Originally Posted by
snakepit
And therein lies the first problem. Only the aircrew will be fully aware of the risk of winching. They should be qualified clinically to make an assessment as to whether the risk of a winch is justified by the casualties condition. A clinical ground party cannot make the decision and non clinically trained aircrew cannot make the decision. You need a wholistic solution otherwise errors and mistakes will continue to occur.
The second problem was how the aircrew dealt with the spin and enough has been said about that already!
My answer had to do with the decision to call for a transport by air. The aircrew always has the right to refuse based on weather, LZ suitability, or other operational issues.
Patient condition is assessed by the first responders and they call for air transport in accordance with their protocols. Generally the only time the aircrew would refuse to transport based on patient condition would be if they were not stable enough for transport.