Air ambulance subscriptions program

[Guest guest]

In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

emsfire@... writes:

With the mention of LZ's, I thought FD had to be on scene for medical helo

to land a makeshift LZ (like on a roadway or in a yard/field)? at least that's

the protocol here.

I checked with my sources at Aviation Fire Journal and they state that " LZ

requirements and protocols are more local, and are not mandated by FAA " .

Doc Bledsoe may have more on that as he's a avid student of helicopter EMS

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

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[Guest guest]

In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

emsfire@... writes:

and if FD does not have to be there, say the Helo comes in and crashes while

trying to land at Q Citizen's place to take him to the hospital because

he has a subscription? Who would be liable?

Why do we care about liability?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

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[Guest guest]

In a message dated 8/3/2007 1:20:35 P.M. Central Daylight Time,

emsfire@... writes:

people are sue happy

As I age I'm less and less convinced that is true.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

[Guest guest]

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

[Guest guest]

2 things

1) I would like a signature on your post

2) the common courtesy of at least contacting the local service prior to selling

subscriptions in their area, regardless of their status

Mike

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

Air ambulance subscriptions program

[Guest guest]

I will also go a little further.

A 15 minute flight time one way, (not counting dispatch and start up time) plus

ground time, plus a 15 minute return flight time would equate to about a 45

minute transport time (at a minimum).

The service is 45 miles from from a facility, that's a 45 minute trip

So what's the benefit?

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

Air ambulance subscriptions program

[Guest guest]

The County should have the decency to include the local EMS service in

addressing the concern of providing services. If there is a problem with

answering calls with an appropriate level of staffing, then the County needs

to commit to providing resources to meet that need. Taking the easy out and

not addressing local concerns with local input and resources will only lead

to ruin of such.

Will the flight service guarantee a response to every call for help? In case

of poor weather, lack of aircraft or difficult LZs, who you gonna call? Will

the flight service send ground units to honor the subscription in the above

mentioned cases? How will the flight service interact with local responders?

Does the stable subscription patient have priority over the critical non

subscriber?

I do appreciate the utilization of air services, but for the right reasons.

Our service will utilize any one of the three services available to us if

the patient's condition warrants and such utilization will benefit the

patient. However, I do think the provision of initial response with the use

of aircraft without consideration of ground response places flight

personnel, persons on the ground and patients at increased risk.

Perhaps the subscription program mentioned here does not intend to provide

initial 911 responses. Maybe there are stipulations as to how flight

services are to be initiated and who will be authorized to do this. None of

this was mentioned in previous posts.

Whatever the conditions, the local EMS service should have been included in

the process.

These opinions are strictly my own, take them and a buck and quarter and it

will get you a soft drink.

, Director

Seminole EMS

302 S. Main

Seminole, Texas 79360

FAX

Cell

Air ambulance subscriptions program

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

[Guest guest]

With the mention of LZs, I thought FD had to be on scene for medical helo to

land a makeshift LZ (like on a roadway or in a yard/field)? at least thats the

protocol here.

IF that is the case, then how could the helo land when Q Citizen calls the

helo company and asks to use their subscription instead of notifying local EMS?

and if FD does not have to be there, say the Helo comes in and crashes while

trying to land at Q Citizen's place to take him to the hospital because he

has a subscription? Who would be liable?

and if Q Citizen does not live with a suitable LZ around? like in a city?

the Helo going to land in an un-secured parking lot? 3AM that might work but

noon on a Monday???

I know the subscriptions are mainly for rural customers but the small town I

live in we have the similar situation except no one bought them. but if I did

called, there is no where to land near my house.

Red

Air ambulance subscriptions program

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

[Guest guest]

1) What would be nice to see is a coordinated effort to provide care to these

folks.

2) It appears that you are proposing to just land anywhere, with nobody on the

ground to survey, secure or coordinate the LZ. That sounds dangerous as hell.

3) If I were living there, I would want everyone involved to provide safe and

appropriate care to my family. Does every patient need a helo? Does every

patient need ALS care? Appropriate care is the issue.

