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Podcast: Revolutions in Vertical Flight S2 E2: The Lifesaving Helicopter

7th September 2021 - 12:00 GMT | by Studio

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The helicopter offers clear advantages for emergency medical services, but just how did an industry evolve to fill this life-saving role?

Welcome to Shephard Studio’s podcast series on Revolutions in Vertical Flight, sponsored by our partner Bell.

Listen on Apple PodcastsGoogle PodcastsSpotify and more.

In our first series, we learnt about the history of vertical flight and discovered the key pioneers and revolutionary moments that created the rotorcraft industry we know today. 

In this second series, we learn more about the helicopter’s role in society, and how it helps overcome obstacles, protect the public and ultimately save lives. 

We'll hear from a range of operators about how they use helicopters to carry out those tasks that are too expensive or dangerous to conduct by other means. We consider the future, discovering how greater autonomy is poised to reshape the role of rotorcraft even further.

In this episode, we hear how an unforeseen consequence of the Vietnam War was the introduction of helicopters as civilian air ambulances. 

The arrival of thousands of young experienced helicopter pilots in need of a job helped drive the evolution of helicopter EMS in the US, offering their skills to rapidly transport patients to hospitals - massively increasing their chances of survival.

Episode 3 of the second series: Airborne Law Enforcement is here.

A transcript of this episode is below:

Stan Rose 00:06: It's a fascinating truth that air medicine is different from anything else. It really is.  

Paul Westaway 00:15 Sparse hospital resources, difficult terrain, difficult geography, and that made for a reasonably sensible place to introduce helicopter air ambulance operation for the first time. 

Ryan Oppel 00:26  It really hit hard for everybody there. Seeing that community of first responders come together like that, that's something I'll never forget. 

Narrator 00:36 The Vietnam War had many consequences. Some less obvious than others. The introduction of helicopters as civilian air ambulances falls firmly into this category. The war brought about many changes to America. One such development was the arrival of thousands of young experienced helicopter pilots in need of a job. These pilots helped drive the evolution of helicopter EMS in the US, offering their skills to rapidly transport patients to hospitals. Massively increasing their chances of survival. One such pilot was Stan Rose, who flew in the early days of the air medical services in the US, following his return from Vietnam. 

Stan Rose 01:24  Problem with the helicopter industry prior to Vietnam was a lack of pilots. There weren't that many helicopter pilots and it wasn't a mainstream thing. Well, Vietnam changed that. I believe that there were somewhere in the neighbourhood of 7000 pilots who came home from Vietnam. Now, we all had the same experience. The same number of hours. The same love of flying and we're all ne'er do wells and part of the ride 'em never check 'em generation. When I was in Vietnam, I totaled five helicopters. I'd never actually got shot down, but I flew five home that never flew again. Before I was 21. The interesting part was we all come home, and we're addicted to excitement, we're sitting there, why isn't there a helicopter industry? 7000 pilots show up looking for a job that doesn't exist. There's 500 jobs and 7000 pilots. Somebody says, hey, I was a med evac pilot, goes down to his local hospital and says, hey, why don't we start one of these things right. 

Narrator 02:49 Welcome to Shepherd Studios Revolutions in Vertical Flight, brought to you in partnership with Bell. In our first series, we learnt about the history of Vertical Flight, and discovered the key pioneers and revolutionary moments that created the rotorcraft industry we know today. In the second series, we learn more about the helicopter’s role in society, and how it helps overcome obstacles, protect the public and ultimately save lives. We'll hear from a range of operators about how they use helicopters to carry out those tasks that are too expensive or dangerous to conduct by other means. We consider the future, discovering how greater autonomy is poised to reshape the role of rotorcraft even further. 

