Proposed IFR Air Ambulance Coverage for Middle and East Tennessee

Rural areas do not receive the same emergency medical services as metropolitan and suburban areas due to their remote locations. In the event of a life-threatening medical emergency, citizens in rural areas cannot be transported to a level-one trauma center within the critical Golden Hour. The Golden Hour is the hour during which the mortality rate can be reduced by 50% if a patient can reach a trauma center. The inability of helicopter EMS operations to fly in poor weather lessens a patient’s chances for surviving a medical emergency. Helicopter air ambulance operations enable hospitals to provide comparable service to rural locations. Low cloud cover and reduced visibility often prevent or hamper air ambulance service to rural areas. This thesis attempts to determine how and where to locate non-precision GPS instrument approach procedures in Middle and East Tennessee so that the area could be served by instrument-certified EMS air ambulance operators during instrument meteorological conditions (IMC). The objective of the thesis is to systematically survey the Middle and East Tennessee area in order to identify proposed locations for GPS approaches to provide 95% EMS coverage. Appropriate maps and statistics are provided to document this survey. Alternatives on how to implement EMS instrument approaches are: (1) Allow continued haphazard commercial development. (2) Wait on the FAA to develop the infrastructure. (3) Press for early development of a publicly-funded integrated system of instrument approaches. iv The author recommends the development of a publicly funded, integrated system of instrument approaches as an experimental test project in the Middle and East Tennessee area and provides a roadmap for the steps required to implement this project. The concept of an integrated system of publicly funded instrument approach procedures is expounded. This system involves instrument approach procedures (IAPs) either based on a particular hospital helipad or on an existing airport approach which is within three nautical miles of a medical center. Such a system would involve the development of 33 instrument approach procedures located at the approximate locations specified in Figure 2.4 page 43. Additional emerging free-flight technology could, and should, be included in this proposed instrument approach system.