Is it worth it?

[fireflymedic]

With the recent tragedies and the most recent being this morning of HEMS, I have been questioning hard whether the benefits really outweigh the risks to patients. Granted as I've said many times, I'm in a very rural area where I believe HEMS definitely has a benefit, but the more I look at it, the more I sit back and say how much will this patient truly benefit from going by air? If I couldn't justify sending them that way if there was a crash ie simply sitting down and saying they will die if they aren't with a surgeon in minutes, then they are going by ground. Period end of story. How many others here are questioning the validity of transports? As I understand it, the most recent was an interfacility due to seizures - could this REALLY not have been managed by ground? We need to allow flight crews to refuse flights and better educate sending facilities/ground crews as to what's appropriate to send by air. We need to sit back and ask ourselves what have we become?

[JakeEMTP]

Depending where I am in my district, our transport times to the hospital can be anywhere from 15 to 30 minutes. The need for my to utilise a helicopter is really minimal. I have called for a helicopter once in the last year. That was due to an extensive extraction with multiple trauma in the most outer region of the district I cover.. The helicopter was on the ground before the pt. was extracted so in that instance, I believe it was warranted.

I was also thinking about the use of helicopters after this mornings tragedy. I think the solution to ending or at least minimizing these accidents is greater than just allowing flight crews to say no. MD took a step in the right direction by the ground crew having to make contact with an Physician before dispatching a helicopter. Once again, proper education of advanced providers who could recognise the need for HEMS transport or not is paramount in beginning to reduce the number of accidents. It's really simple math. Less flights = less accidents. I read somewhere that some services call for a helo so that they can keep their ambulance in their district is happening. WTF? My immediate thought was some vollie whacker rescue squad not wanting to make the trip because they have to go to their REAL job in the morning. That may be a knee jerk reaction, but I'm sure it happens.

I don't know what the answer is. I know that these accidents have to stop. Make certain your pt. would benefit greatly by the use of HEMS. If it takes longer for them to arrive than it does for you to load your pt., HEAD FOR THE HOSPITAL! Do not wait for them, that's just stupid. Cancel the helicopter. There will always be a need for HEMS. However, the number of times it is required cannot continue to rise. In fact, as education of providers SHOULD increase, the need for them SHOULD decrease.

[BEorP]

Is it worth risking lives when it won't benefit patients? No.

Do lives need to be risked for HEMS? No.

End competition among air ambulance providers. Require two pilots and two engines. End scene responses at night without NVG.

[fiznat]

I don't know if I'm qualified to answer the original topic as I really don't have much to do with HEMS in my system. The trauma centers around here have helicopters that they send out to the rural areas, but it shouldn't be surprising that we've never used them here in the city.

Still, I see the helicopter crews come in sometimes with their patients and often they are NOT critical at all. I see patients of minor motor vehicle accidents getting flown in, basic chest pains, basic extremity fractures... etc. I admit I am not a part of that system and am looking in from the outside, but it seems to me that the number of patients flown could be dramatically reduced if there were more stringent qualifications in determining which patients get flown and which do not.

[firedoc5]

Yes, there has been a rash of medical helo's going down recently. But remember, at times it seems like there's a rash of airline passenger jets going down at times also. But you have to look at the percentage of successful flights that had no problem. I know there's a big difference between commercial airlines and HEMS, but accidents do happen. There's always the risk, whether by HEMS or by ground. How many ground units have accidents that you don't hear about everyday? Very few I hope, but it happens.

Kind of a side note. Back in the early and mid-80's, when I was first starting out, almost every HEMS flight had a Viet Nam vet piloting the chopper. They were considered the best due to their experience. Now they are getting older and retiring. Could it be that the pilots of today, even though well qualified and trained, are lacking that edge due to lack of experience?

[chbare]

I disagree. Why do we continue to accept HEMS as dangerous? I am so sick of people who say "well you knew the risks going in." Yeah, accidents will always happen. However, nearly forty people are dead. This has been a catastrophic year for the air medical industry. Yes, many ground incidents occur; however, pointing the finger at what happens on the ground cannot negate that fact that we have a big problem in the air.

Take care,

chbare.

[Arizonaffcep]

I'm not sure how applicable this would be, but also consider the fact that it is safer (generally speaking for travel) by air vs. by ground (the old adage). Now, there are risks to everything we do. The biggest thing we (as ground crews) can do to help the patient (because flight is a LOT more expensive), is, if it's illness/injury, if you can get them (the patient) to an APPROPRIATE hospital (ie, level 1 trauma to a level 1 facility, etc) if the same time OR less than it would take to launch a chopper, have them launch, travel to the scene, land, do their own assessment, lift off, and flight time to the facility, then they MUST go by ground. What would the excuse be other than to buy the patient time? At least in AZ, prehospital care in a helicopter vs ground is in all actuality the same. One just travels faster, and in a straighter line.

[jsadin]

You may be safer in an EMS helo than travelling by ground, but not by much...

http://www.washingtonpost.com/wp-dyn/conte...8100102646.html

A recent FAA news release stated that EMS "operations are unique due to the emergency nature of the mission." The agency needs to ask itself whether this "unique" situation justifies a fatal accident rate that is 6,000 times that of commercial airliners.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5208a3.htm

During 1991--2000, the most recent year for which data were available, 300 fatal crashes occurred involving occupied ambulances, resulting in the deaths of 82 ambulance occupants and 275 occupants of other vehicles and pedestrians.