From what I can read into the posts here, it would seem that a Air Medical

Provider is not generating enough calls to justify the base, is upset because

the local EMS is not calling and is looking for a way to increase revenue.

Sounds like a bad investment to me. But this is just my humble opinion.

paradude4 wrote:

The area we are talking about where this is being promoted is 15

minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

Danny Denson, EMT-P

Assistant Administrator

Akin Ambulance

kcmedic904@...

[Guest guest]

I don't know, maybe if your service had the was the primary EMS provider for

that area and the helicopter crashed. civil suit that your service didn't

respond and either deem the situation to not need a helo or set up a suitable

LZ?

" you're responsible because you should have been there and weren't " people are

sue happy!

ReD

Re: Air ambulance subscriptions program

In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

emsfire@... writes:

and if FD does not have to be there, say the Helo comes in and crashes while

trying to land at Q Citizen's place to take him to the hospital because

he has a subscription? Who would be liable?

Why do we care about liability?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

************************************** Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

[Guest guest]

People are looking at the trees and not the forest. Consider this:

1. There is no significant body of scientific evidence that medical

helicopters benefit most patients. Most trauma surgeons can count on one

hand the number of patients who MIGHT have benefited from helicopter

transport.

2. One of the major helicopter operators who sell subscriptions had their

offices raided by the FBI and FAA with federal warrants alleging Medicare

fraud.

3. That same operator has a questionable safety record with a recent crash

(last week) in Mississippi.

4. The FAA has recommended improved safety devices for helicopters.

Several operators, including the one whose offices were raided, have fought

those changes. That same operator filed suit in Tennessee to keep the state

from mandating improved standards (and won). They won because helicopters

are covered under federal aviation laws that trump state laws.

5. We are seeing a decline in the quality of pilots, paramedics and nurses

on many helicopters because there are so many operators now that the

workforce is diluted.

6. I can go on until this list approaches 100.

The question should not be about subscriptions and such-but more about why

are we even using these services. They are more expensive and more dangerous

that ground transport, they are taking money from ground EMS, they are

uncomfortable (and in many cases not air conditioned), and they lack any

significant empiric support of improvement in patient outcomes.

These are the facts and they are irrefutable.

BEB

[Guest guest]

-That is why we love you Doc, but when is Medicare, and private

insurance companies going to recognize these facts, and quit paying

through the nose for unecessary services?

-- In texasems-l , " Bledsoe, DO "

wrote:

>

> People are looking at the trees and not the forest. Consider this:

>

>

>

> 1. There is no significant body of scientific evidence that

medical

> helicopters benefit most patients. Most trauma surgeons can count

on one

> hand the number of patients who MIGHT have benefited from helicopter

> transport.

>

> 2. One of the major helicopter operators who sell subscriptions

had their

> offices raided by the FBI and FAA with federal warrants alleging

Medicare

> fraud.

>

> 3. That same operator has a questionable safety record with a

recent crash

> (last week) in Mississippi.

>

> 4. The FAA has recommended improved safety devices for

helicopters.

> Several operators, including the one whose offices were raided,

have fought

> those changes. That same operator filed suit in Tennessee to keep

the state

> from mandating improved standards (and won). They won because

helicopters

> are covered under federal aviation laws that trump state laws.

>

> 5. We are seeing a decline in the quality of pilots, paramedics

and nurses

> on many helicopters because there are so many operators now that the

> workforce is diluted.

>

> 6. I can go on until this list approaches 100.

>

>

>

> The question should not be about subscriptions and such-but more

about why

> are we even using these services. They are more expensive and more

dangerous

> that ground transport, they are taking money from ground EMS, they

are

> uncomfortable (and in many cases not air conditioned), and they

lack any

> significant empiric support of improvement in patient outcomes.

>

>

>

> These are the facts and they are irrefutable.

>

>

>

> BEB

>

>

>

>

[Guest guest]

I did not know that EMS was an essential function in Texas.

