Levels of Medevac?

[Cessna driver]

Generally when flying TO the patient, the medevac tag is attached and when patients are on board. In AB at least, pilots dont always know the status of the patient when filing the FP so most just use medevac, empty legs have no tag

As in the medical status of the pt?

What does that matter? Do you fly differently or shoot your approach lower if the pt is going to code or something?

For us it might as well be boxes, we don't give operational control to people in the back of the plane, that's how medevac gets very dangerous.

Yes as in medical status,

No to flying any differently, its more of a do they need to get them on the ground, without being vectored to timbucktoo type of scenario, the planes are flown following every CARs regulation, the MEDEVAC tag is to avoid delays

[PostmasterGeneral]

Is there any regulation which states that speed restrictions (250/1000 and 200/10nm) can be waived in the event of a life saving mission, for example if the patient is "code blue"? Couldn't find anything in the CARs.

[SuperchargedRS]

Hmmm


We fly with a flight medic and nurse, if you're being flown on our plane you're on our stretcher and that is the only place for our pt, meaning we are not a normal pax charter operation, the price of admission on our flights is quite high and I'm not talking money.

If we are inbound to pickup a pt, or inflight with a pt, we are medevac, period.

I do not have a MD after my name, the ATC controller does not have a MD after his name and has ZERO business trying to figure out "how medevac" we are, if I say medevac I expect priority as if the person in the back is a infant on it's last breath, it is not my place as a pilot, their place as a controller, or even my medical crews place to put a diagnosis on the pt, or decide how worthy of priority they are, medevac = priority

[digits_]

Hmmm


We fly with a flight medic and nurse, if you're being flown on our plane you're on our stretcher and that is the only place for our pt, meaning we are not a normal pax charter operation, the price of admission on our flights is quite high and I'm not talking money.

If we are inbound to pickup a pt, or inflight with a pt, we are medevac, period.

I do not have a MD after my name, the ATC controller does not have a MD after his name and has ZERO business trying to figure out "how medevac" we are, if I say medevac I expect priority as if the person in the back is a infant on it's last breath, it is not my place as a pilot, their place as a controller, or even my medical crews place to put a diagnosis on the pt, or decide how worthy of priority they are, medevac = priority

Sure, so what if there is another medevac flight arriving at the same time ? Let's say you are first because you arrived 10 sec earlier. The other guy actually has a patient on it's last breath, you are transporting a non critical patient. Would you keep your first spot, or would you talk to the other crew and figure out who is the most critical ?

On a more philosophical note: you as PIC are responsible for the safe operation of the flight and for your passengers. Would that not imply that you would need to know the status of your passenger ? I am aware that it might not make a difference, and that for safety you should think about them as boxes. But think about it for a moment: if a passenger is having a stroke, you would usually divert to a nearby airport and probably declare a mayday (distress that required immediate assitance with the threat of loss of life). Back to the medevac: medevac gives you priority, but not over other medevac flights. If your passenger is dying in the back, would that not require you, legally, to declare a mayday for priority handling ? But before you can do that, you need to be aware of the state your passenger/patient is in.

I am sure there is some sort of regulation that would contradict this, but I couldn't find anything...

[Cessna driver]

Hmmm


We fly with a flight medic and nurse, if you're being flown on our plane you're on our stretcher and that is the only place for our pt, meaning we are not a normal pax charter operation, the price of admission on our flights is quite high and I'm not talking money.

If we are inbound to pickup a pt, or inflight with a pt, we are medevac, period.

I do not have a MD after my name, the ATC controller does not have a MD after his name and has ZERO business trying to figure out "how medevac" we are, if I say medevac I expect priority as if the person in the back is a infant on it's last breath, it is not my place as a pilot, their place as a controller, or even my medical crews place to put a diagnosis on the pt, or decide how worthy of priority they are, medevac = priority

Sure, so what if there is another medevac flight arriving at the same time ? Let's say you are first because you arrived 10 sec earlier. The other guy actually has a patient on it's last breath, you are transporting a non critical patient. Would you keep your first spot, or would you talk to the other crew and figure out who is the most critical ?

