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De ANWB Medical Air Assistance verzorgt de HEMS-vliegoperatie voor vier traumacentra:

\n\n

Amsterdam UMC locatie VUMC
Erasmus Medisch Centrum
Radboud Universitair Medisch Centrum
Universitair Medisch Centrum Groningen

\n\n

Daarnaast verzorgt ANWB MAA ambulancehelikopter-operaties voor RAV Fryslân.

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Er worden vier EC-135 (H135) helikopters ingezet als traumahelikopter, en twee reservehelikopters, waarvan één helikopter van het type H135. Elke helikopter heeft dagelijks onderhoud nodig en één of meerdere keren per jaar een grote onderhoudsbeurt die wel een aantal weken duurt. Gedurende die tijd wordt de reservehelikopter ingezet. Een Airbus Helicopters H145 helikopter wordt ingezet als ambulancehelikopter voor de Waddeneilanden. Tijdens groot onderhoud wordt de H145 reservehelikopter ingezet.

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Als de Medical Air Assistance Helikopter land zijn er een aantal regels waar je je aan dient te houden voor zowel je eigen veiligheid als die van de bemanning. Wij maakten een mooi overzicht van alle veiligheidsregels.

\n\n

Bekijk de veiligheidsregels

\nAls de Medical Air Assistance Helikopter landt zijn er een aantal regels waar je je aan dient te houden. Zowel voor je eigen veiligheid als die van de bemanning. Wij maakten een mooi overzicht van alle veiligheidsregels.

\n\n

Bekijk de veiligheidsregels

De MAA heeft ruim 38 piloten in dienst en opereert met 8 helikopters. Daar begint het mee.
\nZe vliegt voor vier traumacentra, de Regionale Ambulance voorziening Fryslân, voor (semi)overheden en voor evenementenorganisaties; zeven dagen per week, 24 uur per dag. Haar ruim 50 medewerkers zijn goed opgeleid, betrokken en geïnspireerd.

\n\n

Voor vier traumacentra verzorgt ANWB Medical Air Assistance het vervoer per helikopter van het Mobiel Medisch Team (MMT). Een MMT bestaat uit een arts, een verpleegkundige en de piloot. Deze vier traumacentra zijn door de overheid aangewezen om een MMT per helikopter te vervoeren. De helikopter die door het MMT wordt gebruikt wordt meestal traumahelikopter of Lifeliner genoemd.

\n\n

Voor de Waddeneilanden verzorgt ANWB Medical Air Assistance het vervoer per helikopter van patiënten in opdracht van en in samenwerking met Regionale Ambulance Voorziening Fryslân. Deze helikopter wordt ambulancehelikopter of Medic01 genoemd.

\n\n

De ANWB MAA is een zelfstandig dochterbedrijf van de Koninklijke Nederlandse Toeristenbond ANWB en opereert zes Airbus EC135 helikopters die worden ingezet als traumahelikopter. Daarnaast opereert het bedrijf twee ambulancehelikopters van het type Airbus EC145. Met deze acht helikopters bestrijkt ANWB MAA heel Nederland.

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Waarvoor wordt een traumahelikopter gebruikt?

\n\n

Na een groot en ernstig ongeluk of ramp kun je hem zien vliegen; een gele helikopter. Dat is de traumahelikopter. Het woord ‘trauma’ komt uit de Griekse taal en betekent ‘wond’. De traumahelikopter wordt gebruikt om levens te redden. Met een helikopter kan de piloot heel snel naar de plek vliegen waar een dokter nodig is. Helikopters hebben bovendien het voordeel dat ze vlak bij de plaats van het ongeluk verticaal kunnen opstijgen en landen. Ook heeft de helikopter speciale apparatuur en medicijnen aan boord.

