Re: Medical helicopter crash

[Guest guest]

Donn,

My personal belief is that we should have rethought the use of medical

helicopters 25 years ago. I have never questioned the integrity,

dedication or skill of the air crews, however the original strategy of

hospitals deploying air medical services is rooted in patient

distribution.

In 1977, the Harvard Business Review published a report that first

recommended the strategy of " Captive Systems of Distribution " , one

element of which is the use of medical helicopters. The strategy

identified ways for hospitals to escape the physical constraints of

their fixed location and employ methods to reach out and " pluck "

patients from geographically distant (and competing) markets, thus

enhancing their in-house revenues, market share and market visibility.

The term " flying billboards " soon followed.

As this strategy grew in popularity with hospital administrators, air

crew members began to organize and identify and define the " unique "

characteristics of air medical transport. Organizations, specialized

training and research began to emerge as a means to legitimize the

practicality and necessity of medical helicopters.

The 1980's saw an epidemic of helicopter crashes and line of duty

deaths, which drew national attention in terms of cost vs. benefit and

medical necessity. In Phoenix, there were so many hospital based

helicopters that air traffic safety was a serious concern. Some asserted

that every time two pieces of metal clanged together the sun would be

blotted out by rotor blades.

I'm sure that there are many instances where the use of helicopters have

resulted in lives saved. However, few are willing to critically examine

their true practicality - particularly in view of the lives lost in

providing the service. So, what once began as a competitive strategy and

revenue producing tool for hospital administrators has now evolved into

a full blown industry that annually kills an unacceptable number of its

members. To me, neither the strategy nor the public's expectation or

appreciation of the service was ever worth the human toll it exacts on

on its professional work force.

Bob Kellow

" D.E. " wrote:

> There has been another medical chopper crash killing all aboard. The

> link

> below will take you to the Omaha World Herald online edition.

>

> Correct me if I am wrong, but it seems that the greatest majority of

> EMS

> LODD result from chopper crashes. Is it time we change the way we

> think

> about helicopter transport?

>

> Regards,

> Donn

>

> http://www.omaha.com/index.php?u_np=0 & u_pg=36 & u_sid=428853

>

>

>

>

[Guest guest]

When you review the medical literature (and I have), medical helicopters do

not save lives. Because of this, helicopter operations in London, Cornwall,

and other places have shut down. The medical literature does show that

patients with blunt trauma do better when transported by air, but virtually

nothing else. Canada, England, Australia, and other industrialized

countries have a paucity of aeromedical helicopter operations and for good

cause. My studies have shown that helicopters only make a difference if the

helicopter crew can provide a level of care that ground ambulance crews

cannot. Speed appears to be an advantage in only a small number of cases.

Thus, to be really effective, the number of helicopters should be scaled

back and a physician should be a staff member. This is not an affront to

nurses or paramedics, but how can you have a higher level of care in the

helicopter when the staff is essentially the same as on the ground

ambulances? For those interested, here are the aeromedical helicopter

statistics:

1997: 4 accidents, 5 deaths, 2 injuries

1998: 9 accidents, 14 deaths, 5 injuries

1999: 10 accidents, 7 deaths, 9 injuries

2000: 12 accidents, 11 deaths, 8 injuries

2001: 12 accidents, 3 deaths, 12 injuries

Source: NTSB

Take the money currently being spent on helicopters (it costs approximately

$1,000,000.00 per year per helicopter) and pay EMS personnel more, give them

better equipment, and provide more fixed wing aircraft for transfers within

Texas.

References available upon request.

BEB

Re: Medical helicopter crash

> Donn,

>

> My personal belief is that we should have rethought the use of medical

> helicopters 25 years ago. I have never questioned the integrity,

> dedication or skill of the air crews, however the original strategy of

> hospitals deploying air medical services is rooted in patient

> distribution.

>

> In 1977, the Harvard Business Review published a report that first

> recommended the strategy of " Captive Systems of Distribution " , one

> element of which is the use of medical helicopters. The strategy

> identified ways for hospitals to escape the physical constraints of

> their fixed location and employ methods to reach out and " pluck "

> patients from geographically distant (and competing) markets, thus

> enhancing their in-house revenues, market share and market visibility.

