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Air medical services and Air Ambulances

Air medical services is a comprehensive term covering the use of air transportation, aeroplane or helicopter, to move patients to and from healthcare facilities and accident scenes. An air ambulance is often required to provide urgent evacuation from a remote or medically under-served area to a more suitable, higher-level medical facility.


Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft.


Air medical services can travel faster and operate in a wider coverage area than a land ambulance. This makes them particularly useful in sparsely-populated rural areas. Air medical services have a particular advantage for major trauma injuries. The controversial theory of the golden hour suggests that major trauma patients should be transported as quickly as possible to a specialist trauma center.  Therefore, medical responders in a helicopter can provide both a higher level of care at the scene of a trauma and faster transport to a trauma center. They can also provide critical care when transporting patients from community hospitals to trauma centers.


In some remote areas, air medical services deliver non-emergency healthcare such as general practitioner appointments. An example of this is the Royal Flying Doctor Service of Australia, who also provide emergency care.



Helicopters can bring specialist care to the scene and transport patients to specialist hospitals, especially for major trauma cases. Fixed-wing aircraft are used for long-distance transport. Like ground ambulances, air ambulances are equipped with medical equipment vital to monitoring and treating injured or ill patients. Common equipment for air ambulances includes medications, ventilators, ECGs and monitoring units, CPR equipment, and stretchers.


Medical helicopters, because they are usually based on hospital premises, have no need to use airport facilities or ambulance services and therefore reduce team response time. Helicopters are able to land close to a referring hospital. Additionally, helicopters provide ease in loading and unloading patients and equipment.  The disadvantages of helicopter transport include its limited range, usually less than 150 miles,24 and its nonpressurized cabin, which limits the altitude at which patients can be safely carried. The low-altitude capabilities also subject the aircraft to variability in weather (i.e., fog, rain, and reduced visibility); therefore, helicopter flights experience much more interference due to weather. Other disadvantages include noise, vibrations, reduced air speed, small working space, lower weight accommodation, and high maintenance requirements.


An air ambulance is a specially outfitted helicopter or fixed-wing aircraft that transports injured or sick people in a medical emergency or over distances or terrain impractical for a conventional ground ambulance. Fixed-wing aircraft are also more often used to move patients over long distances and for repatriation from foreign countries. These and related operations are called aeromedical. In some circumstances, the same aircraft may be used to search for missing or wanted people.


When long distances must be traveled (more than 150 miles) or when increased altitude is necessary, fixed-wing aircraft are considered a viable mode of transport for patients. The advantages of using fixed-wing aircraft include long-range capabilities, increased speed, ability to fly in most weather conditions, control of cabin pressure and temperature, larger cabin space, and more liberal weight restrictions. Disadvantages of fixed-wing aircraft include the need for an airport with adequate runway length, difficulty in loading and unloading patients and equipment, and the pressure of air turbulence and noise.



Beginning in the 1990s, the number of air ambulance crashes in the United States, mostly involving helicopters, began to climb. By 2005, this number had reached a record high. Crash rates from 2000 to 2005 more than doubled the previous five year’s rates.  To some extent, these numbers had been deemed acceptable, as it was understood that the very nature of air ambulance operations meant that, because a life was at stake, air ambulances would often operate on the very edge of their safety envelopes, going on missions in conditions where no other civilian pilot would fly. As a result, nearly fifty per cent of all EMS personnel deaths in the United States occur in air ambulance crashes. In 2006, the United States National Transportation Safety Board (NTSB) concluded that many air ambulances crashes were avoidable, eventually leading to the improvement of government standards and CAMTS accreditation


The Federal Aviation Administration (FAA) and National Transportation Safety Board have imposed strict protocols that every air medical service operator must follow. According to a report published by Helioffshore, from 2013 to 2018, there were over 59 helicopter accidents. The FAA has placed specific rules to reduce the risk of fatalities and accidents while offering any emergency medical service.



Technology advances

Air ambulances are equipped with modern and innovative medical devices and accessories such as a ventilator, heart monitor, and defibrillator that provide initial emergency medical care to the  patients. The technological advancements in communication systems in an air ambulance allow the transfer of real-time data of patients’ health to the experts at the hospital, allowing the doctors to prepare for the emergency in advance.

In May 2020, EHang, a leading manufacturer of Autonomous Aerial Vehicles (AAV), successfully transferred staff and medical supplies in its two-seated passenger drone. The improvement in the medical infrastructure backed by AAV development can reshape the future of emergency medical services.


An advanced technology demonstrator (ATD) is an S-Band dual-polarized phased array designed specially to use as an air ambulance. A conventional air ambulance consists of a fixed-wing to transmit radio waves over clouds, a receiver to detect the precipitation, and uses a dish rotary wing craft that rotates and tilts to gather data.


In contrast, an ATD consists of a flat panel incorporated with several small rotary-wings that broadcast radio waves and collect reflections
back from the atmosphere. This phased array system allows the radar to be driven electronically. ATD is the first radar that is integrated with both dual-polarization and phased array technology. With the help of dual-polarization technology, an ATD can detect dry hail, snow, and clear air turbulence, which cannot be detected with the conventional air ambulance


Air Ambulance Market

The global air ambulance services market size was USD 4,476.9 million in 2019 and is projected to reach USD 8,773.6 million by 2027, exhibiting a CAGR of 11.48% during the forecast period


The air ambulance market growth in the Aerospace & Defense Industry is driven by factors such as the increasing prevalence of infectious diseases, the growing geriatric population, and the advanced onboard medical treatment.


The increasing prevalence of chronic diseases such as diabetes, cancer, cardiovascular, and others has surged the demand for air medical services. Another factor that gives rise to severe medical conditions is aging. According to the United Nations publication, in 2019, there were 703 million people over the age of 65 years, and the number is estimated to reach 1.5 billion in 2050. The rising old age population is anticipated to propel the market growth during the forecast period owing to the increasing rate of lifethreatening situations in the age group of 60-75.


