Estimated reading time 14 minutes, 17 seconds.
Not only is A the first letter in the alphabet, it also marks the beginning of a new era in modern helicopter emergency medical services (HEMS) in Austria. It was back in April 2001 when the first of two helicopter rescue bases under the name ARA Flugrettung opened its hangar gate in Fresach, in southeastern Austria with the call sign RK1.
About a year later, a second base called RK2 opened in the north-Tirolean town of Reutte, and Air Rescue Austria (ARA), a sister company of German HEMS giant DRF Luftrettung, started redrafting the way helicopter rescue was done in high-alpine terrain. Flying the legendary MBB (now Airbus) BK117 (versions B2, C1), ARA was the first, and for 13 years the only operator using a hoist for technical rescue missions. In 2018, it became the first air rescue company to introduce the Airbus H145 to Austrian skies. Vertical Valor spent a rather busy August weekend with the crews of RK2 aboard an H145, the operator’s current workhorse and leading HEMS machine.
ARA typically flies with a crew of four, explains chief flight paramedic Elmar Flatz while showing us around the RK2 base. The pilot and technical crew member/hoist operator are in the cockpit, with a flight paramedic and a doctor in the cabin. The hoist operator is also a fully qualified paramedic but does not leave the helicopter for technical rescues during flight missions. If there are missions not indicated for a helicopter, or it can’t take off because of bad weather, that crew member hits the road as an ambulance driver, together with a doctor, to reach the patient by ground.
The concept is simple and serves the region of northern Tyrol close to the German border. The RK2 helicopter is based at the doorstep of Reutte hospital and the base serves as the emergency rescue launchpad for both air and ground response. It is not a permanent job for any of the crew members except pilots, who usually take weekly shifts, while the doctors come from surrounding hospitals. Flight paramedics typically take two to three days of duty a month.
“It may sound like a cliché, but what I value the most is that we’re an excellent group of people, strong team,” Flatz says as Capt. Christian Brunnlechner serves eggs sunny side up during mutual breakfast on a warm August Saturday. It looks like a calm, sunny morning, so the red-white-black H145 goes out from the hangar, patiently expecting its first scramble message. Crew members always wear harnesses on duty because every fifth mission, of about 900 per year, requires a hoist. The first incoming call, shortly before noon, turns out to be one such mission.
Born for the Alps
The Tirolean region close to the German border is filled with treacherous mountain terrain that reaches 3,000 meters (9,842 feet) above sea level, requiring ARA crews to feel at home at high altitude. Flight paramedics must be skilled mountain rescuers as the front-line responder for year-round alpine evacuations. For flight physicians as well, solid mountaineering skills in both summer and winter conditions are an absolutely vital part of the job.
The helicopter and crew serve as a self-contained, mountain-rescue medical unit for most alpine missions in Austria, but technical rescues on the German side of the border require a mountain rescuer on board, according to an agreement with Bavarian Mountain Rescue in Bad Tolz.
With pagers still beeping, everybody gets seated, rotors spin, Flatz completes a standard operating procedure checklist and announces, “Cabin OK.”
After a gentle lift-off, we’re heading to the mountains near Ehrwald, Austria, to help a female patient with head and leg injuries. After receiving the coordinates and details of the mission it is clear we have to use the hoist, as landing would be impossible due to the rather steep slope and trees.
“It’s a hoist one!” doctor Florian Muckenthaler says excitedly. The H145 is certified for hoist operations on both sides of the fuselage, but to standardize operating procedures with DRF — the German mother company — ARA operates the hoist from the right side. From his seat on the right, the pilot can better see hoist operations in progress, especially among steep mountain walls.
The hoist operator has to make his way from the cockpit to the right-side sliding door through the cabin, but the procedure is smooth, and despite being attached to the fixed anchoring points, nobody gets in the way of each other.
It takes a 40-m (130-ft) winch to reach the elderly female patient on a narrow mountain trail, who is in the care of ground-based mountain rescuers. Based on their assessment, Muckenthaler decides evacuation by air is warranted. After safe transport of the tourist to the hospital in Garmisch, Germany, the skids are back on the platform in Reutte — about 43 kilometers (27 miles) away — exactly 45 minutes after take-off.
On the road again
After only a seven-minute pitstop, our H145’s engine spools back up. No hoist this time. We’re called to a grassy area in Mittenwald, Germany, near a bike trail where a female on an electric bicycle lost control and crashed.
The patient is prepared for pick up in an on-scene ambulance and loaded into the helicopter. In short order we’re landing in Murnau, Germany — a hospital about 40 km (25 miles) away by car — and the home base of another H145 called Christoph 74. This particular aircraft is operated by German ADAC, the largest automobile club in Europe that also operates a fleet of rescue helicopters.
There is no time for lunch — just a quick coffee, replenishing medical equipment, and we are skids up for a motorbike accident in Biberwier, Austria, where a local road forms more than a generous landing pad for our helicopter.
While loading the young concussed biker into the cabin, a background panorama of the Alps is a reminder the next mission could be there. As it turns out, that reminder was prescient.
Just 40 minutes after dropping that patient off at the RK2 base in Reutte, the pager beeps again, and everyone on the team, and the helicopter, are ready for whatever and wherever the call may lead them.
This time, the mountains are calling. Specifically, the Wank mountain in Germany, where a hiker suffered a knee injury on a mountain trail. The rescue is routine, with a German mountain rescuer hoisted 25 m (82 ft) down to a ridge trail. Using a rescue triangle, the patient is hoisted and we’re soon on the way to the clinic in Garmisch. What started as a calm day had turned into a series of back-to-back rescue flights. It turns out the climax was is to come.
