Yet another air medical crash.

[paramedicmike]

This one in Oklahoma. At current reporting two are dead and one survived.

Here's the story.

Condolences to family, friends and coworkers of those on board.

[Just Plain Ruff]

Yes condolences to them.

This industry is quickly becoming more dangerous than the alaska fisheries industry it seems.

God speed

[island emt]

more dangerous than being a mine disposal technician in Afghanistan.

Rest in peace to those killed in this crash.

[ClutzyEMT]

Is it just me, or is this happening more and more frequently? Both ground and air? Is it because of "social media" that it seems to be happening more frequently and we just didn't hear about it as rapidly or as widespread before?

Thoughts and prayers go out to all the family and friends of those lost~~

[paramedicmike]

It is happening more and more frequently. The more it happens the more it is covered by the media.

It needs to stop.

[ClutzyEMT]

So where do we start? I have always been a big advocate of only using air medical when it is 'honestly' indicated and will be of benefit to save a life, but then when we have the air medical teams come to the area to give presentations or put on LZ trainings they advocate for ground to call them en route 'if you feel it could be of benefit to the pt' because they don't mind being turned around. A hospital I worked for in SD routinely sent the bird out to area's less than 50 miles away and in truth, by the time the bird was ready and the team, ground crews could have had the pt at the hospital..

Edited February 25, 2013 by ClutzyEMT

[scubanurse]

That's a dilemma we faced a lot where I used to run just outside of DC. We had two major flight services MedStar and MSP. We had protocol on when to call for flight, but even then, we were rarely far enough from a trauma center to call for them. Some of the stations out in the booneys would call for them but they would sit around on scene waiting for them to get there when they could have been halfway to a hospital.

I did a a few ride alongs with MSP and once we were called to a fairly urban area for a pedestrian struck. She had no big traumas, mainly road rash, and the entire ride to the trauma center the medic grumbled about how she should have gone ground instead of them waiting 20 minutes on scene to get there when a trauma center was 25 minutes away by ground.

It's a tricky situation and I don't know what the right answer is. We have no way of knowing the full extent of a trauma in the field, but neither do the flight teams really.

What does everyone else think? Is the risk worth the benefit?

[Just Plain Ruff]

Dr. Bledsoe et al did a big discussion over this on facebook. The discussion focused on the risk versus benefit of flight versus ground.

Also some side discussions focused on the helicopter services when they come to rural EMS systems telling the services "hey call us when you are enroute to the scene and if you get there and decide that we aren't needed we can always turn around" What are the thoughts about that practice? That discussion is similar to Clutzy's comments.

Another portion of the discussion was flights based strictly on mechanism and not actual injuries.

For a relatively unregulated industry, regulation is far from overdue. For you flight medics/nurses/admins out there, just how regulated are you?

[systemet]

What does everyone else think? Is the risk worth the benefit?

I think it depends on the program, depends on the patient, and on the local hospitals and EMS.

The closer the patient to a trauma center, and the lower the acuity, then the reward.

There's probably arguments for some regions that the chopper brings more advanced skills, e.g. RSI, that might not be done well or done at all by the ground crews. In other regions the expectation might be that the chopper arrives to an intubated and paralysed patient - although maybe they bring blood products or the ability to place a chest tube. There's also a huge benefit to having a physician for transfers in from rural ERs with mismanaged critical patients - although sometimes a ground crew is quicker and almost as capable.

I think there's a lot to be said for mitigating risk by having good pilots, a simulation program , twin pilot twin engine airframes and the ability to fly IFR or with NVGs.

[island emt]

We have one flight service offering rotary wing transport for the entire state of Maine.

Lifeflight of Maine has two helicopters, one based in Bangor and the other inLewiston.

https://www.lifeflightmaine.org/

In the past 15 years I have flown 4 pt's. One was a drowning that was resuscitated with severe hypoxic brain injury, another was a child burned over 70% BSA who was flown directly to Shriners burn hospital down in Boston Mass, another was a construction worker with severe thoracic crush injuries from a wall collapse, and the last one was a multi systems trauma with head & neck injuries with an extrication from the cliff she fell off onto the rocks below.

There are a few others that were flown to the trauma center/ cardiac cath lab from our local hospital ER after stabilization.

The flight crew trainers came out and we have set up several LZ's which are safe and pre-plottedin their flight GPS. They tell us if we think the need might be there to put them on call and they will get back to us after the pilot makes a determination on weather meeting flight minimums. We have been turned down at times & met them on the mainland at the hospital helipad for further transport to higher level of care facilities..

Their system is set up with the pilot being blinded to type of call other than location. They then determine if it's safe to pull the mission and discuss with crew for final approval.

These changes came about after a previous flight provider put a bird in the ocean over Casco bay killing the 2 flight medics and the pt on board a few years earlier.

There are some areas of the country served by multiple air services and it seems the competition to make calls might over reach safety precautions sometimes.

corrected URL

Edited February 27, 2013 by island emt