> The term " flying billboards " soon followed.

>

> As this strategy grew in popularity with hospital administrators, air

> crew members began to organize and identify and define the " unique "

> characteristics of air medical transport. Organizations, specialized

> training and research began to emerge as a means to legitimize the

> practicality and necessity of medical helicopters.

>

> The 1980's saw an epidemic of helicopter crashes and line of duty

> deaths, which drew national attention in terms of cost vs. benefit and

> medical necessity. In Phoenix, there were so many hospital based

> helicopters that air traffic safety was a serious concern. Some asserted

> that every time two pieces of metal clanged together the sun would be

> blotted out by rotor blades.

>

> I'm sure that there are many instances where the use of helicopters have

> resulted in lives saved. However, few are willing to critically examine

> their true practicality - particularly in view of the lives lost in

> providing the service. So, what once began as a competitive strategy and

> revenue producing tool for hospital administrators has now evolved into

> a full blown industry that annually kills an unacceptable number of its

> members. To me, neither the strategy nor the public's expectation or

> appreciation of the service was ever worth the human toll it exacts on

> on its professional work force.

>

> Bob Kellow

>

>

> " D.E. " wrote:

>

> > There has been another medical chopper crash killing all aboard. The

> > link

> > below will take you to the Omaha World Herald online edition.

> >

> > Correct me if I am wrong, but it seems that the greatest majority of

> > EMS

> > LODD result from chopper crashes. Is it time we change the way we

> > think

> > about helicopter transport?

> >

> > Regards,

> > Donn

> >

> > http://www.omaha.com/index.php?u_np=0 & u_pg=36 & u_sid=428853

> >

> >

> >

> >

[Guest guest]

There was a helicopter crash in Cleveland earlier this year that killed the

pilot and the nurse. The paramedic survived with significant burns. They

were going for an interfacility transfer of a patient who safely went by

ground. Ken Mattox (down in Houston) and I were interviewed by the

Cleveland Plains Dealer (a large mid-west newspaper). We were both critical

of helicopter operations (Ken was much harsher than old ). I received

some vicious hate mail and have been tagged on EMSHelicopter lists as a

possible bad guy. All for speaking the truth. (I haven't talked to Ken

lately, but I am sure he has received the same--but doesn't really worry

about it). It is just like this CISM crap. The medical literature,

steadfastly, shows that CISM is not helpful and possibly makes people worse.

But, criticize it, and the attacks get personal (believe me I know--I wrote

an article in EMS Best Practices critical of CISM and the fur is flying). I

like helicopters. I love riding in them. Would I work on one? No. I

understand the passion air medical crews have for their work. In a way, I

understand the passion people have for CISM. But neither really makes a

difference.

Oh well. If you are going to the Texas Conference this year, I will be

talking about all of this in my " Myths of Modern EMS Lecture, " It is sure

to upset a few folks.

BEB.

[Guest guest]

It would be interesting to know how many air medical services would

exist if hospital administrators were required to place one of their

immediate family members on every flight.

Bob

" Dr. Bledsoe " wrote:

> There was a helicopter crash in Cleveland earlier this year that

> killed the

> pilot and the nurse. The paramedic survived with significant burns.

> They

> were going for an interfacility transfer of a patient who safely went

> by

> ground. Ken Mattox (down in Houston) and I were interviewed by the

> Cleveland Plains Dealer (a large mid-west newspaper). We were both

> critical

> of helicopter operations (Ken was much harsher than old ). I

> received

> some vicious hate mail and have been tagged on EMSHelicopter lists as

> a

> possible bad guy. All for speaking the truth. (I haven't talked to

> Ken

> lately, but I am sure he has received the same--but doesn't really

> worry

> about it). It is just like this CISM crap. The medical literature,

> steadfastly, shows that CISM is not helpful and possibly makes people

> worse.

> But, criticize it, and the attacks get personal (believe me I know--I

> wrote

> an article in EMS Best Practices critical of CISM and the fur is

> flying). I

> like helicopters. I love riding in them. Would I work on one? No.

