HeliService USA Brings Paramedics to Offshore Wind

0:00Welcome to Uptime Spotlight, shining light on wind energy's brightest innovators. This is the Progress Powering Tomorrow. Welcome to the Uptime Wind Energy Podcast Spotlight. I'm your host Alan Hall. As large offshore wind projects take shape off the coast of Massachusetts and New York, including Technicians Safe Presents, unique challenges required innovative solutions. We are here at Hellas Service, USA's Hangar in Rhode Island, discussing offshore wind operations, specifically emergency medical services and search and rescue capabilities. Joining us today are three leaders in emergency response, Dr. Kenneth Williams, division director of EMS and professor of emergency medicine at Brown University, Michael Toesey, founder and CEO of Hellas Service, USA and Paul Russo, director of operations at Hellas Service, USA. Together, we'll be discussing their collaboration to provide comprehensive emergency medical

1:04services and search and rescue operations for a U.S. offshore wind. Michael, let's start with you today. And thanks for the invite to come out. This is tremendous. Of course, you're welcome. Thanks for coming. Thanks for spending the time. As always, when we come to Hellas Service, the facilities are immaculate, they are craft very immaculate. You run a really high class operation, which is desperately needed for offshore wind in the United States. But now you're expanding into emergency services, rather than just carrying technicians out to sight and dropping them on the top of turbines. Now you're looking out for the health and safety a lot more. So what does offshore wind in the U.S. involve in terms of EMS operations? It must throw a lot of hurdles at you. How do you even approach that problem? Absolutely. Well, thanks for spending the time today on. Thanks for coming out. Certainly appreciate the compliments. The first thing for us is always safety. And it starts with your facility. It starts with making sure everything is immaculate before people get on your helicopters. Regarding EMS and emergency medical services offshore, this has obviously been, I wouldn't

2:07go as far as this is a contentious topic. But it's been one that the industry knows there are some issues with and knew that they're going to need a solution for it. Of course, there's always budget challenges. But the biggest issue is you have folks offshore who are isolated, who are, it's almost like a town out there. At any given time, there'll be 1,500, 2,000 people. If you run the numbers with all the heavy lift vessels offshore. So at any given time, you're talking hundreds if not thousands of people. And they don't have an ambulance service. There is no ambulance service out there. There's, you don't just call 911 and have an ambulance show up. Up to this point, they've been using the Coast Guard to a limited degree. But the problem is the Coast Guard is also not an ambulance service. The Coast Guard serves the entire region of New England with one helicopter. They are out there for folks in the water. They're out there for sinking vessels. They're out there for law enforcement. They have a lot of other responsibilities. They're not designed to be an ambulance service for several hundred if not thousands of people offshore. So what we've done with this program is filled that need.

3:09Because that obviously can manifest itself in all sorts of different ways. Most of them not good if your ambulance service is not available. So developers have seen the need to have an ambulance service to bring folks back. Or forbid there'd be any injury or medical conditions offshore. So that's how we got here. I didn't realize there's only one helicopter serving the whole sort of northeast quarter from the Coast Guard side. Because if you watch the news, anytime there's a severe storm, there's a boat that has sunk in people that need to be rescued. And they're constantly flying around trying to just do that. I didn't realize there's only one serving it. So offshore wind being 30, 40 miles off shore gets to be a real problem for the Coast Guard then. Yeah, absolutely. And it's twofold. One, they can't guarantee anything. They have one helicopter in Falmouth for these projects up here in New England. The next one is all the way down Atlantic City. And that one helicopter in Falmouth may be on the board of Canada, searching for a lost kayaker. I also part time serving the international guard.

4:12Everyone, so while we'll back up the Coast Guard because they are all the way up in Northern Maine and something would happen down on the island where I was at. And unfortunately, we don't provide a guarantee response posture, but if we were out, we would go look. So that's this pretty common place. And also, they won't guarantee that they come because they may have something of higher acuity. Paul spent several years in the Coast Guard flying J. Hawks. And he can speak to a little bit about how that prioritization works and how they're covering lots of folks. Yeah, yeah. So I mean, it's all priority like Michael is saying in terms of what the case may be. If you've got a vessel that's sinking off shore, 200 miles off shore, something like that, then that'll take priority over somebody that may have a fracture or something like that on a wind turbine. So the availability of the Coast Guard, while they are, listen, I spent 14 years doing search and rescue in the Coast Guard. I have the highest regard for my brother and my colleagues there, but they are, they're busy. And to rely on them as a sole source for evacuating your people, it's just not the solution.