\n\n

Alle traumahelikopters in Nederland hebben dezelfde roepnaam: Lifeliner. De helikopters die worden gebruikt zijn van het type EC 135. Ze worden gemaakt in Duitsland, in de fabriek van Airbus Helicopters. Er kunnen vier mensen in de helikopter:

\n\n

De piloot, die de helikopter bestuurt.
De verpleegkundige, die naast de piloot zit en de piloot tijdens de vlucht helpt en navigeert. De verpleegkundige helpt op de plaats van het incident de dokter met de verzorging van de patiënt.
De dokter zit achterin in de helikopter. De dokter helpt op de plaats van het incident de patiënt. Soms vliegt de patiënt ook mee naar het ziekenhuis. Als dat gebeurt, kan de dokter tijdens de vlucht de patiënt verzorgen. De dokter zit dan naast de patiënt. De dokter heeft achterin in de helikopter diverse hulpmiddelen om de patiënt te verzorgen. Denk bijvoorbeeld aan een beademingsapparaat en een infuus.
Achterin in de helikopter, naast de dokter, kan de patiënt liggen. De patiënt ligt op een brancard.

\n\n

Wat zijn de verschillen tussen een traumahelikopter en een ambulance?

\n\n

Op een ambulance rijden een ambulancechauffeur en een ambulanceverpleegkundige. Hun belangrijkste taak is om de gewonde zo goed mogelijk te verzorgen en zo snel mogelijk naar een ziekenhuis te brengen. De dokters in het ziekenhuis beginnen dan met de medische behandeling of de operatie.

\n\n

De bemanning van een traumahelikopter bestaat uit een piloot, een verpleegkundige en een dokter. Samen vormen zij het mobiel medisch team (MMT). De MMT-arts is geen gewone huisdokter, maar een medisch specialist. Medische specialisten zijn artsen die in het ziekenhuis werken. De MMT-artsen zijn gespecialiseerd in het helpen van mensen die ernstig gewond zijn of die accuut heel ziek zijn geworden. Hierdoor kan de MMT-arts onmiddellijk specialistische zorg geven als hij/ zij bij een ernstig ongeluk aankomt of bij een persoon die plotseling ernstig ziek is geworden. De arts kan het slachtoffer bijvoorbeeld anesthesie geven (dat betekent onder narcose brengen of verdoven) en helpen met de ademhaling. De arts zorgt ervoor dat het slachtoffer minder pijn heeft en voldoende zuurstof in zijn/haar lichaam krijgt. De verpleegkundige op een gewone ambulance kan deze specialistische hulp niet verlenen, omdat de ambulanceverpleegkundige hiervoor niet is opgeleid.

\n\n

Dat de traumahelikopter met de arts en verpleegkundige van het Mobiel Medisch Team snel ter plaatse kunnen zijn, is maar goed ook. Want zonder directe hulp op de plaats van het incident, zou de gewonde of ernstig zieke kunnen overlijden.

\n\n

Waarom is de traumahelikopter zo handig?

\n\n

De traumahelikopter kan zo’n 240 kilometer per uur vliegen. Een helikopter heeft geen last van files. Ook staan er geen stoplichten in de lucht. Hierdoor kan een traumahelikopter drie keer sneller dan een ambulance op de plaats van het incident zijn. Eén arts kan hierdoor in een groot gebied helpen. Uit onderzoek blijkt dat het eerste uur na een ongeluk heel belangrijk is voor de overlevingskansen van een gewonde. Dit wordt het ‘gouden uur’ genoemd. In dit uur moet de arts meteen goede hulp geven. Het Mobiel Medisch Team van de traumahelikopter kan deze hulp razendsnel geven. De behandeling van een gewonde begint meteen op de plaats van het ongeluk.

\n\n

Alarmnummer 112

\n\n

Bij een ernstig ongeluk of een ramp is het belangrijk om meteen het alarmnummer 112 te bellen. De mensen aan de telefoon bij 112 (centralisten) beslissen dan of het nodig is een traumahelikopter naar het ongeluk te sturen. Hiervoor bestaan speciale regels. Als je 112 belt stelt de centralist daarom allerlei vragen om te weten wat er gebeurd is, waar het gebeurd is en hoe ernstig het is. De centralist kan dan een brandweerauto, politieauto, ambulance of traumahelikopter naar het incident sturen.

