Upstream DeepwaterLogistics-Aviation

SAR-MEDEVAC Call-out Process

---27 December 2017

Bob JablonskiAviation Manager, Gulf of MexicoLogistics-AviationUpstream DeepwaterRobert.Jablonski@Shell.com

Bristow SAR-MEDEVAC

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BRISTOWSAR-MEDEVAC

+1 (855) 844-2367

Bristow SAR-MEDEVAC: +1-855-844-2367

(1) Facility Information

Type: _____________________________ (TLP, Vessel, Support Vessel, etc)

Name: _____________________________

Location: _____________________________ (Block #/Lat-Long)

Radio Frequency: ________________________

(2) Caller’s Name & Phone Number (3) Nature of Emergency (Injury/Illness) (4) Patient’s Medical Status (To be provided by asset/vessel medic)

Stable or Unstable ________________

Blood Pressure ________________

Pulse ________________

Respirations ________________

Patient’s Weight ________________ (5) Location of Patient aboard the Asset (6) Helideck Information & Status (Used to determine a helicopter landing or hoist aboard the asset/vessel)

AW-139 Capable: Yes or No

S-92 Capable: Yes or No

Open for Landing: Yes or No (7) Aviation Fuel Available: Yes or No (8) Special Equipment or Services Required (if any) (9) U.S. Customs Information Asset/vessel is connected to the ocean floor: Yes or No Patient is a Foreign National: Yes or No

*** Do not delay a call-out request just because all information is not immediately available ***

*** Red font highlights the essential information required to initiate a SAR-MEDEVAC call-out ***

Effective: 1 January 2017

Incident Occurs

Personnel at Incident Site

Assess Scene safety and

Patient

First responder or First

Aider Arrives and

Assesses Patient

Tier 2, < 1 hour

Tier 1, < 4 minutes

Tier 3, < 4 hours

Tier 2 Rescue

Team.

Make Area + Patient Safe

Provide Care

Asset Name Control Room 911

Channel 1 Gaitronic PA

or 5XXX

Notify 911

Stabilized by

first responderNO

YES

Tier 3 Medevac

Required?

Treat Patient on

SiteNO

YES

Tier 2 Rescue Team

arrives to stabilize Patient

Activate Medevac

Contact control room at 911

Confirm Patient

Arrives at Hospital

Company Health Advisor

monitors progress

Contact Details for Tier 2 Call Out

Site Supervisor

Site Specific Contact Info to include phone #

Site Medical Professional Paramedics

Site specific (eg. via site Gaitronics PA or phone

XXXX

Remote Medical Support

Dr. XXXXX

TEL: +1 XXX XXX-XXXX

(Contact via site medical professional)

ER Team

Site specific (eg. 911 control room)

Contact Details for Tier 3 Call Out

Bristow SAR-MEDEVAC

+1-855-844-2367Shell Emergency Hotline

+1-713-241-2532

Company Health Advisor

Dr. Remi Aliyu

Cell: +1-832-530-9287

Hospital – Site Specific Tier 3 Hospital Info

ER (XXX) XXX-XXXX // (XXX) XXX-XXXX

Ambulance Transport - For Land Transport

Coordinated through Bristow as required

• Location • # Injured personnel

• Nature of injury / illness • Name, Age, Sex

• Time of incident• Cause of incident

• Contact info of informant

• Incident contained / escalating, area secure?

Obtain Patient and Scene Details

Activate Tier 2 Asset name control room

911

Confirm transport to hospital is

organized (as required)Medevac

(accompanied by Tier 2 Professional)

Notify hospital of patient

(flight crew normally does this)

Tier 4 Medevac

Required?

