Design philosophy and clinical integration
In creating an aircraft medical fit, interior specialists typically take responsibility for cabin layout, ergonomics, equipment mounting, integration, compatibility, and certification (including crashworthiness and safety).
Operators define medical procedures and Aerolite “provides the aviation set-up for the best possible service to the patient,” as Stefan Spichtig, the company’s Head of Customer Relations, explains.
Rolf Kraus, Bucher’s Director of Sales and Programmes MIC, notes that HEMS crews face growing demands. The cabin must be a real treatment space with thoughtful device placement, power distribution, room for crew movement, and flexibility for mid-mission changes.
A DRF crew works on a patient in an EC145 T2 with a Bucher interior designed around the medical workflow. Image Bucher
Bucher’s infrastructure supports flexible device positioning, structured electrical systems, and accessible service panels.
“We think about the workflow first and design around it,” says Kraus. “The choice and clinical configuration of specific devices, and deeper avionics integration, is typically a conversation between the operator and their equipment suppliers. What we make sure of is that our interiors are ready for that conversation and don’t create obstacles.”
Joe Tolaro, Sales Manager at United Rotorcraft, stresses the importance of designing around in-flight medical workflow, with early engagement of operators and clinical teams to prioritise access, visibility and efficiency.
“Human factors are central,” he says. “Ensuring clinicians can work effectively and safely, even in high-stress scenarios.”
The new skidded ‘Evo’ version of the AW169 offers more than 300 kg of extra payload and a cabin with extra internal volume thanks to repositioned fuel tanks. Image: Gama Aviation
When telemedicine and real-time data sharing extend integration beyond the cabin, responsibility shifts toward avionics partners and operators.
“We design the cabin to support those capabilities, but system-level connectivity and device integration are typically outside our scope. Success depends on tight collaboration – cabin designers, avionics integrators, and operators each own different parts, but the end goal is shared.”
Duncan Daines, Group Head of Engagement at Gama Aviation, notes that local conditions affect HEMS capability needs.
In Italy, high-altitude mountain operations make weight critical, so the focus is rapid scene-to-hospital transport.
In New Zealand, long distances between population centres and definitive care centres make fuel capacity key.
The UK’s blended model includes one-way operations – the aircraft drops off the medical team, who then travel with the stabilised patient by other means – and full airborne ICU missions.
Aerolite’s Spichtig notes that every operator has different mission profiles, medical workflows, and operational priorities, so the company’s policy is to conduct frequent deep reviews with Chief Medical Officers.