5:16If you do indeed have an unfortunate injury offshore. Yeah. And I'm building offshore wind turbines is complicated and there's a lot of heavy equipment, a lot of moving pieces and a lot of people as it sounds like now. And we're in that building phase in the United States where there's a number of construction sites going on. There's a lot of people, technicians out there at the moment that don't have, maybe don't have the coverage they think that they have. Correct. Correct. Okay. Wow. They didn't realize that. Well, this brings in Dr. Williams on the EMS side because what a health service is going to provide is EMS services to those technicians that are offshore working on wind turbines. You've been in the EMS world for a long time and you probably have seen everything. There are similar challenges though of doing helicopter EMS work and making sure that they have a program here that meets the high standards that root island and the U.S. requires. Thank you. And thanks for inviting us to do this.

6:18One of the things that we would like to say in emergency medicine is that you've never seen everything. There are always circumstances or conditions that come up that are novel. And when I was asked to get involved in this project, I saw it as an interesting challenge and an interesting opportunity. In my past, I was medical director for a regular medical helicopter service at the University of Massachusetts, which served both cryic scenes and inter-hospital transfer, but not capable of doing this kind of work. And there's no regular medical helicopter service in the area that is capable of doing this, both landing on some of the assets offshore and doing the hoist work. The regular med flights and life flights are not equipped and not capable, not trained, don't have the aviation or the medical training to do this. Their aircraft are not equipped with a hoist.

7:18They may not be the right configuration or power to do this kind of work. So when Michael came to us at the Department of Health, I happened to be sitting in the room because I'm also the state EMS medical director, and it seemed like a good fit for me to participate. And what we've put together in a very short time frame and very efficiently with some great help from the whole team here is a paramedic level, fully staffed and fully equipped air ambulance, that is limited to supporting the wind farm industry. We're not competing with the med flights and life flights. We're not going to be going to a hospital, to a hospital, or going to a crash on the highway. We hear just to support the wind farm industry. And we've done extensive training with the group of paramedics and the group of flight engineer hoist operators that we have both day and night and of an acquired extensive

8:19outfit of equipment that meets the Rhode Island standards for paramedic ambulance. So we have medications, we have a full cardiac monitor, we have oxygen, we have suction, all the things that you would get in a ground paramedic ambulance, we will have available for people out in the wind farm assets. Wow, that is huge. And a difficult task actually to do that. It was quite a challenge to assemble all of the equipment and to do it in short order and organize it. The state does have a list of things you need to have, but they don't tell you what color bag to put it in or what to put in what pocket and to figure out how to do it so that we can safely and efficiently place it in the aircraft and take good care of patients took a lot of work and a lot of cooperation from the excellent team here. I actually think that it hits off on something else that is really, really important. So if you do get that Coast Guard, if they are available, helicopter and they do come,

9:22one, they are probably not going to launch as quickly as you will see as a civilian operation. The military, Paul and I have both experienced that. They want to get out the door, the crews want to get out the door as quickly as they can, but there is just inherently bureaucracy between them and launching. They need to talk to the folks on site, they need to assess if it is medically acute or not. First for us, we say call first, ask questions later. You call, we get the helicopter there. If it was two minor, say, Lavy, we were closer to it because Lord forbid it was a major incident. You want to get that helicopter and route. And the other thing is when that Coast Guard helicopter comes and can speak a little bit more to this as well, sorry, Dr. Williams, when it shows up, it's not going to be as capable as what you would expect to see from a typical ambulance. It's a back of a pickup truck. The folks will tell you it's the call to pickup truck. It is a pickup truck and all the stuff that Dr. Williams just described is not in the back of a Coast Guard helicopter. So just because they're there doesn't mean that you have now upgraded your care.

