Photos courtesy Saskatchewan Air Ambulance
Earlier this year, Saskatchewan Air Ambulance celebrated 80 years of delivering emergency medical air transport and care to people across the large, landlocked province in western and central Canada. It is the oldest formally organized, non-military air medical transport program in North America, and likely the second oldest continuously operating in the world behind only Australia’s Royal Flying Doctor Service.
Through eight decades, SAA has transported nearly 78,500 patients from newborns to seniors. Beechcraft’s King Air B200 joined the air ambulance service 25 years ago, and today four King Airs comprise the program’s entire fleet – each with the fitting call sign Lifeguard.
“The King Air B200 is well-suited to Saskatchewan Air Ambulance operations because it can reliably operate in all weather conditions and access a wide range of communities across the province,” said Dan Knisley, SAA’s director of flight operations.
It started with a Norseman
Saskatchewan is situated north of the U.S. states of Montana and North Dakota, south of the Northwest Territories and Nunavut and between Alberta to the west and Manitoba to the east. It is Canada’s fifth largest province in area and sixth in population, stretching about 760 miles from north to south and covering more than 251,000 square miles – roughly the size of Texas.
In 1944, Saskatchewan elected North America’s first social government by voting in Tommy Douglas as its premier, a role he would hold until 1961. As World War II ended in fall 1945, and with the country still recovering from the Great Depression, there were few roads and hospitals serving isolated farms and villages across the province. Travel, especially in emergency situations, was tough, with roads commonly blocked by huge snowdrifts, spring thaw or rain.
Keith Malcolm, an air force veteran, would serve as the first pilot for the air ambulance service idea he brought to the provincial government to overcome distance and the challenges of Saskatchewan’s vast geography, connecting patients to specialized care
when they needed it most.
The service started with one pilot, one flight nurse and an aircraft mechanic operating a war-surplus Noorduyn Norseman (CF-SAH) acquired by the Saskatchewan Department of Public Health. The first patient transport happened on Feb. 3, 1946, when the Norseman flew from its base in Regina to pick up a female patient in the town of Liberty and brought her back to Regina, where a ground transfer got her to the hospital.
By April 1, the service had com-pleted 51 flights. In August, a second aircraft (CF-SAM) was added to the fleet, along with an additional pilot and flight nurse, and the SAA averaged 20 flights a month through the first year.
At first, few communities had airfields, so planes often landed on fields or on open water with pontoons attached. For winter landings, skis were attached. In addition to transporting patients, the airplanes also delivered medical supplies and brought physicians or nurses to isolated communities for public health services.
The air ambulance service continued to grow and adapt to community needs through the years. From 1946 to 1976, SAA employed 25 pilots, 17 aircraft engineers and 25 flight nurses.
Today, SAA operates through a partnership between three organizations. The Ministry of SaskBuilds and Procurement provides the aircraft, pilots, maintenance engineers, hangar facilities and operational support. The Saskatchewan Health Authority is responsible for medical oversight, including clinical staff and equipment. This includes flight nurses employed by the Saskatchewan Health Authority and critical care paramedics contracted from Medavie Health Services West. The Ministry of Health administers and funds the program.
Day-to-day operations are coordinated across these partners, ensuring that both aviation and medical expertise are fully integrated into the service. The current team includes 51 employees from the Ministry of SaskBuilds and Procurement and 42 from the Saskatchewan Health Authority.
Since 1993, SAA has operated from its base at Saskatoon John G. Diefenbaker International Airport (CYXE) to dispatch aircraft and crews province-wide as needed 24 hours a day, seven days a week often in challenging weather and geographic conditions.
Each year, they transport approximately 1,500 patients, regularly responding to urgent, life-threatening medical cases, transporting patients from remote communities to specialized care in the province and inter-facility patient transfers within Saskatchewan and outside the province on occasion.
“Working together as one team, SAA’s pilots, aircraft maintenance engineers and medical professionals have demonstrated decades of collaboration and dedicated service to the people of Saskatchewan,” Knisley said.
A quarter century of King Air operations
Since starting with the Noorduyn Norseman aircraft, Saskatchewan Air Ambulance has operated a variety of models through its long history, including the Fairchild Husky, Cessna Crane, Cessna 195, Beechcraft Model 18 and Piper Cheyenne.
In 2001, SAA began replacing its aging fleet of Pipers by acquiring its first two King Air B200 aircraft, citing in a news release that demand for air ambulance services had nearly doubled in the past five years. Increased capacity with the King Air platform was an important factor. The B200s allow for two stretcher-bound patients rather than just one in the Piper Cheyenne III-A and also give the space needed to transport critically ill infants and children when a nurse or parent must accompany the patient.
With the first two airplanes proving themselves reliable and capable of supporting safe and efficient patient transport, two additional King Air B200 aircraft were purchased in 2007. Moving to an all B200 fleet benefitted the in-house maintenance team and streamlined training for pilots and ground crew.
The current quartet has been in place since 2017: two 2007 units, one manufactured in 2001 and another in 2002. Through the years, numerous modifications have been made to these aircraft including Garmin G1000 NXi avionics and ADS-B capability; BLR winglets; Hartzell swept propellers; Raisbeck dual aft body strakes, Ram Air Recovery System and enhanced leading edge modifications; and the CenTex Halo gross weight increase conversions. Each King Air is outfitted with a LifePort medical interior that may allow for up to two non-ambulatory patients.
“A key advantage is the King Air’s capability to operate from short grass and gravel runways, as short as 3,000 feet which is critical for serving rural and remote areas in Saskatchewan,” Knisley explained. “This, combined with its cruising speed, allows patients to access specialized care more quickly. Our King Airs are also equipped for higher-weight operations, providing flexibility when additional fuel or heavier medical payloads are required.”
Typical flights have medical supplies, monitoring equipment and medications on board, including a ventilator, defibrillator/pacemaker and type O blood. Equipment such as a transport incubator is added when neonatal patients are involved.
Proud employees making a difference
A typical crew for a Saskatchewan Air Ambulance mission includes a captain and first officer, a flight nurse and a critical care paramedic. Additional medical support may be added on a case-by-case basis.
SAA operates with an in-house, multidisciplinary team that includes pilots, aircraft maintenance engineers and operational support staff. All pilots are trained in accordance with Canadian Aviation Regulations and are approved by Transport Canada. An ideal SAA pilot candidate has strong instrument flying skills, multi-engine turboprop experience, satellite navigation skills and experience in high-density airspace as well as northern and remote areas.
Many employees have family ties to the organization, like John Wilson, the aircraft maintenance supervisor who started at SAA in 1998 and whose father worked as an aircraft maintenance engineer for 31 years after joining during SAA’s inaugural year.
“Recognizing staff as our greatest asset, Saskatchewan Air Ambulance continues to lead in the field of aeromedical transportation,” Knisley concluded. “Our employees are highly trained and use their skills to change patient outcomes every day. ”