which is faster/cheaper helicopter vs plane?

Depends on the distance. Right now, life flights are used pretty regularly around here to transport injured people; I can't see that going over to small planes. Every hospital would have to have a runway for starters. And 125 miles isn't that much. The only time I personally have encountered planes for such things was when my mother had to be flown back from the Dominican Republic after a stroke and we had to charter a jet for her. But that would most definitely be cost prohibitive for most and certainly not financially viable for just a 125 mile distance.

Helicopters are much better for landing on top of hospital buildings.

Well, then you also need ambulances to get them from the local airport to the hospital, which I understood weren't allowed on the roads in your world. A plane cannot go directly to the hospital unless there is a runway right beside the trauma center.

As far as cost, looking back at my mother's situation once again, the chartering of the jet cost almost 40,000 US dollars. The life flight once she got to the airport and was flown by helicopter to the hospital was 12,000 dollars. The life flight was a distance of about 25 miles; the chartered jet went from the Dominican Republic to Tampa, Florida.

Sounds to me from your answer that you've already determined you want to use airplanes. *shrug* That's your call; it's your story and this is speculative fiction, so you can do anything you want. But, considering the conditions you set out in your OP and the current situation in the present time, and that your storyline is only 20 years in the future, I'm not quite able to buy the viability of using airplanes to accomplish what you're wanting to do here when helicopters are cheaper to buy, already in use, easier to get to the medical facility, are already outfitted with the required medical equipment, cost less to operate and maintain and are eminently more practical than an airplane would ever be. Just sayin'.

Helicopters are ALWAYS more expensive per hour of flight time. Maintenance costs on helicopters is extreme when compared to any airplane. Airplane infrastructure always costs more because of runways, obviously.

A 120m helicopter flight is going to be about 50 minutes from breaking friction to flat pitch in a helicopter. It's probably going to take 35 minutes in an airplane. But, there's some extra time with the airplane for taxiing, takeoff, turns to get on course, etc, so realistically, you can add 10 minutes to the airplane time. So, the difference isn't much on that short of a flight. The longer the flight, the faster the airplane will be at doing it.

The helicopter is valuable because it can takeoff and land anywhere. You don't need costly infrastructure. The infrastructure cost is not just building the runway. It is also the land use. Airports, by necessity are huge. A minimum of 8000 feet of runway that is at least 50 feet wide. Plus, you need a clear approach and departure path where you have minimal chance of hitting something.

There is a compromise and there are a couple of examples flying today. One is a Bell, although it isn't in production, and the other is military, the Osprey. These are hideously expensive right now, and very complex and difficult to fly beasts, but given 20 years or more, they might become something more reasonable.


Osprey


Bell BA609

EDIT
A helicopter is also much more flexible. You can hoist people up from a canyon, you can land on the freeway and take the patient direct from the accident to the hospital, you can fly low and slow in weather that an airplane can't fly in. You can search for people. So, you'll get more use out of a medical helicopter than you will out of a dedicated airplane. Also, I doubt you really understand how complex it is to build a runway with all the safety requirements, landing systems, emergency systems and of course air traffic control considerations. It isn't something you do in a complex urban environment without a whole lot of time and expense.

I second Hallens suggestion of using a tilt-fan or tilt-wing aircraft.
As said, rotary wing aircraft (i.e. helicopters) are much more expensive than fixed wing aircraft, and they're also slower. The advantage of an helicopter over a plane is that it's capable of vertical take-offs and landings, as well as capable of hovering in place, so despite being slower, more expensive, more complicated and more prone to breakdowns, when there's no space for a runway, there's just no alternative to a helicopter.
A tilt-wing or tilt-fan aircraft is not nearly as manoeuvrable as a helicopter, but it is VTOL capable, so when the purpose is to transport something it's pretty much the best choice. Unless you can use a runway and use an even cheaper "normal" plane.
One major reason why today, so many helicopters are in use instead of tilt-wing planes is that helicopters have seen a whole lot of development and improvement because of their military applications, and tilt-wing aircraft haven't.

On another note, propellers are more efficient for air travel than turbines, although top speed and flight height are both lower. If the speed of a jet is required they could be built as vector-thrust planes, like the British harrier, also providing VTOL capability. Though depending on how futuristic the setting is, they might use arcjets instead of jet turbines.

Lhun said:

On another note, propellers are more efficient for air travel than turbines, although top speed and flight height are both lower.

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That's not strictly true. Turbo-prop airplanes are more efficient depending on the length of the flight. That's why you still see turbo-props used by some commuter airlines. However, with the advances we've made with turbine engines, the gap in efficiency has greatly reduced.