10:23In most cases, they've actually downgraded because they have paramedics offshore, whereas it best you get an EMT basic with the Coast Guard. That's, you know, you took a two week course online and you're an EMT basic. I'm being a bit facetious, but it is a very, very quick basic level of medicine. So not to ask the questions here, but I know that Dr. Williams can probably speak to that a little bit as well. And some of the assets offshore are staffed with a paramedicomatic of some sort. And we don't know all the qualifications. It depends on the customer and where these people have come from. But in some cases, the Coast Guard will have to bring that person with them, which leaves the offshore asset without coverage or transfer the patient to the Coast Guard helicopter. And again, I'll do respect to our friends in the Coast Guard. I'm in the auxiliary. I know what they do in boats quite well and I see the aircraft operation. They're focused on rescuing, saving your life. They're not focused on starting an IV and giving you pain medication for your fractured

11:24leg. They can get you out of the water and they can get you into a litter and get you to the hospital. But you're not getting paramedic level care during the transport unless they bring someone with them. And as Michael mentioned, the process of doing that usually involves consulting a flight surgeon, doing a risk assessment. It may take a long time to make that decision. And then there are some things that because of their rules and regulations, they won't do that how they service can do. Like landing on some of these assets where the Coast Guard will hover and do a winch procedure. So we can provide probably faster service, higher level service and safer service because we can land and transfer into the patient as much safer if the aircraft is sitting on a helipad than if it's hovering over. Although we are equipped to hoist the patient, we would prefer that the aircraft land and that we can carry them to the aircraft.

12:24I guess the only experience as an American watching the Coast Guard do those hoists is on deadly as catch, right? The crab boats that go out and when you see somebody get injured, you see the Coast Guard come out and they drop down and they hoist them up, they throw them inside. And that's the last you see of it. You don't see them providing any services to the injured person and you just see them flying away. I guess there really isn't anything going on there. We're just taking them to the nearest airport or hospital wherever they're going to get services. I didn't realize that. So that's an important fact, especially if you're operating offshore wind farms and you're involved in the ships and all that activity. You need to be thinking about that quite a bit because someone's going to get hurt at some point. There's just too many moving pieces of this and we're too far offshore in the United States to allow someone to get hurt and get seriously hurt and not have a way to get them back and get them care given to them. It seems like this is a much better solution than putting them on a ship and hauling them

13:26back to shore. Getting them on to a ship safely is problematic depending on the sea state and where they are. And then it's a multi hour probably bumpy ride in the ship and then they need to get into a ground ambulance. We don't have any hospitals in Rhode Island that have a dock. We have a couple that are pretty close to marinas but they would have to get into ground ambulance and then go to the hospital. So much, much longer evolution to get an injured person or an ill person to shore. And the other aspect of this, certainly there's risk there in terms of injury for the people working there. But if you put a thousand or two thousand people somewhere, people are going to have regular illnesses as well. There will be asthma attacks and allergic reactions and stomach aches and maybe even strokes and heart attacks and things like that. The Coast Guard is able to do CPR and average control. So certainly they're very good at basic first aid things but not only are they not trained

14:31and equipped to do some of the advanced things but their environment is one where they expect everything to get wet. And most of our stuff is not waterproof. So our cardiac monitor and all the other devices that we have here would not do well in a wet salt water environment. So they don't equip the Coast Guard boats or aircraft with things that one wave will destroy. And so they really can't offer that level routinely. They may be able to hoist a paramedic from the boat and go with them with their equipment. But that's one of the reasons that the back of that flying pickup truck is not equipped with all of this electronic medical equipment. Is it just not their operational environment? And another thing to hit off on that is that there's two groups of personnel that we can go to. There's those that are on vessels that have a paramedic thankfully. But there are also those on the turbines.