>

> I don't know, maybe if your service had the was the primary EMS provider

> for that area and the helicopter crashed. civil suit that your service

> didn't respond and either deem the situation to not need a helo or set up a

> suitable LZ?

>

> " you're responsible because you should have been there and weren't " people

> are sue happy!

>

> ReD

> Re: Air ambulance subscriptions program

>

> In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> emsfire@... <emsfire%40redsanders.com> writes:

>

> and if FD does not have to be there, say the Helo comes in and crashes

> while

> trying to land at Q Citizen's place to take him to the hospital

> because

> he has a subscription? Who would be liable?

>

> Why do we care about liability?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> Owner and President of LNM Emergency Services Consulting Services (LNMECS)

> Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

>

> LNMolino@... <LNMolino%40aol.com>

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

> (Home Phone)

>

> The comments contained in this E-mail are the opinions of the author and

> the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended

> only for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain

> by the

> original author.

>

> ************************************** Get a sneak peek of the all-new AOL

> at

> http://discover.aol.com/memed/aolcom30tour

>

>

[Guest guest]

Let me clarify that " legally an essential function "

AJL

>

> I did not know that EMS was an essential function in Texas.

>

>

>

>

> >

> > I don't know, maybe if your service had the was the primary EMS

> > provider for that area and the helicopter crashed. civil suit that your

> > service didn't respond and either deem the situation to not need a helo or

> > set up a suitable LZ?

> >

> > " you're responsible because you should have been there and weren't "

> > people are sue happy!

> >

> > ReD

> > Re: Air ambulance subscriptions program

> >

> > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > emsfire@... <emsfire%40redsanders.com> writes:

> >

> > and if FD does not have to be there, say the Helo comes in and crashes

> > while

> > trying to land at Q Citizen's place to take him to the hospital

> > because

> > he has a subscription? Who would be liable?

> >

> > Why do we care about liability?

> >

> > Louis N. Molino, Sr., CET

> > FF/NREMT-B/FSI/EMSI

> > Owner and President of LNM Emergency Services Consulting Services

> > (LNMECS)

> > Freelance Consultant/Trainer/Author/Journalist/Fire Protection

> > Consultant

> >

> > LNMolino@... <LNMolino%40aol.com>

> >

> > (Cell Phone)

> > (IFW/TFW/FSS Office)

> > (IFW/TFW/FSS Fax)

> > (Home Phone)

> >

> > The comments contained in this E-mail are the opinions of the author and

> > the

> > author alone. I in no way ever intend to speak for any person or

> > organization that I am in any way whatsoever involved or associated with

> > unless I

> > specifically state that I am doing so. Further this E-mail is intended

> > only for its

> > stated recipient and may contain private and or confidential materials

> > retransmission is strictly prohibited unless placed in the public domain

> > by the

> > original author.

> >

> > ************************************** Get a sneak peek of the all-new

> > AOL at

> > http://discover.aol.com/memed/aolcom30tour

> >

> >

[Guest guest]

so, if the city EMS, that has a contract to provide EMS to the citizens, says

" nahh, I don't think we'll respond. " when I call 911 because I amputated my

finger while building a rocking chair, so I call the helicopter because I bought

a subscription from them, that's OK because the city EMS is not a " legally

essential function " ?

Red

Re: Air ambulance subscriptions program

> >

> > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > emsfire@... <emsfire%40redsanders.com> writes:

> >

> > and if FD does not have to be there, say the Helo comes in and crashes

> > while

> > trying to land at Q Citizen's place to take him to the hospital

> > because

> > he has a subscription? Who would be liable?

> >

> > Why do we care about liability?

