Air Rescue Group, founded in Johannesburg in 2000, is an international air ambulance company that provides 24/7 long-distance, international air ambulance services.

The company maintains a number of bases across Africa, Asia, and the Middle East that give it one-stop range across most of the eastern hemisphere, including in Johannesburg, South Africa; Dubai, UAE; Port Moresby, Papua New Guinea; and Singapore.

While the company specializes in fixed-wing air ambulance services, the precise aircraft used vary from base to base. While the African fleet is made up of Hawker 800s, the two Asian ones operate a mix of Learjet 45s, Gulfstream G150s, Citation CJ3s, and Beechcraft King Air B200s. A fleet of Learjet 60s is also based in the Middle East.

Zak Bouhlel, Business Development Director at Air Rescue Group, explained that his company will typically ‘approach each requirement based on the region’s unique demands in terms of aircraft capacity and capability’.

“Every base has been strategically selected to allow a quick response [when evacuating] patients to the nearest center of medical treatment,” he said. “Hence, every type of aircraft aligns with this strategy, in terms of range, performance, and runway requirements.”

As an example, he cited the company’s use of King Airs in Papua New Guinea – an aircraft type that is known for its ability to land and take off on shorter runways, and in areas with less developed infrastructure.

Across each of Air Rescue Group’s bases, the company typically stations two configured air ambulances – however, Bouhlel added that ‘we can flex this capacity during periods in which we need to respond to requests for additional capacity’.

“The fleet composition we have today effectively addresses the needs of our clients, but we are continually working on reshaping our platforms to anticipate future demand and shifts in activity levels,” he said.

Crew and training

On a standard medical evacuation, Air Rescue Group typically deploys a team of one flight physician and one intensive care nurse or paramedic per mission, and aims to maintain enough staff at each of its bases to deliver ‘round-the-clock’ availability for mission activations, said Bouhlel.

Air Rescue Group typically deploys a team of one flight physician and one intensive care nurse or paramedic per mission

Ensuring this availability requires the company to maintain a consistent number of staff – and to make sure that they are well trained. In order that new team members are well prepared and familiar with how Air Rescue Group operates, the company requires all new recruits to undergo a program of training.

“We have comprehensive induction training for all new medical staff members,” he explained. “This includes a structured orientation on equipment, aircraft, and documentation; an introduction to our policies and procedures; observer flights with existing crew members; and a probation period for performance assessment and identification of additional training needs.”

After this, new recruits are put through a ‘thorough ongoing training program’ which includes: ‘monthly training days with skills-based sessions and simulation training; weekly academic meetings; monthly morbidity and mortality meetings; debriefs after flights; provision for mandatory short courses; attendance at relevant conferences; and a program for basic life support and resuscitation training for pilots’.

Equipment and assessing callouts

When Air Rescue Group receives a callout, it is important to determine what the needs and requirements of the patient are, and what the best method of transport would be. “This is always a complex decision to make,” explained Bouhlel, “since the mission profile needs to be considered in conjunction with the patient’s clinical decision.”

When conducting a transfer, ‘information about the patient’s clinical condition’ is often limited, Bouhlel noted, adding that because of this, ‘we always err on the side of caution and make provision for the worst possible scenario’.

We have specialized equipment for certain medical conditions that is prepared and taken along for certain missions

“We have a standard list of medical equipment and medication that are taken on every air ambulance mission, regardless of perceived acuity … enabling us to do critical care transfers for any patient or condition we might encounter,” he said. “In addition, we have specialized equipment for certain medical conditions that is prepared and taken along for certain missions.”

Air Rescue Group’s standard equipment list includes a transport monitor, ventilator, infusion devices, point-of-care blood testing device and a portable ultrasound, as well as ‘all lifesaving medications that will commonly be found in the emergency department and ICU [intensive care unit]’.

He elaborated: “We must ensure that we ‘first do no harm’, and that by transporting the patient, we do not contribute to an unacceptable deterioration in the patient’s condition.” The key factor in this is weighing the potential benefits of transporting a critically ill patient to a place where they can receive a high standard of care, versus what will happen if the patient remains where they currently are. “Putting the needs of the patient first makes the decision on the best method of transport easier, and guides the leadership team in their approach,” he concluded.

Plans for the future

Air Rescue Group has invested in a number of new pieces of equipment in recent years – in part, argued Bouhlel, because ‘medicine is constantly evolving, and as a medically led organization that strives to differentiate itself from the rest, we stay on top of the new developments’.

“Recent updates in basic monitoring equipment, transport ventilators, and automated CPR [cardiopulmonary resuscitation] devices necessitate continuous investment, and we budget for equipment upgrades and enhancements on an annual basis,” said Bouhlel. “Furthermore, specialized modalities like extracorporeal membrane oxygenation (ECMO) transfers have come to the forefront in recent years, and will have to be a consideration going forward.”

The company has also recently deployed ‘generative artificial intelligence’ to support its business process optimization, and to ‘identify opportunities for automation

Air Rescue Group also plans to introduce a new operations software system in 2024. The system is currently undergoing assessments and testing ahead of its implementation. Bouhlel said that the company has also recently deployed ‘generative artificial intelligence’ to support its business process optimization, and to ‘identify opportunities for automation’.