15:31And the turbines, they are extremely isolated. You have three technicians who of course they receive some rudimentary medical care and they have a little bit of medical equipment. But I think most of the technicians will be the first to tell you that they are in no way shape or form qualified medical professionals. And when they're on the top of that turbine, particularly when delivered via helicopter, the only way to get them off is via helicopter. So what that means is that the Coast Guard goes out there with this very rudimentary medical capability several hours later. Because if they're coming from Canada, it could be four hour flight back down to a turbine here south of Nantucket or the vineyard. And when they get there, you're getting an EMT at best. So that is not particularly compatible with the risk of being a bit blunt with life. If you have something that happened to you and four hours later, you're getting a response. It's unacceptable. Everybody knows that. And that causes huge limitations to access to the wind form with helicopters because you can't put folks out there if you don't have a way to get them out.

16:32And the entire reason that you use helicopters in your wind form is to insulate you or ensure you against not having access for huge swaths of the year. So with the helicopter, you also need to provide folks a good way to get out and quite frankly. Even if you don't have helicopter access, as Dr. Williams said, I don't know anyone in the world who wants to take a vessel back if there is a helicopter available in on goal. Yeah. It makes total sense. If you're an operator or a developer off the East Coast, you'd be talking to Hello Service USA and getting this service on your project because there's really no other way to do it. It's just be honest. The other way is so horribly developed and we just don't have the infrastructure for it. The US right now, helicopter is the right way to go. Now let's talk about what that looks like operationally. You get a phone call from a turbine or an operator says, hey, I got a guy that got hurt. What happens next? So for us, we try and make it as easy as possible. There's just a phone number. They contact.

17:33We have our dispatch available currently. It is during daylight hours and here and just under a week or so, two weeks max, we're going to be operating 24 seven. Our dispatch and all these staff 24 seven, the call goes to them within about a minute that helicopter is already starting to get underway to launch. That is the key is to get those folks ready to get those folks mobilized, get the helicopter get murdered and then it turns over to the pilots who start. Yeah, they'll take a look at the weather, look at where the assets located if they're in the land, if their or if this can be a hoist mission and then they decide to accept the mission or not and as long as all the factors are good and safe to do so, then they head out. Okay. Are people stationed in the hangar? Correct. So they're not driving from the home to get over here. No, they're here. Correct. So we have two pilots, a paramedic and a hoist operator. 24 hours a day. Wow. Okay. That's. And the hoist operator will be trained as an EMT. So we have two medically trained people in the back and two pilots up front.

18:36So four people inside the helicopter and there's a switch over that has to happen because it's configured to take technicians on and off. Correct. The wind turbines at the moment. Yep. What does that look like? So that's a great question. This goes back to some of the economics of it. They're there is precedent for this. This is not a totally new concept. The folks in the Gulf of Mexico have been doing oil and natural gas work offshore for 60, 70 years or more. Paul came from a program in the Gulf that was a large search and rescue and EMS program. They have five dedicated helicopters and let Paul speak a little bit more to it. That comes with a price tag. And since offshore wind is newer and smaller, we understand that that is a difficult bill to foot. And while that is probably where this will go with continued development is to have a dedicated asset. So what we had to do to do this economically was use the assets we have because we understand that while the developers know they need to get there and they want to get there, there are ultimately resource limitations. And so with that, we use our existing fleet of helicopters. So the same helicopters that we take the folks out on, we can rapidly convert in less than

19:3810 minutes. I believe the crews have done it. There's a little six minutes. Yeah. They're all way down to six minutes to take this and it is a proper ambulance in the back. When you look back there, it's in not only the proper ambulance. Because this helicopter is much larger than most onshore medical helicopters, this is like the Cadillac or the Mercedes for the crews. It's got a ton of space, lots of space for gear, the stretcher, and it's really great access. But we were able to do this economically for these first couple of developers to get them a solution at a price point that works. Right. Everybody's worried about costs at the minute. And rightfully so, however, you need to be worried about all your people that are out there. So you can, from phone call to being out on a flight line, less than 10 minutes, Paul's in all the weather research. He knows where he's going. Everybody's in the helicopter. He got four people in. Off you go to the turbine. What happens in there? You call and doctor william to say, hey, we got somebody who's injured and be ready.

