Article citation information:
Kozuba,
J., Pila, J., Martinec, F. Analysis of
possible modification of transport aircraft to MEDEVAC in the Czech Republic. Scientific Journal of Silesian University of
Technology. Series Transport. 2023, 118,
109-121. ISSN: 0209-3324. DOI: https://doi.org/10.20858/sjsutst.2023.118.8.
Jaroslaw KOZUBA[1],
Jan PILA[2],
František MARTINEC[3]
ANALYSIS OF POSSIBLE MODIFICATION OF TRANSPORT AIRCRAFT TO MEDEVAC IN THE
CZECH REPUBLIC
Summary. With a
growing number of coronavirus patients worldwide, military and civilian
transport aircraft are increasingly being used for civilian medical evacuation
duties (MEDEVAC) on time-critical flights. This article deals with the
possibility of converting an aircraft fleet in the Czech Republic to MEDEVAC.
The indication for the analysis of the possibility of transforming
transport aircraft was the past and current pandemic situation in the Czech
Republic. The main research question is how to implement the modification of a
selected airline of the Czech Republic to MEDEVAC. An analysis of the technical
data of selected aircraft from Airbus and Boeing was used to investigate this
problem. Further, an analysis of the medical equipment required for the
MEDEVAC aircraft category was also performed using equipment manufactured in
the Czech Republic. The results obtained by the analysis and spatial
arrangement of the aircraft deck for the transport of patients with medical
equipment confirmed the possibility of such a transformation within the Czech
Republic. We consider it important to elaborate on a project that would solve,
in detail, all the steps of the conversion of a transport aircraft to MEDEVAC.
Keywords: aircraft
design, MEDEVAC, medical equipment, transport, pandemic
1.
INTRODUCTION
Determination
of the aircraft is already done during the design process as well as during
utilization. The design of the entire aircraft or its cabin compartments is
aimed to be as efficient as possible for its operator. Given different needs,
the nature of the aircraft can be changed, either purposefully or irreversibly.
In
terms of aerodynamic and structural aspects, current airliners and the air
medical service aircraft have the same shape as the fuselage cross-section. The
shape of the fuselage cross-section is dictated mainly by the strength
requirements of the structure (oval, circular, double-bubble or angular) and
also inner space utilization.
The
only difference between these aircraft is in the equipment of their interior.
Aircraft intended for medical purposes have a specific interior layout
design given by the manufacturer. Nevertheless, it is
possible under certain conditions to transform a conventional airliner into a
medical one, that is, change the function of the cabin. Converting an
aircraft's design configuration for medical purposes involves several factors.
The main factors in the conversion process include the right choice of
aircraft, the layout of the cabin (fuselage), the evaluation of the
functionality of the cabin and the selection of the right improvements.
Among
the most suitable Mid-Size Commercial aircraft whose interior can be converted
into a medical interior are the Beech jet 400A, King Air 200, King Air 350,
Pilatus, Hawker 800XP, Embraer 600 and others. The conversion analysis must
include the necessary medical equipment regarding its weight. The volume of the
fuselage is important for the layout of this equipment.
An
example of a design change is Delta, which has decided to redesign all its
Boeing 777 and 767-400 aircraft. These types of aircraft have enabled Delta to
operate on long routes, as the 777-200 LR is one of the longest-range aircraft
in the world, allowing Delta to fly non-stop between Atlanta and Johannesburg
[1].
Like
most of the major changes taking place in airlines around the world, the
COVID-19 pandemic has played a key role in decision-making. Delta Chief
Operating Officer Gil West explained in a May (2020) statement:
"We are making strategic and cost-effective changes to our fleet to
respond to the impact of the COVID-19 pandemic while ensuring that Delta is
well placed to recover from the crisis” (1)
In
the spring of 2020, airlines were working on how to at least partially exploit
current freight needs due to coronavirus.
While
passenger transport fell by 90% or more, freight transport, especially from
Asia with medical supplies, experienced strong growth in May 2020.
However,
airlines have limited options in passenger aircraft because they can place
boxes of material in relatively small cargo spaces and on seats without
passengers [2].
