Upstream Deepwater Logistics-Aviation

Upstream Deepwater Logistics-Aviation SAR-MEDEVAC Call-out Process --- 27 December 2017 Bob Jablonski Aviation Manager, Gulf of Mexico Logistics-Aviation Upstream Deepwater Robert.Jablonski@Shell.com

Bristow SAR-MEDEVAC BRISTOW SAR-MEDEVAC +1 (855) 844-2367 2

Bristow SAR-MEDEVAC: +1-855-844-2367 (1) Facility Information Type: (TLP, Vessel, Support Vessel, etc) Name: Location: (Block #/Lat-Long) Radio Frequency: (2) Caller s Name & Phone Number (3) Nature of Emergency (Injury/Illness) (4) Patient s Medical Status (To be provided by asset/vessel medic) Stable or Unstable Blood Pressure Pulse Respirations Patient s Weight (5) Location of Patient aboard the Asset (6) Helideck Information & Status (Used to determine a helicopter landing or hoist aboard the asset/vessel) AW-139 Capable: Yes or No S-92 Capable: Yes or No Open for Landing: Yes or No (7) Aviation Fuel Available: Yes or No (8) Special Equipment or Services Required (if any) (9) U.S. Customs Information Asset/vessel is connected to the ocean floor: Patient is a Foreign National: Yes or No Yes or No *** Do not delay a call-out request just because all information is not immediately available *** *** Red font highlights the essential information required to initiate a SAR-MEDEVAC call-out *** Effective: 1 January 2017

Tier 0, Immediately Incident Occurs Personnel at Incident Site Assess Scene safety and Patient Notify 911 Make Area + Patient Safe Provide Care Asset Name Control Room 911 Channel 1 Gaitronic PA or 5XXX Obtain Patient and Scene Details Location Nature of injury / illness Cause of incident # Injured personnel Name, Age, Sex Time of incident Incident contained / escalating, area secure? Contact info of informant Tier 1, < 4 minutes Medical decision made and includes input from combination of: Site Medical Professional Remote Medical Support Provider Company Health Advisor Stabilized by first responder NO First responder or First Aider Arrives and Assesses Patient Tier 2 Rescue Team. YES Activate Tier 2 Asset name control room 911 Contact Details for Tier 2 Call Out Site Supervisor Site Specific Contact Info to include phone # Site Medical Professional Paramedics Site specific (eg. via site Gaitronics PA or phone XXXX Remote Medical Support Dr. XXXXX TEL: +1 XXX XXX-XXXX (Contact via site medical professional) ER Team Site specific (eg. 911 control room) Tier 2, < 1 hour Medical decision made and includes input from combination of: Site Medical Professional Remote Medical Support Provider Company Health Advisor Treat Patient on Site NO Tier 2 Rescue Team arrives to stabilize Patient Tier 3 Medevac Required? Contact Details for Tier 3 Call Out Bristow SAR-MEDEVAC +1-855-844-2367 Shell Emergency Hotline +1-713-241-2532 Company Health Advisor Dr. Remi Aliyu Cell: +1-832-530-9287 Hospital Site Specific Tier 3 Hospital Info YES Activate Medevac ER (XXX) XXX-XXXX // (XXX) XXX-XXXX Ambulance Transport - For Land Transport Coordinated through Bristow as required Contact control room at 911 Medevac (accompanied by Tier 2 Professional) Notify hospital of patient (flight crew normally does this) Confirm transport to hospital is organized (as required) Tier 3, < 4 hours Medical decision made and includes input from combination of: Confirm Patient Arrives at Hospital Company Health Advisor monitors progress Remote Medical Support Provider Company Health Advisor BU Health Advisor Tier 3 Hospital Tier 4 Medevac Required? NO Continue Treatment at Tier 3 hospital YES Tier 4 Effective: 1 January 2017 Confirm Patient Arrives at Hospital Company Health Advisor monitors progress