> I

> understand the passion air medical crews have for their work. In a

> way, I

> understand the passion people have for CISM. But neither really makes

> a

> difference.

>

> Oh well. If you are going to the Texas Conference this year, I will

> be

> talking about all of this in my " Myths of Modern EMS Lecture, " It is

> sure

> to upset a few folks.

>

> BEB.

>

>

>

>

[Guest guest]

Interesting... but I being a paramedic on a truck in the field... I find it a

great resource to use air transport. I hope I continue to have the option for

air transport.

J-B

[Guest guest]

BEB,

Are you saying FDs should be abolished? or would you say to leave them as

they are?

J-B

[Guest guest]

Donn,

Everything that we do in this world has some risk to it... with out taking a

risk... how could ANYTHING that we do today in EMS care be possible?

Well, I know this... they (helicopters) are here, and I hope they stay. If

not, I hope the local EDs increase their resources to treat patients [not

likely to happen anytime soon].

J-B

[Guest guest]

Using the same logic, we should also get rid of Fire Departments, especially

in the NorthEast.

Lee

Re: Medical helicopter crash

Donn,

My personal belief is that we should have rethought the use of medical

helicopters 25 years ago. I have never questioned the integrity,

dedication or skill of the air crews, however the original strategy of

hospitals deploying air medical services is rooted in patient

distribution.

In 1977, the Harvard Business Review published a report that first

recommended the strategy of " Captive Systems of Distribution " , one

element of which is the use of medical helicopters. The strategy

identified ways for hospitals to escape the physical constraints of

their fixed location and employ methods to reach out and " pluck "

patients from geographically distant (and competing) markets, thus

enhancing their in-house revenues, market share and market visibility.

The term " flying billboards " soon followed.

As this strategy grew in popularity with hospital administrators, air

crew members began to organize and identify and define the " unique "

characteristics of air medical transport. Organizations, specialized

training and research began to emerge as a means to legitimize the

practicality and necessity of medical helicopters.

The 1980's saw an epidemic of helicopter crashes and line of duty

deaths, which drew national attention in terms of cost vs. benefit and

medical necessity. In Phoenix, there were so many hospital based

helicopters that air traffic safety was a serious concern. Some asserted

that every time two pieces of metal clanged together the sun would be

blotted out by rotor blades.

I'm sure that there are many instances where the use of helicopters have

resulted in lives saved. However, few are willing to critically examine

their true practicality - particularly in view of the lives lost in

providing the service. So, what once began as a competitive strategy and

revenue producing tool for hospital administrators has now evolved into

a full blown industry that annually kills an unacceptable number of its

members. To me, neither the strategy nor the public's expectation or

appreciation of the service was ever worth the human toll it exacts on

on its professional work force.

Bob Kellow

" D.E. " wrote:

> There has been another medical chopper crash killing all aboard. The

> link

> below will take you to the Omaha World Herald online edition.

>

> Correct me if I am wrong, but it seems that the greatest majority of

> EMS

> LODD result from chopper crashes. Is it time we change the way we

> think

> about helicopter transport?

>

> Regards,

> Donn

>

> http://www.omaha.com/index.php?u_np=0 & u_pg=36 & u_sid=428853

>

>

>

>

[Guest guest]

Let's talk about fire departments. I have a good many friends who are fire

chiefs in this country (including some who are quite famous in fire

circles). Virtually all have told me the same thing:

1. Fire departments were originally developed to save adjoining structures

and prevent conflagrations.

2. Insurance for cities and fire departments is going up so quickly that

many have considered abandoning offensive fire-fighting (entering the

burning building to put out the fire). The exception to this is if there

are people inside and where rescue is needed. Most injuries and deaths in

the fire service are due to interior firefighting tactics.

3. Many insurers of businesses and residences have approached several fire

departments (primarily in the Pacific northwest) asking them to let the

insured properties, that appear to be significant losses, burn to the ground

if they are confident that all have been safely removed from the house. The

reason is that the remains of the house are considered hazardous materials

and must be removed and disposed of in a special way--which is very

expensive. Thus, the more that burns up, the less must be hauled away to a

Haz-Mat site.