We receive another call before returning to Reutte directing us to the scene of a car accident with multiple traumas in Klaus, Austria. When we arrive, the road is blocked and the flashing lights of fire trucks and ambulances light up the sky, quickly darkening because of an incoming storm.
Right after touchdown on a small field near the road, our medical team is running to the crash site, receiving direction from a Red Cross officer to where help is most needed. It’s reminiscent of a movie scene, except it’s real. A car has collided head-on with a van causing several casualties that lie about on the ground. Our team focuses on a patient stuck in the front seat of one of the vehicles with suspected severe leg and spine injuries.
Firefighters and medical personnel scurry amidst the flashing colored lights, equipment, and debris from the crash. The sound of helicopter blades cuts the air as rain suddenly pours from the sky. It’s the Christoph 74 H145 we met in Murnau earlier today, now landing at the scene, as is a yellow OAMTC EC135 T2+, callsign Christophorus 1, from Innsbruck, Austria, that was offloading a patient nearby before being called here.
After rendering urgent medical treatment, the patient is successfully freed from the car and transported on a backboard through the road barriers and up a wet, slippery slope to the helicopter.
The rain intensifies, and we leave the flashing blue lights and busy crash scene behind on the way back to Murnau. Shortly before 7 p.m., the helicopter lands at home base and goes into the hangar in a heavy downpour.
“There’s another storm coming from the northeast,” says pilot Christian Brunnlechner while parking the towing tractor. Sitting in front of a TV to watch the evening news in a break room that resembles a cozy living room, the team is interrupted by another page. We take off into an orange, hazy sky toward the towering walls of the 2,962-m (9,717-ft) Zugspitze — Germany’s highest peak.
This time a hiker has missed the descent path and is stuck at the end of his too-short abseiling rope. Upon reaching the GPS coordinates, Brunnlechner maneuvers the H145 along the mountain wall while the crew scan the rocks for the hiker in distress. In less than five minutes Flatz spots a blue jacket on a small plateau beneath an almost vertical waterfall of glacial runoff.
The hiker is at the end of a very narrow canyon, requiring cautious, precise aircraft handling and rescue operations. It’s also already dark. Flatz dons a rain jacket and rides the hoist 37 m (121 ft) to reach the exhausted, hypothermic man.
Brunnlechner uses the mounted TrakkaBeam searchlight to illuminate a reference point on the mountain wall. Hoist operator Hubert Dreer keeps the lit rock in peripheral sight to better steady the hoist. There’s no room for error, as the patient is perched on a very small outcropping. A static hoisting succeeds without rotating the patient and Brunnlechner reverses the machine out of the narrow canyon into the dark.
“The helicopter’s four-axis autopilot is a huge asset in such situations,” Brunnlechner explains after landing back at home base, just 30 minutes after take-off from the canyon. “The GTC and GTC hover modes are hands-on automated modes, yet still remove a lot of workload in the moments where absolute situational awareness is required and a lot is going on in and under the helicopter.”
The stranded hiker is in the good hands of the doctors at our home base hospital in Reutte, and the helicopter undergoes a thorough clean up after what turns out to be the day’s final mission.
“Well, of course it is hard to predict, but this summer, Sundays are not mission-free days at all,” Flatz says first thing the next morning. “The duty time is 7:30 a.m. until 10:30 p.m. year-round; there is only time for a brief nap between two shifts.”
Today, the team remains the same, except for the young and energetic Henrike Hommel, suited perfectly to the job as a flight physician. She is fond of sports and passionate about both mountains and medicine and will be our doctor onboard for the day.
The first call comes at 10:47 a.m. and it’s another hoist mission to help a patient who has fallen unconscious during a hike to a mountain cabin. The coordinates do not correspond exactly to where the patient is located, but other tourists on the ridge are able to point us in right direction and we’re quickly above the correct steep mountain trail. Hommel treats the unconscious female patient on the ground before they are both hoisted up 54 m (177 ft) using the TYROMONT rescue bag. A brief flight to a small hospital in Füssen, Germany, concludes the first mission of the day.
We try to scarf down a lunch, but after just 40 minutes, we are back on board and headed into the mountains to help a hiker who has fallen and sustained a head injury. Because the hiker is in Germany, we pick up a mountain rescuer and rush towards Imberger Horn to proceed with another hoist evacuation.
“[The] hoist is absolutely an essential piece of equipment,” says Flatz. “Together with the category and configuration of the helicopter it allows for very prompt and foremost safe evacuation, even in very demanding conditions.”
On our way from Immenstaad hospital to home base we receive another call; this time a mountain biker has fallen off a ridge trail and is seriously injured. Flatz and a fellow mountain rescuer are first hoisted down on a fixed rope to secure the position. Hommel follows with medical equipment. The steep, exposed, grassy terrain makes for a demanding rescue, but all goes smoothly and we head back to Murnau hospital once the patient and our own personnel are on board. The mountain rescuer proves essential in preparing the position for safe hoisting. When we lift off, he remains with the rest of the bike crew and, riding the casualty’s bike, guides them safely down to the valley.
Another mission safely and successfully complete, but no time for dessert or coffee. Just six minutes after arrival to Reutte, we’re lifting off to a heart attack patient at a mountain pass gas station in Nassereith, Austria. The elderly woman is treated and transported to the rooftop heliport at AKH Innsbruck, one of the top hospitals in Austria.
“See, I told you, Sundays are not free days here,” Flatz says, loading the stretchers back into the helicopter and wiping sweat from his forehead.
A spectacular sunset over Innsbruck concludes a busy, but rather typical weekend for the RK2 helicopter. The team now must navigate its way back to home base in Reutte through valleys as storm clouds crowd the mountain tops. After a debrief, equipment and hoist check, material replenishment, and some compulsory paperwork, the helicopter is back in its hangar and ready to help those in need.