US HEMS Ops
Join Date: Sep 2007
Location: US
Posts: 186
Likes: 0
Received 0 Likes
on
0 Posts
Shell Management
The IHST has brought up a lot of nice ideas. Some or most of them might be implemented if we could just get the adrenalin out, and the professionalism in, which is of course the thrust of what they are addressing, professionalism. Perhaps there should be formal licensing to be a medical crewmember, from the aviation authorities. It really puts them on the hook with respect to their performance and levels the aviation playing field whilst aloft.
For a pilot to help a medical person, to the extent we can, I have never seen a problem. However, for a medical person to help a pilot, it seems they are all about control, which is indeed what they are taught - control the situation, whether it is in the hospital, or on the street. Obvious reasons for this, and sets up an obvious subtle conflict in the pilot's mind.
However, what the pilot needs is for the medical person to think like a pilot, appreciate the pilot's perspective, and help fill in the gaps in his or her progressive thinking, as the flight unfolds.
The other thing is complication! EMS pilots make so bloody many radio calls it is distracting, then the safety gear in summer, etc. etc.
My general hit list: Get the adrenalin out, and the professionalism in
Get the medical people thinking like pilots to the extent they can provide help to him or her.
Right now where the rubber meets the road, the pilot, there is nothing but drastically mounting initiatives involving the amount of illumination of the moon, a risk matrix, doing all of every bit of admin before taking off, make a LOT of radio calls, etc. To me this is NOT very helpful - the ideas are good, but it just amounts to a load of distraction to performing a safe flight.
Simplify!
Thank you.
The IHST has brought up a lot of nice ideas. Some or most of them might be implemented if we could just get the adrenalin out, and the professionalism in, which is of course the thrust of what they are addressing, professionalism. Perhaps there should be formal licensing to be a medical crewmember, from the aviation authorities. It really puts them on the hook with respect to their performance and levels the aviation playing field whilst aloft.
For a pilot to help a medical person, to the extent we can, I have never seen a problem. However, for a medical person to help a pilot, it seems they are all about control, which is indeed what they are taught - control the situation, whether it is in the hospital, or on the street. Obvious reasons for this, and sets up an obvious subtle conflict in the pilot's mind.
However, what the pilot needs is for the medical person to think like a pilot, appreciate the pilot's perspective, and help fill in the gaps in his or her progressive thinking, as the flight unfolds.
The other thing is complication! EMS pilots make so bloody many radio calls it is distracting, then the safety gear in summer, etc. etc.
My general hit list: Get the adrenalin out, and the professionalism in
Get the medical people thinking like pilots to the extent they can provide help to him or her.
Right now where the rubber meets the road, the pilot, there is nothing but drastically mounting initiatives involving the amount of illumination of the moon, a risk matrix, doing all of every bit of admin before taking off, make a LOT of radio calls, etc. To me this is NOT very helpful - the ideas are good, but it just amounts to a load of distraction to performing a safe flight.
Simplify!
Thank you.
Join Date: Oct 2003
Location: Over here
Posts: 1,030
Likes: 0
Received 0 Likes
on
0 Posts
The attitude of the med crew can usually be adjusted by talking and by the attitude of the pilot. It's not unusual for one of the med crew to get the fuel hose and start refueling the aircraft before I get it shut down, without my even asking. We all do pretty much whatever is required to get the job done, within reason. I don't touch patients, and they don't touch the controls, but other than that, we share duties and attitudes. I assume they know their jobs, they assume I know mine, and we're all willing to help out with whatever needs to be done at the time. I know there are other bases in the company where this isn't the case, and I think those bases suffer as a result. If you walk in thinking you're an aviation god, you're going to meet medical gods and goddesses. If you go in as a human being, you'll likely meet other human beings. At least that's been my experience.
I agree about the radio calls and the "safety" equipment. They're all distractions, usually when you really don't need distractions. IMO, one of my primary duties is task prioritization, and radio calls are never near the top of my list. I call when I get around to it in most cases, except when I'm trying to get into or out of Class B airspace, and then the other radios can wait. My dispatch is at the bottom of the radio list, and near the bottom of all my lists.
I agree about the radio calls and the "safety" equipment. They're all distractions, usually when you really don't need distractions. IMO, one of my primary duties is task prioritization, and radio calls are never near the top of my list. I call when I get around to it in most cases, except when I'm trying to get into or out of Class B airspace, and then the other radios can wait. My dispatch is at the bottom of the radio list, and near the bottom of all my lists.
