Based in the location that gave birth to powered flight, DARE Medflight shows us how they manage to keep their county safe with their forward thinking approach to HEMS.
Dare County, nestled into the corner of beautiful and historic northeastern North Carolina, resides along the Atlantic seaboard. Formed in 1870, Dare County is named in honor of Virginia Dare, the first child born of English parents in America. The county stretches along nearly one-hundred-ten miles of shoreline in an area best known as the Outer Banks. Manteo, the county seat, lies just ninety miles to the south of Virginia Beach, and serves as the base for Dare Medflight, operating out of Dare County Regional Airport.
With a permanent population of approximately 33,900 people, the task of providing helicopter emergency medical services (HEMS) over such a large area would look —to the outsider— to be a fairly uneventful task in such a sparsely populated area. The county’s tourism industry, however, results in quite a large seasonal population. Between the months of June and August, Dare County is home to an estimated 225,000 to 300,000 people. One of the many tourist attractions that draws people to beautiful Dare County, NC, is the First Flight Airport. This little aerodrome, located in Kitty Hawk, is known also as the birthplace of aviation. It is the iconic place where the Wright Brothers took to the skies in the first powered airplane flight on December 17th, 1903. Today, not far from that very beach, there lies a monument to signify that epic historical achievement, as well as a museum commemorating the event.
Dare County first realized the need for providing a county based helicopter program in 1975. The operation recently celebrated their 40th year of service in 2015. Things have come a long way since the inception of Dare Medflight, who began operations with a single Bell 47. At the time, the little Bell was used purely in a search & rescue capacity. After the Department of Defense requested that the county provide medevac services for the nearby combined Air Force and Navy bombing range, a deal was struck between the county and the DoD 1979. The county was given a surplus Bell UH-1H Huey for the role. The deal further allowed for the Huey to be used for county-based missions, thereby allowing for the county to utilize the Huey for its own HEMS needs. As needs changed over the years, the county medical program changed with it. In 1986, Dare Medflight purchased a 1984 model BK117a3, later replacing that aircraft in 1990 with a 1986 model BK117 B2— a helicopter which still serves as a backup aircraft for the county today. Medflight’s most recent acquisition is not without significance; they purchased the first HEMS configured Airbus H145T2 in the United States, taking delivery of the ship in a widely publicized ceremony on August 15th, 2015.
Dare Medflight’s Chief Pilot, Chad Jones, noted that Dare County had been operating the BK117 for 25 years, and while proven to be a capable and robust aircraft for the county, parts were becoming harder and harder to obtain, which meant increased downtime for the program without a backup aircraft in place. During the search for a replacement aircraft, Jones said that they had evaluated several aircraft, including the H145T1, H135, and Bell 429 before finally deciding on the H145T2 due to its larger fuel load capacity, as well as various other advantages they perceived the aircraft had over its competitors. Some of those included the ducted fan fenestron tail, a feature which has become increasingly popular in HEMS operations in the Airbus H135, AS365, and now H145T2. The fenestron offers added protection by way of the enclosed tail rotor system, in addition to a reduced noise footprint— an asset in an area that relies heavily on tourism dollars.
The decision to purchase a new aircraft was one that Jones says was not taken lightly by the county as they narrowed down the selection of aircraft available for their mission. Dare County had, until 2013, operated Dare Medflight as a taxpayer subsidized operation, but with the rising costs of operating the program and the replacement cost of what was to be the new H145T2, the county opted to move forward and transition Dare Medflight into becoming a Part 135 operation. The entity now charges for their flights like most HEMS based operations, although Jones stresses that the move to becoming a 135 operator is not something that the county aims to make a profit from. County representatives hope that, by moving the program into being a 135 operation, it will help offset the cost of the new aircraft and costs of both aircraft operation and maintenance, as well as the personnel and associated costs required to keep the program running each year. They stated that they would be happy just to “make it into the black” each year, rather than be “in the red.” The county views the purchase of the H145T2 as a long-life aircraft, just as the previous 25-year old BK117 was for the county— a workhorse aircraft that served the residents and visitors of Dare County with distinction for a quarter of a century.
Staffing at Dare Medflight consists of Jones as Chief Pilot, four line pilots, a director of maintenance, an A&P Mechanic, and twelve flight paramedics, the latter of whom are sourced from the county’s own road ambulance service. For paramedics to become flight paramedics for Dare County, they must have at least two years of road experience as an ambulance based paramedic before being eligible to apply for a flight paramedic role. Being a county owned and operated program, when the helicopter is not flying due to poor weather, the medics may be reassigned back on to a ground ambulance if the conditions are forecast to last an entire shift. The same applies during maintenance periods where the aircraft is out of service for extended periods of time. That is in sharp contrast from many private HEMS operations, where staff is on call 24/7. Pilots who fly for Dare Medflight must have a minimum of 3,000 total flight hours, at least 2,500 of which must be in a helicopter. Additional requirements are 1,000 hours of flight time in a turbine aircraft, 200 hours flown at night, NVG qualification, and multi-engine experience— tough requirements to meet for all but the most seasoned of pilots.