Fire departments are in a quandry. They need to maintain their present

level of funding to continue operations. But, through fire prevention,

inspections, sprinklers, they have signifcantly decreased the actual time

firefighting. In fact, a study I saw performed several years ago revealed

that the average Melbourne (Australia) fire fighter spent a little over 2

hours a year actually figting a fire.

Thus, FDs have found it necessary to expand into other areas (EMS, specialty

rescue) to continue to justify their level of existence. Many departments,

lead by Phoenix, have developed massive customer satisfaction programs to

keep the taxpayers happy and the budget funded.

EMS is not the only service at a crossroads now.

More rambling...Sorry

BEB

Re: Medical helicopter crash

>

>

> Donn,

>

> My personal belief is that we should have rethought the use of medical

> helicopters 25 years ago. I have never questioned the integrity,

> dedication or skill of the air crews, however the original strategy of

> hospitals deploying air medical services is rooted in patient

> distribution.

>

> In 1977, the Harvard Business Review published a report that first

> recommended the strategy of " Captive Systems of Distribution " , one

> element of which is the use of medical helicopters. The strategy

> identified ways for hospitals to escape the physical constraints of

> their fixed location and employ methods to reach out and " pluck "

> patients from geographically distant (and competing) markets, thus

> enhancing their in-house revenues, market share and market visibility.

> The term " flying billboards " soon followed.

>

> As this strategy grew in popularity with hospital administrators, air

> crew members began to organize and identify and define the " unique "

> characteristics of air medical transport. Organizations, specialized

> training and research began to emerge as a means to legitimize the

> practicality and necessity of medical helicopters.

>

> The 1980's saw an epidemic of helicopter crashes and line of duty

> deaths, which drew national attention in terms of cost vs. benefit and

> medical necessity. In Phoenix, there were so many hospital based

> helicopters that air traffic safety was a serious concern. Some asserted

> that every time two pieces of metal clanged together the sun would be

> blotted out by rotor blades.

>

> I'm sure that there are many instances where the use of helicopters have

> resulted in lives saved. However, few are willing to critically examine

> their true practicality - particularly in view of the lives lost in

> providing the service. So, what once began as a competitive strategy and

> revenue producing tool for hospital administrators has now evolved into

> a full blown industry that annually kills an unacceptable number of its

> members. To me, neither the strategy nor the public's expectation or

> appreciation of the service was ever worth the human toll it exacts on

> on its professional work force.

>

> Bob Kellow

>

>

> " D.E. " wrote:

>

> > There has been another medical chopper crash killing all aboard. The

> > link

> > below will take you to the Omaha World Herald online edition.

> >

> > Correct me if I am wrong, but it seems that the greatest majority of

> > EMS

> > LODD result from chopper crashes. Is it time we change the way we

> > think

> > about helicopter transport?

> >

> > Regards,

> > Donn

> >

> > http://www.omaha.com/index.php?u_np=0 & u_pg=36 & u_sid=428853

> >

> >

> >

> >

[Guest guest]

JB,

We have all looked at helicopter transport as a resource. The question is

whether the risk outweighs the value. Before you answer, ask yourself if

your opinion is based on quantifiable or anecdotal evidence. I'll stick my

neck out and say that we may well have killed as many of our own over the

past five years as we have saved patients. In my mind, the outcome is not

worth the risk in most instances.

Regards,

Donn

Re: Medical helicopter crash

Interesting... but I being a paramedic on a truck in the field... I find it

a

great resource to use air transport. I hope I continue to have the option

for

air transport.

J-B

[Guest guest]

Dr. Bledsoe, Bob, and Donn,

Before we throw the baby out with the bath water, lets take a look at a few

things. First, the studies that show AirMedical is not worth the risk, how

were they constructed? How many patients were studied and where? Before we

park all the helicopters, lets make sure this isn't a MAST study where we

prove things don't work just in big cities with ALS ambulances everywhere.