Critical Category Definitions Category Description Implication Status 1 SAR Response; or Medical Emergency Status 2 Medical Emergency Status 3 Medical Emergency Status 4 Medical (Non-emergency) Status 5 Utility (Non-medical) Status 5 (A) Passenger Status 5 (B) Cargo (SAR) Search and Rescue Tasking or Status 1 (Emergency) Termed Life threatening emergency SAR Tasking Requires urgent search and rescue response to individuals and assets in immediate distress Medical Emergency Critical Medical Patient Definitions: New onset of GCS <13, Resp Rate <10 or >29 or SpO2<90, BP <90 or HR <45 or >145 Status 2 (Emergency) Termed Time Critical Medical Emergency Time critical intervention is required: Major trauma or combination trauma with burns STEMI ST Elevation (>1mm) in at least two contiguous leads New onset of stroke <4.5hours Status 3 (Emergency) Termed Stable emergency Stable Medical Emergency ALS assessment and/or interventions are necessary and ongoing or significant mechanism of injury (MOI) Status 4 (Non-Emergency) Termed Non-emergency No need for ongoing advanced life support (ALS) diagnostic evaluation or medical treatment Status 5 (Non-Medical) Termed Aviation Support Services Unscheduled passenger flights and logistical cargo movements Requires urgent search and rescue response to individuals and assets in distress Helicopter Air Ambulance Operation (HAA) Life threatening emergency meeting the status 1 patient definitions Immediate priority response upon notification Unable to divert to a secondary tasking or assignment Priority over status 2-5 tasking s upon notification Potential for category downgrade by on-site paramedic Potential for category downgrade by on-site assessment by our medical staff Can be diverted by the hospital for ED saturation, ED closure, mass casualty event affecting the receiving facility, non-functioning diagnostic capability, no general surgery available, and significant changes to the patient s medical condition requiring an alternate hospital for immediate stabilization We do not usually accept hospital diversions of status 1 patients where the destination is the definitive care facility Helicopter Air Ambulance Operation (HAA) Rarely diverted for a Status 1 due to the time critical nature of the patient Priority over status 3-5 tasking s upon notification Trauma definitive care destination Regional Trauma Center or 24/7 surgical capabilities STEMI Regional Stroke Center or facility with Percutaneous Coronary Intervention capability Critical Burn Patients Regional burn facility Acute Stroke Patients Regional stroke system or closest level I, II, III stroke center Same diversion criteria as detailed in the status 1 patient category Helicopter Air Ambulance Operation (HAA) Response aircraft may be diverted to a higher category of status 1 or 2 Priority over status 4-5 tasking s upon notification Can divert to a secondary tasking/location with this patient(s) onboard These patients are generally treated at a general care hospital, which is defined as having 24/7 emergency department capabilities The patient requires continuous monitoring and/or medical interventions enroute to the hospital destination We do not accept hospital diversions of status 3 patients Helicopter Air Ambulance Operation (HAA) Response aircraft may be diverted to a higher category of status 1, 2, or 3 Priority over status 5 tasking s upon notification Can divert to a secondary tasking/location with this patient(s) onboard These patients are generally treated at a general care hospital We do not accept hospital diversions of status 4 patients Same contact number (855) 844-2367 for these flight requests Does not require medical attention The caller information will be passed along to the lead pilot for further coordination of the utility flight Cargo is limited to size and weight for these rescue configured aircrafts Aircraft remains in service and is always divertible to higher category 24/7 Bristow SAR-MEDEVAC Dispatch +1-855-844-2367

S-92 & AW-139 SAR-MEDEVAC Aircraft Crew: 2 Pilots 1 Rescue Swimmer 1 Hoist Operator 1 Advanced Care Medic Cruise Speed: 140Knots VFR & IFR Capable SAR Capability 2 x Rescue Hoists Internal Auxiliary Fuel Tank Night Vision Goggles (Q1 2018) DF Homer & Search Radar Forward Looking Infrared (FLIR) Search Sensor Satellite Communications System Sea State 6 Floatation System Rotor Ice Protection System (S-92) Alert-30: SAR & MEDEVAC = Day Alert-45: SAR & MEDEVAC = Night Confined Space Entry & High Capacity Bilge Pumps 4