\n\n

Binnen twee minuten in actie

\n\n

Is een traumahelikopter nodig? Dan komt het Mobiel Medisch Team (de piloot, de arts en de verpleegkundige) van de helikopter die er het dichtste bij is, in actie. De helikopter vertrekt binnen twee minuten na de melding van het ongeluk. Dat kan zo snel, omdat het MMT in een aparte kamer vlak bij de helikopter zit. De piloot hoort vaak pas nadat hij/ zij de helikopter heeft opgestart waar het team naartoe moet vliegen. Is de helikopter bij het incident aangekomen, dan zoekt de piloot een goede plaats uit om te landen. De verpleegkundige heeft een speciale opleiding gehad om de piloot bij het vliegen te helpen. Dit kan soms heel moeilijk zijn. Het is belangrijk dat de landingsplaats groot genoeg en vrij van obstakels is. Midden in de stad staan er vaak allerlei dingen in de weg: bomen, huizen, lantaarnpalen, fietsen. Andere hulpdiensten, zoals politie, brandweer en ambulance en toeschouwers moeten voor hun eigen veiligheid op minimaal 25 meter afstand blijven van de helikopter. De piloot is verantwoordelijk voor de helikopter als de arts en de verpleegkundige de patiënt aan het helpen zijn op de plaats van het incident. Na de landing doen de arts en verpleegkundige er alles aan om de gewonde zo goed mogelijk te verzorgen.

\n\n

Helikopter en ambulance werken samen

\n\n

Op de plaats van het ongeluk is ook altijd een ambulance aanwezig. Heeft de MMT-arts van de helikopter de gewonde behandeld? Dan gaat het slachtoffer meestal met de gewone ambulance naar het meest geschikte ziekenhuis. Een ambulance heeft namelijk meer ruimte voor de patiënt dan de helikopter. Soms rijdt de MMT-arts met de patiënt mee in de ambulance. De MMT-arts bedient dan de ingewikkelde apparaten die de patiënt in leven houden. De helikopter vliegt mee naar het ziekenhuis om de MMT-arts weer op te halen. Het team is dan weer compleet en klaar voor een nieuwe oproep.

\n\n

Als de gewonde of ernstig zieke niet snel genoeg met de ambulance in het ziekenhuis kan zijn, brengt het MMT de patiënt met de helikopter naar het ziekenhuis. Vanwege de kleine ruimte in de helikopter wordt elke centimeter aan de binnenkant gebruikt. Het toestel zit vol met speciale apparaten die het leven van een patiënt kunnen redden. Het lijkt wel op een vliegend ziekenhuis.

\n\n

Waarvoor wordt de traumahelikopter opgeroepen?

\n\n

De meeste incidenten waarvoor de traumahelikopter wordt opgeroepen zijn verkeersongelukken (70%). De rest bestaat uit bijvoorbeeld bedrijfsongelukken (vaak met machines), mensen die van steigers en daken vallen, mensen die bijna verdronken zijn, steekpartijen en schietpartijen. Ook wordt het MMT opgeroepen voor mensen die acuut zeer ernstig ziek zijn geworden zonder dat ze een ongeluk hebben gehad. Bijvoorbeeld bij de reanimatie van een kindje.

\n\n

Van vroeger naar nu

\n\n

Tegenwoordig vervoeren de traumahelikopters de Mobiel Medische Teams van het VU Medisch Centrum in Amsterdam, het Erasmus Medisch Centrum in Rotterdam, het Universitair Medisch Centrum St Radboud in Nijmegen en het Universitair Medisch Centrum Groningen.

\n\n

ANWB Medical Air Assistance voert de vliegoperatie uit voor deze vier traumacentra. De helikopter van Amsterdam opereert nog steeds vanaf het dak van het VU Medisch Centrum. De helikopter van Rotterdam vanaf Rotterdam The Hague Airport, de helikopter van Nijmegen vanaf Vliegbasis Volkel en de helikopter van Groningen vanaf Groningen Airport Eelde. Op de daken van de ziekenhuizen van Erasmus MC Rotterdam, UMC St Radboud Nijmegen en UMC Groningen kan wel nog steeds geland worden om een patiënt naar het ziekenhuis te brengen. Ook sommige andere grote ziekenhuizen hebben een dak waarop de traumahelikopter kan landen.

\n\n

Sinds 2011 mag door heel Nederland 24 uur per dag worden gevlogen, dus ook ’s nachts. De Mobiel Medisch Teams hebben geleerd hoe ze om moeten vliegen met een speciale nachtkijker (Night Vision Goggle). Deze is op hun helm vast gemaakt en kan voor de ogen worden geklapt. Met deze nachtkijkers kunnen ze beter zien wanneer ze in het donker willen landen. De traumahelikopters zijn zo geschikt om dag en nacht te vliegen. De traumahelikopters vliegen 365 dagen per jaar, dus ook in het weekeinde en op feestdagen.

