Was the helicopter necessary?

[Just Plain Ruff]

Mom also has a very good case for not paying the bill.

[uglyEMT]

transport time 15 minutes to the hospital """ But they waited 30 minutes for the rotary wing aircraft to get to them :: WTF ?????????????

While he may have thought they needed a specialized pediatric hospital, it would have made more sense to load and go to the nearby hospital and let the medivac meet them there as necessary.

My guess is the local ER could have handled these children and not cost the added $$$$.

As a person who works in an area that flys patients quite often I have to agree with island here. Waiting 30 min for the bird vs 15 ground transport to a higher care facility was wrong. Get the kids to the ER and if it was necessary for a more specialized care then the medivac could be done from the hospital.

Why risk the pedi crashing for the additional 15 minutes wait time if they were in such a condition that required medivac.

As a note as per the article, the flight medic and nurse both stated the second child needed medivac as well and requested a second bird. So somewhere along the line the pedi's condition or injuries made them make the same call. So either their condition was worse then stated by the news article or the news article is being biased against the responding medic for whatever reason. Without us being there we only have one side of the story. I still agree though waiting was a wrong decision as ground transport was a faster option to higher level of care.

[ERDoc]

I don't think a kidnapping charge would ever hold up in court. A jury would just say he was doing what he thought was in the best interest of the kids (although, never underestimate a jury of US citizens). I agree Ruff, mom should not pay the bills. The only part that doesn't make sense to me is that the flight crew called for a second helicopter. I'm just baffled by the story from beginning to end. If the medic wasn't comfortable handling the pts (which is why I personally feel helicopters are called out so much) then he should have scooped and ran to the local facility.

EDIT: Looking at the local facility's website, I would say they would have been more than prepared to handle these kids.

http://www.emhealth.org/index.php/services/medical-services/emergency-care

I think it is even more telling that the doctor at the peds facility who treated them even questioned why they were flown (according to the mother). And a follow up article: http://www.wkyt.com/news/headlines/Patients-Rights--224342991.html

And an opinion piece by Rogue Medic: http://roguemedic.com/2013/09/two-children-abducted-by-ems-helicopter-for-one-laceration/

Edited September 24, 2013 by ERDoc

[island emt]

links not working Doc.

[Just Plain Ruff]

Ok, I had a incident when I was working triage and I remember this patient well.

The husband of a patient came in and was very very nice. He asked me who to talk to about a helicopter bill. He said that the insurance denied it, saying that based on the charting by the doctor that the patient was stable enough to go by ground ambulance that the helicopter transport was not warranted. The patient also had the helicopters flight frequent flyer plan which for one low yearly price the helicopter service would accept what the insurance would pay and you would never see a bill. Well the flight plan didn't get any money from the insurance plan because the insurance denied the flight as being UNNECESSARY so they didn't pay the helicopter service

Thus leaving this patient to pay the 37000 bill.

Background - the patient was being transported by ground initially to the cardiac center for a slightly elevated troponin and a nurse in the ER when a "smart cookie" nurse asked the Patient "Do you have the X Air services membership plan?" and the family said "Yes we do" so the decision was made to go ahead and fly the patient. Remember that the patient initially met the ground transport criteria and it was noted in the T-sheet in the doctors handwriting that the patient would go by ground to the receiving facility. But once it was found out that the patient had the membership plan, the decision was made to fly the patient.

NO Patient status had changed, well one status had, the financial status had changed, and that status was that the patient had a membership plan that would allow the patient to go by air and never receive a bill. Well unfortunately this family who is on a fixed income did receive a bill. a huge bill.

[ERDoc]

links not working Doc.

I'm not sure why. They work for me. Try them without the >

http://www.emhealth.org/index.php/services/medical-services/emergency-care

http://www.wkyt.com/news/headlines/Patients-Rights--224342991.html

http://roguemedic.com/2013/09/two-children-abducted-by-ems-helicopter-for-one-laceration/

EDIT:I reposted them without the >, but it ended up there anyways.

http://www.emhealth.org/index.php/services/medical-services/emergency-care

http://www.wkyt.com/news/headlines/Patients-Rights--224342991.html

http://roguemedic.com/2013/09/two-children-abducted-by-ems-helicopter-for-one-laceration/

Tried to post them using the link button. If that doesn't work then I have no idea.

Edited September 25, 2013 by ERDoc

[scubanurse]

They work for me.

[island emt]

Working for me now. Thanks for putting all that info up for us Doc.

It sounds that there is a lot more behind the story than we are getting from the news reports.

In some areas there is a culture of flying pt's out when not necessarily needed,'Is it because of the numerous medevac services competing for their business or is it a case of not wanting to deal with a PT that might need more than see spot run "cookbook" medicine????

[paramedicmike]

...Is it because of the numerous medevac services competing for their business or is it a case of not wanting to deal with a PT that might need more than see spot run "cookbook" medicine????

I can only speak from my experiences for the area in which I flew. Your mileage may vary.

There are a good number of flights in which patients are transported via HEMS simply due to medics either not wanting to transport because of "traffic" (ignoring alternate destinations) or because it was the end of their shift and they didn't want to get off duty late. (It was particularly infuriating to have them tell me, to my face, that we were called simply because it was the end of their shift. While I did appreciate their honesty, it didn't help their credibility in the long run.)

I don't know how many flights were generated from services competing for business. I imagine there was some of that. The service for which I worked didn't do any advertising. Another service in the area did advertise. Unfortunately, I think many calls to specific services were being made based on incomplete knowledge of political bickering between management which overruled the idea that the flight crews were all there to do a job management politics be damned. Fortunately, for much of the area (with some holdouts) HEMS dispatching became a "closest available aircraft" decision process.

Take it for what it's worth.

[ambodriver]

flown by chopper, gets 4 stitches and a 14k bill.

ems failure.

(part time medic!)

Edited September 28, 2013 by ambodriver