In the air with ORNGE

Outside the Ornge hangar in Toronto, the sky is clear and the day is tranquil. But inside, the phones are ringing, and Ornge’s Operations Control Centre (OCC) has just received a call to attend a three vehicle collision in Caledon, and a Communications Officer is calling the hangar to request response. After a check on the weather, pilots deem the conditions safe to fly, and are soon on their way.

It is roughly 09:30 and Critical Care Flight Paramedics Michael Longeway and Justin Smith receive basic details while getting ready to attend Milton District Hospital where the patient was transported by local land paramedic services immediately following the collision. While enroute to the hospital on board Ornge’s AW139 helicopter, they prep their equipment and begin discussing who would carry out each task, and analyzing the possible ‘what ifs’. A classic example of teamwork and preparation by Ornge crews for each call.


“Like any other field of medicine, working in our environment has its unique challenges. In flight, we have to rely on a thorough baseline assessment and monitor for changes using a modified assessment,” explains Longeway. “With the noise of the engines, vibration, and constant flickering light, normal assessments like using a stethoscope are impossible.”

Safely loaded into the helicopter, the patient is conscious, but crying out loudly in severe pain as fractured bones shift under his own weight.

The Ornge paramedics administer Fentanyl to ease the pain, and manage to calm the patient as the helicopter lifts off the helipad and begins its trek to Hamilton General.


On arrival at Hamilton General, the paramedics transfer patient care to hospital staff and soon after, the aircraft lifts off and begins its way back to the Toronto Base at Billy Bishop Airport. Minutes into the flight, a new request is received to divert to another crash site for a motor vehicle collision in Milton.

“Scene responses are a challenge,” says Longeway. “You have a lot of information coming at you from different sources and you usually only have a short time to make sense of it all. Collaboration between our partners, our pilots, OCC dispatchers and local EMS dispatchers is crucial.”

The speed of the helicopter and proximity to the crash site allowed for a quick response only surpassed by local emergency services personnel, who manage to clear and secure a 500 metre stretch of highway west of the scene. The pilots circle once, and approach the landing site cautiously and safely to avoid power lines towering over the north side of the road.

Once on the ground, Mike and Justin head to the crash site where the patient is being extricated from his vehicle by local emergency services using the Jaws of Life, and human strength. Working together, Ornge, fire and local paramedics establish a plan to transfer the patient, who, within minutes is on a stretcher and headed towards the helicopter, with Justin going ahead to establish IV lines and lay out an airway solution.


As the helicopter spools up, the patient gets buckled in, and local EMS secures the area for a rapid departure. Within only 35 minutes of receiving the call, the aircraft is in the air and headed back to Hamilton.

Landing at Hamilton General, the patient is transferred to the trauma team for evaluation. Mike and Justin have completed two emergency transports in less than three hours, and they are only halfway through their day.

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