Founded in 2023 as a spin-off of fixed-wing operator Tropic Air Charters, Tropic Air Rescue is a membership-based air ambulance program that provides air medical services between the US state of Florida and the Caribbean nation of the Bahamas – a country comprised of approximately 3,000 islands of varying sizes.

Tropic Air operates a fleet of six Sikorsky S-76B helicopters, of which two are in medical evacuation configuration, one is configured for VIP flights, two more serve as backups, and one is currently in the process of being retrofitted.

“All of the helicopters are company-owned,” said Anthony Marinello, President and Founder of Tropic Air Rescue, and all of them are based at Fort Lauderdale Executive Airport in Florida.

He added that the helicopters were equipped with “all the standard advanced life support (ALS) equipment and medications, [and] we are always looking to stay on top of new equipment needs and ideas”. This includes a defibrillator, heart monitor, onboard oxygen, and whole blood.

To support its operations, Tropic Air Rescue employs a staff of eight pilots and 34 medics and nurses, with many drawn from the networking connections of existing employees. “We source most of our pilots, medics, and nurses from employee referrals,” said Marinello, before adding that they “also accept unsolicited résumés of qualified persons”.

The operational challenges of flying between Florida and the Bahamas

Marinello explained that while there were a number of challenges to operating an air medical service between Florida and Bahamas, in terms of weather, geography, and other factors, one of the biggest challenges is the relative unfamiliarity of local Bahamians with the concept of a helicopter air ambulance service.

“As the first, fully dedicated helicopter ambulance service [in the Bahamas], most locations have never had a helicopter respond to their island,” he said. “The normal regulatory framework requires multiple agency involvement on each flight. Also, the culture has always been to use fixed-wing aircraft from the island airports.”

As the first, fully dedicated helicopter ambulance service in the Bahamas, most locations have never had a helicopter respond to their island

Alongside this, there is a high level of autonomy in how the various islands of the Bahamas regulate air medical operations. Marinello noted that beyond the unfamiliarity itself was the challenge of building understanding between Tropic Air and local officials.

“Trying to educate the different agencies as to our capabilities is a challenge since there is no one cohesive group to speak to,” he said. “Many islands operate as to their own independent rules and past perceptions of the rules. It is difficult but we continue to educate and move forward.”

A broad range of medical incidents

Tropic Air Rescue responds to a broad range of medical incidents as part of its day-to-day operations. Marinello explained that, ultimately, “any type of injury or illness that happens in the USA, also happens in the Bahamas”. He noted, though, that some of the most common types of incidents were cardiovascular – including strokes and heart attacks – and a range of traumatic injuries, including vehicle and boating accidents, as well as shark bites.

Tourists, expats, and interhospital transfers

Marinello described how Tropic operates as a membership program, primarily serving a mix of American, European, and Canadian tourists and expats. “We do have some Bahamian members,” he added; “however, they must maintain a US medical insurance to qualify for transport to the US, as well as a valid passport and US visa. They must be able to enter the US legally and have medical health coverage for use in the US.”

Additionally, Marinello stated that the company had also been granted special authorization by Civil Aviation Authority Bahamas to conduct “inter-island transports from the scene to local hospitals for Bahamian residents or visitors who do not qualify for entry into the US”.

The company had also been granted special authorization by Civil Aviation Authority Bahamas to conduct inter-island transports from the scene to local hospitals for Bahamian residents or visitors who do not qualify for entry into the US

He added that the Bahamian healthcare system did not reimburse costs for medical helicopter flights, but that the flights were conducted “at our sole discretion”.

Preparing for the worst: the risks of flying over water

Marinello explained that Tropic Air provides a high standard of training to its crewmembers, with the aim of ensuring a high level of safety during operations.

“We conduct company employee induction training, as well as normal Federal Aviation Administration (FAA) mandated helicopter orientation training,” he said. “We also have quarterly safety meetings, as well as quarterly training events.”

Given the extensive amount of time that Tropic Air’s helicopters spend operating over the open water of the Caribbean, a great deal of emphasis is placed on ensuring that its crew are as safe as possible in the event that they are forced to go down in the ocean.

“All crewmembers must wear life vests,” Marinello said. “Our crews are all mandated to have Florida aircrew member (ACM) training upon employment, which includes helicopter underwater escape training (HUET).”

Our crews are all mandated to have Florida aircrew member (ACM) training upon employment, which includes helicopter underwater escape training (HUET)

Additionally, he explained that all of Tropic Air Rescue’s aircraft are twin-engine, and equipped with pop-out flotation equipment, emergency locator transmitters (ELTs), emergency position indicating radio beacons (EPIRBs), and satellite tracking for search and rescue purposes.

Moving forward

Since establishing its membership plan three years ago, Tropic Air Rescue has continued to establish itself as a player in the air medical sector.

“The membership program is progressing as expected,” said Marinello. “It continues to grow as our reputation and word of our existence spreads. We’ve had nothing but praise from our rescued members and their families.”

Looking to the future, Marinello concluded by confirming that while Tropic Air was continuing to focus its operations on the Bahamas for the foreseeable future, its ultimate ambition was to expand further to serve other parts of the Caribbean.