This
paper aims to determine the elements of aircraft design for the needs of the
society in the current situation, which is affected by a pandemic (or in any
emergency) from the perspective of the customer - the patient. The patient or
the wounded can be described as one of the possible types of customers in air
transport.
The
hypothesis is that emergencies may affect the change of equipment and
installation characteristics of the aircraft in the air transport system.
Individual countries with a fleet of transport aircraft can convert selected
types to become flying hospitals. This article focuses on the analysis of these
possibilities in the Czech Republic.
2. AIRCRAFT
FUSELAGE CHARACTERISTICS
For
a better understanding of the nature of the aircraft, that is, its use in air
transport, it is necessary to describe the fuselage and its design (Figure 1).
The design of the fuselage is based on payload requirements where either
passengers, goods, mail or cargo are transported. The shape of the fuselage is
normally determined by the mission of the aircraft. The fuselage is called the
central body of the aircraft since it provides the overall structural
integrity. From the perspective of interior space, the fuselage can have
various uses as described in Figure 1.
Fig. 1. Typical
airliner's fuselage sections
This part of the airframe integrates wings, tail
surfaces, and nose landing gear and is used to accommodate the aircraft systems
components. The fuselage structure must have high strength and durability and
all its interior spaces must be used to the maximum. During the flight, the
design of the fuselage must protect against the adverse effects associated with
the flight – alternating temperatures, humidity, pressure and noise.
Another cabin aspect is safety as a field that reduces
fatalities and injuries resulting from an accident and provides for a safe
environment for passengers and crew members in and around the aircraft, before
and during boarding and deplaning phases, while the aircraft is on the airport
apron with people on configuration, its furnishings, its equipment and its
people [3].
A
traditional wide-body aircraft typically has a fuselage diameter of 5-6 metres
(16-20 feet) with the largest wide-body equipment having a diameter of over 6
metres (20 feet). In the commercial airline world, these are typically
twin-aisle aircraft. The largest wide-body aircraft are the Boeing 747 and the
Airbus A380. Other wide-bodies configured for GA include the Boeing 777, Boeing
787, Boeing 767, Airbus A330/340, MD-11 and MD-11ER (Table 1).
Larger
narrow-body aircraft typically have fuselage diameters of 3 – 4 meters
(10-13 feet) and include aircraft the size of, or larger than, a Gulfstream
G650. BBJ variants of the Boeing 737, and ACJ versions of the A318/319, are
examples of popular large narrow-body aircraft. Other large narrow-bodies in
the GA configuration include the Airbus A320-300, Boeing 757-200/300, Boeing
727 and Boeing 737-300/400/500/600/700/800/900ER (Table 2) [4].
Arrangement of wide-body aircraft
All possibilities of arranging wide-body
aircraft in a conventional transport aircraft (economy class) are presented in
Table 1.
Tab. 1
Arrangement of wide-body aircraft
|
7 seats in a row |
of 160-260 passengers
seats arranged 2-3-2 |
|
8 seats in a row |
of 250-380 passengers
2-4-2 |
|
9 seats in a row |
of 350-480 passengers
3-3-3 or 2-4-3 |
|
10 seats in a row |
of 350-480 passengers
3-4-3 |
Arrangement of narrow-body aircraft
All possibilities of arranging narrow-body aircraft in a conventional
transport aircraft in the economy (tourist) class are presented in Table 2.
Tab. 2
Arrangement of narrow-body airplanes
|
2 passengers in one row |
4–19 passengers |
|
3 passengers in one row |
24–45 passengers |
|
4 passengers in one row 5 passengers in one row |
44–80 passengers 85–130 passengers |
|
6 passengers in one row |
120–295 passengers |
3. ANALYSIS OF THE POSSIBILITIES FOR
THE TRANSPORT OF THE SICK AND INJURED BY AIR
The
first part of the analysis was conducted through interviews with experts from
rescue air service on the possibilities of air transport and they provided us
with the following interesting information:
1. “A medical report is required for the transport
of each patient, which should then be evaluated by the medical staff and a
doctor who will provide medical assistance on board the aircraft to decide
whether the patient or passenger is capable of transport at all. The physician
should determine if any special equipment is needed before the aircraft is
equipped as standard”.
(Mrs. Denisa Beránková, Aeropartner)
2.