The first dedicated use of helicopters by US forces occurred during the Korean War. The popular image is of the bubble fronted Bell 47, removing casualties from the battlefield and transferring them to mash units. But helicopters also moved critical patients to more advanced hospital ships once initial emergency treatment and field hospitals had occurred. The next major advance in air medical transport occurred during the Vietnam War, where the Bell UH-1 helicopter was placed into operation. The Huey was large enough to hold patients inside where medical personnel could begin treatment during the flight to a field hospital. Vietnam demonstrated the life saving capability of the helicopter as an air ambulance, crewed by specially trained paramedics 

Stan Rose 04:48 Phase one of air medicine in the United States was it was cool and we had people that could do it and we had proved the concept both through Korea and the mash units. Then dust off in Vietnam. This proved the concept of the golden hour. If you can get a trauma patient to the right facility, within an hour, you triple and quadruple the survival rate. Here's the problem. Because we have this capability, how do you make a bet? That's really hard. In the early days, foundations were set up, bake sales. I mean, we literally paid for our medicine, you know, but by the fact that the public love the whole idea. We got donations, and we were working hard, and it was really hard. Getting the funding to do it was number one problem. Pilots were available. We were cheap, because there were no jobs, we work for nothing. The hard part is how to get it paid for. 

Narrator 06:05 In 1973, the EMS Systems Act was passed by US Congress. This funded 300 Regional EMS systems. 

Stan Rose 06:15 The second generation is that the government stepped in and helped the hospitals who wanted to do this through a thing called the Medicare Cost Report. The Medicare cost report was a method of getting paid, so hospitals could get paid. That was an annual event that you could go back and get some additional monies. That's really what built the helicopter air ambulance business. Well, the problem happened that now there's no secrets to getting paid. Anybody who wants to can start an air ambulance. Well, we went from somewhere in the neighbourhood of 300 helicopters in the United States to over 900 right. They're fighting each other for the flights and they drive the volume down per flight. When you got 900 in there, if you're getting 15 flights a month, you're lucky. It's nowhere near the 600 a year that you need to do. They had to drive the price up in order to make up for the lack of volume. I love free market economies. However, you know, this went back and forth. To me that the real history of the air medicine in the United States was we started making nothing as soon as we could make something everybody jumped in. 

Narrator 07:47 As helicopters began to offer air medical services around the US, similar developments were springing up all over the globe. Helicopter operator Babcock is now a major provider of helicopter air medical services, with 140 EMS bases around the world. In the UK, Babcock's HEMS work began through an earlier manifestation Bond Air Services, in the 1980s. Here's Paul Westaway now a business development director with Babcock. 

Paul Westaway 08:22 I think it's probably useful to get a bit of context for the introduction of the helicopter, which was first launched in Carmel in 1987. Just at that time, back in 1985, we were introducing paramedic training for the first time in the county. Prior to that we've been Miller qualified, and we were a standard Ambulance Service, but extended training as it was initially called, and then formally, paramedic training really was properly launched in 1985. So when the chief ambulance officers said, look, I'm pretty interested in introducing a helicopter in 1987, that really went in hand in glove, we had just a limited number of paramedics who were capable of delivering that additional care, because we just started our training in 1986. As a consequence, it was a very effective way of getting paramedic care out to the many people that lived in Cornwall, you know, disparate areas.  

The helicopter was seen really as a service multiplier in those early days. The sort of first launch, it was predicated on getting paramedic air care out to a county that actually had fairly remote locations, relatively limited road infrastructure, a significant impact of holiday visitors during the summer months. You combine that with just one primary hospital that received most of the serious injuries and illnesses in Truro, which is in the centre of the county and anybody in the north or east of the county had to travel to Punus, which is in Devon. Sparse hospital resources, difficult terrain, difficult geography, and that made for a reasonably sensible place to introduce helicopter air ambulance operation for the first time. From then on, this footprint has developed across the country. 

Narrator 10:17 Westaway was himself a crew member on that first mission. 