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\nOpen sollicitatie

\n\n

Op dit moment hebben wij geen vacatures voor piloten. Ben je piloot en wil je graag bij de MAA solliciteren? Als je voldoet aan de volgende minimumeisen kun je een open sollicitatie, inclusief cv, e-mailen naar officemaa@anwb-maa.nl.

\n\n

De minimumeisen zijn:

\n\n

Het bezit van een geldig CPL(H) of ATPL(H) met geldig medical klasse I.
Minimaal 1000 vlieguren als pilot in command van vliegtuigen of helikopters, waarvan minimaal 500 vlieguren als pilot in command van helikopters. Of minimaal 1000 vlieguren als copiloot in HEMS-operaties, waarvan 500 vlieguren als pilot in command onder supervisie, 100 vlieguren als pilot in command van helikopters.
500 vlieguren ervaring op turbine helikopters, opgedaan in een vergelijkbare operationele omgeving als een HEMS-operatie.
20 nachtvlieguren als pilot in command.

\n\n

Mocht je interesse hebben in het werken op de ambulancehelikopter, dan gelden daarnaast de volgende eisen:

\n\n

Het bezit van een geldig IR(H) met minimaal 100 uur IFR ervaring.

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De bemanning van de traumahelikopter wordt Mobiel Medisch team (MMT) genoemd. Op een incidentslocatie werkt het MMT samen met de ambulanceverpleegkundige(n) om de beste zorg aan de patiënt te verlenen.

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Criteria inzet traumahelikopter

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Er zijn landelijke inzetcriteria vastgelegd voor het MMT. Naast een vitale bedreiging zijn de belangrijkste criteria voor het inzetten van een traumahelikopter:

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ernstig (verkeers)ongeluk
aanrijding met hoge snelheid
val van hoogte
meerdere ernstige slachtoffers
onderkoeling
schiet- of steekverwondingen
verbranding
verdrinking
(te) lange aanrijdtijd van de ambulance
reanimatie van een kind
bedreigde luchtweg

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Mobiel Medisch Team

\n\n

Het MMT kan op twee manieren ingezet worden:

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Primaire inzet: Op basis van de melding die een de centralist van de meldkamer ambulance binnenkrijgt via een 112-oproep bepaalt de centralist dat het MMT wordt ingezet.

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Secundaire inzet: Soms blijkt de situatie op de incidentlokatie ernstiger dan in eerste instantie verwacht. Op verzoek van het ambulancepersoneel ter plekke roept de centralist van de meldkamer dan alsnog het Mobiel Medisch Team op. Belangrijke criteria voor deze zogeheten secundaire inzet zijn bijvoorbeeld:

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bedreigde ademweg en/of ademhaling
bedreigde bloedcirculatie
bedreigd bewustzijn
direct benodigde amputatie of indicatie tot amputatie van een ledemaat

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Helicopter Emergency Medical Services

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De vliegoperatie van de traumahelikopter wordt ook wel HEMS genoemd, wat staat voor Helicopter Emergency Medical Services. De vluchten die met een traumahelikopter gemaakt worden, vallen onder een andere wetgeving dan normale helikopter vluchten. Zo mag de traumahelikopter lager vliegen en op straat, op (sport-)veldjes, bij iemand in de tuin of op de snelweg landen.

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Elk MMT met een helikopter beschikt ook over een MMT-auto, die wordt ingezet als het weer te slecht is om te vliegen, zoals bij dichte mist of laaghangende bewolking. De auto wordt ook ingezet wanneer de helikopter niet kan vliegen vanwege een technisch defect of wanneer het MMT met de auto sneller ter plaatse kan zijn dan met de helikopter. Dit is bijvoorbeeld het geval, wanneer de incidentlocatie heel erg dichtbij de basis is en/of er op de incidentlocatie nauwelijks mogelijkheden zijn om de helikopter te landen.