“Based on
information from rescue air service, it was found that no truly mass air
transport has taken place in the recent history of the Czech Republic. The only
similar to this type of transport could be compared to the transport of three
soldiers, which took place several years ago, by the air medical service of the
Czech Army. Examples of private companies such as Ambulance Meditrans, OK
ambulance or Aeropartner were provided with an example for passenger transport.
(Dr. Ondřej Franěk,
rescue air service”)
The
Czech Republic army uses government specials (Airbus A-319 CJ aircraft or CASA
aircraft) for medical transport. They are used to save the lives of soldiers or
civilians in the event of a natural disaster or mass accident, either in the
Czech Republic or outside.
4. STATE OF EMERGENCY, AIR TRANSPORT
AND THE CZECH REPUBLIC
Another way to change the character of the aircraft is
a short-term reconstruction. The moment the aircraft fulfils its purpose, it is
rebuilt back to its original form.
Many different types of emergencies can occur anywhere
in the world, such as natural disasters, pandemics, environmental or industrial
accidents, mass accidents or other dangers that pose a significant threat to
the lives of people, property or national security.
In the Czech Republic, we have been dealing with the
Covid-19 disease pandemic since last year (2020), which can be described as an
emergency with which not only our state is fighting but the whole world, and
unfortunately, the end is still not in sight.
Despite all the "weapons", the Czech
Republic cannot cope with the disease (February 2021), and the result is
overcrowded hospitals and healthcare due to alarming capacity depletion.
Because of this, transports had to be carried out, either by the ground rescue
service or by the air rescue service. However, these types of transport have
only the minimum possible capacity for transport. Several patients also had to
be transported to secondary countries.
One example from Slovakia, which transported
coronavirus (COVID 19) patients by air to Germany: A spokesperson of the
Ministry of Health of the Slovak Republic stated that:
“The fact is that there are few free beds for patients on
artificial lung ventilation. We have to think ahead. The situation may worsen
unexpectedly. If the number of patients who need the support of artificial lung
ventilation increases, we need to have free capacity so that we can hospitalize
them immediately," Eliášová added[4].”
Example
from Italia:
“At the end of March 2020, special passengers arrived in the
German city of Cologne on a special flight - six coronavirus patients from
Bergamo, Italy, where the situation with COVID-19 was the most difficult in the
whole country. They were brought by a special Airbus A310 MedEvac, which has
all the necessary medical equipment"[5].”
Airbus and
Embraer Executive Jets have each separately unveiled their own air ambulance
conversion kits, enabling operators to transform passenger aircraft to carry
COVID-19 patients in intensive care.
A
multi-functional team comprising Airbus Commercial Aircraft, Airbus Defence and
Space and Airbus Helicopters proposed the Airbus medical evacuation (MEDEVAC)
solution, which is based on the A330/A340 platform.
In a
statement, Airbus says the French DGS (Direction Générale de la
Santé) actively supported the airframer by providing all the medical
specifications associated with COVID-19 patients in intensive care and low
care. The work took six weeks.
Czech Airlines j.s.c. (CSA) is the flag carrier of the
Czech Republic. It is a modern airline that offers friendly and flexible
services. CSA was founded in 1923 and emphasizes safety, quality, experience
and tradition. It is one of the oldest airlines in the world. They are members of
the global SkyTeam alliance.
However, In the Czech Republic, Czech Airlines,
alongside Smartwings, had to lay off around 600 employees due to the COVID-19
pandemic crisis and start implementing several measures.
One of the ways in which CSA's assistance could cope
with this crisis could be the possibility of using its fleet to transport the
sick and infected to another state.
The government has air transport for heads of state
and government that can be used for transport; however, their equipment
has not been innovated for decades; hence, they would not be able to cope with
the needs of the COVID-19 transport.
It is necessary to use the most modern equipment and
facilities, especially patient isolation.
The use of the CSA fleet itself would not necessarily
serve only in case of the pandemic, but it could be implemented for other types
of emergencies that could happen in the Czech Republic, be it political or
military attacks, natural disasters, other types of epidemic or pandemic,
environmental or industrial accident or mass accident with a large number of
injured people.
