdonia
HM Coastguard attending to a call out on Crib Goch April 2017

Air rescue in the UK will be covered either by the HM Coastguard search and rescue services (SAR), or by the Helicopter Emergency Medical Services (HEMS). The SAR helicopters are typically large and come equipped with a winch which is necessary where the terrain won’t allow the helicopter to land. The winchman is a trained paramedic – so you can think of one of these SAR helicopters as being a bit like a flying ambulance that has the capability to get in to some tricky locations.

HEMS helicopters are typically smaller and won’t have the capabilities offered by a winch. If you’re on the side of a mountain, don’t expect a rescue from one of these. But HEMS helicopters generally carry Critical Care Paramedics (CCPs) and Pre Hospital Care Doctors, (but not always): pretty much as high a standard as you can have in the NHS. They are experts in pre-hospital care. CCPs can issue greater levels of anaesthesia without a doctor present. Having a doctor onboard brings greater surgical intervention to the road-side that a paramedic cannot accomplish at the moment. This is critical for such things as traumatic cardiac arrests and head injuries as examples. The idea of HEMS is to stabilise the casualty and get them to hospital ASAP.

Who can request air support?

If you can see that the location you’re in won’t be accessible to a vehicle you should always call 999 and ask for the police to coordinate the rescue.

You should explain to them that you would need a mountain rescue team, and you could advise that due to the casualty’s condition, as well as the remoteness of the location, that an air support may be needed. The final decision will not be yours however.

What happens once you request air support?

You make the request to the 999 coordinating authority (Police or Ambulance) and they process the information you give them and decide whether or not an air rescue is suitable. Your location and the severity of the casualty’s condition come into play here.

They contact the Aeronautical Rescue Coordination Centre (ARCC) to request helicopter support who then look to see which resource is the most appropriate and available. It may be that the local helicopter base is already tasked and so another aircraft is sent. Possibly (though unlikely) the nearest available aircraft is across the country, and so a flight time of around 90 minutes may need to be factored in to the overall timings.

Once a helicopter is scrambled they are expected to take off inside 15 minutes (during the day), although typically this may be faster – around 7/8 minutes.

When might we not expect an air rescue?

Helicopters are incredibly versatile and that’s why they are such a terrific resource as a means of casualty evacuation. But, they are not without their limitations.

As mentioned earlier the SAR helicopters have the ability to winch casualties out of some pretty precarious locations. Also the winching capability means that they don’t have to land and so can work in conditions of poor visibility such as at night time. That said if you’re in fog or dense cloud or triggered lightning then it may be difficult for a helicopter to get to your location.

The HEMs helicopters are funded locally in their various regions through charitable donations. Their capabilities therefore vary up and down the land accordingly and so you can’t expect these to operate in poor visibility or in locations where the helicopter can’t land. Some may have the capability to fly at night time.

As well as physical constraints, air rescue is also a finite resource. If there is another casualty whose condition is worse, then they will get the priority. Priority cases will include cardiac arrest, casualties going into hypervolaemic shock or those suffering with a stroke. Broken limbs are not always up there as a high priority.

Helicopters will be tasked to relevant jobs as appropriate. You can be lucky or unlucky in terms of what is available. A lot of HEMS units also run rapid response cars and SUVs instead of helicopters when the weather is too bad to fly or at night.

If a first-aider thinks an air rescue is required, is there any key information that they need to pass on that would assist with this request

When calling for help in a wilderness location and away from roads an accurate map reference is crucial. The free app, OS Locate, gives you a pretty accurate fix and usually within seconds. It also works when there is little or no phone signal. The app then allows you to share your location via text message, which if your phone is registered to 999, you can do when you next have some signal to work with.

Note: the grid reference is important and some ambulance control staff may be reluctant to take it. If it’s all you have, it’ll be all you can give though. And remember to include the two letter map code as well!

Don’t risk lives or waste valuable time if there are obstructions nearby that may make an air rescue unsafe or untenable. For example, you must make mention of masts, towers or electricity pylons that are in the area. These can be lethal for a helicopter.

What can people on the ground do to make air rescue safer? 

Stay calm and allow the helicopter access. Stay focused on the casualty and keep others away from the helicopter if possible. Helicopters won’t want to land if there are loads of people milling about so try and keep the area clear of any bystanders. In addition, try to secure all loose kit as the down-draft from a helicopter can be pretty powerful: a blizzard blanket through the rotor blades could be catastrophic. Remove hats and sit on top of any bags for they too can easily be blown off. Stash away your group shelter too if you have one out. At night time be aware the pilot will be using night-vision goggles, so be careful not to direct your torch beam at the helicopter. Don’t approach a helicopter while the rotors are turning. Above all, always follow the direction of the helicopter crew.

Texting 999

If you’re reading this now, then do these two steps now (literally could be a life-saver)

i. Download the OS Locate app to your phone. This app will quickly give you your grid reference even without any signal.

ii. Register your mobile phone with the emergency services before an emergency happens. (Important: You will need to register again if you change your mobile phone number).

If an emergency happens you should only use SMS text message to contact the emergency services if you have no other option.  This is because it will take longer than other methods such as calling 999. (You must register with the service beforehand).

Create an SMS message containing the details below:

Which service do you require?Need Ambulance, Coastguard, Fire Rescue, or Mountain Rescue/Police
What?Briefly, what is the problem?
Where?Exactly where is it?
Give the name of road and town / six figure grid reference
Plus more information like: house number; or nearby landmarks or main roads

Do not assume that your message has been received until you get a message back from the emergency service, an SMS ‘Delivery Report’ does not mean your message has been received.

It can take around 2 minutes for you to get a reply to your emergency message. If you have not received a reply within 3 minutes then send another message straight away.

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Will Legon (of works professionally in the outdoors leading groups walking and instructing single pitch rock climbing. Since 2009 Will has been delivering first aid training specialising in outdoor first aid courses. He is an ITC (Immediate Temporary Care) trainer, offering a range of courses accredited by Ofqual and the SQA. In a former life, Will was a maths teacher and an infantry officer in the Territorial Army.

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