Confirm Patient

Arrives at Hospital

Company Health Advisor

monitors progress

YES

Tier 4

Medical decision made and includes

input from combination of:

Continue Treatment

at Tier 3 hospitalNO

Tier 0, Immediately

Medical decision made and includes

input from combination of:

• Site Medical Professional

• Remote Medical Support Provider

• Company Health Advisor

Medical decision made and includes

input from combination of:

• Site Medical Professional

• Remote Medical Support Provider

• Company Health Advisor

• Remote Medical Support Provider

• Company Health Advisor

• BU Health Advisor

• Tier 3 Hospital

Effective: 1 January 2017

Critical Category Definitions

24/7 Bristow SAR-MEDEVAC Dispatch +1-855-844-2367

Category Description Implication

Status 1 SAR Response; or Medical – Emergency

(SAR) Search and Rescue Tasking or Status 1 (Emergency) Termed “Life threatening emergency”

SAR Tasking

Requires urgent search and rescue response to individuals and assets in immediate distress

Medical Emergency

Critical Medical Patient Definitions:

New onset of GCS <13, Resp Rate <10 or >29 or SpO2<90, BP <90 or HR <45 or >145

Requires urgent search and rescue response to individuals and assets in distress

Helicopter Air Ambulance Operation (HAA)

Life threatening emergency meeting the status 1 patient definitions

Immediate priority response upon notification

Unable to divert to a secondary tasking or assignment

Priority over status 2-5 tasking’s upon notification

Potential for category downgrade by on-site paramedic

Potential for category downgrade by on-site assessment by our medical staff

Can be diverted by the hospital for ED saturation, ED closure, mass casualty event affecting the receiving facility, non-functioning diagnostic capability, no general surgery available, and significant changes to the patient’s medical condition requiring an alternate hospital for immediate stabilization

We do not usually accept hospital diversions of status 1 patients where the destination is the definitive care facility

Status 2 Medical – Emergency

Status 2 (Emergency) Termed “Time Critical”

Medical Emergency Time critical intervention is required: Major trauma or combination trauma

with burns STEMI ST Elevation (>1mm) in at least

two contiguous leads New onset of stroke <4.5hours

Helicopter Air Ambulance Operation (HAA)

Rarely diverted for a Status 1 due to the time critical nature of the patient Priority over status 3-5 tasking’s upon notification

Trauma definitive care destination – Regional Trauma Center or 24/7 surgical capabilities

STEMI – Regional Stroke Center or facility with Percutaneous Coronary Intervention capability

Critical Burn Patients – Regional burn facility Acute Stroke Patients – Regional stroke system or closest level I, II, III stroke center Same diversion criteria as detailed in the status 1 patient category

Status 3 Medical – Emergency

Status 3 (Emergency) Termed “Stable

emergency”

Stable Medical Emergency

ALS assessment and/or interventions are necessary and ongoing or significant mechanism of injury (MOI)

Helicopter Air Ambulance Operation (HAA)

Response aircraft may be diverted to a higher category of status 1 or 2

Priority over status 4-5 tasking’s upon notification

Can divert to a secondary tasking/location with this patient(s) onboard

These patients are generally treated at a general care hospital, which is defined as having 24/7 emergency department capabilities

The patient requires continuous monitoring and/or medical interventions enroute to the hospital destination

We do not accept hospital diversions of status 3 patients

Status 4 Medical (Non-emergency)

Status 4 (Non-Emergency) Termed “Non-emergency” No need for ongoing advanced life support (ALS) diagnostic evaluation or medical treatment

Helicopter Air Ambulance Operation (HAA)

Response aircraft may be diverted to a higher category of status 1, 2, or 3

Priority over status 5 tasking’s upon notification

Can divert to a secondary tasking/location with this patient(s) onboard

These patients are generally treated at a general care hospital We do not accept hospital diversions of status 4 patients

Status 5 Utility (Non-medical)

Status 5 (A) Passenger Status 5 (B) Cargo

Status 5 (Non-Medical) Termed “Aviation Support Services” Unscheduled passenger flights and logistical cargo movements

Same contact number (855) 844-2367 for these flight requests

Does not require medical attention

The caller information will be passed along to the lead pilot for further coordination of the utility flight

Cargo is limited to size and weight for these rescue configured aircrafts

Aircraft remains in service and is always divertible to higher category

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▪ Crew:

▪ 2 Pilots

▪ 1 Rescue Swimmer

▪ 1 Hoist Operator

▪ 1 Advanced Care Medic

▪ Cruise Speed: 140Knots

▪ VFR & IFR Capable

▪ SAR Capability

▪ 2 x Rescue Hoists

▪ Internal Auxiliary Fuel Tank

▪ Night Vision Goggles (Q1 2018)

▪ DF Homer & Search Radar

▪ Forward Looking Infrared (FLIR) Search Sensor

▪ Satellite Communications System

▪ Sea State 6 Floatation System

▪ Rotor Ice Protection System (S-92)

▪ Alert-30: SAR & MEDEVAC = Day

▪ Alert-45: SAR & MEDEVAC = Night

▪ Confined Space Entry & High Capacity Bilge Pumps

S-92 & AW-139 SAR-MEDEVAC Aircraft

• The best method to rescue or MEDEVAC a patient is to land on the vessel.

