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A medical or trauma emergency situation occurs and the local METRO is activated.

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Based on the information gathered by the METRO control room operators, a call is made to the AMS base either via landline, cell phone or base radio, dispatching the appropriate aircraft (fixed or rotor wing) depending on incident / mission requirement.

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The METRO dispatcher provides the heli crew with info about: incident location, number of patients, types of injuries and resources on scene.

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The helicopter is moved from the hanger to the flight area. A maximum take off time of 5 min is allocated for primary response calls from the time of dispatch.

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A maximum take off time of 10 min is allocated for inter-facility transfers. This enables the crew to upload any specialised equipment required for the specific mission (incubator, ventilator etc.)

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At take-off the primary crewmember will make contact with the METRO dispatcher advising them of estimated time of arrival.

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Inflight the crew assists the pilot with navigation and detection of hazards (other aircraft, electrical wires etc.)

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On arrival at the scene, the ground crew or traffic officers secure a safe landing zone. If not already done, advanced life support is initiated on the patient.

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Continuous communication is maintained with METRO control regarding the patient's condition, allowing the referring and receiving facilities to be updated.

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Inflight the patients vital signs are monitored. On arrival at the receiving hospital a concise handover to the awaiting physician is given informing him/her of medication administered or changes in patient condition.

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Ground times at the scene / referring / receiving facility are kept to a minimum to ensure that the aircraft is available for the next emergency mission.

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On completion of a mission the heli crew returns to the AMS base to refuel, clean the interior and if necessary replenish disposable stock, at times responding from the hospital to the next mission.

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The Wilderness Search and Rescue (WSAR) co-ordinator is alerted to the possibility of person/s injured, lost or trapped on a mountain. The co-ordinator gathers as much information from the requesting party as possible, often consulting with the lost party on GPS location, various landmarks or pathways used.

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An appropriate crew of 2 skilled mountain rescuers, a medic, hoist operator and pilot are scrambled to extricate the party off the mountain. These persons are often located in tight areas where winching them to the safety of the helicopter is the only way out.

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These calls are received from various sources (Port Control, SAPS, NSRI, etc).

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A pager message is sent out to all surf rescue members of the possibility of a person or boat in difficulty. Depending on the location of the incident the closest members will be picked up enroute.

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The rescue will be conducted by dropping a jumper/swimmer in the water as close to the person as possible. The rescue swimmer will attach a sling /harness to the rescuee. An 8 meter rescue line attached to the bottom of the helicopter by a cargo sling assembly is lowered to the rescuer who attaches himself and the patient to the line. The helicopter lifts the rescuer and the patient approximately 1-2 meters above the water and slings them across the water to the beach.

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During this time the pilot is kept informed about the position of the ‘patient’ by the primary crew member / patterer.

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The request is received by the AMS co-ordinator, who then activates the appropriate flight crew, based on the patient's condition.

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The co-ordinator also liaises with the referring and receiving facilities, as well as all the other services involved (e.g. road services) who may be required to assist in moving the patient to and from the airstrips.

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The co-ordinator serves as the hub through which all movements of the aircraft, its crew, road units and ultimately the patient, are facilitated.