Conditions for life on Earth are changing and it is
difficult to predict what else may affect us in the future.
For possible use, it would be this CSA fleet to the
rescue, and it includes three Airbus A320 jets registered with OK-HEU, A319
registered with OK-REQ and Boeing 737-800 registered with OK-TST. This fleet is
current as of March 1, 2021.
5.
CONVERSION OF THE
FUSELAGE COMPARTMENTS OF CSA FLEET AIRCRAFT FOR THE TRANSPORT OF PATIENTS AND
PATIENTS WITH COVID-19 IN AN EMERGENCY
In recent cases of infectious diseases caused by
highly pathogenic agents (for example, Ebola fever virus, Lassa fever virus,
SARS-CoV, MERS-CoV, pandemic influenza virus), which have the potential to
spread over several continents within a few days, international health
protection authorities took measures – which are, in part, of high
economic relevance – to limit the consequences of a possible spread [9].
In the event of an emergency, air transport presents several
advantages over land transport by ambulance or helicopter. Among the advantages
is the saving of transport time as up to dozens of the sick or wounded can fit
on board such a rebuilt aircraft. Aeromedical evacuation (AE) is a challenging
process, further complicated when a patient has a highly hazardous communicable
disease (HHCD) [8].
Few organizations maintain AE-HLCT (Aeromedical
Evacuation High-Level Containment Transport) capabilities, and little is
publicly available regarding the practices [10].
In an emergency such as the COVID-19 pandemic, it may
be necessary to transport a larger number of patients with the indication
COVID-19, as well as patients who would not rule out the disease.
This would mean that seats have to be dismantled on selected
aircraft. Rails would be installed here, such as in freight transport.
The whole concept of rebuilding an airplane into a
flying hospital is very simple. The whole system works on aircraft seat floor
track quick release fitting. Depending on the needs, it is possible to either
snap the beds, seats and other medical equipment and furnishing.
Then, it would be necessary to install either
deckchairs or PTU (Patient Transport Unit) units on board the aircraft,
depending on the possibilities of space on board the aircraft.
PTUs
would include:
•
four oxygen cylinders with a safety system for venting
oxygen overboard through a safety port, if the pressure gets too high,
•
defibrillator,
•
vital signs monitor,
•
transformer for power failure,
•
positioning bed with seven-point seat belt attachment and retractable
armrests,
•
portable breathing apparatus,
•
construction for mounting devices,
•
suction pump,
•
infusion pump and dispenser,
•
additional light,
•
other medical devices.
In addition, when transporting patients with highly
contagious diseases, which also includes the new COVID-19 disease, it is
necessary to use special transport and isolation biobags (Figure 2), which
until now have been used for transporting patients by helicopter. These are
insulating biobags that could easily be attached to loungers or PTUs.
Bio-bag
is a highly functional isolation device, tested in practice in the most
demanding conditions and is used to transport a person infected with a highly
contagious disease or a person to whom it is necessary to ensure protection
from the outer environment (typically in case of reduced immunity of the
person).
Another option is to place a
smaller surgical room on board the aircraft, which would have to be operated in
a similar box as the Biobox (medical isolation chamber) – Czech Republic
product sold by EGO Zlín (Figure 3), to meet all the hygienic needs of a
sterile environment for surgery [6].
Fig. 3. Medical isolation chamber EBX-06 [6]
To operate an aircraft in an emergency, such as
transporting infected or sick or injured patients, a trained and experienced
team of people is needed to take care of the persons on board the aircraft.
In
addition, medical equipment would have to be installed on board the aircraft,
including the following:
•
loungers with seven-point seat belt attachment and retractable armrests,
•
humidifier,
•
mobile fan,
•
portable vital signs monitor,
•
oxygen flow metre,
•
inhaler,
•
transport incubator,
•
set of breathing masks for adults and children,
•
thermal insulation blankets,
•
suction units,
•
blood pressure analyser,
•
intubation kits,
•
neck brace,
•
chest drainage kits,
•
backup oxygen bombs,
•
vacuum mattresses,
•
surgical dressings,
•
surgical kits for minor operations,
•
wide range of drugs and infusions,
•
catheters,
•
small medical supplies,
•
electrical outlets and a satellite telephone are required.
