Whats the go with HEMS in the states?

[spenac]

Although, as it was mentioned in the many investigations, the helicopters were called because they "could" and not because they "should". I believe in one of the reports published it mentioned how many patients walked out of the trauma center before the helicopter even got back to base.

So then as a tax payer maybe we should just vote to cancel all helicoptors as whats the odds I will ever need it? And even if I use it perhaps it is a waste based on your statement. So now I'm stuck with large bill and if I can't pay tax payers are stuck paying for it.

[VentMedic]

So then as a tax payer maybe we should just vote to cancel all helicoptors as whats the odds I will ever need it? And even if I use it perhaps it is a waste based on your statement. So now I'm stuck with large bill and if I can't pay tax payers are stuck paying for it.

Why do you take everything to the extreme?

Basically the bills introduced are just asking for better equipment and more regulation for the proper dispatching of helicopters. If the state of Maryland can not effectively provide that, then open it up to others who can.

[WelshMedic]

Were they invited and did they have a personal escort? Chances are you might not even make it past the front door with very tight security in some trauma centers so they should consider themselves lucky they got as far as they did.

They were invited as part of the JEMS conference programme. They are both very experienced ER and pre-hospital RN's. That's why it was a shame.

WM

[spenac]

Why do you take everything to the extreme?

Basically the bills introduced are just asking for better equipment and more regulation for the proper dispatching of helicopters. If the state of Maryland can not effectively provide that, then open it up to others who can.

Extremes are important to consider. We learn by considering that which is not popular. I do not oppose flight.

But I think we need flight it just needs better guidelines for use raher than flying anyone more than X minutes away. It should be based on actual patient benefit. Would they suffer harm by taking 30 minutes to the hospital compared to 10?

[VentMedic]

They were invited as part of the JEMS conference programme. They are both very experienced ER and pre-hospital RN's. That's why it was a shame.

WM

But were prior arrangements made by with the center itself by JEMS to have a guided tour? If not, it is not necessarily the fault of the hospital. We also get many tour requests but can only accomondate X amount and with an escort of course. Some also show up because their conference included us in the "sight-seeing" program. There are also some areas we may not be able to show them once they are on the tour and we get disappointed complaints about that also.

I am sorry your friends had a bad experience but with a center as popular as the Shock Trauma center in Baltimore, sometimes patient care must still take the priority.

[Dustdevil]

A news update was just posted:

Maryland May Lose 'Trooper' Medevac Program

pwn3d

Good riddance.

[CBEMT]

pwn3d

Good riddance.

Ok, fine. Then no more complaining about private HEMS services flying everything and anything in unsafe weather in search of a buck.

[Dustdevil]

Ok, fine. Then no more complaining about private HEMS services flying everything and anything in unsafe weather in search of a buck.

They're talking about regulating them to the same degree as MSP. And the quality of the flight crews is almost guaranteed to improve. So no, I don't see a particular problem with this. The best hospitals in the world are the private hospitals. There is no reason that being "private" has to be a negative thing in medicine.

[fiznat]

The HEMS people I know seem to be less upset about this than I might have thought. The MSP program, it's safety record aside (which I don't know much about), has some problems that I think a lot of HEMS people raise their eyebrows at. First of all, it is a single-provider ALS service that does not do critical care. That is way outside of the standard for HEMS in this country, which usually runs critical care-capable teams of RN/Medic or RT/RN. The lack of critical care has necessitated that a number of private services supplement the system so that critical care IFT can get done (which really is the big deal in HEMS). MSP has gone to extraordinary lengths to limit these private services from doing scene flights even though they are a higher level of care, which has resulted in some turf battles that is likely a disservice to the patients.

MSP could probably do well to cut the amount of helicopters they have out there and reinvest that money into their people. Two providers. Critical care. Meet the CAMTS standards (from which they now exempt themselves). Figure out a system that works and provides the best service possible rather than A. trying to save money with drastic cuts or B. selfishly protecting turf.

That said, I can't say I blame Maryland for their interest in cutting this (medically) sub-standard, expensive service and trading it out for a higher level of care that won't cost the taxpayer a dime.

[VentMedic]

MSP: Use of scene personnel criticized

Sunday, March 08 2009

http://www.washingtonpost.com/wp-dyn/conte...9030701842.html

When she climbed aboard a medevac helicopter in Charles County in September, emergency medical technician Tonya Mallard had no helmet, no flame-retardant flight suit and virtually no training. Hold the patient's hand and listen to the flight paramedic, a colleague told her over the roar of chopper blades.

Had it been almost any other medevac flight in the country, Mallard would not have boarded. Maryland's state-run service is among the 3 percent of operators whose crews include only one staff medic. In one of every five missions, the helicopters pick up another medic from the rescue scene to care for a second patient or one who is critically injured.

The helicopter that carried two victims from a Waldorf car accident Sept. 27 crashed in Prince George's County, killing four people, including Mallard, a volunteer with a Waldorf fire department. She suffered severe head injuries, chemical burns and bone fractures.

For decades, the Maryland State Police medical helicopter program has been praised as a national model for emergency care, but documents compiled since the crash make clear that it adheres to some safety and flight standards that are less rigorous than industry norms.

Police officials say adding a second medical provider to each flight would be a poor use of resources. State lawmakers are expected to discuss the issue and other possible changes to the program this week.

The sole survivor of the Washington area's only other fatal medevac crash in many years, a 2005 accident that killed a pilot and a paramedic near the Woodrow Wilson Bridge, called recruiting medics from the ground "one of the most egregious breaches in air medical safety."

"They are putting these ground providers on helicopters who have never had survival training, no helmet, no flight suit, no boots, no idea how to use the medical equipment," said Jonathan Godfrey, who was a staff nurse on a flight run by a private service. "It's all of this risk with very little benefit to anyone."

In addition to using a single crew medic, the Maryland service follows less restrictive Federal Aviation Administration flight rules than private medevac companies do, meaning the state's operation is not subject to the same inspection and maintenance rules.

Maryland's pilots are not required to conduct a written or computerized risk assessment before accepting a mission, a routine step for most private medevac companies.

Maryland State Police pilots are trained to mentally evaluate potential risks posed by weather, crew fatigue, distance, the type of mission and other factors, officials said. They are allowed to turn down missions and are not punished for doing so.

On the night of the September crash, pilot Stephen H. Bunker discussed the possible flight with a duty officer who did not mention that two patients would be transported. It was stormy, and the two discussed flying conditions, according to a transcript of the exchange.

Bunker, who was among those killed, reviewed cloud ceiling reports and noted that a MedStar helicopter had just landed at Washington Hospital Center in the District.

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http://www.washingtonpost.com/wp-dyn/conte...30701842_2.html