❖ Primary = Vessel’s Helideck

❖ Secondary = Alternate Hoist Location

• Some vessels do not have AW-139 or S-92 capable helidecks, or the helideck is fouled, which may drive the need for hoisting using one of the following:

• Rescue Basket • with or without guideline

• Stokes Litter or Bauman Bag• with or without guideline

• Air Rescue Vest (ARV)• with or without guideline 5

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CAP 437 Obstacle Clearances

• S-92 Helicopter• D = 68.49 feet (20.88 meters)

• AW-139 Helicopter• D = 54.6 feet (16.63 meters)

• Vessel Winch Area• Clear Zone: > 5 m diameter

• Maneuvering Zone• Inside Ring: no obstacles > 3 m• Outer Ring: no obstacles > 6 m

• Portion of the maneuvering zone, outside the clear area, may be located beyond the vessel’s side

Keep the patient in a warm, dry area, well clear of the intended hoisting site and as close to the helicopter pick-up area as the patient's condition permits.

Ensure the patient is tagged with details of any medication that has been administered.

Prepare the patient's seaman's papers, passport, medical record, and other necessary documents in order to transfer them with the patient.

Ensure personnel are prepared to move the patient as directed by the helicopter crewmember.

Keep all unnecessary personnel away from the helicopter hoisting area.

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Secure or remove all loose objects surrounding the operating area

Lower or secure all aerials and standing/running gear, above and in the vicinity of the operating area

Confirm the Deck Party Leader has a portable radio to communicate with the bridge

Confirm the Deck Party is complete, correctly dressed, and in position

Confirm that fire-fighting equipment is available and ready Keep the hose near, but not in the operating area Point hoses and foam nozzles away from the operations area

Confirm the correct lighting is on for night operations (including special nav lights) Direct available lighting to illuminate the pick-up area (do not blind the aircrew)

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Confirm the Deck Team is ready and wearing brightly colored clothes and protective helmets

Confirm that access to and from the hoisting area is clear with all cargo securely fastened

Confirm that the Officer of the Watch has been consulted about the ship’s readiness

Maintain communications with the helicopter pilots

Always maintain the agreed upon speed and heading throughout the hoisting procedure. Advise if course corrections are required.

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Helicopter hoisting is a high risk operation. A helicopter in flight generates powerful static electricity that can cause serious injury. Therefore, rules to live by:

• Never assist the Rescue Technicians being lowered to the deck• If they need assistance, they will request it after they discharge the static

electricity

• Never touch personnel or equipment being lowered to the vessel

• Never allow unnecessary people near the hoisting area

• Never connect any line or hook from the helicopter to the vessel

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This briefing will be relayed by the Helo to the bridge crew.

1. Establish working frequencies;2. Confirm position of vessel;3. Current sea conditions and wind;4. Request change of course and speed of the vessel if needed;5. Secure deck and all loose objects;6. Keep patient in a protected place;7. Do not help the hoist personnel unless signaled8. Turn vessel radar to stand by;9. Do not attached any cable or lines from the helicopter to the vessel;10. Vessel must maintain constant speed and heading through out the hoist

operation (Failure to do so could result in injury to hoist personnel). Advise if course corrections are required; and

11. Confirm estimated time of arrival.

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Standard hoist sequence Insertion will include:

• Insertion of SAR personnel with guideline;• Delivery of Medic / SAR personnel guideline attached; and• Delivery of Equipment with guideline attached.

(Equipment May include a Basket and/or Stokes Litter)

Standard hoist sequence Extraction will include:

• Extraction of Medic / SAR Personnel (with or without guideline);• Extraction of Equipment with guideline attached; and• Extraction of remaining SAR personnel (Possible circuit in-between to

police guideline)

MEDICAL NOTE: In most cases the Patient will be packaged in the Helicopter Litter for hoisting.

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Safety First – Goal Zero18