One of the coolest parts in EMS in my opinion...

[Tyler_EMT]

Don't get me wrong, I love my ambulance but I love helicopters as well . The situation on which a helicopter is needed however is never good one. I just find them very fascinating on how they move and how they work. We had StatFlight from Hendricks County, IN land at fire station I volunteer at in my hometown. It was just awesome. I have a few questions for flight crews or anybody else that can answer.

1. Do you take a PT if they are still recieving CPR? They said something about it but i couldn't hear them.

2. They said something about pushing for transporting stroke PT's?

Thanks for all answers.

[Vorenus]

1. Do you take a PT if they are still recieving CPR? They said something about it but i couldn't hear them.

2. They said something about pushing for transporting stroke PT's?

Thanks for all answers.

1. Around here, patients who still recieve CPR would be transported on the ground and the Heli-Doc would accompany the transport. But we have relatively short transport times (if I compare to some of yours). The major factor is, that it`s nearly impossible to do a sufficient CPR in a Heli, at least with ours.

2. Could be to get Pt., who are still in the timeframe for a Thrombolysis as fast as possible into the clinic, which would lift there chances.

But these are only my thoughts, I can`t talk about your regional characteristics.

[WelshMedic]

I wouldn't have thought so, most choppers are physically too small to do so.

Re: Stroke patients. Any form of acute neurological event needs to be investigated. The problem is that you are never entirely sure what's going on until a CT scan is made. It can either be a hemorrhagic or an ischaemic CVA. As long as the ischaemic CVA doesn't have any contra-indications (onset time being very very important) they can sometimes be thrombolyzed. The other side of the coin is that giving thrombolytics to a hemorrhagic CVA would be a disaster.

So, the trick is to get your pt. to a dedicated stroke center on time. I can imagine that in some rural areas the chopper may offer a pt. more chance by reducing transport times.

WM

[tcripp]

1. Do you take a PT if they are still recieving CPR? They said something about it but i couldn't hear them.

We only fly the patient in ROSC. There's not enough justification to fly a dead person. We will, however, drive a CPR patient to the local facility to be worked further or for the family. Small community, so that does occur.

2. They said something about pushing for transporting stroke PT's?

We will fly to a designated stroke center if the onset of symptoms are < 8 hours otherwise we will take local or drive.

Of course, the weather isn't always agreeable in Texas and we will drive those same patients because Air won't fly.

[WelshMedic]

1. Do you take a PT if they are still recieving CPR? They said something about it but i couldn't hear them.

We only fly the patient in ROSC. There's not enough justification to fly a dead person. We will, however, drive a CPR patient to the local facility to be worked further or for the family. Small community, so that does occur.

2. They said something about pushing for transporting stroke PT's?

We will fly to a designated stroke center if the onset of symptoms are < 8 hours otherwise we will take local or drive.

Of course, the weather isn't always agreeable in Texas and we will drive those same patients because Air won't fly.

Wow, 8 hrs!!!! It's <4 hours here.

[DwayneEMTP]

And at my last gig <3hrs for strokes.

While I love the flight medics with Flight for Life in the Springs/Denver area, they are great at teaching the proper uses of flight and their advice is certainly valuable, don't forget to compare their advice to that of your services protocols for utilizing the flight services. They want you to fly more people, as it's a business too of course. Your service, and current studies, will likely will suggest that you fly less.

Flight isn't something to be done for the cool factor, as it most often is. Though yeah, it's cool. :-)

Utilizing flight is a clinical intervention like any other, only it comes with the possibility of hurting/killing many instead of just one. You need to always keep that in mind.

Having said that...I've never met a Flight for Life medic that didn't make me feel like an ignorant child when it came time to discussing medicine...though my exposure is small.

I've not been around a service that will fly active CPR, though I've heard that it's done in some places with larger helicopters.

And strokes, as was mentioned above. But as I said, it has to be considered whether or not it will be a beneficial intervention. In the service I last worked for on the street it never was with any of my patients, but was sometimes for the ER. 45 mins Flight response min, 20 min transfer time, 45 min return...I would have been to the stroke center 20-30 mins ago.

Good question.

Dwayne

[paramedicmike]

If they code on the ground we'll accompany ground medics to the closest hospital on the ground. If they code in the air we'll code them in the air.

Strokes are one of those things that can truly benefit from a rapid transport to a center that can effectively treat the patient. Locally, there are many changes being implemented to facilitate air transport of stroke patients.

Keep in mind that every time you call out a helicopter you are putting the lives of the flight crew at risk. If you've paid attention to the news over the past few years you'll have seen/heard about the increasing number of HEMS crashes resulting in the loss of life of crews and patients alike. Make sure you're calling for the right reasons and not because you think it's cool.

As a flight crew member, I am willing to accept the risks of the job if truly warranted. However, it is a *HUGE* disservice to call out a helicopter for someone who doesn't really need it because you think it's cool. Aside from the risks involved in HEMS transports there are substantial costs involved. Do you really want to add a $12K to $15K helicopter bill to your patient who may or may not be able to pay even part of that? All because you think it's cool?

Yes. Helicopters are cool. I can't deny you that. I think they are, too. But use your head when calling for one. Your patient, the flight crew and the families and friends of everyone involved will thank you.

[tcripp]

And strokes, as was mentioned above. But as I said, it has to be considered whether or not it will be a beneficial intervention. In the service I last worked for on the street it never was with any of my patients, but was sometimes for the ER. 45 mins Flight response min, 20 min transfer time, 45 min return...I would have been to the stroke center 20-30 mins ago.

Good point, Dwayne. Depending on where we are in the county, we could be looking at up to a 1.5 - 2 hour drive time to the closest appropriate facility by ground. That is in good weather with decent traffic. We have, technically, 2 air ambulances in our backyard. If they can be on scene by the time I'd be ready to move...then I'll set up an LZ and wait for them. If we have to wait any significant time, then we will meet them in the middle somewhere. With all the farm land, getting a good LZ usually isn't a problem.

As a flight crew member, I am willing to accept the risks of the job if truly warranted. However, it is a *HUGE* disservice to call out a helicopter for someone who doesn't really need it because you think it's cool. Aside from the risks involved in HEMS transports there are substantial costs involved. Do you really want to add a $12K to $15K helicopter bill to your patient who may or may not be able to pay even part of that? All because you think it's cool?

Good point about the cost. Another thing we take in to consideration when making the decision to drive or fly is quality of life. Sometimes it really sucks to be in that position, but it is what it is.

Both of our air services have memberships. Cool idea I didn't know existed until I started on this rural service, but you can pay something like $50 or $100 per year. If you get a HEMS trip, they write off what insurance doesn't pay. Not a bad idea (Christmas gift anyone?) for someone in poor health out in the sticks.

[ambodriver]

I never understood EMS's fascination with helicopters. I live in a very large city, a chopper is never needed on a scene. I did do a ride on one though while I was in school. I almost shit myself, so scary! Yes, I'm a bitch.

[HERBIE1]

Around here, choppers are used for IFT's. I simply do not have experience with utilizing them in the EMS setting.