Delivered in August of 2015, the new H145T2 flown by Dare Medflight is state of the art. Fitted with IBF and WSPS, ADS-B IN/OUT compatibility, Weather Radar, as well as downloadable WX via SiriusXM, and four-axis autopilot that is coupled with dual Garmin GTN 750, though they expect a WAAS upgrade in mid-2016. The H145T2, as previously mentioned, also offers increased fuel load and range capacity— a deciding factor in the choice by Dare County to pick the aircraft. The rear configuration of the aircraft contains an EMS interior that also sports the latest in technology. Outfitted by Metro Aviation, the HEMS interior features the latest medical equipment on board, and even has functionality to change cabin lighting from the standard white lighting, to the more appealing blue interior lighting— a feature which is controlled by a screen that each paramedic can manipulate in back if needed. Also in the rear cabin is a touch screen communications panel, enabling the rear cabin crew to dial in the communications channel needed while in transport to a hospital to communicate with trauma teams if needed before arriving at the destination, saving precious moments during “the golden hour,” or first hour between injury and treatment at a level one trauma center.
Dare Medflight, while operating primarily in the HEMS role, performs in a multi-mission capable role as needed. Although not fitted with traditional multi-mission equipment —such as a FLIR unit and rescue hoist— due to the limitations it would incur on patient weight and flight speed, Dare County performs a wide range of activities outside of a traditional HEMS role. Dare’s program has an average of 286 patient transfers each year, in addition to responding to calls for search & rescue, and related activities, an average of ten to fifteen times each year. Any hurricane activity in the area —a weather phenomenon that’s no stranger to the Carolina coast— can significantly increase that number depending on the severity of the hurricane damage to the area.
As a regional resource, Dare Medflight has been called out to look for missing boaters in a search capacity previously, as well as to help disaster victims along the coast after hurricanes have left many stranded in their homes due to flooding between the many islands in and around the outer banks. Dare Medflight successfully executed countless missions during the last hurricane. Among their more unconventional mission profiles that become anything but uncommon during times of crisis, included flying in generators and food to areas that had been cut off due to rising flood waters. The aircraft was also used to ferry rescue workers, power company workers, and other forms of aid into and out of affected areas. The aircraft is also used, albeit only occasionally, for prisoner transport in emergencies, should a prisoner need level one trauma care. In such a case, the crew is augmented by a police officer or deputy to ensure the safety of the crew during transportation.
Overseen by the Dare County Public Safety Department, Dare Medflight is headed up by the county’s EMS Deputy Chief, George Farah. Deputy Chief Farah has been with Dare County for the last twenty-seven years, and a member of the Dare Medflight team in some capacity for a majority of that time. Chief Pilot Chad Jones said, in relation to their multi mission work, “While we are primarily helicopter EMS, the role we play for the county is being a first responder in our area. We have great support from the Coast Guard for search & rescue, but due to our close proximity, it makes sense for us to respond initially, as their response takes some time. Once they arrive, we hand the mission over to them and break off. The same can be said for the National Guard during hurricanes. WE are able to provide the citizens of the county immediate life support response in some way to help until mission-specific aircraft arrive on scene to take over.”
Dare Medflight responds to scenes around their own county regularly, and have also been called in to provide mutual aid to neighboring counties on multiple occasions. The operator will take patients from many facilities in the county, including the Outer Banks Hospital, Hateras, and Avon medical centers, and deliver patients to Norfolk General in Virginia to the north and Vidant Medical Center to the southwest, in Greenville, SC. Several other level one trauma centers can also be utilized by Dare Medflight depending on a patient’s treatment needs. Dare Medflight saves vital time in a large response area— an area so large, in fact, that it could take a ground ambulance up to two and a half hours to complete a transport that takes the helicopter can accomplish in under forty-five minutes.
One thing is evident in Dare County: Their focus on providing the most up to date equipment to service the citizens and visitors to the county is second-to-none. Their acquisition of the H145T2 was a purchase geared not only to the increasing need for quality helicopters, but with a view of the aircraft being in service for many years to come. In the county where the first powered flight was completed over one-hundred years ago, Dare County Medflight is still making strides in providing the most modern technology available to its citizens.
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Ryan Mason is the Publisher and Editor in Chief of Collective Magazine. Ryan has worked in aviation media for the last nine years as a photographer and journalist, providing written and photographic content for multiple international aviation publications covering both fixed wing and helicopters. Ryan has also written for law enforcement publications on tactics, equipment and airborne law enforcement, drawing on his years of experience as a police officer in the Midwest United States. You can reach Ryan at email@example.com