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Re: Points to Ponder (most startling facts I have seen)

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In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

hatfield@... writes:

Taking off is optional........landing however, is mandatory.

HOW you land, now that is an issue all it's own.

Seriously though, I think one of the reasons that there is an increase

in Med HELO accidents is the overuse, the fault lies squarely on the

shoulders of those that accept the flights. We used to fly at the

absolute bare minimum visibility, and push our luck all the way there

and all the way back, because we were dispatched to what sounded like a

critical patient in need of transportation. More often than not, we

arrived to find a patient that was nowhere near the description that we

received in our dispatch information. Had we crashed, it would have been

our fault, it would have been out fault for not saying 'no', for

whatever reason. Be it a) poor flight conditions, B) patient condition

didn't warrant, etc.

We all used to stand there and say, " In bad conditions, I will not fly " ,

but when the pagers went off, into our flight suits we would go, and off

into the wild blue yonder, weather be damned!!!

Something to consider when you call for the HELO, is it REALLY

necessary? Could they go by ground? If you are waiting on the ground for

a helicopter, you are wasting valuable time.

I believe there is a place for medical air transportation, but its use

must be judicious, sparing, and made with concern for the flight crew

and the patient, every time they take off, they put their lives in

danger. It would be a shame to have a crew killed, as well as the

patient, because someone wanted to get the adrenalin rush of 'flying one

out'.

Mike

Howdy Mike and All,

I can absolutely appreciate what you are saying here. I also appreciate Dr.

Bledsoe's comments or anybody else's who is concerned for the safety of the

air medical industry.

I have to respectfully and adamantly disagree with folks who think it's only

worth flying if it's a critical patient. That just can't be more wrong.

It's either safe to fly to anything, or it's not!

Mike wrote: " We all used to stand there and say, " In bad conditions, I will

not fly " , but when the pagers went off, into our flight suits we would go,

and off into the wild blue yonder, weather be damned!!! "

In no circumstances should any program be flying in " bad conditions! " I

know my program doesn't practice this, nor do many others.

Crews " pushing " weather for whatever reason, will eventually run out of

luck. If you have a car load of precious children in a horrendous crash that

meets flight criteria and the weather is less than minimums, the helicopter

stays home. The severity of the patient, or lack thereof, should never be the

deciding factor to fly an aircraft, safely anyway.

Every flight, whether it be for Health Safety day with other agencies,

Shattered Dreams to promote safety for our teens, an isolated femur fracture,

or

that critical child, should always meet the same criteria in regard to

launching for the safety of the crew, folks on the ground and the patient.

Question: Is the unfortunate crash rate due to too many aircraft or overuse

of aircraft, or is it possibly due to some questionable decisions on the

part of the crew?

I've seen a lot of stats posted here lately on helo crashes, and I may have

missed some, but I don't recall seeing stats on why the crashes are

happening. I could be wrong, but to my knowledge, the majority of the crashes

are due

to human error, not catastrophic events. And BTW, while the PIC (pilot in

command) is technically and ultimately responsible in the end. . . the truth

is, the entire crew on that aircraft is ultimately responsible. NO ONE

should ever " push " weather for any reason! Every crew member should be

responsible for walking around the aircraft, looking for hazards during take

off's and

landings and saying " turn around " or " land " at the hint of less than

desirable weather conditions or for any other reasons, just to name of few.

I hope what I have said here makes sense. There are a few of us that have a

hard time explaining our thoughts in writing, hence the reason I try to

avoid posting. :)

Thanks for reading,

Link to comment
Share on other sites

In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

hatfield@... writes:

Taking off is optional........landing however, is mandatory.

HOW you land, now that is an issue all it's own.

Seriously though, I think one of the reasons that there is an increase

in Med HELO accidents is the overuse, the fault lies squarely on the

shoulders of those that accept the flights. We used to fly at the

absolute bare minimum visibility, and push our luck all the way there

and all the way back, because we were dispatched to what sounded like a

critical patient in need of transportation. More often than not, we

arrived to find a patient that was nowhere near the description that we

received in our dispatch information. Had we crashed, it would have been

our fault, it would have been out fault for not saying 'no', for

whatever reason. Be it a) poor flight conditions, B) patient condition

didn't warrant, etc.

We all used to stand there and say, " In bad conditions, I will not fly " ,

but when the pagers went off, into our flight suits we would go, and off

into the wild blue yonder, weather be damned!!!

Something to consider when you call for the HELO, is it REALLY

necessary? Could they go by ground? If you are waiting on the ground for

a helicopter, you are wasting valuable time.

I believe there is a place for medical air transportation, but its use

must be judicious, sparing, and made with concern for the flight crew

and the patient, every time they take off, they put their lives in

danger. It would be a shame to have a crew killed, as well as the

patient, because someone wanted to get the adrenalin rush of 'flying one

out'.

