Provider Profile: CareFlight
CareFlight’s Chief Executive Officer Mick Frewen talks to AirMed&Rescue about how an organisation that started with just one helicopter now offers world-class aeromedical services
Founded in Sydney, Australia, in 1986 as an aeromedical charity with a mission to save lives, speed recovery, and serve the community, CareFlight now delivers medical expertise in emergency trauma, pre-hospital and remote medicine to patients using a fleet of helicopters, jet aircraft, turboprop planes and road vehicles, across Australia.
Rapid response helicopter service
Thirty-five years ago, CareFlight founders had the idea to fly a specialist doctor to patients in need of critical trauma care. The idea paved the way for the development of CareFlight’s Rapid Response Helicopter (CRRH) service and established what has now become best-practice. As the name suggests, the rapid response helicopter service gets to patients very quickly, becoming airborne in only two to three minutes. Research completed both in Australia and internationally provides clear evidence that the faster the patient gets medical treatment from a specialist doctor, the better the outcome.
“Indeed, CareFlight’s largest-ever research project, the Head Injury Retrieval trial, which examined more than 1,500 patient cases over six years, proved exactly that, and was instrumental in the development of our rapid response model,” explained Mick Frewen. “We fly our specialist doctor and New South Wales (NSW) Ambulance intensive care paramedic to the scene of trauma so they can immediately assess and commence clinical treatment. For patients who are critically injured or ill, we know this gives patients the best chance of survival.”
The rapid response helicopter is specially configured with the most up-to-date medical equipment, including a mobile intensive care unit and ultrasound. During any given mission, a CareFlight doctor might have to put a patient under anesthetic, as well as perform roadside surgery, which could include inserting drains into the chest, or even opening the chest to manage an injury to the heart.
“We are equipped to give blood and plasma transfusions. We were one of the first services in the world to carry red blood cells, and in April 2018, became the first civilian aeromedical service in Australia to perform pre-hospital plasma transfusions as part of our rapid response helicopter service. This first has been described by clinicians as a ‘quantum leap’ for emergency treatment that experts say, in certain cases, could save one in three people who would otherwise die,” commented Frewen.
As part of its mission to deliver the best possible service to patients, CareFlight has recently acquired an Airbus H145 helicopter, which Frewen said ‘is internationally recognised to be one of the safest and most advanced aeromedical helicopters in the world’. “This will help save lives, and deliver an outstanding aeromedical service to the community,” he added.
Since 2017, CareFlight has been tasked to respond to more than 1,300 medical incidents with its rapid response helicopter. Of these incidents, 45 per cent have been road-related accidents.
Aeroplane and medical jet retrieval
Frewen explains that treating patients at scenes of critical incidents is only one part of CareFlight’s work.
CareFlight also operates a fleet of turboprop air ambulances to transport patients between hospitals and clinics, as well as from accident scenes: “The CareFlight planes are a welcome sight to people living in remote locations who would not otherwise be able to access appropriate medical care. They also bring support to remote area health professionals who provide primary healthcare through community clinics and regional hospitals.”
CareFlight planes are staffed by a pilot, nurse, and often a doctor. The highly experienced aeromedical teams provide a ‘flying hospital’ – a patient retrieval service with a hospital standard of care.
In the Top End of Australia’s Northern Territory (NT), CareFlight operates five B200 King Airs which, during 2019-2020, were used to transport 3,199 patients. Equipped to carry the most critical patients, the planes are fitted with stretcher bases, wide cargo doors, loading systems, oxygen and medical equipment. The aircraft can carry two adult stretcher patients and two sitting patients, as well as the aeromedical crew.
In NSW, CareFlight operates three dedicated B200 King air ambulances to transport patients from regional areas, to and from, major hospitals. From 2019-2020, over 1,000 patients were transported across NSW using this service. “We transport patients with all levels of need, including serious cardiovascular problems, obstetric complications, snake bites and severe burns, as well as people injured in car, motorbike, farm vehicle and aircraft crashes,” explained Frewen.
CareFlight has also provided specialist medical teams to transfer critically ill and injured patients anywhere in the world since 1990, and has the capability to organize the most complex national and international retrieval missions. “CareFlight is the only aeromedical retrieval organisation in Australasia that owns and operates its own fleets across the three retrieval platforms of dedicated jets, turbo prop aircraft and helicopters providing national and international missions,” Frewen told AirMed&Rescue.
“We own a G150 and three Beechcraft B400 air ambulance jets that operate international and long-range jet services from bases in Sydney and Darwin to every state in Australia and throughout Southeast Asia and the south-west Pacific. These missions are often to collect patients who are injured or have fallen ill while travelling overseas or interstate and need to be brought home under clinical supervision for further medical treatment in hospital.”
Rescue missions over land
CareFlight’s Top End Rescue Helicopter is the only dedicated rescue helicopter in Australia’s NT. Operating out of NT’s capital, Darwin, the AW139 covers a geographic region greater than 600,000kms. “We identified the need to dramatically improve services to remote and isolated locations,” explained Frewen. “To that end, we purchased a larger and longer-range emergency helicopter in a partnership with the NT Government, and tasked under the Top End Medical Retrieval Service, which CareFlight delivers in the Top End of the NT.
“We were able to do so by harnessing the support of the community to fund the AW139. Partly funded through our partnership with the NT Government, CareFlight invests more than Au$1 million each year of our social purpose funding to ensure the helicopter can reach and treat people in NT when they need it most.”
Rescue missions over sea
CareFlight has an agreement with the Australian Maritime Authority (AMSA) to provide search and rescue support, and is on 24-hour call. AMSA is responsible for resolving any emergency beacon activation in Australia’s region of international rescue responsibility. “Over the years, we have been called on to help locate and / or rescue sailors from stricken yachts, fishermen swept from rocks, ill or injured crew from passing freight ships, as well as missing and crashed light aircraft.”
Bringing lifesaving education to the community
Being first on the scene of an accident can be a daunting experience for first responders such as police, rural and country fire services, state emergency services, and fire and rescue officers, who are experts in their field, but may have little experience in responding to medical traumas. Yet, what they do in the first few minutes can significantly improve the final outcomes for patients. Their actions can mean the difference between life and death.
“We have been providing evidence-based, mobile, medical simulation (MediSim) trauma care training since 2011, and, more recently, vital pediatric, infant and neonatal assessment and resuscitation knowledge and skills through our Sick and Injured Kids in the Bush workshop since 2017,” explained Frewen. The program is delivered across Australia, with more than 6,200 participants having completed the vital training nationally.
Looking to the future
“CareFlight was founded on innovation, and we continue to ensure we invest in the world’s most advanced aircrafts such as the H145, as well as stay ahead of the latest aeromedical technologies,” Frewen concluded. “Doing this ensures we get the best outcomes for our patients while at the same time raising the standards of aeromedical services across the country, ultimately benefitting all Australians.”