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Protocol inzet traumahelikopter

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Door alles wat erbij komt kijken is de inzet van een traumahelikopter een complexe operatie. Een protocol zorgt ervoor dat de inzet routineus, snel, efficiënt en veilig verloopt. Hoe werkt het?

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Melding
\nIemand belt 112. Oproepen vanaf een vaste lijn komen direct binnen bij de alarmcentrale in de eigen regio. Oproepen vanaf een mobiele telefoon komen terecht bij het callcenter van het Korps Landelijke Politie Diensten (KLPD) in Driebergen. De medewerker van de meldkamer (centralist) vraagt wie de beller wil spreken: politie, brandweer of ambulance. Vervolgens verbindt de centralist de beller door met de gewenste hulpverleningsdienst.

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Oproepen MMT
\nIs er een Mobiel Medisch Team (MMT) nodig, dan ontvangt het dienstdoende team een melding via een pieper. De melding op de pieper bestaat alleen uit een adres. Tijdens het vliegen heeft de arts via het C2000-communicatiesysteem in de helikopter contact met de centralist van de Meldkamer Ambulancezorg en krijgt mondeling aanvullende informatie.

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Vliegen
\nNa de melding via de pieper gaat de piloot direct naar de helikopter en start de motoren op. De verpleegkundige voert het adres in in het navigatiesysteem. Als het hele team in de helikopter zit, vertrekt het team naar de inzetlocatie. In principe vertrekt het MMT bij daglicht binnen twee minuten. In het donker vertrekt de traumahelikopter normaliter binnen 5 minuten na de melding.
\nDe traumahelikopter heeft in principe altijd voorrang boven ander vliegverkeer. Ook hebben de traumahelikopters een ontheffing om te vliegen boven gebieden waar dat voor ander vliegverkeer verboden is.

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Piloot
\nDe piloot is verantwoordelijk voor de keuze van de landingsplaats. Bij de inzetlocatie bepaalt de piloot door middel van een verkenningsronde welke landingsplaats geschikt is. Bij daglicht moet de landingsplaats minimaal 25x25 meter zijn, in het donker minimaal 25x50 meter. Als de piloot in het donker op een onbekende locatie landt, doet hij dit veelal aan de rand van aaneengesloten bebouwing. In het donker vliegen de piloten en HEMS Crew Members met Night Vision Goggles (NVG). Dat is een soort nachtkijker; een kijker die het aanwezige licht versterkt om in het donker beter te kunnen zien. De Night Vision Goggles worden voor de ogen op de helm gemonteerd

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Keuze vervoermiddel
\nIn de meeste gevallen wordt de patiënt per ambulance naar het ziekenhuis gebracht. Indien nodig rijdt de arts van het MMT met de ambulance mee naar het ziekenhuis. Alleen als er belangrijke tijdwinst voor de gezondheid van de patiënt te behalen valt, wordt de patiënt per helikopter naar het ziekenhuis vervoerd. Ook als de patiënt ergens is waar de ambulance moeilijk kan komen (bijvoorbeeld op het strand of in een bosgebied), kan besloten worden de patiënt per helikopter naar het ziekenhuis te vervoeren. De MMT-arts neemt de beslissing hierover.

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Piloot

\n\n

De piloot is verantwoordelijk voor de helikopter en vervoert de arts en de verpleegkundige naar de plaats waar spoedeisende medische hulp vereist is. De piloot is niet medisch geschoold. Op de inzetlocatie blijft de piloot bij de helikopter. In sommige gevallen assisteert de piloot de arts en verpleegkundige op locatie, b.v. door spullen te halen of een infuuszak omhoog te houden. De politie neemt dan de bewaking van de helikopter over.

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MMT-verpleegkundige

\n\n

De MMT-verpleegkundige is een ervaren verpleegkundige met een subspecialisatie als spoedeisende hulp (SEH) verpleegkundige of als ambulanceverpleegkundige. Daarnaast heeft de verpleegkundige specialistische MMT-opleidingen gevolgd en een opleiding in luchtvaartcommunicatie, luchtvaartnavigatie en de techniek van de helikopter. Tijdens de vlucht treedt de verpleegkundige op als HEMS Crew Member (HCM); hij/ zij is de navigator en assisteert de piloot tijdens de vlucht. Op de inzetlocatie assisteert de verpleegkundige de arts bij de hulpverlening.