> >

> > Louis N. Molino, Sr., CET

> > FF/NREMT-B/FSI/EMSI

> > Owner and President of LNM Emergency Services Consulting Services

> > (LNMECS)

> > Freelance Consultant/Trainer/Author/Journalist/Fire Protection

> > Consultant

> >

> > LNMolino@... <LNMolino%40aol.com>

> >

> > (Cell Phone)

> > (IFW/TFW/FSS Office)

> > (IFW/TFW/FSS Fax)

> > (Home Phone)

> >

> > The comments contained in this E-mail are the opinions of the author and

> > the

> > author alone. I in no way ever intend to speak for any person or

> > organization that I am in any way whatsoever involved or associated with

> > unless I

> > specifically state that I am doing so. Further this E-mail is intended

> > only for its

> > stated recipient and may contain private and or confidential materials

> > retransmission is strictly prohibited unless placed in the public domain

> > by the

> > original author.

> >

> > ************************************** Get a sneak peek of the all-new

> > AOL at

> > http://discover.aol.com/memed/aolcom30tour

> >

> >

[Guest guest]

If they are a contracted provider I will agree with you. I was commenting

on the original scenario where a distant provider would be responding.

>

> so, if the city EMS, that has a contract to provide EMS to the citizens,

> says " nahh, I don't think we'll respond. " when I call 911 because I

> amputated my finger while building a rocking chair, so I call the helicopter

> because I bought a subscription from them, that's OK because the city EMS is

> not a " legally essential function " ?

>

> Red

> Re: Air ambulance subscriptions program

> > >

> > > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > > emsfire@... <emsfire%40redsanders.com> <emsfire%40redsande

> rs.com> writes:

> > >

> > > and if FD does not have to be there, say the Helo comes in and crashes

> > > while

> > > trying to land at Q Citizen's place to take him to the hospital

> > > because

> > > he has a subscription? Who would be liable?

> > >

> > > Why do we care about liability?

> > >

> > > Louis N. Molino, Sr., CET

> > > FF/NREMT-B/FSI/EMSI

> > > Owner and President of LNM Emergency Services Consulting Services

> > > (LNMECS)

> > > Freelance Consultant/Trainer/Author/Journalist/Fire Protection

> > > Consultant

> > >

> > > LNMolino@... <LNMolino%40aol.com> <LNMolino%40aol.com>

> > >

> > > (Cell Phone)

> > > (IFW/TFW/FSS Office)

> > > (IFW/TFW/FSS Fax)

> > > (Home Phone)

> > >

> > > The comments contained in this E-mail are the opinions of the author

> and

> > > the

> > > author alone. I in no way ever intend to speak for any person or

> > > organization that I am in any way whatsoever involved or associated

> with

> > > unless I

> > > specifically state that I am doing so. Further this E-mail is intended

> > > only for its

> > > stated recipient and may contain private and or confidential materials

> > > retransmission is strictly prohibited unless placed in the public

> domain

> > > by the

> > > original author.

> > >

> > > ************************************** Get a sneak peek of the all-new

> > > AOL at

> > > http://discover.aol.com/memed/aolcom30tour

> > >

> > >

[Guest guest]

It has begun. I have been periodically asked to review some air medical

cases for insurance companies in terms of necessity.

BEB

From: texasems-l [mailto:texasems-l ] On

Behalf Of markpo95

Sent: Friday, August 03, 2007 2:27 PM

To: texasems-l

Subject: Re: Air ambulance subscriptions program

-That is why we love you Doc, but when is Medicare, and private

insurance companies going to recognize these facts, and quit paying

through the nose for unecessary services?

-- In texasems-l <mailto:texasems-l%40yahoogroups.com> ,

" Bledsoe, DO "

wrote:

>

> People are looking at the trees and not the forest. Consider this:

>

>

>

> 1. There is no significant body of scientific evidence that

medical

> helicopters benefit most patients. Most trauma surgeons can count

on one

> hand the number of patients who MIGHT have benefited from helicopter

> transport.

>

> 2. One of the major helicopter operators who sell subscriptions

had their

> offices raided by the FBI and FAA with federal warrants alleging

Medicare

> fraud.

>

> 3. That same operator has a questionable safety record with a

recent crash

> (last week) in Mississippi.

>

> 4. The FAA has recommended improved safety devices for

helicopters.

