Ornge flies AW139s, S76s, PC12s across Ontario for medical transport

Going everywhere in Canada's most populous province, airborne med activity brings healthcare and saves lives.

By Mike Potts
Corporate Aviation Writer

A day in the life of an Ornge flightcrew. (Main photo) A PC12 has landed at YHF (Hearst ON) and the pilots stand by to assist paramedics in loading a patient awaiting transport. (Insets L–R) Capt Paul-Erik Binderup (L) and FO Patrick Rolls have the PC12 airborne again and bound for YQT (Thunder Bay ON), where the patient will be hospitalized. In the cabin of the PC12 Flight Paramedics Travis Given (L) and Mary Curry work to keep the patient stable throughout the flight. On the ground at the Ornge base in YQT, the flightcrew assist paramedics unloading the patient, who will be transferred to a waiting ambulance and taken to a nearby hospital for surgery.

It's pronounced "orange," like the color, so you think, "It must be an acronym." It's not. Instead, it's a transport medicine organization named after the color of its aircraft, which are bright orange. But they couldn't trademark "orange," so they dropped the A, creating a name that's distinctive and definitely makes you look twice.

What also makes you look twice is the scope of its mission. Ornge is responsible for providing medical transportation to the 13.2 million citizens of Ontario—Canada's second largest province, which spans 415,598 square miles. That's approximately the size of Texas, Oklahoma and Kansas put together.

Ontario's southern border extends 1677 statute miles east from Minnesota to the western part of upstate New York and reaches approximately 500 miles north all the way to Hudson Bay.

More than 90% of Ontario's residents live within 200 miles of the southern border, but if an indigenous fisherman gets injured in distant Fort Severn (population 400) or perhaps one of the smaller remote communities that dot the shore of Hudson Bay, it's still Ornge's job to go get him.

To accomplish this mission, Ornge uses a mixed fleet of fixed and rotary-wing aircraft, consisting of 10 Pilatus PC12 turboprops and 11 Sikorsky S76 helicopters, which are being replaced by Agusta­Westland AW139s.

But the Ornge organization is much more extensive than just its flight department. It has more than 400 employees, including physicians, paramedics and communications specialists as well as the pilots and maintenance personnel who support the flight department.

Its operation is also quite different from typical air ambulance operations in the US. In fact, what they do isn't called "air ambulance" at all. It's called transport medicine—which, Ornge executives explain, is a higher level of service than an air ambulance, with more extensively equipped and more highly trained medical personnel.

There are other differences as well. For one, fewer than 10% of Ornge flights involve transporting victims from an accident scene to a hospital. Instead, more than 90% are missions to transfer patients from one medical facility to another, usually so they can receive more extensive care.

1000 calls a day

Chief Operating Officer Tom Lepine inside the Ornge Communication Centre, which fields calls from all over Ontario. Communications specialists monitor patient conditions and adjust transportation plans to fit changing needs.

An Ornge flight begins with a call to Ornge Communication Centre (OCC), situated in a dedicated 4-story building about a 15-min drive from YYZ (Pearson, Toronto ON, Cana­da). The call will come from a medical professional or central ambulance communications center, as Ornge is not accessible through 911 calls from the public.

Ornge COO Tom Lepine says the OCC fields more than 1000 calls a day, with transportation requests ranging from simple patient transfers that can be accomplished in a basic land-based ambulance to moving the most critical patients requiring the maximum services Ornge can provide. Each call is routed to a triage system, where it is evaluated by a trained staff including an onsite physician whom Ornge refers to as the "doc in a box."

The name comes from the glass cubicle where a physician usually sits, evaluating patient conditions and transport requests, making sure that the most critical patients get service first.

Because new requests come in all the time and patient situations can change, the process involves a continuous balancing of needs and resources. It's not uncommon, says Lepine, for the OCC to divert a flight in progress to handle a more critical need that has arisen. In that case, he says, another aircraft is usually requested to take care of the patient whose initial trip was diverted.

Once the OCC determines that air transport is warranted, a decision is then made whether to use rotorcraft or fixed wing aircraft. If the trip will be in southern Ontario, where most of the population is located, it will probably be assigned to a helicopter. If the distances are longer and a proper landing site is available, fixed-wing will get the call. Patient location and aircraft availability will dictate the base from which the flight will originate.

Moving rotor ops

In southern Ontario, Ornge rotary ops are based at YTZ (City Centre, Toronto ON), although they are slated to relocate to YHM (Hamilton ON) later this year. Additional rotary-wing bases include YMO (Moosonee ON), YOW (Intl, Ottawa ON), YQK (Kenora ON), YQT (Thunder Bay ON), YSB (Sudbury ON) and YXU (London ON).

Fixed-wing ops are based at YQT, on the shore of Lake Superior, colocated with the Ornge helicopter operations, with satellite bases in YTS (Timmins ON) and YXL (Sioux Look­out ON).

When a flight is authorized, the request is sent to the flightcrew to evaluate weather conditions and any other safety issues that would affect the operation. If the crew declines a flight for safety considerations, there is no second-guessing, Lepine says.

"We also don't advise the flight­crew of the patient's circumstances," he explains. "We don't want them to accept a flight they would otherwise decline because we told them a 4-year-old just got hit by a car in some remote community. The flight decision is based strictly on flying safety factors, not the patient's situation."

At the operating bases pilots are standing by, waiting for the phone call that sends them into action. Ornge pilots fly no scheduled operations. Every flight begins with a call from the OCC.


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