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MMT-arts

\n\n

De arts, in de meeste gevallen een anesthesioloog of een traumachirurg, is specifiek opgeleid voor spoedeisende geneeskunde op de locatie van het incident. Hij of zij kan ter plekke direct ingrijpen en de vitale functies van het slachtoffer stabiliseren, zodat het slachtoffer zo stabiel mogelijk vervoerd kan worden naar het best passende ziekenhuis. De MMT-arts heeft tijdens de vlucht geen vliegtechnische taken, maar verzorgt wel de communicatie met de Meldkamer Ambulancezorg (MKA) via het C2000-communicatiesysteem.

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Op vliegbasis Leeuwarden staat 24/7 een ambulancehelikopter paraat om mensen vanaf de Friese Waddeneilanden naar het ziekenhuis op het vaste land te brengen. ANWB MAA vliegt deze helikopter in opdracht van de Regionale Ambulance Voorziening Fryslân.

\n\n

De ambulancehelikopter wordt ingezet door de meldkamer Noord Nederland en dient bij daglicht binnen 6 minuten na oproep in de lucht te zijn. In het donker dient de ambulancehelikopter binnen 7 minuten na oproep in de lucht te zijn. De inzetcriteria voor de ambulance helikopter zijn gelijk aan die van een 'normale' ambulance.

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De vlucht

\n\n

Tijdens vlucht wordt er veelal op zicht genavigeerd (Visual Flight Rules, VFR), maar bij slechter weer kan de bemanning ervoor kiezen om over te gaan op het navigeren middels de instrumenten in de helikopter (Instrument Flight Rules, IFR). Hierdoor kan er in veel gevallen ook bij slechter weer met minder zicht of laaghangende bewolking worden gevlogen. Als het weer te slecht is om te vliegen, wordt de patiënt met ambulance op de boot naar een ziekenhuis op het vasteland gebracht.

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Aan boord

\n\n

Op de Waddeneilanden wordt de patiënt in de meeste gevallen met de ambulance naar de vaste landingsplaats van de helikopter gebracht. Na de landing wordt de patiënt overgedragen aan de verpleegkundige van de ambulancehelikopter. Indien de patiënt op een plaats is, waar de ambulance niet kan komen, kan de helikopter ook bij de incidentlocatie landen. De patiënt wordt dan direct in de ambulancehelikopter meegenomen. Eenmaal aan boord van de ambulancehelikopter kan dezelfde zorg gegeven worden aan de patiënt als in een gewone ambulance. Vervolgens vliegt de bemanning met de patiënt naar een ziekenhuis op het vaste land om daar de patiënt over te dragen aan het ziekenhuispersoneel.

\n\n

De helikopter

\n\n

De Ambulancehelikopter is van het type Airbus Helicopters H145. De medische apparatuur in de helikopter is vergelijkbaar met de medische apparatuur in een ambulance. Daarnaast is er in de cabine van de ambulancehelikopter ook ruimte voor de ambulanceverpleegkundige, een extra hulpverlener (denk aan de huisarts of de verloskundige) en voor één familielid. Een reservehelikopter is beschikbaar, om de continuïteit van de ambulancezorg per helikopter vanaf de Waddeneilanden te waarborgen.

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Piloot

\n\n

De piloot is verantwoordelijk voor de helikopter en het vervoer van het helikopterambulanceteam.

\n\n

Ambulancechauffeur

\n\n

De ambulancechauffeur is een ervaren ambulance chauffeur, die door ANWB Medical Air Assistance wordt opgeleid tot HEMS Crew Member. Hiervoor volgt de ambulancechauffeur een specialistische opleiding in luchtvaartcommunicatie, luchtvaartnavigatie en de techniek van de helikopter. Als HEMS Crew treedt de ambulancechauffeur tijdens de vlucht op als navigator en als assistent van de piloot.

\n\n

Verpleegkundige

\n\n

De ambulanceverpleegkundige aan boord van de ambulancehelikopter is verantwoordelijk voor de verzorging van de patiënt aan boord van de helikopter. Na de landing bij het ziekenhuis wordt de verzorging van de patiënt door de verpleegkundige overgedragen aan het ziekenhuispersoneel.

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Helikopterlocaties

ANWB Medical Air Assistance