> Several operators, including the one whose offices were raided,

have fought

> those changes. That same operator filed suit in Tennessee to keep

the state

> from mandating improved standards (and won). They won because

helicopters

> are covered under federal aviation laws that trump state laws.

>

> 5. We are seeing a decline in the quality of pilots, paramedics

and nurses

> on many helicopters because there are so many operators now that the

> workforce is diluted.

>

> 6. I can go on until this list approaches 100.

>

>

>

> The question should not be about subscriptions and such-but more

about why

> are we even using these services. They are more expensive and more

dangerous

> that ground transport, they are taking money from ground EMS, they

are

> uncomfortable (and in many cases not air conditioned), and they

lack any

> significant empiric support of improvement in patient outcomes.

>

>

>

> These are the facts and they are irrefutable.

>

>

>

> BEB

>

>

>

>

[Guest guest]

Whether or not EMS is a " legally essential function " and whether or not any

EMS service has a contract to provide service are two entirely separate and

different issues.

1. No governmental entity is mandated by law to provide EMS in Texas.

2. If a governmental entity elects to provide the service, it does so

subject to the Texas Tort Claims Act, which is rather complex and difficult to

understand and apply when it comes to providing EMS service. The city may not

have legal liability, but the individual crew members probably do, an

unfortunate thing if you're a crew member.

3. A private contractor who undertakes to provide service under a contract

with a governmental entity then has the legal duty to perform within the terms

of its contract.

It has been held that such a contractor is not considered to be a

governmental entity for purposes of immunity issues even though it is doing the

job that

the governmental entity might do if it had chosen to do so.

So a private contractor might be held liable for failure to respond, while a

governmental provider might not.

This is entirely dependent on state law, and state laws vary.

4. If a HEMS service contracts with an individual, through subscription, it

must honor the promises made in the contract. It may be accurate to say

that few subscribers to a HEMS service would study the contract with the service

in detail, or have their lawyers study it, or even have access to it, prior to

joining the plan and paying for the service.

I expect that the list of " exceptions in fine print " would be extensive and

would relieve the service from performing in bad weather, et cetera.

Gene Gandy, JD, LP

EMS Dinosaur IV

>

> so, if the city EMS, that has a contract to provide EMS to the citizens,

> says " nahh, I don't think we'll respond. " when I call 911 because I amputated

my

> finger while building a rocking chair, so I call the helicopter because I

> bought a subscription from them, that's OK because the city EMS is not a

> " legally essential function " ?

>

> Red

> Re: Air ambulance subscriptions program

> > >

> > > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > > emsfire@... <emsfire%40redsandeemsfir> writes:

> > >

> > > and if FD does not have to be there, say the Helo comes in and crashes

> > > while

> > > trying to land at Q Citizen's place to take him to the hospital

> > > because

> > > he has a subscription? Who would be liable?

> > >

> > > Why do we care about liability?

> > >

> > > Louis N. Molino, Sr., CET

> > > FF/NREMT-B/FSI/ FF/

> > > Owner and President of LNM Emergency Services Consulting Services

> > > (LNMECS)

> > > Freelance Consultant/Trainer/ Freelance Consu Freelance Consul

> > > Consultant

> > >

> > > LNMolino@... <LNMolino%40aol.LNM>

> > >

> > > (Cell Phone)

> > > (IFW/TFW/FSS Office)

> > > (IFW/TFW/FSS Fax)

> > > (Home Phone)

> > >

> > > The comments contained in this E-mail are the opinions of the author and

> > > the

> > > author alone. I in no way ever intend to speak for any person or

> > > organization that I am in any way whatsoever involved or associated with

> > > unless I

> > > specifically state that I am doing so. Further this E-mail is intended

> > > only for its

> > > stated recipient and may contain private and or confidential materials

> > > retransmission is strictly prohibited unless placed in the public domain

> > > by the

> > > original author.

> > >

> > > ************ ******** ******** ************<wbr>*********<wbr>********

> > > AOL at

> > > http://discover.http://discovehttp://disco

> > >

> > >

[Guest guest]

Red,

First of all, I'm not criticizing, just asking questions. I know where

you're coming from and I've been there, and this is just to try to get out all

the

facts, OK?

