Orange County (Fla) FireStar investigated by news.

[Flasurfbum]

from http://www.wftv.com/news/16810836/detail.html

Video of investigation also on the above website.

ORANGE COUNTY, Fla. -- Some think Central Florida’s busiest medical helicopter is too busy going on unnecessary calls, costing patients thousands of dollars. 9 Investigates looked at hundreds of calls involving Firestar and found in some of those cases a patient could have arrived faster if taken by ambulance.

When suspects shot two deputies at the Caribe Royal Resort in Orange County last year, time was critical and the Firestar helicopter swooped in to rush one of the injured to Orlando Regional Medical Center.

But time didn’t appear to be critical in the case of Kiarha Rivera’s son Xavier who broke his leg at their apartment in East Orlando. Paramedics loaded Xavier onto Firestar and flew him to Orlando Regional Medical Center about eight miles away.

“They didn't tell us nothing, they didn't tell us where they were going,” said Rivera.

Rivera said the bill was $10.800, including a nearly $9,000 "lift off fee" and more than $87 a mile after that. It was an expensive ride even though insurance covered most of the cost.

“It was very frustrating, very aggravating,” said Rivera.

9 Investigates examined more than 250 Firestar calls between October 2007 and May 2008. Calls for auto and motorcycle accidents were by far the most common, followed by trauma calls and strokes.

Orange County policy simply says "the route that enables the patient to arrive at the trauma center the earliest" should be used, but former paramedic and dispatcher, Joe Mattern, said that didn't happen when he monitored a call for a broken leg at this intersection on John Young Parkway in Hunter's Creek.

“They could've been taken by emergency ground to O.R.M.C twice in distance and speed as opposed to waiting for an air medical helicopter,” said Mattern.

We tested his theory and drove the route, obeying all traffic signals and not speeding, we got there 1 minute faster on the ground then Firestar did that night.

Orange County Fire Rescue Division Chief Mark Rhame said paramedics have at least two checklists to follow and make split second decisions about whether to use the helicopter.

“It’s easier to judge it after the fact and say that was an appropriate usage or note, but we have to base that decision on that paramedic and what they see,” said Rhame. Rhame insists that most times paramedics get it right.

Firestar is operated through a private contractor called Air Methods, but Rhame said the county isn't required to use the helicopter a minimum number of times. He says the only priority is the patient's safety.

Orange County recently approved a five year contract with Air Methods worth nearly $18-million, but county officials say that figure represents the money paid by patients or their insurance companies. The county says it simply passes that money on to the contractor.

[VentMedic]

The Division Chief Mark Rhame is also over Quality Assurance.

Florida has trauma protocols which outline the criteria for a "trauma". Of course, there might be some extreme circumstance that warrants the call to be handled differently.

If the time waiting for a helicopter exceeds ground transport time, then poor on scene judgement was utilized.

Part of the "skills" for EMS providers, along with knowing trauma criteria, should be knowing where you are, where you can go and how quickly along with alternate routes and resources to accomplish this.

[Michael]

Compromise?

[web:d303b68a98]http://www.bendbulletin.com/apps/pbcs.dll/article?AID=/20080706/NEWS0107/807060418[/web:d303b68a98]

[firedoc5]

One rule of thumb we went by was that if the patient had trauma and at least two bodily functions were compromised, then it was time to call for an Air-Lift. But of course common sense would tell you that if you were less then twenty minutes away from the nearest facility, and you knew it would take at least 30-45 mins. just for a chopper to respond, then go ahead and transport. We would do that but would also let them know to be on alert for them to possibly get called from the hospital that they may need air transport from their facility to another later.

[CBEMT]

I'm willing to admit if I'm wrong, but does it seem to anyone else that Florida's use of HEMS in general is a classic case of treating protocols instead of patients?

[FormerEMSLT297]

To medevac someone who is 8 miles away from a trauma center, seems a bit much,, but i dunno what the driving conditions are like there........ hindsight is 20/20