Another option is to place a smaller surgical room on
board the aircraft; its operation would have to take place in a similar box as
the Biobox to meet all the hygienic needs of a sterile environment for surgery.
To operate an aircraft in the event of an emergency,
such as the transport of the infected, sick or injured patients, a trained,
experienced team of people is needed to take care of the persons on board the
aircraft.
The team would consist of 2 pilots and an aircraft
technician for smooth flight operations.
From
a medical perspective, there would be two medical teams, each consisting of two
doctors specializing in the necessary field of medicine (in this case, the
field of infectious diseases), nurses and paramedics. Dimensions of medical
equipment are presented in Table 3.
Tab. 3
Dimensions
of the medical devices
|
Equipment |
Length |
Width |
Height |
|
Biobox |
4.84 m |
2.12 m |
2.10 m |
|
Bio-bag |
2.03 m |
0.64 m |
0.56 m |
|
PTU unit |
2.08 m |
0.65 m |
1.50 m |
|
Folding
stretcher |
2.01 m |
0.55 m |
0.17 m |
|
Trolley
with stretcher |
2.12 m |
0.80 m |
0.93 m |
To give an idea of the arrangement of the Airbus A319
aircraft deck from the CSA airline, a graphic sketch was created according to
the actual dimensions of the aircraft, medical equipment and facilities (Figure
4).
Fig.
4. Airbus A319 - layout design for the MEDEVAC version
On the layout of the aircraft cabin with two exits and
one emergency exit (Figure 4), after deducting the already built-up area, the
length of the aircraft cabin for use is about 17 m, the cabin width is 3.70 m
and the cabin height 2.21 m. Other parameters are in Table 4.
In this space, it would be possible to install in the
front part one Biobox measuring 4.84 m x 2.12 m x 2.10 m, in which there would
be a PTU unit.
Opposite it, the space could be used for another box
with the necessary medical supplies and seats for the medical staff.
At the rear of the aircraft, 9 folding stretchers
would be installed, which would be attached to the snap rails, and these beds
have a special point attachment for the patient in flight.
Biobags can be attached to the folding bed according
to the needs of patients' health.
Tab. 4
Dimensions
of the Airbus A319
|
Length [m] |
33.8 |
|
Wingspan [m] |
34.1 - 35.8 |
|
Height [m] |
11.8 |
|
Wing area
[m2] |
122.4 |
|
Weight |
|
|
Maximum
take-off weight [kg] |
64 000 - 75 500 |
|
Maximum
landing weight [kg] |
61 000 - 62 500 |
|
Operating
empty weight [kg] |
40 300 |
|
Maximum
zero fuel weight [kg] |
57 000 - 58 500 |
|
Maximum
payload [kg] |
13 200 - 14 000 |
|
Standard
fuel capacity [litres] |
23 860 - 29 840 |
The second layout or graphic representation of the
aircraft deck concerns the Airbus A320 from CSA. The sketch was created based
on the actual dimensions of the aircraft, medical equipment and facilities
(Figure 5).
Fig. 5. A-320 layout design
for the MEDEVAC version
Compared to the A-319, the Airbus A-320 aircraft has
longer cabins, that is, more space for medical equipment and equipment on
board. It is possible to use around a 19 m long deck for this aircraft, 3.68 m
in width and 2.23 m in height.
In front of the aircraft, the PTU unit is placed with
the possibility of a Bio-bag, next to it could be boxes with additional medical
supplies. Furthermore, 9 folding beds would be installed in the front part.
The rear of the aircraft could then have one PTU unit
with the possibility of a Bio-bag and the rest of the space would fit 12
folding beds.
The space would also have medical boxes with medical
supplies and seats for the medical staff at the end of the deck.
The last graphic arrangement focuses on the board of
the CSA airline, namely, the Boeing 737-800 aircraft. The sketch was created
based on the actual dimensions of the aircraft, medical equipment and
facilities (Figure 6).
Fig. 6. B-737-800 layout design
for the MEDEVAC version
Tab. 5
Dimensions
of the B-737-800
|
Length [m] |
39.5 |
|
Wingspan
[m] |
34.3 |
|
Height [m] |
12.5 |
|
Cabin with [m] |
3.54 |
The Boeing 737-800 has the longest deck of the three
aircraft in the CSA fleet. Therefore, the use of its deck has more options.