The best method to rescue or MEDEVAC a patient is to land on the vessel. Primary = Vessel s Helideck Secondary = Alternate Hoist Location Some vessels do not have AW-139 or S-92 capable helidecks, or the helideck is fouled, which may drive the need for hoisting using one of the following: Rescue Basket with or without guideline Stokes Litter or Bauman Bag with or without guideline Air Rescue Vest (ARV) with or without guideline 5

CAP 437 Obstacle Clearances S-92 Helicopter D = 68.49 feet (20.88 meters) AW-139 Helicopter D = 54.6 feet (16.63 meters) Vessel Winch Area Clear Zone: > 5 m diameter Maneuvering Zone Inside Ring: no obstacles > 3 m Outer Ring: no obstacles > 6 m Portion of the maneuvering zone, outside the clear area, may be located beyond the vessel s side 7

Keep the patient in a warm, dry area, well clear of the intended hoisting site and as close to the helicopter pick-up area as the patient's condition permits. Ensure the patient is tagged with details of any medication that has been administered. Prepare the patient's seaman's papers, passport, medical record, and other necessary documents in order to transfer them with the patient. Ensure personnel are prepared to move the patient as directed by the helicopter crewmember. Keep all unnecessary personnel away from the helicopter hoisting area. 8

Secure or remove all loose objects surrounding the operating area Lower or secure all aerials and standing/running gear, above and in the vicinity of the operating area Confirm the Deck Party Leader has a portable radio to communicate with the bridge Confirm the Deck Party is complete, correctly dressed, and in position Confirm that fire-fighting equipment is available and ready Keep the hose near, but not in the operating area Point hoses and foam nozzles away from the operations area Confirm the correct lighting is on for night operations (including special nav lights) Direct available lighting to illuminate the pick-up area (do not blind the aircrew) 9

Confirm the Deck Team is ready and wearing brightly colored clothes and protective helmets Confirm that access to and from the hoisting area is clear with all cargo securely fastened Confirm that the Officer of the Watch has been consulted about the ship s readiness Maintain communications with the helicopter pilots Always maintain the agreed upon speed and heading throughout the hoisting procedure. Advise if course corrections are required. 1 0

Helicopter hoisting is a high risk operation. A helicopter in flight generates powerful static electricity that can cause serious injury. Therefore, rules to live by: Never assist the Rescue Technicians being lowered to the deck If they need assistance, they will request it after they discharge the static electricity Never touch personnel or equipment being lowered to the vessel Never allow unnecessary people near the hoisting area Never connect any line or hook from the helicopter to the vessel 1 2

This briefing will be relayed by the Helo to the bridge crew. 1. Establish working frequencies; 2. Confirm position of vessel; 3. Current sea conditions and wind; 4. Request change of course and speed of the vessel if needed; 5. Secure deck and all loose objects; 6. Keep patient in a protected place; 7. Do not help the hoist personnel unless signaled 8. Turn vessel radar to stand by; 9. Do not attached any cable or lines from the helicopter to the vessel; 10. Vessel must maintain constant speed and heading through out the hoist operation (Failure to do so could result in injury to hoist personnel). Advise if course corrections are required; and 11. Confirm estimated time of arrival. 16

Standard hoist sequence Insertion will include: Insertion of SAR personnel with guideline; Delivery of Medic / SAR personnel guideline attached; and Delivery of Equipment with guideline attached. (Equipment May include a Basket and/or Stokes Litter) Standard hoist sequence Extraction will include: Extraction of Medic / SAR Personnel (with or without guideline); Extraction of Equipment with guideline attached; and Extraction of remaining SAR personnel (Possible circuit in-between to police guideline) MEDICAL NOTE: In most cases the Patient will be packaged in the Helicopter Litter for hoisting. 17

Safety First Goal Zero 18