On a more philosophical note: you as PIC are responsible for the safe operation of the flight and for your passengers. Would that not imply that you would need to know the status of your passenger ? I am aware that it might not make a difference, and that for safety you should think about them as boxes. But think about it for a moment: if a passenger is having a stroke, you would usually divert to a nearby airport and probably declare a mayday (distress that required immediate assitance with the threat of loss of life). Back to the medevac: medevac gives you priority, but not over other medevac flights. If your passenger is dying in the back, would that not require you, legally, to declare a mayday for priority handling ? But before you can do that, you need to be aware of the state your passenger/patient is in.

I am sure there is some sort of regulation that would contradict this, but I couldn't find anything...

In AB atleast, patient details to the pilot are generally left out as to avoid the crews doing something faster/cutting corners due to a sick/dying patient. It is preferred that crews fly the same way regardless of patient status

[digits_]

In AB atleast, patient details to the pilot are generally left out as to avoid the crews doing something faster/cutting corners due to a sick/dying patient. It is preferred that crews fly the same way regardless of patient status

Yes, I am aware of that, I've heard it from multiple people, and I don't dispute that. I am just wondering how this can be legal if an upgrade from medevac to mayday might save your patients life. A decision the PIC can only make when he is aware of the patient's status.

[SuperchargedRS]

First off, in the years I've been doing this, I have yet to be on final neck to neck with another medevac and have to decide who should land first, could it happen, I guess, is it likely no.

And if you change the way you do things based on what's going on in the back, find another line of work, there is a good reason not to do this and it's people who let the pt rush them who are the reason for so much death in the industry.

Its just medevac, not "priority" medevac, not "super double priority" or any of that other nonsense.

You go to pick up your pt and while you're flying them, medevac and make best possible time, doesn't matter what the condition of the guy in the back is, let your med crew worry about that, you just fly the plane and make best possible time.


"Upgrade" to mayday?! If that even sounds like a possible option to you, you're a save the world type and you're more likely with that attitude to not only get your pt killed, but your med crew and self as well, I would highly advise to say away from EMS with that attitude.

[digits_]

"Upgrade" to mayday?! If that even sounds like a possible option to you, you're a save the world type and you're more likely with that attitude to not only get your pt killed, but your med crew and self as well, I would highly advise to say away from EMS with that attitude.

I'm not saying it is an option that is being used in real life, I am just wondering how you deal with the legalities. A dying passenger on a normal flight would warrant a mayday, but a dying passenger in a medevac apparently not. I am wondering what the legal difference is. Unless you use the argument that you didn't know the passenger was dying, which then places the responsibility of not using a mayday in a loss of life situation on the medic.

(Note, a mayday should be used in a distress situation, pan pan in an urgency situation. Urgency situation is described as a situation where there is no immediate danger for loss of life. I could not find a clear description of a distress situation, but the danger for loss of life is implied to be a mayday situation)

Mostly a hypothetical situation, but if you think about it a bit more, not just theoretically. Let's say a passenger dies on medevac flight 20 sec before touchdown. Medevac flight did not use mayday call sign even though at least one person on board knew the passenger was critical and loss of life was possible. You landed 2 minutes later then you could, because there was a light twin with an engine failure that declared a pan pan and landed before you. You could have been first if you declared a mayday. The (lawyer of the) wife of the dead passenger can see in the publicly accessible cadors you did not declare a mayday. What would happen ?

[SuperchargedRS]

The problem with comparing medevac and a medevac worthy person in a non medevac, is a medevac worthy person in ANY non medevac plane would constitute a medical emergency, mayday.

So if we use the non medevac logic for a medevac, I would never use the term medevac, I would just always check in with mayday instead. If that makes sense.

[digits_]

The problem with comparing medevac and a medevac worthy person in a non medevac, is a medevac worthy person in ANY non medevac plane would constitute a medical emergency, mayday.

So if we use the non medevac logic for a medevac, I would never use the term medevac, I would just always check in with mayday instead. If that makes sense.

Yes, I understand what you are saying. But what allows you to not declare a mayday on medevac flights if your patient is dying ? I know it is not being done, and I don't blame you or other medevac pilots for that. I am just really curious what legally allows medevac pilots not to do that.