A side note is that except in private airplanes, almost all aircraft engines today, including helicopters and tilt rotors, are turbine engines. The difference is that some turbines are connected to a drive shaft that spins a propeller or rotor, and some are designed to produce thrust. The ones used to produce thrust are generally called "jet" engines. Even the ones that produce thrust are mostly "high-bypass turbo-fans". They have huge fans in the front of the engine that do three things. 1) provide initial compression of incoming air for the combustion section 2) direct airflow. 3) the bypass air is used for thrust much like a propeller would be. Think of this like a ducted fan.

Anyway, probably more than you wanted to know.

Hallen said:

That's not strictly true. Turbo-prop airplanes are more efficient depending on the length of the flight. That's why you still see turbo-props used by some commuter airlines. However, with the advances we've made with turbine engines, the gap in efficiency has greatly reduced.

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Well, i'm just talking about the basic propeller vs. reaction thrust difference. If you want to compare the fuel efficiency of an entire airplane, a lot more, from efficiency of the power generation to efficiency of the fuel type comes into play and you can get much different total efficiency figures. Heck, just imagine a propeller craft with a steam engine used to turn the propeller.

I agree that a helicopter would be more expensive but more likely to be able to take off and land where is would be needed. Since this is speculative fiction, you might want to consider an autogyro. They haven't caught on, but they are inexpensive to operate and are capable of taking off and landing on ordinary highways,and W. C. Fields flew one.
http://en.wikipedia.org/wiki/Autogyro

GeorgeK, I think the over-riding factor might be the smoothness of the ride. If you have a broken back, you would not want to be lugged in and out of ambulances, planes, etc. So for versatility, I think a helicopter would probably be the best option and it would end up being used for everything.

GeorgeK said:

But is a helicopter ride really smoother? I don't know. I've never ridden in one. When I rode in an ambulance on the road, I decided it probably didn't have any shock absorbers. Most plane rides that I've been on were smoother than the ambulance. Also theoretically in a transfer situation, the paramedics should have less to do than when they pick someon up in the field, so I'm not sure how big an issue that would be.

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They are the transport of choice in the UK for emergency transfers. I go to a lot of dirt track meetings and in the event of a very serious accident, they call in the 'copter rather than use a road vehicle (which thankfully happens very rarely). The distances involved are often the same as the ones you are talking about (100+ miles). I think helicopters are preferred because they are more versatile than aircraft and because you can utilise them more (for example, you could send one out to a road accident if necessary). It costs about a £1m to run one for a year (I think).

GeorgeK said:

I may be misinformed about driving in the UK, but it seems from what I've heard that the cities are clogged with vehicles. My own experience, having been involved doing trauma surgery and dealing with helicopters is that ground vehicle ambulances are more efficient from a speed and cost standpoint in rural settings where the roads are not clogged with cars, (for distances under around 50 miles) whereas in very urban settings with a high traffic volume, choppers are far quicker since they don't have to negotiate around other vehicles.

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I think the UK roads are heavily clogged in general, but the cities are probably no worse than anywhere else. I don't know at what distance helicopters become faster, but a fair few counties have an air ambulance service (and they don't just cover big cities). You have to remember that in rural areas, the roads might be rough (or even unpaved in some countries) and you need some way to get people to hospital that wouldn't involve shaking them to death (literally if they have broken their back or have internal injuries).

GeorgeK said:

I may be misinformed about driving in the UK, but it seems from what I've heard that the cities are clogged with vehicles. My own experience, having been involved doing trauma surgery and dealing with helicopters is that ground vehicle ambulances are more efficient from a speed and cost standpoint in rural settings where the roads are not clogged with cars, (for distances under around 50 miles) whereas in very urban settings with a high traffic volume, choppers are far quicker since they don't have to negotiate around other vehicles.

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It's not only the vehicles. An aircraft can go point-to-point in an emergency, while an ambulance has to stick to the roads, even if those aren't clogged. Given the already higher maximum speed, from a certain distance upwards (to compensate for longer startup times), aircraft are just faster.

GeorgeK said:

But is a helicopter ride really smoother?

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The ride itself isn't any smoother than in a plane. Depending on the road and ambulance, it can be smoother than a ride in that.

GeorgeK said:

In the cities that distance was very variable depending upon the city and even regions of cities. Some places and some times of day a chopper was faster at only 1-2 miles.

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That can easily happen. Most important is probably that in any area with enough population density, the helicopter will be on standby, cutting down a lot on startup time.
Otoh, not all areas in a city are possible landing spots for a helicopter. (or other VTOL aircraft)

Julie Worth said:

Helicopters are much better for landing on top of hospital buildings.

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Unless you're Snake Plisken.

GeorgeK said:

No, either I wasn't clear or you are grossly inflating the parameters.

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Yep. That's what I normally do when I take the time to address someone's question. I waste my time and theirs by grossly inflating the parameters. You got me. Totally busted.

