Medical Transport Helicopters

Medical Transport

Conversion and Maintenance issues for these special mission aircraft

By Joe Escobar

February 2001

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In the hustle and bustle world we live in, many people are getting tired of the congested living accommodations and dense populations found in cities. Some of them are choosing to move to more rural areas of the country. As the population moves more towards this country living, the distance from major medical facilities increases. In many cases, hospitals have not kept up with the rapid population migration. Because of this, the need for medical helicopter transportation has seen a significant rise.
Only a few decades ago, medical transport helicopters were a rarity. Some considered them a luxury – available only to the wealthy. Now they are a way of life. These specially converted aircraft now service almost every major city.
Now that the need for medivac services has increased, the issue of converting a standard helicopter to a medical transport is one that many companies face. Some of them are choosing to do the work themselves; others are contracting the work out. In addition to trying to decide who will do the conversion, these companies are bombarded with a wide range of medical equipment installation options. Many items need to be installed, including medical pumps, monitoring equipment, and oxygen supply. Other needed equipment may include a searchlight, GPS system, or enhanced radio system. Whatever the final equipment tally is, it is going to be a tedious process to perform the job.

Contracting out the conversion
There are several reasons companies choose to contract the installations. These may include lack of resources, lack of trained personnel, or not wanting to tackle such a time consuming endeavor. Whatever the reason, there are quite a few companies that offer conversion services. A fairly new company in this market is Helicopter Specialties Inc. (HSI) in Janesville, WI. HSI performs contract installations for medivac operators. They also offer limited technical support on systems. The company has just completed its inaugural conversion contract. They took a helicopter that was previously used for oil rig transport and completely converted it into a medical transport helicopter.
HSI chose to perform the majority of the alterations necessary for the medical conversion themselves. About the only STC kit they bought was for the floor installation. The new floor is a pre-formed floor designed for ease of cleaning and the ability to prevent biomedical fluids from seeping into the bilges of the helicopter. Other than the floor, HSI had to fabricate different structural components in order to facilitate the installation of all the equipment. A support platform had to be designed and installed in the lower aft fuselage in order to install the medical pumps. A unit was also built to house the liquid oxygen system. The battery had to be relocated in order to accommodate the additional equipment in the nose section. Needless to say, at the end of the process, there was a large stack of 337’s and supporting documentation.
Jim Freeman, owner of HSI, says that one very important issue when considering performing a contract conversion is communication. "You need to make sure the customer is clear about what he wants" says Freeman. It helps to be as informed as possible when suggesting components to install. Some items may cost less money at the time of installation, but will be nothing but a headache and money pit in the long run. It has been said that price is only an issue in the absence of value. This holds true in medical installations. This is not to say that the most expensive product is always the best; the customer just needs to be well informed of all the products available to make the choice that will best fit his company needs.

GPS navigation system
In this day of high tech navigation devices, Freeman says that a good GPS system is practically essential in an air ambulance installation. Many emergency medical technician (EMT) units on the ground have GPS capability. This would allow them to radio the exact GPS coordinates to the aircrew, allowing them to make a time saving point-to-point flight. Since mere minutes can make the difference between life and death in a medical emergency, any time saved is critical.

Lighting concerns
Another factor that comes into play in medical transport aircraft is the issue of lighting – both interior and exterior. When it comes to interior lighting, there is a need for additional illumination for both the medical equipment and the patient. Traditional incandescent lights are still widely used. This type of light has the tendency to produce dark spots in areas. Often, light shaping diffusers are also installed in order to provide a more uniform light output.
One recent development in the area of interior lighting has been the use of Light Emitting Diode (LED) technology. Light assemblies have been developed that utilize LED’s within them to provide illumination. Two advantages to these types of lights are their low heat output and low power requirements. They are also very slim, thus allowing for installation in very limited spaces.
When it comes to exterior lighting, helicopters often need to have searchlights installed when they are being converted. These million plus candlepower lights allow pilots to locate victims more quickly in low visibility or night operations.