However, factors such as the high air ambulance service charges, the operational constraints, and the lack of proper communication will hamper the market growth. Stringent Rules & Regulations Related to Emergency Medical Services to Hinder Market Growth.


Recently, the demand for air ambulance services increased owing to the lockdown across several developed countries, allowing only services of medical emergencies to operate since the COVID19 outbreak. However, the overwhelming process of obtaining permission from the government and mandatory COVID-19 tests have slowed down the operations.

In the past, global pandemics such as Ebola, MERS, SARS, H1N1, and the recent COVID-19 epidemic have revealed the speed at which the infections spread worldwide. The pandemic situations demand an agile response from healthcare teams, thus surging air ambulance services. Therefore, the novel coronavirus is likely to support market growth. Rapid Technological Advancements in Air Ambulance Services to Drive Market Growth


Based on the air ambulance market segmentation by type, the rotary-wing aircraft segment will have significant growth during the forecast period. This segment offers stainable growth opportunities to market vendors to improve business efficiency.


Based on the service operator, the market is divided into hospital-based, independent, and government. The independent segment is anticipated to be the largest segment during the forecast period due to increasing partnerships between private players and community health organizations.

For instance, in July 2020, GAMA Aviation was awarded a five-year contract by the Government of Jersey and the Government of Guernsey to provide air ambulance services between Channel  island and the U.K. mainland. The hospital-based segment is projected to be the fastest-growing segment during the forecast period. The growth of the segment is attributed to the improving business and types of service
models of hospitals.

Rotary Wing Aircraft to be Fastest-Growing Segment Fueled by Surging Demand for HEMS Amid COVID19. Based on aircraft type, the market is classified into fixed-wing and rotary-wing. The rotary-wing is predicted to be the largest and fastest-growing segment during the forecast period owing to the surge in demand for helicopter emergency medical services (HEMS) during the COVID-19 epidemic. Moreover, the increasing development of helicopters by key manufacturers dedicated to providing healthcare services is predicted to support market growth.

In January 2019, Airbus added 250 helicopters to HCare Smart, making the total count of aircraft to 2250. Airbus now has 19% of its worldwide fleet dedicated to HCare. The fixed-wing segment is anticipated to grow substantially during the forecast period. The segment’s growth is attributed to the wide range of services provided by fixed-wing aircraft such as aero-medical transportation, medical escort service, repatriation, and critical care patient transportation.

Organ Transplant Logistics Segment to Exhibit Significant Growth Fueled by Rising Organ Donations Based on the application, the market is divided into inter-facility, rescue helicopter services, organ transplant logistics, and others. A rise in the number of cardiac patients requiring immediate medical attention is likely to augment the inter-facility segment’s growth.

The rescue helicopter service segment is expected to dominate the market during the forecast period owing to the high demand for rescue helicopters to transport patients from remote locations. The organ transplant logistics segment is anticipated to grow at a high CAGR during the forecast period. A rise in organ donation is expected to increase the rate of organ transplants, which, in turn, increases the demand for organ transportation.


The global air ambulance services market is segmented into North America, Europe, Asia-Pacific, and the Rest of the World.


By geography, North America is going to have lucrative growth during the forecast period. About 52% of the market’s overall growth is expected to originate from North America owing to which the region will offer several growth opportunities to market vendors. The US and Canada are the key markets for Air Ambulance in North America.


North America stood at USD 2,142.8 million in 2019 and is anticipated to dominate the market due to the presence of several air medical service providers and the availability of advanced medical facilities in the region. Air Methods, Air Medical Group Holdings, Acadian Companies, and PHI Air Medical are some of the major players in the U.S.


The market in Europe is expected to grow significantly during the forecast period. The increasing investment by key players to develop and adopt advanced technologies that will improve the air ambulance service operations is likely to drive the market growth. For instance, in May 2018, the British Columbia Ambulance Service invested in enhancing its air ambulance program. The program included the adoption of night vision technology to improve emergency service quality in low-light conditions.


The market in Asia-Pacific is projected to grow at the highest CAGR during the forecast period. The improving economy of emerging countries such as China and India and the increasing healthcare investment by governments are anticipated to fuel market growth. The growing population, continued economic growth, rise in tourism, and the improving healthcare sector will increase demand for air ambulance operations in the Middle East.



EHang and the International Civil Aviation Organization (ICAO) are jointly developing an ambulance drone, Ambular, to efficiently tackle healthcare emergencies.


In September 2020, India’s first-ever integrated air ambulance was jointly launched by Kyathi and the International Critical Air Transfer Team (ICATT). The fixed-wing aircraft ambulance is equipped with an isolation pod to enable safe transport of critical patients affected by COVID-19.


Air Methods Corporation is a Leader in Offering Air Ambulance Services with its Large Aircraft Fleet Air Methods Corporation provides emergency air medical transport and treatment services through helicopters in rural and urban areas. High investments in integrating air safety programs and advanced technologies will help the company sustain its market position.


The market competition has raised the standards for new entrants, thereby challenging the major player’s community based on the quality and price of their services. Thus, major players such as Air Methods Corporation are focused on strategic mergers & acquisitions to endure their global market position.


Some of the companies are Air Methods Corporation (The U.S.), Global Medical Response Inc. (The U.S.), Acadian Companies (The U.S.), PHI Inc. (The U.S.), REVA Inc. (The U.S.), Express Aviation Services (The U.S.), European Air Ambulance (Luxembourg), Babcock,  Scandinavian Air Ambulance (Sweden), Air Charter Services Pvt. Ltd. (India), Gulf Helicopters (Qatar)


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