Mike

Howdy Mike and All,

I can absolutely appreciate what you are saying here. I also appreciate Dr.

Bledsoe's comments or anybody else's who is concerned for the safety of the

air medical industry.

I have to respectfully and adamantly disagree with folks who think it's only

worth flying if it's a critical patient. That just can't be more wrong.

It's either safe to fly to anything, or it's not!

Mike wrote: " We all used to stand there and say, " In bad conditions, I will

not fly " , but when the pagers went off, into our flight suits we would go,

and off into the wild blue yonder, weather be damned!!! "

In no circumstances should any program be flying in " bad conditions! " I

know my program doesn't practice this, nor do many others.

Crews " pushing " weather for whatever reason, will eventually run out of

luck. If you have a car load of precious children in a horrendous crash that

meets flight criteria and the weather is less than minimums, the helicopter

stays home. The severity of the patient, or lack thereof, should never be the

deciding factor to fly an aircraft, safely anyway.

Every flight, whether it be for Health Safety day with other agencies,

Shattered Dreams to promote safety for our teens, an isolated femur fracture,

or

that critical child, should always meet the same criteria in regard to

launching for the safety of the crew, folks on the ground and the patient.

Question: Is the unfortunate crash rate due to too many aircraft or overuse

of aircraft, or is it possibly due to some questionable decisions on the

part of the crew?

I've seen a lot of stats posted here lately on helo crashes, and I may have

missed some, but I don't recall seeing stats on why the crashes are

happening. I could be wrong, but to my knowledge, the majority of the crashes

are due

to human error, not catastrophic events. And BTW, while the PIC (pilot in

command) is technically and ultimately responsible in the end. . . the truth

is, the entire crew on that aircraft is ultimately responsible. NO ONE

should ever " push " weather for any reason! Every crew member should be

responsible for walking around the aircraft, looking for hazards during take

off's and

landings and saying " turn around " or " land " at the hint of less than

desirable weather conditions or for any other reasons, just to name of few.

I hope what I have said here makes sense. There are a few of us that have a

hard time explaining our thoughts in writing, hence the reason I try to

avoid posting. :)

Thanks for reading,

Link to comment
Share on other sites

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like a

>critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that we

>received in our dispatch information. Had we crashed, it would have been

>our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not fly " ,

>but when the pagers went off, into our flight suits we would go, and off

>into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground for

>a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying one

>out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's only

>worth flying if it's a critical patient. That just can't be more wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions, I will

>not fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! " I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out of

>luck. If you have a car load of precious children in a horrendous crash that

>meets flight criteria and the weather is less than minimums, the helicopter

>stays home. The severity of the patient, or lack thereof, should never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur fracture,

or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or overuse

>of aircraft, or is it possibly due to some questionable decisions on the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the crashes

are due

>to human error, not catastrophic events. And BTW, while the PIC (pilot in

>command) is technically and ultimately responsible in the end. . . the truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should be

>responsible for walking around the aircraft, looking for hazards during take

off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of few.

>

>

>I hope what I have said here makes sense. There are a few of us that have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

Link to comment
Share on other sites

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like a

>critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that we

>received in our dispatch information. Had we crashed, it would have been

>our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not fly " ,

>but when the pagers went off, into our flight suits we would go, and off

>into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground for

>a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying one

>out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's only

>worth flying if it's a critical patient. That just can't be more wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions, I will

>not fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! " I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out of

>luck. If you have a car load of precious children in a horrendous crash that

>meets flight criteria and the weather is less than minimums, the helicopter

>stays home. The severity of the patient, or lack thereof, should never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur fracture,

or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or overuse

>of aircraft, or is it possibly due to some questionable decisions on the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the crashes

are due

>to human error, not catastrophic events. And BTW, while the PIC (pilot in

>command) is technically and ultimately responsible in the end. . . the truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should be

>responsible for walking around the aircraft, looking for hazards during take

off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of few.

>

>

>I hope what I have said here makes sense. There are a few of us that have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

Link to comment
Share on other sites

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like a

>critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that we

>received in our dispatch information. Had we crashed, it would have been

>our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not fly " ,

>but when the pagers went off, into our flight suits we would go, and off

>into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground for

>a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying one

>out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's only

>worth flying if it's a critical patient. That just can't be more wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions, I will

>not fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! " I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out of

>luck. If you have a car load of precious children in a horrendous crash that

>meets flight criteria and the weather is less than minimums, the helicopter

>stays home. The severity of the patient, or lack thereof, should never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur fracture,

or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or overuse

>of aircraft, or is it possibly due to some questionable decisions on the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the crashes

are due

>to human error, not catastrophic events. And BTW, while the PIC (pilot in

>command) is technically and ultimately responsible in the end. . . the truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should be

>responsible for walking around the aircraft, looking for hazards during take

off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of few.