20:39So when we do get the call, we have an intake form that dispatch will write down the basic information of where we're going. If it's an amatory, not an amatory, and then they'll get further information, paramedical get that information as well, which is patient condition. Is this a fractured leg? Is this a stroke or a heart attack? Is it just somebody that's not feeling well? Or the case may be. Once they get that, then, and that's all happening at the same time. How does that work? I mean, if I'm a technician on top of a turbine, I'm 30 miles from shore. Do I have a radio? How am I getting a cell phone? How am I calling you? Yeah, they have comms offshore. Cell phones actually work pretty well. There's a really good coverage out there. I mean, these turbines are 500 feet off the water, you know, at the Nacell. So they've your great cell service. They have pretty good cell service out there, but they also, I think they also have tetra radios as well that they use. So they have several ways of communicating back with their people, and they have several ships out there as well that are vessels that are in comms with them.

21:40So they would make a call to that entity out there with their marine control center, coordination center, and then that call would come to us. So somebody gets hurt. It's basically like, get on the radio, 9-1-1. We've got somebody that's got injured and need to get them off. And here's a condition, whatever it may be. Okay, so you're now flying towards the turbine. You get to the turbine. This person is not ambulatory. They're just sitting on the deck, broken leg, broken arm, whatever it is. What does that look like? And how does weather play into this? Well, I mean, the weather is really low. Then we may not be able to get to the turbine against 500 feet above the water line. So if you're sealing it down at 300 feet, that could be prohibited from forgetting up there. Most days we don't get that here in New England. So whether more likely be okay, the majority of the time. So we get into a position to hoist out our paramedic. He'll go out first, he or she will go out first, and then medical equipment after that.

22:43And then they'll pack the patient, do whatever they got to do. Take as much time as they need to take. They're crafting that. During that time, we'll just enter a loiter pattern. Just a conserve fuel. Come back in, pick up the patient, pick up the paramedic, and off they go to the hospital. Okay, so they actually stabilize in the patient on the top of the turbine. Get them packed in the... Get them all correct in our stretcher system. Right, okay. That's when heck up a ride then. Okay, so the get back onto the helicopter, you're flimed to where you're going. You're going to Massachusetts. Probably in the hospital. In the hospital. Yeah, in the hospital. Okay, whatever it's closest to, I guess we call it now. So, the only level one trauma center in South East New England is also a foreign center. An excellent helipad system. There's a ground-based telepad that can handle two pretty good size aircraft and a rooftop helipad that's right over the emergency department. And it's a couple of minute flight from here where we are.

23:43So it's our intended destination for almost all of our patients. They have an excellent medical communication center that's staffed by paramedics, have radios and telephones and computer screens that we can communicate with them. So from the medical chronology of this, everything that we need to take care of the patient is coming on every flight. So we're not picking and choosing both a guy as a broken leg. Let's go get a splint out of the cabinet. Everything is on the aircraft. If we get additional medical information, let's say there's a paramedic out there or our medic here can talk to whoever is with the person. Yes, we'd love to have that information to kind of know what we're going to. We're trusting our paramedics to make that decision that this is how I'm going to manage this patient. And as Michael said, we're not triaging. If they call us, we're going to go. And we'll sort it out later.

24:43But once we've got some information, there'll probably be a notification to the hospital. Hey, we're going on a mission. You're going to be getting a patient. Once they get to the patient, they'll do what they need to do. They'll get the patient back in the aircraft. And then there will be communication to the hospital. Now we're inbound. We're 10 minutes out. This is what we have with a much more detailed medical report. And that'll either go directly to the hospital or be really through dispatch here. Depending on where the aircraft is and who we have radio communication with. And then the trauma center will get ready to receive the patient with whatever they have. They're fully prepared there to handle strokes and heart attacks and medical issues as well as trauma. So they can handle anything that we might be bringing them. Wow. Okay. Actually brings up something I think is also important to highlight is a lot of folks perceive with the military. It's just very organized. Everyone's sort of knows exactly what they're doing.