In our region, TSA P, there are many places our aeromedical service goes and

provides a higher level of care...plus with a lack of resources a much more

rapid transport to a Level 1 trauma center.

I came to this area from an extremely urban sprawl area of Florida. In the

Tampa/St. Pete area there are over six helicopters....they all stay

busy....but is it necessary to fly my fx. ankle to the level two trauma

center? I am a big proponent of using aeromedical resources in areas where

they have the highest potential of making a difference and on the PATIENTS

where they have the highest chance of making a difference. Education is the

key to making sure when we call our fellow care providers out in their " great

gods of wind and noise " that it is truly for patients who appear to have the

greatest need....and yes, I believe research MUST be done to determine

who/what these patients are.

If we are going to examine this objectively however, I feel we must also

examine the danger of using lights and sirens on ground units. Why are we so

quick to say ground the helicopters with limited research but with tons and

tons of research on ground units we still are not ready to do away with

lights and sirens on the MAJORITY of responses? In our region, many agencies

use lights and sirens on every response and every transport to the hospital.

With all due respect Donn, I see many more LODD deaths and injuries on here

from ground accidents than I do air....plus they are not nearly as

publicized.

Here is an interesting question: Is the accident rate per flight per flight

service greater or less than the accident rate per ambulance call per

ambulance service? 47 accidents, 40 deaths, and 36 injuries in 5 years of

air ambulance data? How many accidents, deaths, and injuries have been

caused by ground units in the same amount of time? Believe me, I enjoy the

use of a flight service but I am not a cheerleader. I am however a HUGE

cheerleader when it comes to shutting off lights and sirens on ambulances and

traveling non-emergency.

Dr. Clawson had a quote in the recent USAToday article on ambulance

accidents: " There is no evidence that EMS saves more lives (from its care and

driving fast) than it takes (from ambulance accidents). Now, speaking of

funding...what can we prove?

I think this is an important debate and would encourage all to check your

ego's and preferences at the door and join in. If we are going to examine

the risk of one branch of the EMS picture (even though it did start as a

money making venture) then we need to take an equally in-depth look at the

other piece (which....seems to have probably started as well to make

money....hmmmmm).

My thoughts, what are yours.

Dudley Wait

[Guest guest]

Dr. B:

Your study resonates with my experience on the border. If the

patient

could get the care they needed on scene and enroute, most would

survive. Massive trauma patients and code patients did not (the

average length of time from patient coding to 911 activation tended

to be >20 minutes..a lot of this was due to the reticence of the wife

or mother to call 911-usually a male relative had to be located to

make the decision. Most of the patients were new immigrants or old

world hispanic in culture). However, It was common for our patients

to be critical (AMI, shock etc.) on scene and have their condition

improve enough enroute to have the hospital question why we even

bothered to transport. The basics of EMT and paramedicine work well

in these extreme rural areas. They just need to be supported and

protected.

BTW: in 9+ years on the border, only two calls were ever airlifted

out

of there. The first was a marine doing drug interdiction with the BP

who was in an MVA-military flight took him to El Paso. The

second was the 18yo goat herder shot by a marine in Redford Texas a

few years back (mistaken for a drug mule)..they airlifted him out as

well too. The first patient survived and the second one never had a

chance to. In both cases the feds were attempting to CYA .

Air medics would have worked wonderfully on the relatively few multi

victim MVA's with lots of blunt trauma/ and patients; and perhaps

would have made a difference on some of the more critical trauma

patients. Of course, our patients tended not to have money or were

Medicare so would anyone have come if they were available out there?

[Guest guest]

Fire Departments should NOT be abolished. But, they must adapt to fit

changing times and shrinking dollars. Thet may mean doing some things they

have not done in the past. Old habits and practices are hard to change.

BEB

Re: Medical helicopter crash

> BEB,

>

> Are you saying FDs should be abolished? or would you say to leave them as

> they are?

>

> J-B

>

>

>

[Guest guest]

Can you prove it makes a difference? or do you FEEL it makes a difference.

Big difference here when it comes to funding.

