Flying and Ambulancing

[ERDoc]

How big were the Medivac Helo crews? The TV depiction I referenced was a pilot and one Paramedic.

Oh, by the way, if the NYPD runs a Medivac flight, it is usually the pilot, an observer, and an EMT or Paramedic borrowed from a ground ambulance accompanying the patient. Most of the Medivac flights I have seen, or heard about, using an NYPD helo, a ground ambulance crew was usually already on the scene, or bringing the patient to the aircraft. This included the rare IFT flights from some hospital's heli-pad, to another, "specialty" hospital.

OK editing problem. Standard NYPD crew is a pilot, and an observer.

In Suffolk County it was one or two PD pilots. If there were 2, one would get out and stand by the tail rotor. They said it was to make sure no one got hurt by walking into the tail rotor, but I think it was really to prevent damage to the helicopter and mountains of paperwork if someone walked into the tail rotor. Solo pilot NEVER left the helicopter. The medical crew consisted of a flight paramedic and if they were using one of the BKs, one of the vollies on scene got to go along.

Where I am now, cockpit has a pilot who never leaves the ship. Medical crew is either RN/RN or MD/RN.

[NinerThreeKilo]

Well I am OK with not combining the two, I figure adding EMT-P to my resume might help put me on the top vs other pilots; pilot/medic with XX hours beats pilot/nothing with XX hours, and with my current setup at work I could also work part-time EMS.

ANYWAY had my first day of class today. I like it!

The instructor appears to be experienced and has quite a few active EMS people stop by to help out with the class. We have just over 20 students and will be taking 3 semesters for our EMT-I then another 3 for the EMT-P. Seems like a little bit of a stretch of time but I'm not in too much of a hurry.

The only thing I found odd was it wasn't until the first day of class I found out which books I needed (book store said the program head kept changing his mind), so I am getting Emergency Care (12th Edition) and the workbook.

I found a site with a whole bunch of power-point presentations that might come in handy (EMT Powerpoint ). Oh yea, I also need to get a stethoscope, after a little online research found a good deal on a Littmann master cardiology (black edition), probably overkill but when I buy headsets/watches/flashlights/EFBs etc. for work I dont buy junk, figure spending more and not having to upgrade later saves money in the long run.

[paramedicmike]

Well I am OK with not combining the two, I figure adding EMT-P to my resume might help put me on the top vs other pilots; pilot/medic with XX hours beats pilot/nothing with XX hours, and with my current setup at work I could also work part-time EMS.

Actually, I think having the medic after your name might hurt you.

There is a big movement within air medical circles, especially HEMS operations, to not provide any information outside of location information to the pilot when a flight is being requested/dispatched. The reasoning is that if the pilot doesn't know why they're going s/he can make a decision to accept or decline the flight based simply on available weather and aircraft conditions.

Throwing a pilot in who's also a medic may add a layer of questioning there that does not need to come into play when it comes down to accepting or declining a flight. If any of the pilots with whom I work started asking these questions there'd be issues at multiple levels.

All the EMS pilots I know or have worked with, in order to be hired, were considered based on their experience, hours and ratings.

[NinerThreeKilo]

I would not be trying to get hired onto any EMS operations as a pilot, I was more talking about, say flying a beaver in AK or something and having a medic background.

Also you point about knowing the condition of the pt, if I am operating as PIC or even SIC, I really could care less, I make my decisions based on the conditions, getthereitis is taken its fare share of aircraft and if the aircraft goes down the patient dies anyway, along with the crew and, most unfortunately, ME. So no, knowing the condition of the person on board would change NOTHING when it comes to how and when I fly.

[ERDoc]

It's easy to say that, but reality is different. There are plenty of veteran pilots that have been know to push the limits if they know a kid is involved (think 3y/o trauma pt on scene that needs to go to trauma center). It's the human factor.

[paramedicmike]

Also you point about knowing the condition of the pt, if I am operating as PIC or even SIC, I really could care less, I make my decisions based on the conditions, getthereitis is taken its fare share of aircraft and if the aircraft goes down the patient dies anyway, along with the crew and, most unfortunately, ME. So no, knowing the condition of the person on board would change NOTHING when it comes to how and when I fly.

