Do emergency services helicopters fly VFR when leaving base?

Question

I've recently been watching an interesting documentary on helicopter paramedic teams. As you all probably know, their job consists of a lot of sitting around doing nothing before a scramble and then a short (or not-so-short) flight out to the middle of nowhere and back again. On the (UK) documentaries I've seen, the aircraft are usually based at reasonably large commercial airports, physically located close to the fixed-wing runways.

In order to find the guy lying injured in the field and help him out of asystole, they have to rapidly launch from a presumably busy airspace, and get there ten minutes ago. Do airports have procedures that allow them to always assume an "exit route" is always okay, under some ceiling? Do they have to get take off clearance as other private aircraft would? I understand that they get given priority ATC clearance when in controlled airspace, but quite often their target call-to-takeoff times are less than two minutes, and it seems unlikely that the nearby 777 on FA would be done that quickly.

What happens if it's not possible to be VFR entirely on route? I have seen cases reported where difficulties are encountered due to fading light halfway through treating a patient -- meaning that the pilot is worried he can't take off again. It seems rather odd that, if a pilot was able to land in a field comfortably with good visibility, he can't ask for a route to be cleared, file a flight plan, and go to hospital IFR.

For that matter, how do police helicopters chase the bad guys at night in zero visibility?

Disclaimer: I've never set foot in a helicopter in my life, but have a single-digit number of hours in light aircraft -- sick people are more my forte.

Answer 1

If the helicopter is operating at an airport, it needs clearance like a regular flight, otherwise it would be a very dangerous situation for the helicopter and any other traffic in the area. Usually the ATC will give priority to the emergency helicopter (as much as possible), so it will leave the area without delay.

Regarding the weather conditions, there are two aspects that need to be considered:

• The regulations allow emergency helicopters to fly VFR below VMC minima (this is true in Europe, I have no idea about FAA). So, an emergency helicopter, can continue VFR with visibility down to 1km, or even 800 meters for short periods of time.
• If the helicopter is IFR equipped and the pilot(s) IFR rated, it can switch to IFR if necessary. On the way to the accident site this might not be very useful if the weather will not allow safe descent and switch to VFR, but on the way back to the airport/hospital, it can be very useful, provided the landing site has some kind of IFR procedure. Again, ATC will usually offer full cooperation in all this switching of plans and flight rules.

Answer 2

I dont fly rotorcraft but I do interact with emergency choppers in 2 ways. I'll speak form what I have seen, I am in Philadelphia (PA, USA) so all my experience is with the procedures around here (FAA).

Storage And Takeoff:
I am currently doing my training at Northeast Philadelphia Airport (KPNE) where the local police and news choppers are stored (I think the medical choppers are there as well but I have yet to see them there). I have seen them depart often and generally they can get in the air and get out of the way so fast they don't interrupt normal aircraft traffic.

I have, on a few occasions, been instructed to extend my downwind for one of them to land or take off but again they are out so fast it's almost a non-issue. Keep in mind that KPNE is not Philly international so I don't know what its like at other cities and if they hold traffic for them. I would think they try to store the choppers at smaller airports near the city for this reason. Most major cities have a few airports anyway.

Landing At The Hospital:
My apartment happens to be next to one of the major hospitals in Philadelphia and I have the pleasure of looking right at the pad on the roof from my window. That being said I also have the "pleasure" of watching them practice and make approaches at the hospital. I can confirm that they have made landings (and frequently at that) in IFR conditions or even what seems below IFR minimums.

I would say in the time frame I am home (after 5pm every day) they make on average one landing every other day or more. If the weather is good, they will try and get more in, I would assume these are practice but I can't see the doors of the chopper so I can't be sure.

Bottom line is in my area the rescue choppers do fly IFR. I'll try and capture a picture today (it's very cloudy) if they are on approach.

Answer 3

I don't fly rotocraft, but I can tell you if the airport is of any size they have to get a clearance unless they want to be turned into a hood ornament.

If the helicopter is pre-flighted and ready to go, it only takes few seconds to get a clearance, so it will not normally cause a delay.

Concerning IFR Flight: rotocraft require special equipment to fly IFR and it is much, much more dangerous than flying aircraft IFR because you are landing off field. Each operator and pilot have different policies, but in general police helicopters will rarely if ever fly IFR, and medivacs will only fly IFR if they judge it safe.

Note that flying at night is not the same thing as flying IFR. If the sky is clear it is VFR, even if it is night.

Being on a medivac crew is the most dangerous regular job in the United States and hundreds have died doing it.