More HEMS discussion.

[Just Plain Ruff]

I know a lot of agencies around here will call for Metro Life Flight (Cleveland) to be put on standby, especially the rural agencies, as they roll up to a scene based on what they see. (I've heard some departments make the request before anyone was on-scene.. :roll: ). While they get their intial assessment, the dispatchers are getting on the same page, agreeing on frequencies, and the flight crew is starting up the engine. If air is not needed, the bird never lifts off. If they are needed, they saved 5 minutes or so.

One definate advantage that Metro provides is a DO or MD on every helicopter, so their playbook is pretty much wide open and limited only by what gear they can carry.

Metro Life Flight

Ok, having a physician on board trumps my argument.

[dougd]

Ok, having a physician on board trumps my argument.

I'm not sure if this was meant in sarcasm or not, because your argument applies. You still have space and gear constraints. I'm just saying that THIS particular system has a doc on board, which can raise the level of care provided in a pre-hospital setting, especially when you're considering the rural areas with volunteer departments who may only get a handful of ALS calls a month and a couple of serious traumas in a year.

I don't want to give the impression that it is THE answer, nor that it trumps legitimate safety concerns. I was just answering one very small part of what you stated.

Having a helicopter available is one tool in the toolbox. But it is just that, one tool. You don't use a hammer to put in a drywall screw. Ask me how I know.

[Just Plain Ruff]

no no no, you get a helicopter with a doctor(probably one who knows his stuff) and you get them to a rural ER or a Rural Scene and they can do soooo much.

No sarcasm at all

You have a seasoned trauma surgeon or physician to augment the ER Staff and ER physician.

It's a win win

[paramedicmike]

Not many flight services use MD/DO as members of their regular flight crews. As specialty team members? Sure. But most will use either RN/RN, RN/P or RN/RT.

As to what flight crews can bring to the patient, that will depend on the service. My service brings RSI/advanced airway management. Some places I've heard about can do more invasive procedures up to and including chest tubes. So it depends from service to service.

I didn't not initially notice a slant towards interfacility flights versus scene flights. Although, looking at it now, it could be interpreted that way. I wonder if Dr Bledsoe intended that slant or if it was just a result of how he wrote the piece.

-be safe

[JakeEMTP]

Mike,

I too think Dr. Bledsoe was leaning more towards the use of helicopters in inter-facility transports after re-reading the article. He does mention that ground crews should share some of the blame for the misuse of air transport on scene runs. I completely agree with that by the way.

I ask you in all seriousness, as a flightmedic, how many scene runs do you go on that truly had a impact on patient outcome vs. ground transport? I have a few friends that fly here and to be honest, their answer was not many.

We've all heard the "3 to go, 1 to say no" line. How often though does it happen? Is there a perception that one would be viewed as weak or chicken and didn't belong in the flight service if they uttered no?

( random thoughts from a tired ground medic )

[Flasurfbum]

I have to ask this, what is the proven benefit for a medical helicopter flight from the scene to a hospital.

If it takes 10-20 minutes for the ems crews to get there, then 5 minutes to assess the need for a helicopter(I'm being overly generous here), then 5 more minutes to get the helicopter notified, 30 minutes(at least) for the helicopter to get airborne and fly to the scene, a 3-7 minute loading, and then 30-45 minutes to the nearest trauma center what is the benefit. I count 90 minutes to get the bird there and then to the trauma center.

WHAT?!

Based on MOI, the aircraft can go to standby before the first crew is even on scene. The aircraft is wheeled outside, and preflight plans are done. Within 3 minutes of the crew on scene, the crew can determine if the pt needs air transport. Since the aircraft is prepped, it can launch within 5 minutes of notification.

Is it possible that the communications center/launch protocal for your aircraft needs serious reevaluation?

[paramedicmike]

I ask you in all seriousness, as a flightmedic, how many scene runs do you go on that truly had a impact on patient outcome vs. ground transport? I have a few friends that fly here and to be honest, their answer was not many.

I have the same answer as your friends. There haven't been many flights in which I've been involved where I think we made a huge impact. Granted, there have been a few. But they are few and far in-between.

We've all heard the "3 to go, 1 to say no" line. How often though does it happen? Is there a perception that one would be viewed as weak or chicken and didn't belong in the flight service if they uttered no?

Fortunately, our pilots are smart enough to decline a flight if it's questionable. They also go out of their way to ask if anyone else has turned it down. The bosses say that if there's ever a question and one of us says "no" there will be no repercussions.

That being said, I have not had to say "no" during my tenure here. Every time I would have declined a flight due to weather (or other concerns) our pilot has already turned it down for us.

( random thoughts from a tired ground medic )

It's alright. I've been back and forth between the air and the ground and without a vacation in way too long. I know all about tired.

-be safe

[JakeEMTP]

Another article about helicopter medical flights.

http://www.ems1.com/ems-products/specialty...out-med-copters

I find it hard to believe Mr. Disman could have arrived by ground at the trauma centre some 50 min ahead of the second helicopter. What I ask, were these people thinking? IMHO, as soon as the first helicopter canceled their response, a ground unit should have immediately been dispatched. Hell, there quite possibly may have been a ground ambulance at the hospital already.

[CBEMT]

I seems to me from skimming the article and Dr. B's repsone, that he is really questioning the efficacy of using helicopters for interfacility transfers.... Not so much for scene work especially when the patient is critically injured,, is that the impression that you all are getting, or did i miss something ???

Wait.. what?

He's ABSOLUTELY talking about scene calls. The fatal crashes he lists are mostly interfacility, but everything else is completely scene-based scenarios.