>

>

>I hope what I have said here makes sense. There are a few of us that have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

Link to comment
Share on other sites

The training and advise we use for " major trauma " is if the chopper can

save 10 to 15 minutes it's worth the call. That 15 minutes savings

includes the landing, initial assessement by the airlift crew, loading

the patient, and the flight back to the trauma center.

If the ground crew can do this within that set of parameters, then we

ground transport them. As you stated, the chopper should be used only

when you suspect that patient requires the services of the Trauma Center

and time is of the essence for saving the life or limb of the patient.

That's how we do it.

BH

Re: RE: Points to Ponder (most startling facts I

have seen)

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like

>a critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that

>we received in our dispatch information. Had we crashed, it would have

>been our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not

>fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground

>for a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying

>one out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also

>appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety

of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's

>only

>worth flying if it's a critical patient. That just can't be more

wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions,

>I will

>not fly " , but when the pagers went off, into our flight suits we would

go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! "

I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out

>of

>luck. If you have a car load of precious children in a horrendous

crash that

>meets flight criteria and the weather is less than minimums, the

helicopter

>stays home. The severity of the patient, or lack thereof, should

never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur

fracture, or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the

patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or

>overuse

>of aircraft, or is it possibly due to some questionable decisions on

the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may

>have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the

crashes are due

>to human error, not catastrophic events. And BTW, while the PIC

(pilot in

>command) is technically and ultimately responsible in the end. . . the

truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should

be

>responsible for walking around the aircraft, looking for hazards during

take off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of

few.

>

>

>I hope what I have said here makes sense. There are a few of us that

>have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

Link to comment
Share on other sites

The training and advise we use for " major trauma " is if the chopper can

save 10 to 15 minutes it's worth the call. That 15 minutes savings

includes the landing, initial assessement by the airlift crew, loading

the patient, and the flight back to the trauma center.

If the ground crew can do this within that set of parameters, then we

ground transport them. As you stated, the chopper should be used only

when you suspect that patient requires the services of the Trauma Center

and time is of the essence for saving the life or limb of the patient.

That's how we do it.

BH

Re: RE: Points to Ponder (most startling facts I

have seen)

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like

>a critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that

>we received in our dispatch information. Had we crashed, it would have

>been our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not

>fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground

>for a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying

>one out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also

>appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety

of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's

>only

>worth flying if it's a critical patient. That just can't be more

wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions,

>I will

>not fly " , but when the pagers went off, into our flight suits we would

go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! "

I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out

>of

>luck. If you have a car load of precious children in a horrendous

crash that

>meets flight criteria and the weather is less than minimums, the

helicopter

>stays home. The severity of the patient, or lack thereof, should

never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur

fracture, or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the

patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or

>overuse

>of aircraft, or is it possibly due to some questionable decisions on

the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may

>have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the

crashes are due

>to human error, not catastrophic events. And BTW, while the PIC

(pilot in

>command) is technically and ultimately responsible in the end. . . the

truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should

be

>responsible for walking around the aircraft, looking for hazards during

take off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of

few.

>

>

>I hope what I have said here makes sense. There are a few of us that

>have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

Link to comment
Share on other sites

The training and advise we use for " major trauma " is if the chopper can

save 10 to 15 minutes it's worth the call. That 15 minutes savings

includes the landing, initial assessement by the airlift crew, loading

the patient, and the flight back to the trauma center.

If the ground crew can do this within that set of parameters, then we

ground transport them. As you stated, the chopper should be used only

when you suspect that patient requires the services of the Trauma Center

and time is of the essence for saving the life or limb of the patient.

That's how we do it.

BH

Re: RE: Points to Ponder (most startling facts I

have seen)

I had a situation (as a first responder) last spring where a person

had an eye injury from an encounter with the hook from a bunji cord.

The eyeball was lacerated, but the patient was stable and alert. City

EMS was called via 911, and the Paramedics said that the local (small

town) hospital couldn't handle the injury, and that he needed a trauma

center (which I could agree with). They elected to have him airlifted

to San , about 40 miles away. At first, they wanted to set up

the LZ in our parking lot. I pointed out that a front was moving

through, and the winds were a little harry for a landing in this area

due to cars, buildings, high power electrical lines and that a safer LZ

was just down the street in the local Lions Club parking area (a pretty

good sized empty parking area). One of the Paramedics started to argue

with me about it until I told him that I had been in the 101st Airborne,

and had been well trained in evaluating and setting up LZ's in addition

to training I had received since then through my VFD, and the condition

of the patient didn't justify the added risk to the aircrew. This whole

thing started about 4:30 in the afternoon. At about 5:45 my relief

showed up, and he said that the helo was on the ground at the LC parking

lot. My son was born premature, and I had driven daily to University

Hospital from near my workplace. It usually took me about 45 minutes.

