Provider Profile: Airlec Ambulance
Group Medical Director Dr Yann Rouaud introduced Airlec Ambulance’s blood carrying capacity to the travel insurance and assistance community at the ITIC Global event in November last year. AirMed&Rescue found out more about the French fixed-wing international air medical service
The Airlec Group we know today dates back to 1997, when Patrick Tiba bought the rights to the name of what had been a major firm and France’s oldest business aviation company. He decided at that time to specialise in air ambulance flights, which now account for some 80 per cent of Airlec’s work. The company flies more than 1,000 patients each year.
Patrick Tiba continues to serve as President and Chief Pilot – he is qualified as a Captain on the service’s Merlin IIIB and Citation planes. It’s a family concern, with son Paul Tiba in the role of Managing Director. Like his father, Paul is also a pilot, flying as captain on the Hawkers; both father and son still fly air ambulance missions alongside their leadership roles. Paul completed an aeronautical degree before working in every department at Airlec, an experience that he says gave him a deep understanding of every position in the company. He has served as managing director since 2011.
Headquartered in Bordeaux, southwest France, the overall Airlec Air Espace group employs 35 staff, comprising pilots, engineers and technicians. The firm also has a presence at Paris-Le Bourget Airport, including a permanent logistics replenishment base and a supplementary pharmacy.
The group includes the Airlec Medical division, which provides international medical escort services onboard commercial flights and ground ambulances, and Airlec Ambulance, which flies patients onboard fixed-wing aircraft. Airlec Medical has 55 doctors and nurses at its disposal, who are called on for the medical evacuations carried out by Airlec Ambulance.
Structure
The current fleet, split between Bordeaux Aiport and Paris-Le Bourget Airport, comprises three turboprops (Merlin IIIBs) and three jets (a Citation Eagle II and two Hawker 1000B Elixirs). At least one aircraft (usually two) is on stand-by in Paris, along with four pilots. Each of the jets can accomodate two stretchers.
Regular flight simulator training affords ‘the ability to perform any kind of flight to any destination
For long-range missions, the Hawker 1000Bs offer a range of 3,000 nm, along with a stand-up cabin, a toilet, generous luggage bays and a loading ramp. When the second Hawker joined the fleet in summer 2017, Airlec highlighted its capabilities by listing the journey times possible, such as Paris to New York in eight hours, or Paris to Tokyo in 15 hours. As an example of actual missions, in March 2017, Airlec flew a patient from Montreal to Paris non-stop, and in May 2017, the firm completed a successful medevac from Iran to Belgium in one flight.
Airlec says it only uses experienced pilots, with its captains having an average of 8,000 flight hours under their belts. Regular flight simulator training affords ‘the ability to perform any kind of flight to any destination.
The planes are maintained by Airlec’s team of in-house tehnicians in Bordeaux, supplemented by manufacturer service centres.
Medical specialities
The medical side of the business is headed up by Dr Hamida Chaouky (scientific and human resources) and Dr Yann Rouaud (communications and corporate side), who was appointed as Group Medical Director in August 2017. Dr Rouaud specialises in emergency medicince and disaster medicine, and has advanced cardiac life support (ACLS) and PALS certifications. As well as his hospital roles as an emergency physician, he worked as a flight doctor for a medical assistance company, performing medical evaucations, and has held senior positions with assistance companies around the world.
A standard flight medical team comprises of a nurse and a doctor, and Airlec can dispatch paediatricians, gynaecologists, obstetricians and surgeons for difficult cases. All medical crew have an emergency care background, enabling them to repatriate patients in need of intensive care. The team also undergoes continuous training in medical aviation to keep abreast of the latest methods and technologies, and to guarantee the best care possible.
Airlec’s medical specialities include neonatal and paediatric intensive care. The service accepts bariatric patients weighing up to 168 kg, using loading ramps to board patients through the 92-cm wide door of a Citation Super II plane. Airlec can also conduct extracorporeal membrane oxygenation (ECMO) flights, and a surgical team consisting of a heart surgeon, a perfusionist, an anaesthetist and an intensive care nurse is operational for repatriation of patients with acute respiratory distress syndrome (ARDS) or cardiogenic shock.