Paul Westaway 10:22 Frankly, it was an exhilarating and an exhausting day. We've done quite a bit of training. Jeff Newman, the original pilot, had worked with the bond team to pull together an effective training programme for us. But it was the first time on the morning of the first of April 1987 that we assembled as an operational crew. We were living in a borrowed speech therapy caravan, and we had a very small team of paramedics. Just two of us onboard, Nigel Harris and myself as the clinicians for the day, Jeff Newman is the pilot. The first operational mission came through sort of around about 9:30 in the morning, and we were deployed north of the county towards a road traffic collision, which turned out to be minor, and we were stood down from that incident. But shortly thereafter, we were deployed down to Porthcurno beach for our very first operational mission where we landed, and we treated and we carried the patient back to hospital.  

This was a young lady that had fallen or in fact, she jumped off rocks along with other colleagues and friends from university, they were just jumping off some rocks onto the beach, she landed sadly, quite awkwardly, and had a lumbar fracture. We were able to transfer her straight into that hospital from that remote beach down in southwest Cornwall. An idealic place to be when things are going well, but not too good when you're actually injured. We have the privilege of sort of carrying that sort of first mission and a very meaningful one. We met Ann some 10 years later when she came to Cornwall, and happened to be in the county holidaying when we were celebrating our 10th birthday. She came and met us. Then I had the privilege again of meeting her some 30 years later, when we had our 30 year celebrations, she came down from the other side where she was living. But yeah, that was the first mission. 

Narrator 12:16 Helicopters hold clear advantages in emergency medical services. Some of these are universal, while others can vary depending on the particular location, or the distances that must be covered. Here's Ryan Oppel from CareFlight, providing an insight into just some of the incidents he's experienced in his career.  

Ryan Oppel 12:37 The obvious easy answer is that helicopters provide the speed and the direct access to the patient. We're able to land on the scene of an accident. We're able to go to these small town hospitals, where the patient is and get them to a major trauma centre or a higher level of definitive care in the major metro area. That's obviously the easy, obvious answer. As far as the advantage of the helicopters in the area of North Texas, it's not like we're up in the Rocky Mountains, where you got major obstacles to get up and over and around. But we do have really large distances. This part of the world is known for wide open spaces and long distances. What could very easily be a two or three hour commute for somebody to get to definitive care by ground transportation, the helicopter obviously, is point A to point B direct, the speed is a huge advantage. 

You're talking 130 140 150 miles an hour or more. But based on my experience, what I've seen as a as a major advantage of the helicopter is it goes beyond just the speed and the direct access to the patient. Helicopters are not a cheap asset. They're a limited asset. It's it's a luxury item for a community to have a helicopter. By extension, those in the medical profession, see it as a career terminal position, something that they aspire to. In addition to the speed and the direct patient access, one of the major advantages I see is that the helicopter provides an incentive on the medical side of things for people to work towards that career goal. By extension, you end up in a lot of times the best of the best as far as the medical people involved as well. Even if a ground transportation was equally accessible, or can get a patient there in a similar timeframe, the level of care that we're able to provide, because in so many words, it's a scarce resource.  

That creates more competition and demand on the medical side, which allows us to provide a higher level of care, more advanced protocols and the patient ends up getting not only to the destination quicker, but they're getting a higher level of care along the way. That's one of the kind of the non-obvious advantages of the helicopter that I've seen in my experience. 

 Narrator 15:16 Helicopters equipped for the air medical mission can quickly deploy with a range of equipment, depending on the aircraft in question. 

Ryan Oppel 15:24 All of our aircraft and basic configuration are able to provide the same level of care. You know, all of our medical people have the same monitors and vent pumps and IV pumps. They're all able to provide in route innovation. We've got automatic defibrillation devices. If I start going much more into detail about the medical equipment, I'll be lying to you because I know just enough to get through a five-minute conversation. But then we do have for our larger aircraft for the 429s and to some extent the 407s are capable as well. But one of our major advantages as far as specialised equipment is the ability to transport neonatal patients. The premature babies in the isolettes. We work directly with the NICU teams at the surrounding hospitals. We take their personnel with their isolette out to pick up these babies at outlying facilities.  