BEB

Re: Medical helicopter crash

> Interesting... but I being a paramedic on a truck in the field... I find

it a

> great resource to use air transport. I hope I continue to have the option

for

> air transport.

>

> J-B

>

>

>

[Guest guest]

air lifting a patient has nothing to do with " feeling that it makes a

difference " or " proving that it makes a difference " .. it also has nothing to

do with the level of care. what determines aeromedical transport is the

time. the time from when that accident or that gsw or that WHATEVER was

called in, until the time that patient can get to the hospital and begin

receiving definitive care.

i work for a major hospital in temple, and im thankful for the air guys that

we have. they're great to work for, and they're great to work with.

~alli~

[Guest guest]

Donn,

I will be interested to see what you come up with. I can tell you that in my

previous system we had " numerous " accidents each year and ended up with 3 or

4 per year that had injuries. In 8 years we probably had 8 to 10 serious

injuries (including the last one I was there for) and we had one fatality

(person that was hit, not an EMS worker).

I realize this was a discussion about air transport safety, but I really

don't feel it can be ruled out as a viable alternative based upon safety

without looking at the safety of the alternatives.

I was always fond of saying it isn't if the helicopter crashes but when...so

we use them only when necessary (literally I have been told by flight crews

outside of my current region to " call us for anything, we will come get your

chest pain and your ankle injuries...we just want to fly " . I haven't asked

if that attitude changed since they lost 3 crew members... By the same

token, it isn't if the ambulance has a wreck running emergency...it is when.

And I have lost may friends in this business from ground accidents as well.

Good luck finding numbers. When I was doing EMS driver education in the

early 90's, DOT had only " estimates " as ambulance accidents were not required

to be separately reported. Makes it hard to truly chart...but that may have

changed.

Dudley Wait

[Guest guest]

Dudley,

Regarding the use of lights and siren, I can't say that I disagree with what

you say. In fact, I feel that we use L & S to a far greater degree than is

necessary. Just like calling for the chopper, I feel that we operate under a

" if it feels good, do it " plan of action. We **feel** that we are doing good

for our patient by calling for the chopper, but what evidence do we have to

prove it? We **feel** that we are doing good for our patient when we run L & S

on our ground units, but are we really? The only true measure of our success

is patient outcome, but if we kill as many or more of our own in the effort,

are we making a difference?

I'm not saying that we should " throw the baby out with the bath water " . All

I'm saying is that I feel we use choppers at times when the risk is greater

than any possible benefit, and that ground transportation, L & S or not, would

be a safer and just as effective an alternative. This does deserve some

research and I agree that the statistics should consider urban vs. rural and

the length of transport time ground vs. air.

I didn't start this thread with the intention of expanding the discussion to

the hazards of ground transportation, but I'll do a bit of research and see

if I can come up with the statistics regarding ground L & S transport LODD. I

don't have any proof yet, but I'll stick my neck out and bet you that the

average per transport will be lower than air transport.

Regards,

Donn

Re: Medical helicopter crash

Dr. Bledsoe, Bob, and Donn,

Before we throw the baby out with the bath water, lets take a look at a few

things. First, the studies that show AirMedical is not worth the risk, how

were they constructed? How many patients were studied and where? Before we

park all the helicopters, lets make sure this isn't a MAST study where we

prove things don't work just in big cities with ALS ambulances everywhere.

In our region, TSA P, there are many places our aeromedical service goes and

provides a higher level of care...plus with a lack of resources a much more

rapid transport to a Level 1 trauma center.

I came to this area from an extremely urban sprawl area of Florida. In the

Tampa/St. Pete area there are over six helicopters....they all stay

busy....but is it necessary to fly my fx. ankle to the level two trauma

center? I am a big proponent of using aeromedical resources in areas where

they have the highest potential of making a difference and on the PATIENTS

where they have the highest chance of making a difference. Education is the

key to making sure when we call our fellow care providers out in their

" great

gods of wind and noise " that it is truly for patients who appear to have the

greatest need....and yes, I believe research MUST be done to determine

who/what these patients are.