[SuperchargedRS]

Don't know

But if that were the case you'd have like 80% of medevac flights declaring maydays.

Think about it a different way, as you're loading your pt, you can see they are critical, what are the ramifications of firing up and taking off knowing your going to be declaring a emergency?

[digits_]

Think about it a different way, as you're loading your pt, you can see they are critical, what are the ramifications of firing up and taking off knowing your going to be declaring a emergency?

True. Another question I hope someone has the answer too.

[lownslow]

I always thought Mayday was reserved for when the threat of imminent danger was coming from the airplane itself. Medevac is when there is a critical patient on board under the care of a medical professional.

So I can have a patient in the back having a heart attack and keep the medevac tag, but if one of my engines decides it's had enough of my crap for one day I'll be calling in the mayday.

[photofly]

Seems to me "mayday" is when the emergency occurs in flight. If a passenger became very sick or unexpectedly deteriorates in flight then a routine flight may become a "mayday".

But medevac implies you're not expecting them to be any sicker at the end of the flight than at the start, when you made the decision to take off (and you understood and accepted at that time the risk of later being delayed by an in-flight emergency declared by another aircraft.)

So if you're a medevac flight and you're delayed by a pan-pan call from another aircraft requiring priority, well, you figured that possibility into your decision making before you decided to take off.

However if your medevac patient now has an unexpected deterioration in flight that necessitates immediate priority, feel free to declare an emergency.

Does that make sense?

[kevenv]

We deal with medical emergencies on non medevac aircraft all of the time. Never have I heard one declare Mayday (or PAN for that matter). They always say something like "we are declaring an emergency (nature of emergency) request diversion to XXXX". On occasion we have also had medevac aircraft tell us that the patient has taken a turn for the worse and they really need to get down now and upgrade to an emergency. It's pretty straight forward on our end.

[digits_]

We deal with medical emergencies on non medevac aircraft all of the time. Never have I heard one declare Mayday (or PAN for that matter). They always say something like "we are declaring an emergency (nature of emergency) request diversion to XXXX".

Does it make a difference on your end wether they "declare an emerency" or use "mayday" ?

Does that make sense?

It does. It sounds logical as well. Just wondering if there are any legal arguments to support this.

[Married a Canadian]

Does it make a difference on your end whether they "declare an emerency" or use "mayday"

Interesting question. In my career to date I have NEVER had a pilot declare a Mayday for a medical reason. I would say 99% of the planes that fly into YYZ declare "Medical Emergency" when they have an extremely sick passenger (ie heart attack, stopped breathing etc). They get priority treatment when they do this, which they would also do if they declared Mayday.
It was the same when I worked in the UK, pilots would declare medical emergency, and save PAN or MAYDAY for other issues.

Some of the Medevacs that fly into YYZ have been in the air for over 2 hours...so the question can be asked, how "emergency" is the situation on board. When the airlines declare medical emergency it is nearly ALWAYS heart attack, stopped breathing, stroke.

I have always looked at the term "Mayday" as a more aircraft control/mechanical/flying the aircraft term, but would be interested to hear others opinions on this.

[bandaid]

It has been a while since I was doing medevacs but I believe that this is how it is done. A medevac is a medevac. These people would not be going by air most time if tertiary care was not needed. Out of Kelowna we have two types of medevacs (at least I believe that they still do this) a high acuity and low acuity medevac craft. The high acuity is for those patients who are unstable and really need a higher level of care and the lower acuity is for those who are stable and being transferred for a medical procedure that can not be accommodated in Kelowna. What I don't know is if the lower acuity medevac gets priority landing but I suspect they do and for a simple reason. These aircraft cover a missive area and are in big demand. Being low acuity does not mean that you will remain that for the whole day. It is need driven.
As for the need for a Mayday? I think for the most part it is a given that the passengers on these craft are in need of critical medical intervention or they would not be transported. Seems to me it would hardly be necessary to declare a Mayday when that is what this aircraft does on almost every flight, transport critical patients.
It was quite a few years back now but I remember a number of aircraft being sent to Golden on a priority bases due to a bad bus accident with unknown injuries. They came in empty but were desperately needed and I was glad they were there.