We have partnerships with some of the hospital teams, who were able to provide ECMO transport, balloon pump transport. There are a few specialty medical devices specialty medical considerations, that we can reconfigure the aircraft for the ECMO, the balloon pump, being the big two neonate, another big one. In that respect, that's where our specialty comes in. We are not search and rescue. We don't have the hoist. We don't have the ability to do swift water rescue or anything like that. But providing the additional specialty medical transportation for those higher risk patients, the neonates, the balloon pump, the ECMO. Those are really specialised equipment that goes above and beyond the basic EMS equipment that all helicopters would would have onboard. 

Narrator 17:20 Like the helicopters themselves and their onboard technology, the mission has evolved over the years. Paul Westaway outlines the demands placed on Babcock, and how it addresses them. 

Paul Westaway 17:33 I think first of all, we're there to deliver service. As a helicopter operator, to me, I'm challenged most often about what's my availability. We push hard to achieve an excess of 98% availability for our customers. Having that aircraft serviceable, and having the pilot fit, trained and well and capable of delivering the mission, to me is at the root of what we do. But I think you can develop that out. Because that's predicated on stable and strong relationship with suppliers, with good training capabilities to deliver the pilots with the appropriate training and the high skills, and of course, our relationships with the OEM and the regulators, in order to deliver that service in a sort of collaborative approach. I think that's the next theme I would pick up. 

I think customers really want their helicopter operators to be partners and collaborators. Because the truth is, we've seen huge developments in this service from 1987. That has to continue. In a spirit of partnership and collaboration, we can constantly change and design innovation into our developing demands for the service. Our new services for the future, will be looking back on where we were today and saying, my goodness, we had some lessons to learn. We undertook those lessons, we've introduced new services and elements. We've moved our service forward. Collaboration and partnership, to me is equally value. To talk to your point about specification in the aircraft, there have been some fantastic developments in the cockpit. We have now the glass cockpit capabilities. We have four axis auto pilots, we have GPS navigation, and we have a sort of stabilised platform for the pilots to fly in to deliver and that's all about developing safety.  

It's about developing redundancy so that the pilot can focus more on staying ahead of the aircraft and delivering a safe mission. But actually, I think some of the specification now that customers are looking for is in their patient compartment. That's their clinical layout. That's the ergonomic design, that's supportive of positioning the missions and the patients close together so that they can deliver the effective treatment. It's lighting, it's heating, it's making sure that they have access to the life saving equipment, onto which you can then add data transfer. Making your aircraft a WiFi hotspot, being able to download clinical data, to upload information as required, and to introduce latest procedure. I think that's the area of interest.  

To me that the focus has shifted from the front of the cabin, actually to the aft. So it's all about the patient care compartment now. I think that's where the greater specification is being brought out. And we're seeing the introduction of larger airframes. The VA-105 by today's standards is a relatively small cockpit and carrying and compartments. Now you're looking at slightly larger aircraft. But of course, we have that eternal compromise of being able to get close to the scene. If the aircraft is too big, you won't be able to get close enough to the scene, and therefore you're extending your therapy for interval. It's that constant compromise of getting the most out of a compartment, a cabin, and an airframe and a team. I think those are the areas of focus for future. 

Narrator 21:12 What does it take to be a helicopter EMS pilot? According to Stan Rose, the challenge is less to do with mastering particular skills, and more with having the right mindset. 

Stan Rose 21:24 It's a fascinating truth, that air medicine is different from anything else. It really is. I always believed that about half of the pilots in the world could do it. It's not flying skills. It's mental. The first time you fly a kid that your kid's age, you'll find out whether you can do this job. Because you know, that's brutal. The second part is we get called to only the top 5% of patients. The first time you see a patient whose face is split in half and he's still conscious, right? It's a test. It's not for everybody. Unfortunately, what it drives you to is making bad decisions. One of the one of the early interventions we did because our accident rate was high, is that we isolated the pilot, from patient information until after they had made the decision about whether to go or not.  