It is possible to use the length of something around
21 m for this aircraft, 3.53 m for width and 2.20 m for the height of the
cabin.
The front part of the Boeing is used for the Biobox,
which has a PTU unit as a part. Furthermore, 3 folding stretchers could be
placed here, around them and the necessary medical equipment would then be
placed above them. There would also be seats for the medical team.
At the rear, there would be two PTUs that could be
used either alone or with biobags.
The rest of the free space would be used by folding
stretchers, which would fit eight. The space would be complemented by boxes for
medical supplies.
Tab. 5
Number
of medical equipment on board aircraft
|
Aircraft type |
Biobox |
Bio-bag |
PTU unit |
Folding stretcher |
|
Airbus A319 |
1 x |
up to 9 x |
1 x |
9 x |
|
Airbus A320 |
0 x |
up to 23 x |
2 x |
21 x |
|
Boeing 737-800 |
1 x |
up to 14 x |
3 x |
12 x |
Table 5 summarizes the number of medical equipment on
board CSA aircraft. A fleet consisting of three aircraft was selected for
comparison, namely, the Airbus A319 and A320 and the Boeing 737-800.
6.
RESULTS
AND DISCUSSION
As can be seen, each of the aircraft, depending on its
dimensions, can be used for different types of medical equipment and mix. Of
course, this form might not be final. From the overall analysis of the possibilities
of transporting sick or injured patients, it can be said that in the Czech
Republic, there are several options for the method of transport itself.
However, these are only individual patient transports,
in the case of the use of private airlines or air rescue service helicopters,
as these decks do not have room for more patients.
The Czech Army has aircraft or so-called
“government specials” for transporting more people; however, their
technology is no longer state-of-the-art and innovated. If needed for
situations such as transporting patients with COVID-19, the need to isolate
some patients could be a problem.
One solution for such an emergency, such as the
COVID-19 pandemic and any other emergency, is the possibility of changing the
aircraft's own character to another. An example is a passenger airliner
equipped with air ambulance equipment.
This
change could occur in the aircraft of the CSA airline, which got into a crisis
after the outbreak of the pandemic; however, the state has no need to help it.
However, if the state used its fleet for its needs to transport patients from
overcrowded hospitals to other states or hospitals across the country, for
example, it would help not only CSA airlines but also relieve the health care
system in the Czech Republic.
Because
of the complex setup involved in air medical evacuation for a highly contagious
infectious disease, especially found in repatriation missions that often
involve long distances, patients must be optimized before transport. Only
patients likely to survive transport will be evacuated. Especially in the case
of pulmonary insult, which is predominant in SARS, patients requiring
extracorporeal membrane oxygenation may need to complete therapy before air
medical evacuation [11].
7.
CONCLUSION
The
purpose of a medical evacuation (MEDEVAC) is to allow staff members and
eligible dependants the opportunity to secure essential medical care or
treatment for a severe illness or injury requiring medical intervention that is
locally unavailable or inadequate [7].
MEDEVAC
has become commonplace. Aircraft equipped with medical equipment deliver the
sick and wounded to inpatient hospitals from remote or hard-to-reach places. If
necessary, personnel perform operations or other procedures during the flight.
The flying medical facility allows the patient to
receive the same level of intensive care on board the aircraft as in the
hospital. It only takes a few hours to turn the plane into a flying hospital.
The patient is attached to a stretcher with a
four-point harness like an aircraft pilot wears. The wheeled stretcher can be
adjusted so the person can lie down, half sit, or have their legs raised.
Medical devices monitor the patient’s pulse rate, respiration, blood
pressure, and temperature; it also measures the concentration of carbon dioxide
in exhaled gases to let the doctors know if they are over- or under-ventilating
the patient.
Furthermore, this article focused on the
characteristics of aircraft in the air transport system and their
unconventional usage. Submitted proposals were prepared based on the current
situation in the world affected by the pandemic, which put air transport in an
unfavourable position in various areas. The character of the aircraft is
already determined during the design and determination of what it will be used
for. Therefore, the design itself, whether of the entire aircraft or its cabin,
is designed to be as effective as possible for its operators.