If we are going to examine this objectively however, I feel we must also

examine the danger of using lights and sirens on ground units. Why are we

so

quick to say ground the helicopters with limited research but with tons and

tons of research on ground units we still are not ready to do away with

lights and sirens on the MAJORITY of responses? In our region, many

agencies

use lights and sirens on every response and every transport to the hospital.

With all due respect Donn, I see many more LODD deaths and injuries on here

from ground accidents than I do air....plus they are not nearly as

publicized.

Here is an interesting question: Is the accident rate per flight per flight

service greater or less than the accident rate per ambulance call per

ambulance service? 47 accidents, 40 deaths, and 36 injuries in 5 years of

air ambulance data? How many accidents, deaths, and injuries have been

caused by ground units in the same amount of time? Believe me, I enjoy the

use of a flight service but I am not a cheerleader. I am however a HUGE

cheerleader when it comes to shutting off lights and sirens on ambulances

and

traveling non-emergency.

Dr. Clawson had a quote in the recent USAToday article on ambulance

accidents: " There is no evidence that EMS saves more lives (from its care

and

driving fast) than it takes (from ambulance accidents). Now, speaking of

funding...what can we prove?

I think this is an important debate and would encourage all to check your

ego's and preferences at the door and join in. If we are going to examine

the risk of one branch of the EMS picture (even though it did start as a

money making venture) then we need to take an equally in-depth look at the

other piece (which....seems to have probably started as well to make

money....hmmmmm).

My thoughts, what are yours.

Dudley Wait

[Guest guest]

I'm reminded of a quote I heard once. Can't remember who said it.

" If you always do what you've always done, you'll always get what you've

always got. "

Regards,

Donn

Re: Medical helicopter crash

air lifting a patient has nothing to do with " feeling that it makes a

difference " or " proving that it makes a difference " .. it also has nothing to

do with the level of care. what determines aeromedical transport is the

time. the time from when that accident or that gsw or that WHATEVER was

called in, until the time that patient can get to the hospital and begin

receiving definitive care.

i work for a major hospital in temple, and im thankful for the air guys

that

we have. they're great to work for, and they're great to work with.

~alli~

[Guest guest]

Before you make such an uneducated statement as this maybe you should look

at actual numbers of flight hours, missions, patients transported etc. Then

compare these numbers with the same data for ground ambulances, fire

responses, police chases etc. Once you take the time to do that you might

have to eat some crow.

Re: Medical helicopter crash

Interesting... but I being a paramedic on a truck in the field... I find it

a

great resource to use air transport. I hope I continue to have the option

for

air transport.

J-B

[Guest guest]

Uh... it was stated as an opinion, not fact. I think I made that clear. But

I guess I'll just have to go get me some edjumacation 'cause I don't think

I'd like crow too much... less maybe it was barbecued.

Donn

Re: Medical helicopter crash

Interesting... but I being a paramedic on a truck in the field... I find it

a

great resource to use air transport. I hope I continue to have the option

for

air transport.

J-B

[Guest guest]

BEB,

Can I prove it makes a difference? Simply put " no " , but in all honesty, I

don't have to prove it. I am not the one funding the service. Someone feels

that funding the air services is in their best interest [and possibly the

community].

If they decide to pull their services, I will adjust and adapt, but for now,

I will enjoy having that choice [to call for air ambulance].

J-B

[Guest guest]

BEB,

Can I prove it makes a difference? Simply put " no " , but in all honesty, I

don't have to prove it. I am not the one funding the service. Someone feels

that funding the air services is in their best interest [and possibly the

community].

If they decide to pull their services, I will adjust and adapt, but for now,

I will enjoy having that choice [to call for air ambulance].

J-B

[Guest guest]

I, myself, once had to make the decisions to place my wife on a helicopter and

did not even hesitate (forty minute flight time vs. two hour rough and bumpy

road trip). My wife was pinned between two surburbans and had a fractured

pelvis in several places. Yes, there are pros and cons to everything we do in

EMS. In my humble opinion, flight services did fit into the patient transport

mix.

Take for instance what happened on I-20 today near Terrell. A bus wreck with

many causalties. The flight services played a major role in getting the right

patient to the right facility in the right amount of time.