In marginal weather, we said, you can't tell the pilot that it's a three-year-old who's going to die if you don't get there. Because that's horribly unfair, right? That's just one intervention. But when you think about the people who, you know, if you're too much of a white knight, we can't have you in the industry. You got to be able to make that decision and live with it that you couldn't go that night. Tonight's the night we don't go. That's a tough one. That's only step one. Step two, is actually seeing the blood and guts and step three is living with that responsibility. One guy I trained him up when he went along on you know, they put them through the company training. I had him for three days of riding along and I left him on his own one one afternoon, and I came back the next evening, to relieve him. He said, I'm sorry, I spent the whole day sitting here praying the phone wouldn't ring. He says I can't live like this, and he quit, and good for him. It's a tough one. Air medicine is not for everybody. 

Narrator 23:51 Ambulance pilots and crews are tasked with often traumatic work. Here's Ryan Oppel from CareFlight providing an insight into just some of the instance he's experienced in his career.  

Ryan Oppel 24:05 It's one of those things that when you're in the in the line of duty, so to speak, day in and day out, you see things every day that you just never even thought of. Ways to hurt yourself or situations that people get themselves into. You think man, I'll never forget that or anything else. But then another day goes on and you see something else. I spend a lot of time trying to think of you know, there's one or two calls that that were really unique that stuck out. I do have a couple I had. We had a really bad flood one year up in Sherman and a lady had been trapped in her car on a road and the fire department couldn't get to her. Again, not being search and rescue equipped we weren't able to provide any kind of extrication. But we were able to pick up a fireman take him up in the air with us he had direct communication with the other firemen on the ground, and we were able to help coordinate some rescue attempts on the ground.  

But I remember a scene we responded to typical motor vehicle accident, nothing unusual until we got in route. The agency on the ground when they were given us the LZ briefing, you could hear a different tone in their voice the officer on the ground, relaying the information was audibly shaken up. Then he mentioned that this is one of our own. It ended up being a fairly new recruit to a small-town police department who was off duty. They came over a rise in the road and an 18-Wheeler was trying to make a U turn on a divided two lane highway and the back of the trailer was sticking out just enough into the left lane that this new recruit's vehicle didn't have time to get out of the way. They went they went head on into the back of an 18-Wheeler with the back of the trailer, basically right at head height and while the patient was still technically alive when you picked them up, you know, by the time we got to the major trauma centre, and we took one of the officers there on the scene with us as well.  

By the time we got there, and they had worked the patient, I'm pretty sure the entire police force for this small town had made the drive up because we ended up being there for a while and the med crew was up in the hospital staff. This young new recruit to this Police Department didn't make it. But what I saw was this overwhelming sense of community, not just among the police department, but among the entire first responder community. They had embraced this new recruit as one of their own. They gained a lot of respect. And even though we didn't have the chance to save that person, we gave him every opportunity that was available, you know, something that without the helicopter would have been a complete loss right there on the scene. We were able to provide yet another tool to give them that much more of a chance and that stuck with me because I saw an entire ER full of police officers, old Grizzly veterans and career police officers who had really come together and were mourning the loss of one of their own. As a fellow member of the first responder community, you know, it doesn't just belong to the police department. It included all of us, the helicopter crew, the ER staff. It really hit hard for everybody there. Seeing that community of first responders come together like that, that's something I'll never forget. 

Narrator 28:03  To understand the advantages of helicopter EMS, it's important to grasp the golden hour concept, the crucial life saving benefit gained from rapidly treating patients. This is Denise Uhlin, EMS customer solutions manager at helicopter manufacturer, Bell. 

Denise Uhlin 28:23 Years and years, well actually decades of research has determined that if a trauma patient is able to reach a hospital within an hour of the time of injury, their chances of success increases dramatically. Hence, it's been called the golden hour. It's not just from the time a helicopter is called or EMS is called. It's the time from the actual injury to the time the patient arrives at the hospital. You're working with a very limited amount of time. The fastest way to get to the patient and get them back to the hospital within that golden hour would be by air medical transport helicopter. 