So basically, an EMS unit and a Helo were tied up with a non critical

patient, and the patient was still at the pre hospital stage, when I

could have packed the guy in my POV and drove him to a trauma center and

almost made it back to my workplace while that bird was still on the

ground.

I would have felt very badly had someone been in dire need of that

helo and had died because it was tied up with a relatively minor

injury. The city Paramedics made the call for air transport, when they

could have handed him off to one of the private EMS services in the area

and gotten the patient to a trauma center just as fast as he ended up

with by going by air. I understand that a city unit couldn't do an

intercity transport themselves (at least they say they cant). Oh, and

the guy didn't have workers comp or medical insurance. How long do you

think it will take him to pay off the transport bill? If he paid

anything that is.

lisawhir@... wrote:

>

>

>In a message dated 1/25/2005 3:04:45 A.M. Central Standard Time,

>hatfield@... writes:

>

>

>

>Taking off is optional........landing however, is mandatory.

>

>HOW you land, now that is an issue all it's own.

>

>Seriously though, I think one of the reasons that there is an increase

>in Med HELO accidents is the overuse, the fault lies squarely on the

>shoulders of those that accept the flights. We used to fly at the

>absolute bare minimum visibility, and push our luck all the way there

>and all the way back, because we were dispatched to what sounded like

>a critical patient in need of transportation. More often than not, we

>arrived to find a patient that was nowhere near the description that

>we received in our dispatch information. Had we crashed, it would have

>been our fault, it would have been out fault for not saying 'no', for

>whatever reason. Be it a) poor flight conditions, B) patient condition

>didn't warrant, etc.

>

>We all used to stand there and say, " In bad conditions, I will not

>fly " , but when the pagers went off, into our flight suits we would go,

>and off into the wild blue yonder, weather be damned!!!

>

>Something to consider when you call for the HELO, is it REALLY

>necessary? Could they go by ground? If you are waiting on the ground

>for a helicopter, you are wasting valuable time.

>

>I believe there is a place for medical air transportation, but its use

>must be judicious, sparing, and made with concern for the flight crew

>and the patient, every time they take off, they put their lives in

>danger. It would be a shame to have a crew killed, as well as the

>patient, because someone wanted to get the adrenalin rush of 'flying

>one out'.

>

>

>

>

>

>Mike

>

>

>

>

>

>

>

>Howdy Mike and All,

>

>I can absolutely appreciate what you are saying here. I also

>appreciate Dr.

>Bledsoe's comments or anybody else's who is concerned for the safety

of the

>air medical industry.

>

>I have to respectfully and adamantly disagree with folks who think it's

>only

>worth flying if it's a critical patient. That just can't be more

wrong.

>

>It's either safe to fly to anything, or it's not!

>

>Mike wrote: " We all used to stand there and say, " In bad conditions,

>I will

>not fly " , but when the pagers went off, into our flight suits we would

go,

>and off into the wild blue yonder, weather be damned!!! "

>

>In no circumstances should any program be flying in " bad conditions! "

I

>know my program doesn't practice this, nor do many others.

>

>Crews " pushing " weather for whatever reason, will eventually run out

>of

>luck. If you have a car load of precious children in a horrendous

crash that

>meets flight criteria and the weather is less than minimums, the

helicopter

>stays home. The severity of the patient, or lack thereof, should

never be the

>deciding factor to fly an aircraft, safely anyway.

>

>Every flight, whether it be for Health Safety day with other agencies,

>Shattered Dreams to promote safety for our teens, an isolated femur

fracture, or

>that critical child, should always meet the same criteria in regard to

>launching for the safety of the crew, folks on the ground and the

patient.

>

>Question: Is the unfortunate crash rate due to too many aircraft or

>overuse

>of aircraft, or is it possibly due to some questionable decisions on

the

>part of the crew?

>

>I've seen a lot of stats posted here lately on helo crashes, and I may

>have

>missed some, but I don't recall seeing stats on why the crashes are

>happening. I could be wrong, but to my knowledge, the majority of the

crashes are due

>to human error, not catastrophic events. And BTW, while the PIC

(pilot in

>command) is technically and ultimately responsible in the end. . . the

truth

>is, the entire crew on that aircraft is ultimately responsible. NO ONE

>should ever " push " weather for any reason! Every crew member should

be

>responsible for walking around the aircraft, looking for hazards during

take off's and

>landings and saying " turn around " or " land " at the hint of less than

>desirable weather conditions or for any other reasons, just to name of

few.

>

>

>I hope what I have said here makes sense. There are a few of us that

>have a

>hard time explaining our thoughts in writing, hence the reason I try to

>avoid posting. :)

>

>Thanks for reading,

>

>

>

>

>

>

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