You really could care less? That's what I was afraid of.

The rest of your statement is really the crux of the point I was trying to make. I think ERDoc has an astute observation on this particular issue as well.

I would not be trying to get hired onto any EMS operations as a pilot, I was more talking about, say flying a beaver in AK or something and having a medic background.

You'll have to forgive me as I don't think I'm following you. Given the scenario you just described, why do you think you'd have an advantage with EMS training?

[Richard B the EMT]

Paramedic Mike and ERDoc both make valid points.

If NYPD Aviation is requested for a Medivac by FDNY EMS Command, procedure used to be as follows (no idea if this is still the protocol, but was 5 years ago, anyway):

1) Sending hospital doctor in charge of the case contacts EMD (Emergency Medical Dispatch) on duty Tour Commander with request.

2) Tour Commander contacts On Line Medical Control doctor, who landline confrences with both sending and recieving facility Doctors. OLMC Dr. advises the Tour Commander if they feel it to be a medical nessesity or not. If yes...

3) EMD Tour Commander contacts NYPD Aviation on duty Tour Commander of need.

4) Aviation Tour Commander confers with Helo pilot as to any conditions that the pilot feels threatened by (weather related low visibility, wind gusts, snow, lightning).

5) Pilot is responsible for helo and all aboard (duh!), has final say. If yes...

6) EMD notified, puts assignment "into the system" (Computer Assisted Dispatch system, and FDNY EMS ground units are assigned to both sending and recieving LZs (if helipad is not on hospital grounds, EMS ground crew will transfer the patient from sending facility to the LZ).

7) EMT or Paramedic riding as "Tech" accompanies the patient in the Helo to the recieving LZ, transfers care either to 2nd EMS Ground Crew, or to the recieving hospital's ER, who is already notified they're recieving a Medivac.

8) Tech either will either await arrival of partner with the ambulance at recieving facility, or will be flown to the NYPD Aviation Base, where the driving partner will meet up, and then go back to their normal response area and resume the tour.

9) EMT or Paramedic driving the ambulance will be directed by EMD to respond, with NO lights and siren, to either the recieving hospital, or the NYPD Aviation Base, to "recover" the partner, return to their normal response area, and resume their tour.

<10) If the recovery of the flown "tech" will delay the next tour's using the ambulance significantly, the driving tech might be instructed by EMD to return to their station, and the local field supervisor near the Aviation base (out of either Kings County or Coney Island Hospital) will recover the flown "tech" and bring them back to their station (easy overtime for that tech when that happens). Otherwise, the next crew goes out in a spare vehicle, and both of the "late call" crew earn the easy overtime while returning to their base.>

[NinerThreeKilo]

You really could care less? That's what I was afraid of.

The rest of your statement is really the crux of the point I was trying to make. I think ERDoc has an astute observation on this particular issue as well.

You'll have to forgive me as I don't think I'm following you. Given the scenario you just described, why do you think you'd have an advantage with EMS training?

Sorry if I’m not articulating this very well! What I am saying is I am happy flying in a FIXED wing NON EMS role and picking up EMS shifts outside of flying during my down time (time permitting).

Now what I said about the EMT-P helping, I brought up the fact that I started EMT-P school with my boss, he doesn’t so ANY EMS flights and he was very interested in it, he said he is very happy someone will have some medic training incase anything happens at work.

And for me caring less as for a go/no go on a theoretical EMS flight, yes I could care less about how quickly the pax needs to get to the ER.

ALL of my flights are flown at best possible time. This may sound cold but the aircraft, the weather and terra firma underneath the aircraft does not know, nor care how sick or how young my pax is, icing, wind, visibility, etc do not change for sick people no matter how nice they are and getting everyone killed does not do a damn bit of good for anyone.

Edited August 19, 2011 by NinerThreeKilo

[paramedicmike]

You keep saying you could care less. Do you really mean that it is possible for you to care less than how much you really do care about it? Or do you really mean that you *couldn't* care less?

What's a "pax"? Do you meant patient? Patient is commonly abbreviated "pt".

Thanks for the clarification about your work.

[ERDoc]

Pax is a common aviation term for passengers. It is to pilots what pts is to EMS.