Narrator 29:17  A helicopter air ambulance pilot must be capable of balancing a range of demands, addressing these with a mixture of skills. Here's Babcock's Paul Westaway again. 

Paul Westaway 29:30 I think for us, we employ over 100 pilots in our organisation at the moment, and we're looking for those mixed qualities really, of being a decision maker. Very often HEMS missions are requiring sort of dynamic risk assessments on landing sites and the ability to communicate that well with the team. Obviously safe operations is essential but you are balancing that risk versus needs the whole time. I think for a modern pilot doing EMS operations, they need to be integrated with the team, not just the clinical crew, but with the broader emergency services response crew on the scene, as well as actually supporting many of the activities that the charities undertake in order to continue their income. Quite often, you'll find that a pilot will be at one moment on the roadside, having made a challenging landing, and delivered a patient out to hospital. Then within an hour and a half, having sort of arrived back at the base supporting a charity visit where people are coming to look at the aircraft, and participate and hear all about it.  

I think, a good communicator and someone who's integrated, clearly, you know, their ability to clearly think in challenging scenarios, because with any HEM scene, you're inevitably going to have a high degree of adrenaline and emotion. Therefore, at the root of it, really, I want a high quality pilot to be as boring as possible in the cockpit. We don't want emergencies, we don't want extremists flying, we want things to be controlled, and well managed. The truth is a boring day is a good and safe day in my book. 

Narrator 31:21 Back at Bell, the company has noted a range of important trends in recent years. Matt Jayne is a marketing manager for the company's 505 helicopter, and has seen growing trust in single engine platforms, among EMS operators. 

Matt Jayne 31:38  You're seeing operators having trust in that single engine platform where you know, the 407 is consistently the best-selling HEMS aircraft on the market. You're starting to see where they're balancing capability with cost efficiency, and that if you can get to a person quickly, and get them to a hospital more quickly, you have a better chance to save their life, but don't necessarily know that you need the biggest, baddest platform to do that. Even again, going back to the file five, having a big open cabin, we have two stretcher systems one that's coming in January. But you can do that in a sub $2 million helicopter now where you can put a full-sized stretcher system in there. Whether it'll be, you know, police agencies picking up on it or a full HEMS operator, you have the capability of getting more cost-efficient platforms, and potentially increasing your service range where you would be able to definitely make a business case to have a $10 million helicopter out in the middle of nowhere.  

But if you can do it in a two $3 million helicopter, perhaps you can bring that service to a portion of the country that previously didn't have it available. Also with the the 407 platform, with this newly certified IFR capability, you're starting to see a lot more operators start to ask about that and look into that, because that is literally half the price of any other IFR platform out on the market. If you can go out there and do the same mission as a twin and flying in IMC conditions and pick up the same number of people, why wouldn't you do that in a more cost-efficient platform and potentially pass that savings on to the customer, the patient base or the hospital base, whoever's paying for the service. I've seen operators out there, operating large twin aircraft and in IMC conditions, they'll go out and they'll pick somebody up and they'll fly into an airport with an approach and put them on an ambulance.  

What you'll see moving forward is platforms like the 407 or the, you know, the 119 now having that iPad capability, you're either going to get operators switching to smaller platforms because it has that capability, or you're going to see it become a more widespread capability. Really, that's just a benefit to us, the people because that means more service, that means more availability. That means more capability for operators that can't necessarily afford a twin aircraft but can afford a single engine, because now they can go out there and pick people up and provide service in a wider variety of conditions. 

Narrator 34:12  The evolution of technology on board the helicopters has also transformed the working environment for HEMS operators. 