Can a ground crew provide the same amount of care as a flight service? With the

proper amount of training, a ground crew can provide the same level of care as a

flight service. Are the flight services over utilized? Yes they are. Flying

someone with a fractured ankle is a waste of resources. Is the benefit versus

cost worth it? In my case, it was well worth sending my wife by a helicopter to

the right facility.

Just my humble and not so worthy opinion, Flame away if you must.

s, EMS Director

FCH EMS

Lee wrote: Before you make such an uneducated

statement as this maybe you should look

at actual numbers of flight hours, missions, patients transported etc. Then

compare these numbers with the same data for ground ambulances, fire

responses, police chases etc. Once you take the time to do that you might

have to eat some crow.

Re: Medical helicopter crash

Interesting... but I being a paramedic on a truck in the field... I find it

a

great resource to use air transport. I hope I continue to have the option

for

air transport.

J-B

[Guest guest]

Alli, a.k.a. emschick

You must realize that there are more factors than just time that are

required when considering air medical transport. In certain instances, when

dispatch time, helicopter warm up time, lift off time, flying time, landing

time, second patient assessment (by the helicopter personnel in addition to

the assessment already done by the ambulance personnel), additional

treatment time, loading patient time, flying time, landing time, and

transferring of care time is all factor together, ambulances transport might

be a better option. This is particularly true for urban, semi-urban and

rural communities close to an urban setting.

Additionally, there are many risks associated with helicopter transport,

not only the personnel but also the patient. Anytime EMS personnel thinks

about calling a helicopter, the they must weigh the potential cost versus

the benefits (not just the " time " it saves). I know of many instances where

rural communities have called the copter for cardiac arrests or common

medical problems. This is NOT a good use of a helicopter service. Three

lives are risked for the sake of clinically dead individual or the

individual who will remain stable for a long period of time. I do agree

that when the above times are factored in and a SIGNIFICANT time is gained

for the severe trauma victim, where SECONDS count, that air medical

transportation should be considered. It should remain a resource that is

used only after logical consideration of all the options, and not for every

" serious call " just because we have the mindset that the helicopter is the

ONLY way to save time. Time is only one factor and NOT the definitive

factor, but level of care, seriousness of condition, potential benefits

versus risks, and the " potential for making a difference " are ALL very

important to consider before setting up you LZ, calling out the " bird " , and

risking lives.

The same argument can be used for L & S response by the ambulance. It's all a

weight of potential gain over costs. (Sounds a little like I'm back at

college in economics)

Dawn Bitz BS, LP, NREMTP

Re: Medical helicopter crash

air lifting a patient has nothing to do with " feeling that it makes a

difference " or " proving that it makes a difference " .. it also has nothing to

do with the level of care. what determines aeromedical transport is the

time. the time from when that accident or that gsw or that WHATEVER was

called in, until the time that patient can get to the hospital and begin

receiving definitive care.

i work for a major hospital in temple, and im thankful for the air guys

that

we have. they're great to work for, and they're great to work with.

~alli~

[Guest guest]

,

Actually the situation you describe is one of the few where the chopper

would have been an appropriate call. The statistics show this kind of trauma

patient is in the very small subset that benefits from helicopter transport.

In other words, your wife came out on the plus side of the risk/benefit

equation.

I guess I haven't been making myself too clear. I'm not saying that we

should eliminate helicopters from the picture All I'm saying is that we

should rethink where the risk/cost/benefit line really lies. Medical

helicopters are falling from the sky at an alarming rate killing pilots,

nurses, paramedics and patients. We need to look at which patients could do

just as well with ground transport without risking the patients and our

people. If the difference between ground crews and flight medics is in

training, ground medics could receive advanced training with the cost

savings by keeping the choppers parked.

Twice in two years I have attended funerals for medics killed in chopper

crashes. Enough is enough.

Regards,

Donn

Re: Medical helicopter crash

Interesting... but I being a paramedic on a truck in the field... I find it

a

great resource to use air transport. I hope I continue to have the option

for

air transport.

J-B