Let's take what happens when HEMS gets dispatched. Generally, it is not

dispatched until a call from another provider, generally the 911 EMS provider.

So in your case, who would make the call to initiate HEMS response? Would

it be done by the 911 answer point without input from the local EMS responders?

Or would it be done after they were notified and enroute? Or would the

HEMS have been called directly by somebody who was a member of its program?

That wouldn't happen in the case of an MVC, would it?

So there's an MVC. Somebody gets to a phone and calls. 911 dispatches the

locals, and what happens then? Does HEMS automatically get called? If so,

how do they know what the location is? Will the 911 dispatcher have the

info to give them to pinpoint their response area? I doubt it.

Then, who is going to land them in the dark? Somebody's got to do it, and

it will be the locals. Then, once they're there, yes, if the patient is one

of the 0.5 % that might actually profit from helo transport, then they might do

the patient some good, but as I am sure you know, most of the time they get

there and it makes no difference whether or not the patient gets to the

hospital in 45 minutes or 1:15. If he needs to be in surgery and he's at

anything

but a Level I or II, he'll be waiting for another couple or three hours anyway.

If he won't survive that, he wouldn't have survived anyway, most of the

time.

So what's being gained by dispatching the HEMS?

I worked on a case as an expert where a patient whose only injury was a fx of

the 4th metatarsal of the right foot was flown, RSI'd, intubated intubated in

the esophagus by the air crew, suffered permanent brain damage, and it all

could have been avoided if the ground crew had simply said, " Well, this is a

head-on, but the patients are not badly injured, according to our thorough

assessment, and therefore no helo is needed. "

Helicopters are called because folks don't know how to do a patient

assessment, because they're operating under stupid rules, or because they are

lazy and

don't want to stay up for the transport, among other things.

Where is the patient's interest in this? We're supposed to be patient

advocates, are we not?

Gene Gandy, JD, LP

EMS Curmudgeon

>

> well what if the distant provider had the contract? where I am, the CITY EMS

> has the contract for the whole 1100sq. mi. county, some of their response

> times are 30+mins, especially if at 2AM(they respond from home to the

ambulance

> station), and in that scenario, the helo would be faster because they would

> both be on scene at the same time, but the helo could get the pt to a level

> II trauma center in 30 more min as opposed to the MICU calling the helo when

> they get on scene.

>

> Red

>

> Re: Air ambulance subscriptions program

> > > >

> > > > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > > > emsfire@... <emsfire%40redsandeemsfir> <emsfire%40redsande

> > rs.com> writes:

> > > >

> > > > and if FD does not have to be there, say the Helo comes in and crashes

> > > > while

> > > > trying to land at Q Citizen's place to take him to the hospital

> > > > because

> > > > he has a subscription? Who would be liable?

> > > >

> > > > Why do we care about liability?

> > > >

> > > > Louis N. Molino, Sr., CET

> > > > FF/NREMT-B/FSI/ FF/

> > > > Owner and President of LNM Emergency Services Consulting Services

> > > > (LNMECS)

> > > > Freelance Consultant/Trainer/ Freelance Consu Freelance Consul

> > > > Consultant

> > > >

> > > > LNMolino@... <LNMolino%40aol.LNM> <LNMolino%40aol.LNM>

> > > >

> > > > (Cell Phone)

> > > > (IFW/TFW/FSS Office)

> > > > (IFW/TFW/FSS Fax)

> > > > (Home Phone)

> > > >

> > > > The comments contained in this E-mail are the opinions of the author

> > and

> > > > the

> > > > author alone. I in no way ever intend to speak for any person or

> > > > organization that I am in any way whatsoever involved or associated

> > with

> > > > unless I

> > > > specifically state that I am doing so. Further this E-mail is intended

> > > > only for its

> > > > stated recipient and may contain private and or confidential materials

> > > > retransmission is strictly prohibited unless placed in the public

> > domain

> > > > by the

> > > > original author.