More unusual, perhaps, are the service’s history of flying patients infected with Ebola, and its recent adoption of a blood-carrying protocol
More unusual, perhaps, are the service’s history of flying patients infected with Ebola, and its recent adoption of a blood-carrying protocol. Airlec has transported infectious patients using a negative-pressure isolation stretcher, and says it transferred the majority of European patients during the Ebola disease crisis in the winter of 2014-15 – one mission in October 2014 saw it become the first European aviation company to repatriate a confirmed Ebola patient, says the firm. The pilots and plane were supplied by Airlec, joined by a doctor, nurse and medical equipment from Medic’Air International.
In October the following year, Airlec was awarded the Baltic Air Charter Association’s (BACA) Humanitarian Award for its Ebola work. Speaking at the time, Paul Tiba, who received the award at a ceromony in London, said: “During the Ebola crisis, we instinctively knew we had to act and were confident that our aircraft and team were equipped to carry out the flights.”
BACA noted that while global advice was against flying into the region, Airlec created plans in co-ordination with the French government. BACA said: “The whole mission lasted only 42 hours, between the alert from the NGO and the return of the patient from Sierra Leone to Norway. The flight was conducted on Airlec’s Citation Super IIXR aircraft, (fitted with a cargo door) with most flying taking place at night. The most challenging part of the mission was to obtain landing permits for technical stops (refuelling). In total, Airlec safely performed eight repatriations of aid workers who were suspected or infected by the Ebola virus.” The company now uses its own medical team for cases involving infectious diseases, including Ebola, and last month successfully flew a patient with suspected Lassa fever.
In July 2017, Airlec Ambulance announced that it had developed a medevac blood transfusion protocol after signing an agreement with the Etablissement Français du Sang (EFS), the French national blood service, which gave it access to plasma and red blood cell concentrate. The firm said it was taking the initiative to respond to the need for blood transfusions on medevac missions, putting an end to dramatic situations where patients could not be rescued due to blood needed for transfusion being either unavailable or unsafe where they were being treated. Dr Rouaud, in presenting the new protocol to the audience at the International Travel & Health Insurance Conference (ITIC) in Barcelona, Spain, last November, gave road traffic accidents and gastrointestinal bleeding as examples of situations where the ability to fly blood to patients would be advantageous, and detailed the company’s first use of blood products on a live mission: a patient with malaria was successfully flown from Abidjan, Côte d’Ivoire, to Paris, France.
Ethics
Something emphsasised in Airlec’s marketing is its pride in French medical culture and strong belief in ethics. Dr Yann Rouaud explained: “Airlec Ambulance, a state-of-the-art air ambulance company, is first of all a family business with genuine human values and truthful leadership. By experience, we know that urgent evacuation/repatriation situations carry many challenges with a lot of emotion for patients, families and clients. Therefore, we proudly commit to keep all stakeholders at the centre of everything we are doing. Top technology, [high] performing jets as well as highly skilled medical teams is one thing, but a benevolent and empathetic relationship is a must through hard times. Trust has to be well deserved. Our philosophy is, and will always be, to offer efficient solutions and make a positive difference in people’s lives.”
Looking forward
As for the future, a representative told AirMed&Rescue that Airlec is constantly on the move. The company acquired two more jets, a Hawker 1000B and a Hawker 9000XP, in late February. They are now being modified to air ambulance configuration and will be integrated into the fleet this summer. Airlec said that the purchase was made ‘in order to respond to an increasing number of requests’. For Airlec, it seems, the only way is up.
June 2018
Issue
James Paul Wallis
Previously editor of AirMed & Rescue Magazine from launch up till issue 87, James Paul Wallis continues to write on air medical matters. He also contributes to AMR sister publication the International Travel & Health Insurance Journal.