Experts: Air ambulance helicopter would be a 'luxury' for Estonia

The recent tragic death of a sick child after a helicopter was unable to be sent from the mainland due to bad weather has once again raised the question of what capabilities Estonia needs. The Ministry of the Interior will complete an analysis within a month.
In Estonia, rescue or emergency flights are provided by the the Police and Border Guard (PPA). Those connected to medical issues account for around 25 percent of all flights made.
"In Estonia, the most cost-effective way to maintain a helicopter fleet for the state is to ensure the helicopters are involved in rescue operations, support K-Commando missions, and also assist in transporting people when someone has been injured," Minister of the Interior Lauri Läänemets (SDE) told Sunday's "Aktuaalne kaamera."
The PPA flight unit has three helicopters and two airplanes. In an emergency, they must take off within 15 minutes. They must undergo regular maintenance and sometimes unexpected breakdowns occur.
They are also limited by bad weather. "Unfortunately, our current system is not very reliable. Therefore, we must avoid flying under these conditions," said Rain Jõeveer, head of the PPA's air unit.
Last week, newspaper Eesti Ekspress reported a child with flu could not be airlifted to hospital from Estonia's largest island Saaremaa due to bad weather conditions. Instead, the child was driven by ambulance, but sadly died.
There are weather conditions that no helicopter can fly in, but it is also true that insufficient de-icing capabilities and problems with spare parts mean Estonia's helicopters are increasingly unable to take off, AK said.
The questions of exactly which capabilities Estonia need was also raises. Should Estonia have a separate helicopter for the ambulance? Flights could be provided by a private company but it would cost approximately €8,000 per hour.
"Maintaining a dedicated medical helicopter would cost us around €2 million per year. When we talk about Estonia, the number of trauma cases is so low that it is very difficult to say how many lives we could save if we had a separate medical helicopter," said Nikita Panjuškin, head of healthcare services at the Ministry of Social Affairs.
Ninety-five percent of Estonians live in areas where an ambulance service is 15 minutes away. Ministry officials and medics still a separate air ambulance as more of a luxury service.
"Unfortunately, living in the periphery where connectivity might not be the best, we cannot always count on suitable flying weather in Estonia. Investing a significant amount of additional money to improve a system that already operates at 95 percent efficiency to reach 99 or 100 percent efficiency — spending such a large sum for that 4 percent — seems somewhat impractical," said Lilian Lääts, head of the ambulance center at the North Estonia Medical Center (PERH).
The Ministry of Social Affairs estimates that medical flights have such a limited capacity that it makes more sense to develop the availability of medical care on the ground. The majority of helicopter flights are made to Hiiumaa and Saaremaa hospitals.
"The most important thing is how quickly the initial ambulance crew reaches the person to begin life-saving measures, stop bleeding, and so on. The speed at which the secondary responder, such as a medical helicopter, arrives is already a secondary matter," said Panjuškin.
He said improving medical flight capabilities would not prevent similar incidents form occurring again. Instead, the whole healthcare system needs to be developed.
"Above all, we must ensure that all necessary healthcare services are available everywhere in Estonia, not just in Tallinn and Tartu," the official said.
Air Squadron Commander Jõeveer said most of the time there is enough equipment to go around. The problem is when several incidents occur at the same time.
"We would be able to take on more tasks, including medical flights, to some extent. However, when we talk about rescue or police work, a helicopter or airplane by itself does not constitute a rescue. It is just one part of a whole system, as there are always ground units and marine units as well. If someone notices today that a helicopter is in maintenance for a certain period, it does not mean that rescue capabilities are lacking in Estonia. It is often said that if we lack one specific tool, everything is missing — but that is not the case," he said.
The Ministry of the Interior is currently studying what the future of Estonia's helicopter fleet.
"It is intended to fulfill as many functions as possible for the state, and this function should likely remain in the future as well. Whether we should purchase additional helicopters beyond the current three, renew the existing ones earlier, or update all of them or just a few, are questions we need to consider," Läänemets said.
Two things are clear: helicopters should all be the same and they should all be equipped with de-icing systems. This function is currently only available on one out of three helicopters.
Jõeveer said de-icing equipment is needed for at least four months of the year.
The results of the analysis are expected in about a month.
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Editor: Marko Tooming, Helen Wright