25:45For those of us who spent some time in the military, well, it does come across that way. Sometimes internally, you see a bit how the cake is baked. And the military is not designed to be an ambulance service. Never has. Never will be the Coast Guard, be it in depoined environments. One many missions in the military providing search and rescue services or coverage or medevacs. And some issues that they've seen is that military helicopters don't have the ability to necessarily deliver report to the hospital they're going to. So they sort of show up and I hate to say it. They kind of say, hey, here's your guy and they sort of dump them off on the hospital. And the hospital doesn't necessarily know what it was, what the symptoms were. And there's been several cases up here in New England where that has happened, where they have had someone go to Rhode Island Hospital. The hospital didn't know what they were getting. And they had a difficulty, you know, I don't know, I say diagnosing per se, but they didn't get the best level of care immediately because the hospital needs to know what they're getting. They need a good handoff.

26:45And there have also been some adverse outcomes from folks that have gotten potentially delayed responses. Or there's been cases here in the Eastern seaboard where the Coast Guard has said no. And you know, for those who've been involved, they've heard this, you know, for the last couple of years, hey, they are going to say no. And at some point the Coast Guard is going to have limitations because however acute you may think your particular patient is, I guarantee you that the, you know, fishermen who's vessel sank and is in 33 degree water is in a far more acute condition than almost anything you can imagine because that person has a very limited window. And the Coast Guard is going to prioritize that. So there are going to be times and there have been times now where they have said no. And I think that's really important for folks to understand if they're not utilizing a service like this yet. Now I'm curious because last year, Ella Service USA did about 10,000 flights to turbines of shore, which was an incredible number. I didn't realize you had done that many flights last year. How many injuries happened last year where they could have used your service?

27:47It is a fabulous question. So admittedly, while we are part of the industry, folks, you know, there are organizations like G-plus, but our observation is that, you know, folks don't like airing their dirty laundry to be entirely frank. We have seen from behind the scenes is that I know that one particular Tier 1 operator out there had at over a dozen alone in one summer campaign. There are, and that is just one. There are many, many out there. I would estimate at any given time or any given year so far, I think 30, 40, 50 different cases. Now, you know, mind you, the acuity can go from, you know, extraordinarily low, all the way up to there have absolutely been some, some much higher acuity cases out there. The other thing that speaks to is the lower acuity cases where the Coast Guard just is not, you know, you're not going to call them, but it's this in between where you don't actually want to stick them on a vessel. You do want to get them to care in the next 12 hours. Maybe it doesn't need to be in the next hour or two hours, but the next 12 hours and the

28:50vessels are not necessarily running in some of the poor sea conditions. So, you know, there is a whole waiting of stuff. Most of your town's ambulance calls are not tremendously acute. That doesn't mean you don't need an ambulance service or you count on the ambulance service from four towns over. You know, you still need your own ambulance service to handle those. And that goes back to Dr. Williams's point that a lot of what happens on the EMS side is not, you know, a cute, horrible injury. A lot of it is just general things, but they require EMS services. And to amplify on that one of the reasons why medicine is so interesting, but so frustrating for some people is things can look minor and actually be a serious problem. And so if somebody is on top of a turbine and gets a sudden toothache, well, maybe they're having a heart attack. So somebody made triage, oh, it's just a toothache. Why don't you give the guy a couple of Tylenols and he can finish his work day. Maybe they do need to be evacuated and when our paramedic gets out there and says, oh,

29:54did you start having this job pain? Do you have any chest discomfort with? And as you know, that you mentioned, it might just as kind of tight. Well, that person now needs a cardiogram and an IV and maybe oxygen and maybe medication, all of which we can provide, none of which the Coast Guard can provide and none of which is available on top of that turbine. It may be available if they're on a boat with a paramedic offshore, but now you've got a patient where advanced care has started and the Coast Guard can't continue that advanced care. So either again, the paramedic that's on the boat gets on the Coast Guard aircraft with the patient or a service like our service can come in and handle off at a same level of care or even a more advanced level of care than what's available out there. Yeah, I experience that many, many times in my previous operation prior to coming up here where we're going out to pick up somebody that is complaining of heartburn or maybe attangling in the arm, whatever the case may be.