*adds another name to the 'do not respond' list*

I'm a retired surgeon. I've done trauma surgery. I've dealt with chopper transfers and ambulance transfers. I remember one of the choppers going down and we had to send Deathstar 2 after Deathstar 1. Over the last 20 years I've seen a growing dichotomy between the rural hospitals gradually only doing elective stuff and the major trauma centers gradually taking more and more transfers on an emergent basis. It simply seemed to me that if this trend continued, it seems logical that communities would find a safer, cheaper way to transer patients on an ongoing basis. It sounds like especially if there are more than one patient to transfer, an ambulance plane (used strictly for transfers) would be a viable thing in the future (assuming no significant improvement in the current trend of declining per capita numbers of physicians)

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Based on this, I'm not sure why you're bothering to ask the opinions of writers about something you know more about than anyone else here with the possible exception of some of our other MDs.

*shrug*

But what do I know? I'm one of those bizarre,strange people who responds to questions that interest me with my opinion but then grossly inflates the parameters just to confuse the issue a little more. It always makes that courteous "Thanks for responding" mean so much more.

Best of luck to you.

A patient needing critical care would be better suited being loaded into a fixed wing aircraft for a 125 mile jaunt. In a helicopter, it would take almost an hour to cover that distance, depending on the airframe in use (though I could do it faster, I just know it!). Turboprops realize their best performance at higher altitudes, and a 125 mile run probably isn't worth it to climb out over FL250 to realize the benefits, but the speed would still be there, and in trauma situations, speed counts. (Hallen would know more about this stuff, I'm sure, since he was a seized-wing driver.)

Tiltrotors are technically the wave of the future, and in a science fiction circumstance, would be eminently reasonable. Not so much in the near term, however; the tech is still somewhat nascent, despite decades of playing with it. It's also remarkably expensive; the V-22 program clocks in at almost 50 billion!

I don't have any HEMS experience, as all my time fighting the sticks was in attack aircraft, but one of my workmates is a MEDEVAC pilot who straps on a UH-60A Black Hawk once a month. If you want details and specifics on that kind of mission, I can get it for you easily.

ETA: Just read Hallen's post, he pretty much nails it.

GeorgeK said:

This would be taking into account too many variables for me to figure out, like FAA regs, prep time to get something into the air, fuel efficiency, flight time, etc. Assume for the sake of the argument that municipalities have had time to dedicate a medical or emergency use only landing strip.

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I think we've gotten a little off-track here. It is up to you to figure out your medical evacuation system, and build your world. What you asked for is above.

I think I've generally covered the speed thing.
I have seen a First Up Medivac get off the ground in less than 5 minutes from emergency to lift-off. (A C-130 crashed on landing at Ft. Campbell, KY while I watched. I was on the ramp next to the UH-60 Medivac helicopter. The thing that took the longest time was having to wait for the second pilot to get to the bird and get strapped in. The first pilot already had the bird ready to go by the time that happened.)
Prep time is 99% prior to the call. As a crew comes on duty, they preflight, run the aircraft up to do checks then shut down, and do the preflight checks right up to engine start (this is called "cocked" as in a weapon that has been cocked and ready to fire), brief, and prep for the day. Once they are ready, they debrief with the current on-duty crew and then take over. If the siren sounds, they can be airborne in less than 5 minutes.

The medical system you describe is all fine and dandy, except for the runways. Your main medical centers are going to be close to the center of major metropolitan areas, yes? If so, a runway is completely infeasible. Unless, you can make them as suspended runways over the top of multiple buildings or something like that, but then you still run into problems with run-off and other freaky things.

The Tilt-rotor is really your best bet. It's like a swiss army knife, useful, but doesn't do any one thing particularly well. It has the good qualities of an airplane and some of the good qualities of a helicopter. It's hover capability is extremely limited based on density altitude and aircraft weight. You can overcome this with future advances easily for a sci-fi story. The tilt wing's fuel efficiency will fall somewhere between a helicopter and a dedicated airplane.

If this story is going to be 1000 years in the future, then you can make yourself really advanced aircraft that solve all your problems.

FAA rules and regulations are not really a problem. Medical aircraft are given priority over everything but a declared emergency from a crippled aircraft. Medical aircraft still must conform to airspace requirements, but this again is just a normal course of aviation. There are restricted zones, altitude restrictions, traffic flows, etc. But none of this is going to have much impact, especially for a helicopter flying in VFR conditions.

Anyway, if you want to go into details on specific technical details, either me or Noah can probably answer your questions. I did fly military medivac for a while in UH-60L Blackhawks. And I flew "fixed wing" (Army for airplane). Noah blew things up, but he still knows aviation. ;-)

And if you were at Campbell when I was, then I know you most assuredly helped yourself to some of my many, many castoffs. Gunslingers for the win! (Until we get a splinter, then we frantically call for DUSTOFF and a fresh pair of Underoos.)

I don't remember a C-130 burning in at CAAF in my time... I was there from 1987-1994. Was this before or after?