In December 2014, two-year-old Yatharth Upadhyaya became the youngest cadaver donor in Karnataka when his family decided to donate his organs after he was declared brain dead due to a cardiac arrest. His heart, transported to Chennai via an air ambulance, was implanted into a Russian toddler.
Similarly, in October 2023, when a 57-year-old woman from Bangalore fell critically ill while in Tel Aviv, she got a new lease on life thanks to an air ambulance service that airlifted her back home right before Hamas rockets hit the Israeli city. The woman’s family got in contact with ICATT (International Critical Care Air Transfer Team), a Bangalore-based air ambulance service. “We were able to complete the entire operation swiftly. Even the doctors’ visas were granted by the Israeli embassy within a few hours. With the help of the ground staff at the Bangalore airport, we were able to bring the woman home and rush her to emergency care at a local private hospital in time,” Dr Shalini Nalwad, founder and operator, ICATT, shares with Happiest Health.
These examples highlight the critical role that air ambulances play in swiftly delivering life-saving services, accentuating their importance in the healthcare field.
How does an air ambulance work?
Air transfers are carried out either on helicopters or planes. Speaking about the equipment present inside an air ambulance, Dr Nalwad says it comes with all the components of a traditional on-the-ground intensive care unit (ICU). “We usually carry around 110 kilos of equipment with us. Anything present in an ICU — such as ventilators, cardiac monitors, defibrillators and syringe pumps — is available in an air ambulance,” she adds.
She further notes that ECMO (extracorporeal membrane oxygenation) transfers require a lot of expertise. “It takes a lot of training and skilled personnel. We would require a perfusionist and a cardiothoracic surgeon, among others,” she elaborates, adding that ICATT has carried out nearly 260 ECMO transfers over the past two years.
Benefits of an air ambulance
Highlighting the boons of an air ambulance, Dr Nalwad says it improves access to critical healthcare services in any remote corner of the world. “Tertiary healthcare centers are located in urban areas, even in developed countries. Hence, people from remote parts are flown into cities [via an air ambulance] with tertiary care hospitals. For instance, if a critically ill person has to be flown from Guwahati to Chennai, it is not practical to bring them by road. This is where an air ambulance comes into play,” she adds.
ICATT recently partnered with Pawan Hans, an India-based helicopter operator, to launch air ambulance services in Madhya Pradesh — an initiative spearheaded by the Indian Ministry of Civil Aviation (MoCA).
What types of emergencies can an air ambulance handle?
Dr Navneet Singh, chairman and managing director, Emsos Aviation and Medical Pvt Ltd, a luxury private charter provider based in New Delhi, lists the common scenarios where an air ambulance can help save lives:
- Transporting critically ill individuals from a remote location (that lacks appropriate medical facilities) to a tertiary healthcare center.
- Bringing people home who visit a foreign country and fall severely ill.
- Quickly transporting cadaver organs between cities.
The company, which started the service in 2005, has completed more than 4000 air transports.
ICATT currently offers services such as planned air transfers, trauma emergency response, organ retrievals, ECMO transfers, neonatal and pediatric transfers, high-risk obstetric transfers and disaster management.
Speaking about the neonatal transfers completed by ICATT, Dr Nalwad cites the example of a case where a one-and-a-half-month-old baby was airlifted from Goa to Hyderabad while being placed on a ventilator. Similarly, another infant who required high-frequency oscillatory ventilation (HFOV) and nitric oxide was transported to a specialized healthcare center.
She recalls another case where a group of boys from Bangalore vacationing in Azerbaijan met with an accident around 300 kilometers from Baku. “We were contacted by their family members and had to bring them to Baku swiftly. There were a lot of issues in this case — the police had taken away all their passports and mobiles, and we had very little information on what the injuries were,” she shares.
In yet another case, an Indian woman (67) staying with her family in Oregon, US, had developed heart-related issues. She was flown home to Chennai for emergency surgery in a 26-hour-long aeromedical evacuation in July 2022.
How much do air ambulance services cost?
In the case of air ambulances, a round trip within Karnataka would typically cost around Rs 4–8 lakhs, informs Dr Nalwad, adding that a dedicated international air ambulance service will cost between Rs 1.8 and 2 crores. “We work with a few international airlines and transport people on commercial planes. We cordon off an area on the aircraft for medical emergency travel. This costs around 10 to 20% of the dedicated air ambulance cost,” she notes.
Air ambulance services: What are the challenges?
Dr Singh says when it comes to air ambulance services in India, one of the major challenges is the lack of regulatory control. “Due to the rising demand for air ambulances in the country and the high cost associated with each trip, several unauthorized service providers have mushroomed. In the West, not everybody can operate an air ambulance, as it is a critical part of ambulatory medical care. Whether the medical teams transporting critically ill people are properly trained is the main cause for concern,” he elaborates.
Speaking of other obstacles, Dr Singh adds that air ambulances are cost-intensive. Procuring and maintaining an aircraft takes a toll on finances.
Takeaways
Air ambulances are equipped with the components of a traditional ICU and make critical healthcare services accessible to remote corners of the world. Whether it’s flying critically ill people to tertiary healthcare centers or transporting cadaver organs on an urgent basis, an air ambulance can significantly contribute to saving lives. However, strict regulatory measures need to be implemented to prevent adverse consequences.