30:56And we get them on and they're, you know, they're coding out from our attack. And without that advanced level of care that we provided, at the same level of care we're providing here, we provided down there as well, that person would not have made it. So wow, this is amazing because I didn't realize how serious this was. Now you walk me through it. If you're out on a turbine and something happens, it's isolated place to be. You're on an island and you may be there for several hours unless you have health service coming to your rescue. How quickly can you get somebody off of that top of that turbine and then to Rhode Island hospital? It's so overall, it's is a very, very quick response time. So for here for our closest turbines for the nearest windpark that we serve, only about a 13 minute flight. So if that helicopter's off the ground 15 minutes, which during the day is very plausible, especially when the crew is here and postured, you're talking a 15 minute launch time, 15 minutes off short, you're at 30 minutes until that person is receiving the highest level

31:57of care that you could ever expect. The same that you would get if you called 911 in the biggest city with the best, you know, ALS level of care that you're going to see to recover that person depending on how they're packaged, 10 minutes. 15 minutes would be a long time. It can be very, very quick depending on how ready they are. So you're off the turbine in 15 minutes, 15 minutes flight to the hospital and you're talking that it is possible on some of the nearest turbines to be an hour. From the point where that entry occurs to the hospital. Now obviously you can see delays with confusion with folks and there's the fog of war as us military folks call it, but an hour is very doable for some of the turbines that we service there a bit further out, 90 minutes is very, very doable. The other day we had a drill at our furthest turbine that is currently in our service area and between call when we received our call to getting that person to Rhode Island hospital was just a little over 90 minutes from that call. From what we've seen with the Coast Guard responses in the area, it's been generally three

32:57hours or more from that call just because of their launch time is a little bit slower, the notification process, the medical discussion. Sometimes that's four to five hours that we've seen on several other calls. So the difference is dramatic. We're talking about improvement almost 100% or more, so it is drastic. So if you can hear it behind us, we're at an active flight line and health services busy today, taking technicians on and off of wind turbines. So it is a busy place. This discussion has been fantastic. I did not realize the need for this as much as I thought the Coast Guard would handle some of this and that's what was going on, but in reality they're not able to do the service at the level in which it is required. And Dr. Williams, I mean, you pointed out very clearly there's a lot of things that happen on wind turbines and a lot of cases that need to be taken care of. Ella service is the way to do that and they're qualified and they're trained and they got 24 hour coverage. That is the right way to do this in the States.

33:59Michael, how do people get a hold of you and turn on the service and get it implemented for their wind farm? Yeah, so very fortunately the service is now here. We had a big industry stakeholder really stepped up, made the right decision to do this, go ahead and because they have taken that leap, now it is really easy for everybody else because the service is here. All that needs to happen is a contractual discussion. Another big, big item with this is we are doing cox sharing with this. So the next person who participates, the first participant is going to see a reduction in their service, so a pretty substantial reduction. The next member is going to see an already reduced price and then as that keeps going, it's a bit of a consortium. It's unfortunately it's almost impossible to organize a consortium with a lot of big players, but what I like to call it is cox sharing. So as each member goes and joins the service, the price continues to drop. Also, you tend to see the service increase in quality because there's a little bit of an additional margin with each to provide coverage for a greater swath of the offshore population.

35:00So the more people that participate in it, the better the service gets in the less that it costs because very obviously, thankfully, even if there are, say, 36 calls a year, that's three every month. Nobody needs to pay for their individual service for each win park. I mean, that's a gross misuse of resources. So by having that cox sharing model, everyone can get a really high quality service, but they're not paying a loan for it. And that I think is a huge deal for the industry that now that there's, like I said, someone who took the first big job now, it's really easy for everybody else to scale that to get involved. So they just need to reach out to us and the service is here. It's really just a commercial discussion. Yeah, it makes a lot of sense that the more people that join health services, EMS service, the lower the cost is for each one of them, and you're going to need it. So you're going to have to have it really. If you want to do your technicians and all your people right, you want to have the EMS services for them. So thank you so much for inviting us back to Rhode Island and to the wonderful

36:03health service site. Dr. Williams, thank you for being here. I didn't realize all the complexities to the EMS world. It's quite enlightening and to Michael and Paul, thank you so much for having us back. I appreciate it. Thank you for coming. Yeah, of course. No, thanks for your time. Thanks for joining. And I hope you're excited to watch the demo. Yeah. Thank you for coming. We're thrilled to be able to offer the people working and offshore wind the same level of EMS service they would expect onshore.