> > > >

> > > > ************ ******** ******** ************<wbr>*********<wbr>********

> > > > AOL at

> > > > http://discover.http://discovehttp://disco

> > > >

> > > >

[Guest guest]

I would want cooperation and teamwork between the local ground EMS provider that

is going to come out when I have abdominal pain at 0200 in the am (or?when the

life saving/death cheating helicopter is doing an inter-facility transfer)?and

the resources THAT agency has to best meet my needs.? The last thing needed in

an area where resources are scarce is a 2nd or 3rd tier agency trying to take

advantage of this situation to make money...at the expense of the volunteer

organization and the organized, coordinated EMS System.

Dudley

Air ambulance subscriptions program

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

________________________________________________________________________

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[Guest guest]

I wonder how many, if any, people who buy a subscription would beleave that they

can all the helo service directly and have them transport them vrs. calling a

ground unit.

THEDUDMAN@... wrote: I would want cooperation and teamwork between

the local ground EMS provider that is going to come out when I have abdominal

pain at 0200 in the am (or?when the life saving/death cheating helicopter is

doing an inter-facility transfer)?and the resources THAT agency has to best meet

my needs.? The last thing needed in an area where resources are scarce is a 2nd

or 3rd tier agency trying to take advantage of this situation to make money...at

the expense of the volunteer organization and the organized, coordinated EMS

System.

Dudley

Air ambulance subscriptions program

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

__________________________________________________________

AOL now offers free email to everyone. Find out more about what's free from AOL

at AOL.com.

[Guest guest]

well what if the distant provider had the contract? where I am, the CITY EMS has

the contract for the whole 1100sq. mi. county, some of their response times are

30+mins, especially if at 2AM(they respond from home to the ambulance station),

and in that scenario, the helo would be faster because they would both be on

scene at the same time, but the helo could get the pt to a level II trauma

center in 30 more min as opposed to the MICU calling the helo when they get on

scene.

Red

Re: Air ambulance subscriptions program

> > >

> > > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > > emsfire@... <emsfire%40redsanders.com> <emsfire%40redsande

> rs.com> writes:

> > >

> > > and if FD does not have to be there, say the Helo comes in and crashes

> > > while

> > > trying to land at Q Citizen's place to take him to the hospital

> > > because

> > > he has a subscription? Who would be liable?

> > >

> > > Why do we care about liability?

> > >

> > > Louis N. Molino, Sr., CET

> > > FF/NREMT-B/FSI/EMSI

> > > Owner and President of LNM Emergency Services Consulting Services

> > > (LNMECS)

> > > Freelance Consultant/Trainer/Author/Journalist/Fire Protection

> > > Consultant

> > >

> > > LNMolino@... <LNMolino%40aol.com> <LNMolino%40aol.com>

> > >

> > > (Cell Phone)

> > > (IFW/TFW/FSS Office)

> > > (IFW/TFW/FSS Fax)

> > > (Home Phone)

> > >

> > > The comments contained in this E-mail are the opinions of the author

> and

> > > the

> > > author alone. I in no way ever intend to speak for any person or

> > > organization that I am in any way whatsoever involved or associated

> with

> > > unless I

> > > specifically state that I am doing so. Further this E-mail is intended

> > > only for its

> > > stated recipient and may contain private and or confidential materials

> > > retransmission is strictly prohibited unless placed in the public

> domain

> > > by the

> > > original author.

> > >

> > > ************************************** Get a sneak peek of the all-new

> > > AOL at

> > > http://discover.aol.com/memed/aolcom30tour

> > >

> > >

[Guest guest]

I doubt many would...the literature I have seen from these subscriptions do not

encourage it...but I have seen newspaper articles over the last 2 to 3 years of

some places where it was behind discussed or disagreed about...and if

appropriate regulations are not put into place, it certainly could happen.

Dudley

Air ambulance subscriptions program

The area we are talking about where this is being promoted is 15 minute

flight from the air base. The area has no full time EMS....the closest

EMS comes from 10-20 miles away and is primarely volunteer with no

paramedic guaranteed....What would you want if you had family living

there?