Matt Jayne 34:21 Previously, you know, you have a medic, over somebody working on them. Now they have a whole gadget hanging from the ceiling that can provide chest compressions just by attaching it to the stretcher system. It literally hooks to the stretcher system and does the chest compressions automatically so that the flight nurse can go and handle other portions of the flight or the service. It's pretty amazing to see the technology, developing not only getting more advanced as far as life saving but also lighter, and so you can carry more of it. That's always a factor of how much can I bring on board? You know, how big of a patient can I bring on board? How big can the flight nurse be? How much equipment can I take? How much gear I mean. Some of the equipment we've seen, you have, two flight nurses plus two to 300 pounds of loose equipment and that doesn't count the stretcher system or the oxygen or anything else they want to carry on board. 

The lighter that equipment can become the more life saving equipment they can carry on board. They got to be ready for anything they're going to see on the ground and any, you know, variety of patient from, gender, conditions, size. It doesn't matter, they got to be ready to go because they are going to the most serious cases. The ability to up that technology and allow them to carry more with them is just going to be a benefit to everybody. 

Narrator 35:43 How will helicopter EMS evolve looking forward? What are the challenges and opportunities for the future against the backdrop of COVID-19 and other long term trends, such as the rise of E-VTOL platforms. Let's turn to Denise Uhlin and Ryan Oppel for some concluding thoughts.  

Denise Uhlin 36:03  The challenges I think right now are pretty significant in the industry as a whole, due to many reasons, not just the pandemic itself. But there are other challenges that have impacted the air medical industry even prior to COVID-19. That brings me to the point of there have been a lot of hospital rural hospital closures and rural air medical base closures. Due to these closures, over the last 10, 15 years, there have been 85 million Americans that can only access the level one or level two trauma centre by a helicopter within the golden hour that 60-minute time frame. Additionally, there's another 30 million that do not have access within that golden hour, even if transported by a helicopter. So, this is a market that rural area, an underserved market where there is great demand for many reasons, the hospital closures, the base closures and an ageing population in a lot of these areas. What a lot of customers have been looking to and looking for, are ways to address the economics, the rising operating cost and looking to other opportunities for a more efficient and more economical way to operate in order to reach these populations where the demand is very high. But they're underserved right now, 

Ryan Oppel 37:55  The whole idea of VTOL and E-VTOL and urban Air Mobility, especially being in the Dallas area, you know, Dallas was selected, I guess prior to Uber selling off their Uber air division. But you know, for the last couple of years, it's been really exciting to think about Dallas being one of three initial launch cities for urban Air Mobility. While on one hand I can I can be saddened by the idea that being a pilot will lose its lustre and become as ubiquitous as driving a car, on the other side of that same coin, the idea of the technology that's coming along with E-TOL and E-VTOL and new propulsion and safer equipment, more efficient transportation, I look at the fact that I've hopefully still got maybe another 20 or 30 years left in my career. It seems like we really are kind of on a major transition in aviation where you're seeing the technology in batteries and electric engines reach the point where that's going to be feasible, whether it's in fixed wing aircraft, rotor aircraft, hybrid VTOL aircraft, you know, up until the point where my job gets eliminated the transition and the evolution over the next 20 or 30 years as we find new ways to power our aircraft and navigate the aircraft and introduce aircraft into these urban environments. That really is exciting. I love my job here at CareFlight. But I look at opportunities in the emerging urban air mobility market. I see a lot of exciting opportunities all across the industry. 

Narrator 39:58 Next time on Revolutions in Vertical Flight. We hear from police departments that use the helicopter as a vital force multiplier. We learn about the challenges and advantage of setting up an airborne Law Enforcement Unit. The Revolutions in Vertical Flight podcast is produced in partnership with Bell. A huge thanks for their support. A big thanks to everyone who gave their time to support the project. 

Revolutions in Vertical Flight was produced by Tony Skinner, with interviews conducted by Scott Gourley, script writing by Gerrard Cowen and audio edits by Carmac Media. I'm your narrator to Gennifer Becouarn. Until next time. 

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