Care in the Air

posted on 20th March 2023
Care in the Air

Industry veteran Aircare International and innovative technology company Aiber provide essential, potentially complementary solutions to assist crew during a medical emergency

Even a minor medical issue in the air can become a crisis, for the stricken person, of course, but also for crew if they are ill equipped or poorly trained to deal with the event. For pilots and operators, a quality response to a medical emergency can facilitate decisions over whether an urgent landing is required and even where the optimum location for that landing might be; it may be worth flying 300 miles further to a city with advanced care facilities rather than landing at the closest airfield.
Tacoma, Washington-based Aircare International offers an array of services to the business and VIP aircraft industry, including Aircare FACTS Training for cabin emergency procedures and Aircare Access Assistance. Proven over three decades, Access Assistance is a 24/7 inflight telemedical service connecting crews to Aircare’s carefully selected doctors.

Access Assistance
Jake Paini, Aircare International’s Director of Sales, explains: “If someone is suffering a medical issue in the air or overseas on the ground, [the crew] can call us and we route them through our communications centre, patching in a physician as appropriate. The physician can give a recommendation, which might be, ‘We need to get this patient to a cardiac centre’, or ‘Open the medical kit and use certain medication while we wait for the next level of care’.”
The Access Assistance package includes a medical kit familiar to the Aircare physicians. In a crisis, therefore, the instruction could be something like, ‘Use the medication in the blue wrapper,’ avoiding complicated, unfamiliar medical terminology. On the other hand, Access Assistance customers are trained to use the system and medical kit, work informed by Aircare’s expert FACTS Training – but Paini takes a realistic approach, noting that while crews might train once or twice annually, in a moment of high stress the doctor’s familiarity with the tools to hand is invaluable.
Meanwhile, Aircare’s communications team works to facilitate whatever needs to happen next. When the emergency is critical, a cardiac incident, for example, Paini says: “They’re liaising between the aircraft, our physicians and wherever that continuation of care may be. They’ll set up ground support, they’ll ensure there’s an ambulance and paramedics at the airfield, brief the receiving facility and take all the information gathered securely during the call and pass it to that facility.”
The Access Assistance training is about understanding what’s in the kit and how to use it, plus extensive instruction in symptom recognition and how to respond to it under the guidance of qualified medical personnel. Half-day and full-day crew training courses are offered depending on customer need, while the physician team is based at the George Washington University Medical Faculty Associates. “All of our physicians are board-certified and work in a rotation that allows them to divide their time between the ER and the phones,” Paini notes.
Aircare also takes care of the medical kit. Paini continues: “We have multiple levels of kit, from basic to quite robust with multiple prescription medications. The choice depends on the operator. Those making short trips may take the basic kit, while we recommend the robust kit for international flying; the majority opt for the robust kit anyway. We track the kits and refurbish them every year, telling customers when we need to do it.”
Beyond the medical kit, Aircare offers other equipment including Heartsine and Philips defibrillators, and a range of safety and survival equipment. “Anything you might need in an emergency, we likely carry it,” Paini says. He also adds that the single annual fee customers pay for Access Assistance includes refurbishment as required, so that crew are more likely to use the kits for basic requirements. “If they go into it for something simple like a band aid we take care of it: they aren’t going to have to pay to send the whole thing back to us. We want people to go into their kits, we want them to be familiar with the content. We don’t want them opening the kit for the first time in an emergency.”

Aiber onboard medical technology
In contrast with Aircare International’s 40 years in business aviation, Scotland’s Aiber is making an early foray into the industry, albeit based on the extensive aviation medicine and first response experience of its seasoned team. The med-tech company has created unique iPad-based onboard medical technology based on many years of development and recently optimised for aviation use following six months of flight trials with Boeing Executive Flight Operations.
Aiber’s equipment is equally applicable to the marine environment and Anne Roberts, CEO, explains: “As a university spin-out company we’ve gone through significant research and development. Our idea came out of the University of Aberdeen’s Institute of Applied Health Sciences, where a team first developed the technology for remote care, specifically designed to help people manage a medical emergency when no professional help was immediately available. We started out looking at community first responder schemes, fire and rescue, that type of thing.
“There was an obvious application to aviation and Boeing selected us as part of its Aerospace Xelerated programme. It really helped us optimise the technology and obtain product market fit for aviation. We realised that cabin crew in the commercial and private aviation sectors have emergency first aid training, but maybe only for one or two days per year. An operator might subscribe to a service through which the crew can speak with a doctor, but the crew may not fully understand the passenger’s status – are they deteriorating or improving? Are they stable? Are they having a heart attack or a stroke?
“The carry-on Aiber kit is based on an iPad, loaded with proprietary software, including a library of first aid support, and equipped with a pulse oximeter and Bluetooth wireless 12-lead ECG recorder. If a crewmember can’t remember how to perform a technique – CPR for example – Aiber can prompt them, while simultaneously collecting critical data on the patient’s condition. It helps reduce stress and facilitates the doctors on the ground with their review and the recommendations they make. There’s also a communication channel in the software, via voice or text, so the crew can communicate without leaving the passenger’s side. This really helps their experience and brings comfort to the passenger and crew.”
As well as providing a real time data stream, the Aiber software records the actions, observations and treatment given in detail, providing an accurate report of the incident, ensuring continuity of care, preventing inaccurate communication and providing a useful debriefing/training aid. On screen, during the crisis, it provides only the information and prompts the crew need, retaining the detailed medical report in the ‘back end’ and sharing it with the medical support on the ground.
Aiber is now beginning its journey into business aviation with a future-proof technology product, backed up by specialist training. The Aiber team has already met its target of doubling its workforce in 2022 and has plans to continue its growth trajectory through 2023. The company is gaining traction with commercial airlines and is bringing its product to the private jet industry.
Meanwhile, Jake Paini reports: “Medical problems are among the most common causes of inflight emergencies. We have people coming back to us for their annual training and saying, ‘I had to perform CPR, or the Heimlich manoeuvre, or something happened. I got the medical kit out, and was able to walk through it.’”