The main benefit of this analysis could be the design
presented proposals, where the possibility of changing the character of the
aircraft in an emergency, with the current CSA fleet, took place.
References
1. How Delta redesigned its 777 interiors, according to designers. Business –
Insider. 2021. Available at:
https://cryptopress.network/how-delta-redesigned-its-777-interiors-according-to-designers/.
2.
Obendrauf L. Cestující už do nich nesmí. Jak se z dopravních letadel
stávají nákladní. [In Czech: Passengers
are no longer allowed in them. As airliners become cargo]. 1999-2021.
Available at: http://www.idnes.cz/technet/technika/cargo-letadla-naklad-prestavba-
postup.A190719_163701_tec_technika_erp.
3.
Cabin safety program. Government of Canada.
Available at: https://tc.canada.ca/en/aviation/commercial-air-services/commercial-business-aviation/cabin-safety/cabin-safety-program.
4. Wide-body and large general aviation aircraft operating considerations. Universal, Weather and
Aviation, Inc. Available at: https://www.universalweather.com/blog/wide-body-and-large-general-aviation-aircraft-operating-considerations/.
5. EGO Zli, Bio-bag EBV-30/40 IN/CH. Available at: https://www.egozlin.cz/en/products/cbrn-protection/patient-isolation.
6. Systém
biologické ochrany – EGO Zlín, spol. s r. o. O nás
– EGO Zlín, spol. s r. o. [In Czech:
Biological protection system - EGO Zlín, spol. s r. about. About us
- EGO Zlín, spol. s r. about]. Available at: http://www.egozlin.cz/24806-system-biologicke-ochrany.
7. Medical evacuation (MEDEVAC) table of contents. Available at: https://cms.emergency.unhcr.org/documents/11982/48687/UNHCR,+MEDEVAC+Procedures/b5d0df8d-1ca7-4d52-9fce-47de6b819f21.
8. Gibbs S.G., at all. 2019.
“Review
of Literature for Air Medical Evacuation High-Level Containment Transport”. Air Medical
Journal 38(5):
359-365. Avalaible at: https://www.sciencedirect.com/science/article/pii/S1067991X19300410.
9.
Klaus J., at all. 2016. “Disinfection of aircraft: appropriate disinfectants
and standard operating procedures for highly infectious diseases”. Bundesgesundheitsbl
59: 1544-1548. DOI: 10.1007/s00103-016-2460-2. Avalaible at: https://link.springer.com/content/pdf/10.1007/s00103-016-2460-2.pdf.
10. Gibbs
S.G., at all. “Need for Aeromedical Evacuation High-Level Containment
Transport Guidelines”. Emerg Infect
Dis 25(5): 1033-1034.
11. Cornelius B. 2020. “Mass Air
Medical Repatriation of Coronavirus Disease 2019 Patients”. Air Medical
Journal 39(4):
251-256. Available
at: https://www.sciencedirect.com/science/article/pii/S1067991X20300766.
Received 13.11.2022; accepted in
revised form 21.01.2023
Scientific Journal of Silesian University of Technology. Series
Transport is licensed under a Creative Commons Attribution 4.0
International License
[1]Faculty
of Transport and Aviation Engineering, The Silesian University of Technology,
Krasińskiego 8 Street, 40-019 Katowice, Poland. Email: jaroslaw.kozuba@polsl.pl.
ORCID: https://orcid.org/0000-0003-3394-4270
[2]Faculty
of Transport and Aviation Engineering, Silesian University of Technology,
Katowice, Poland, Email: jan.pila@polsl.pl.
ORCID: 0000-0001-7336-5826
[3]Department
of Aviation Transport, University College of Business in Prague, Prague, Czech
Republic. Email: zyka@vso-praha.eu. ORCID: 0000-0001-7407-668X
[4]
https://www.noviny.sk/slovensko/593865-prevoz-pacientov-s-covid-19-do-nemecka-vzbudil-mnozstvo-otazok-ministerstvo-podozrievaju-z-protekcie
[5]
https://ekabu.ru/190246-chto-vnutri-samoleta-kotoryy-stal-letayuschim-gospitalem.html