Hidden Damage
The process of converting a helicopter to a medical transport can be a lengthy process. One issue that needs to be kept in mind that may affect the delivery is that of hidden damage. As with other maintenance undertakings, the possibility exists that additional maintenance requirements may be discovered while performing the conversion. Be sure that the customer is aware of this right from the beginning. This may help prevent a headache later on down the road.
One contributor to hidden damage "surprises" is corrosion. During the disassembly phase, areas may be uncovered that are not normally viewed during routine inspections. These areas are prone to have some corrosion. Severe corrosion can cause numerous hours of added work and can lead to delays in the delivery date. It is very important to inspect for and treat all corrosion when performing the conversion.

Parts problems
In addition to the problem caused by hidden corrosion, parts availability can become an issue. Sometimes parts may not be available or they may have a very long lead-time. Unfortunately, when it comes to some parts issues, your hands are tied. The best thing to do is to discuss the possibility of parts problems with the customer before any maintenance begins and keep in close communication with him throughout the process.
For those companies that do not have the time or the resources to perform all of the alterations themselves, there are a wide variety of suppliers of medical conversion kits. One such company is Spectrum Aeromed. They offer installations for many rotary wing and fixed wing aircraft. One benefit of their product line that they stress is the ease of installation. They also enable the aircraft to be used for both medical and normal transport applications. After the medical equipment kits are installed, the aircraft can still convert from medivac to corporate configuration in approximately 10 minutes.
Aside from the actual conversion of the helicopter, the major issue inherent to most medical transport aircraft is that of scheduling maintenance. Aaron Rogers, chief inspector Air Evac Lifeteam’s maintenance department, notes that with the need to have the aircraft at the ready 24 hours a day, scheduling maintenance is often a challenge. He says that in the past, they always tried to have a standby aircraft ready to go when another one had to have maintenance performed on it. Sometimes a standby is not always available. They wanted to come up with an ideal time they could work on the aircraft without affecting availability. In order to this, the company did a study to determine what hours of the day were the lightest as far as aircraft demand. The resulting data showed a trend of lighter flight loads on Monday through Thursday from 8 a.m. to 10 a.m. They now try to schedule any maintenance during these low usage times even if they have a standby helicopter available. Another practice they use is to schedule maintenance during inclement weather when the aircraft are grounded anyway.
One way that Air Evac’s maintenance team has helped to lessen the impact of maintenance on aircraft availability is the establishment of an AAIP inspection program. This program is approved by the FAA, and basically breaks up the 100-hour inspection requirements into four 25-hour inspections. This minimizes down time and allows them to schedule inspections during off peak times.

To STC or not to STC
An issue that will probably come up if your company is doing the conversions in-house is whether or not to apply for a STC. The process for obtaining a STC is a long and tedious one. It may not be worth it if you only plan to do one or two conversions. In this case, field approvals via 337’s may be the best way to go. However, if you plan on doing numerous installations, a STC application may be the way to go. It will make future installations easier as far as paperwork goes, and it opens up the possibility of selling the STC to other companies for their conversion needs. You need to weigh the advantages and disadvantages of each and make the choice that best fits your company’s needs.
There are many factors to consider when contemplating a medical transport conversion. One is whether your company wants to tackle the project yourselves or contract it out. Another issue is the customer’s needs. A good line of communication is critical to the customer’s happiness with the final product. All maintenance technicians also need to realize the special precautions that should be taken when working on medical transport aircraft, especially biomedical ones. In the long run, if thorough research is accomplished into the available products and the benefits and drawbacks of each, the final outcome should be favorable to all parties concerned. The company will have a newly refurbished helicopter flying – ready for its new role of saving lives. One additional word about working on medical transport aircraft. There is a minor risk of contracting a communicable disease from blood and other fluids present in the transport area. Maintenance personnel need to be aware of the biohazard risk associated with working on these aircraft. In fact, it is a requirement that all employees undergo training on the risks involved and how to minimize the chance of exposure. At most operations, the hospital’s medical technicians handle the cleanup of all equipment and surrounding areas. Even though they may be careful to clean up all areas very thoroughly, residual biohazards may still be present. It is always a good practice for technicians to be careful when working in the medical transport area of the aircraft or when handling any of the medical equipment. Many companies provide a Hepatitis B vaccination to any maintenance technicians who may be exposed to biohazards. If the company doesn’t provide for the shot, it may be a good idea to get the vaccination yourself.


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