__________________________________________________________

AOL now offers free email to everyone. Find out more about what's free from AOL

at AOL.com.

[Guest guest]

Gene,

I understand you're just asking questions, I'm not mad. I was just trying to

throw more " what-if's " in there. Where I work, most of the scenarios you

mentioned below happen alot. Our closest helo is a 30-35min flight away. The

medics and dispatch here will WAIT to call a helo until they see the patient.

Well that 30min here, 15min on the ground and 30min back to the hospital,

whereas its about an hour by ground. The EMS director does not want the lone

ambulance crew out of the county that much, so they fly everything, or they

transport to our " hospital " here. a 20bed facility that will have a DR on call

at 4AM and 1RN. Well the DR gets in, sand decides he's tired and does not want

to treat, so he transfers the pt. guess who transfers the pt by ground to that

hospital an hour away? the ambulance crew that did not want to leave the

county...................................

and with the subscriptions sold here, the helo company presented the program as

if grand-ma is sick and needs to see her PCP in the town 50miles away, call us.

of course they threw in about the MVC and we'll give you a window sticker &

such. But the situation comes in as to which helicopter is used. We have 2

available with simular ETAs (approx 30min). Well one comes from a level II

trauma center to the west and the other comes from their base to the NE. we

obviously use the hospital based service the most because they fly back to their

own pad, but the service selling subscriptions was the one to the NE.

Also, we have a bad MVC with multiple pts and call both helos. Well, I'm sorry

Mr. subscrober but it's first come first serve with the helos. First one on the

ground gets the first extricated pt, and so on.

I get so frustrated by crap like this, like you said, we are supposed to be

taking the patients best interests in mind, and are clearly not sometimes!

ReD

Re: Air ambulance subscriptions program

> > > >

> > > > In a message dated 8/3/2007 11:59:23 A.M. Central Daylight Time,

> > > > emsfire@... <emsfire%40redsandeemsfir> <emsfire%40redsande

> > rs.com> writes:

> > > >

> > > > and if FD does not have to be there, say the Helo comes in and crashes

> > > > while

> > > > trying to land at Q Citizen's place to take him to the hospital

> > > > because

> > > > he has a subscription? Who would be liable?

> > > >

> > > > Why do we care about liability?

> > > >

> > > > Louis N. Molino, Sr., CET

> > > > FF/NREMT-B/FSI/ FF/

> > > > Owner and President of LNM Emergency Services Consulting Services

> > > > (LNMECS)

> > > > Freelance Consultant/Trainer/ Freelance Consu Freelance Consul

> > > > Consultant

> > > >

> > > > LNMolino@... <LNMolino%40aol.LNM> <LNMolino%40aol.LNM>

> > > >

> > > > (Cell Phone)

> > > > (IFW/TFW/FSS Office)

> > > > (IFW/TFW/FSS Fax)

> > > > (Home Phone)

> > > >

> > > > The comments contained in this E-mail are the opinions of the author

> > and

> > > > the

> > > > author alone. I in no way ever intend to speak for any person or

> > > > organization that I am in any way whatsoever involved or associated

> > with

> > > > unless I

> > > > specifically state that I am doing so. Further this E-mail is intended

> > > > only for its

> > > > stated recipient and may contain private and or confidential materials

> > > > retransmission is strictly prohibited unless placed in the public

> > domain

> > > > by the

> > > > original author.

> > > >

> > > > ************ ******** ******** ************<wbr>*********<wbr>********

> > > > AOL at

> > > > http://discover.http://discovehttp://disco

> > > >

> > > >

[Guest guest]

In a message dated 8/5/2007 8:23:01 P.M. Central Daylight Time,

squeakerwood@... writes:

You seem to like to put all of your eggs in one basket and seem to be very

narrow minded for such an intellegent man!

If using science as a basis for ones arguments then yes you seem to be right

on target with that personal attack.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour