Answer

The decision on how to evacuate a worker depends on the distance to the hospital and the seriousness of the worker’s injury.

Factors That Determine Helicopter Use

Tree planting operations often take place in rugged and remote locations that are far away from hospitals or attended ambulance stations. In addition to the distance that must be covered, a tree planter who is injured may also need to be rescued from the side of a mountain or a forested area where regular vehicles cannot readily reach them. In such cases, helicopters can provide an important means of rescue, and a properly trained rescue team can pluck a worker from a mountainside and take them directly to the hospital.

Choosing a helicopter for an evacuation is an obvious choice in cases where helicopters were initially used to get to the site, or where there are no roads connecting the worksite area to roads leading to hospitals. This includes many islands and remote coastal areas. However, even where road access is provided, helicopters should still be used when they will significantly decrease the travel time for the patient.

The Golden Hour and the Importance of Quick Medical Care

The “Golden Hour” states that a critically injured worker’s chance of survival decreases greatly if they are not provided with proper medical care within 60 minutes. This is a guiding principle in determining how to transport a worker. Section 3.17.1 of the BC Occupational Health and Safety Regulation guidelines which states that air transportation should be used when it is the primary means of accessing the work location, or when surface travel time to the hospital is greater than two hours. The OHSR Guidelines also state that air transportation should be used if it is likely to save more than 30 minutes in transport time.

Regulations Guiding Air Transportation for Injured Workers

At each worksite, the employer needs to consider these directives in developing their emergency response plan and should provide their crew with clear directions based on the time and distance to the hospital. When air transportation is deemed to be the primary method of evacuation, the employer must verify that a helicopter is available each day and have a system for being notified if the helicopter becomes unavailable due to any reason. In cases where helicopter transport is not available, an employer must have an alternative means of transporting an injured worker or consider shutting down operations until rescue can be guaranteed in the case of an emergency.

Emergency Response Plan and Helicopter Availability

If and when a serious injury occurs, it may be necessary to make a judgment call on what type of transportation to use. In some cases, it may be most efficient to quickly package an injured worker into an emergency transportation vehicle and meet an ambulance at a set rendezvous point. However, in other cases, particularly when a worker is stuck in the middle of a forestry site and must be carried out before being loaded for transport, calling a helicopter can save precious time.

Making the Right Transportation Decision During an Emergency

During an emergency, it is up to the first aid attendant to make the transportation decision based on the situation and the needs of the patient. This decision is usually made immediately following the primary survey (airways, breathing, circulation, and rapid body survey). However, sometimes it may be made immediately based on the nature of the accident or injury. The first aid attendant needs to consider the time required to rescue the worker based on moving them from their current location, and not just the distance between the worksite and the hospital. In even moderately rugged terrain, it can take over an hour to carry an injured worker over a few hundred meters of ground. In that respect, the clock that calculates travel time starts the moment the first aid attendant decides that the worker must go to the hospital. Once the first aid attendant makes their decision, other employees must follow their direction and assist in preparing the injured worker for transport.

Preparing for Helicopter Evacuations: Marked Landing Areas

When relying on a helicopter, it is necessary to have a clearly marked landing area that has been identified prior to starting work. This landing spot needs to be away from any potential danger trees, and have adequate space for the aircraft to land. All loose items and debris needs to be removed, and workers need to be directed toward safe locations during landing and takeoff.

Helicopter Service Providers and Limitations

Employers may establish relationships with various helicopter companies and maintain a list of the independent service providers and BC Emergency Medical Services that are available in their area. Private helicopter companies often are limited in that they cannot always be guaranteed to be available, and may only provide aircraft support without medical services. Some employers also may hold memberships with TEAAM Aeromedical. TEAAM has multiple bases throughout BC and offer specialized extraction and medical assistance to support workers in remote and difficult-access areas. Several seriously injured workers have been rescued under the TEAAM program.