Join Date: Dec 2001
Location: Philadelphia PA
Age: 73
Posts: 1,835
Likes: 0
Received 2 Likes
on
2 Posts
Slightly off topic perhaps, but how is it that airline dispatchers and corporate flight department dispatchers are trained and tested and qualified, and EMS dispatchers are not?
Join Date: Sep 2007
Location: USA
Posts: 336
Likes: 0
Received 0 Likes
on
0 Posts
Shawn :
I maybe wrong here and I hope somebody will jump in and set me straight.
Technically, EMS 'dispatchers' are not really FAA certified dipatchers.That is, they have not taken the FAA exam and received the dispatcher ticket from the FAA.All Part 121 operators and some Part 135 carriers do use qualified dispatchers,who are FAA certified.
In the HEMS world , they are, in reality, Communication Specialists:ComSpecs. for short. The term 'dispatcher' is a throw over from the ambulance /police system, on the ground.
The ComSpecs. field calls and send the aircraft on their way, but do not share operational responsibility with the pilot, as they do in Part 121 ops.
Anybody else care to elaborate? Gomer Pylot, WWIII,SASLess???
Alt3
I maybe wrong here and I hope somebody will jump in and set me straight.
Technically, EMS 'dispatchers' are not really FAA certified dipatchers.That is, they have not taken the FAA exam and received the dispatcher ticket from the FAA.All Part 121 operators and some Part 135 carriers do use qualified dispatchers,who are FAA certified.
In the HEMS world , they are, in reality, Communication Specialists:ComSpecs. for short. The term 'dispatcher' is a throw over from the ambulance /police system, on the ground.
The ComSpecs. field calls and send the aircraft on their way, but do not share operational responsibility with the pilot, as they do in Part 121 ops.
Anybody else care to elaborate? Gomer Pylot, WWIII,SASLess???
Alt3
A3,
You hit the nail on the head.
Until very recently, "dispatchers" were basically "ambulance"/"fire"/"public safety" comm center workers. Things might vary a bit from operation to operation but as far as being "FAA Licensed" aviation dispatchers they are not.
The FAA did recently require 135 Operators (HEMS) to comply with aircraft dispatch and flight following requirements as set forth by FAR 135. Some operators now have a central "dispatch" office manned by FAA licensed pilots who "track" flights and monitor pre-flight weather decisions.
I flew at one operation where some of the dispatchers were very switched on and would monitor weather for us and several times made a real difference. But again, they were not "FAA Licensed, trained, or rated pilots" but were just very sharp folks.
Perhaps some of the active EMS pilots can describe how their system works.
You hit the nail on the head.
Until very recently, "dispatchers" were basically "ambulance"/"fire"/"public safety" comm center workers. Things might vary a bit from operation to operation but as far as being "FAA Licensed" aviation dispatchers they are not.
The FAA did recently require 135 Operators (HEMS) to comply with aircraft dispatch and flight following requirements as set forth by FAR 135. Some operators now have a central "dispatch" office manned by FAA licensed pilots who "track" flights and monitor pre-flight weather decisions.
I flew at one operation where some of the dispatchers were very switched on and would monitor weather for us and several times made a real difference. But again, they were not "FAA Licensed, trained, or rated pilots" but were just very sharp folks.
Perhaps some of the active EMS pilots can describe how their system works.
Shawn asked:
"Slightly off topic perhaps, but how is it that airline dispatchers and corporate flight department dispatchers are trained and tested and qualified, and EMS dispatchers are not?"
My answer:
10 $ and change per hour. At least in this South TX location.
"Slightly off topic perhaps, but how is it that airline dispatchers and corporate flight department dispatchers are trained and tested and qualified, and EMS dispatchers are not?"
My answer:
10 $ and change per hour. At least in this South TX location.
Tott,
That is for pilots....and less for the "dispatchers" right?
That is for pilots....and less for the "dispatchers" right?
Join Date: Jun 2007
Location: United States
Posts: 40
Likes: 0
Received 0 Likes
on
0 Posts
Shawn asks a great question. But at the pace it takes the FAA to make rule making happen...ugh.
HEMS operators would be well served to make this happen themselves. And to stop the "out Part 91, in Part 135" nonsense.
HEMS operators would be well served to make this happen themselves. And to stop the "out Part 91, in Part 135" nonsense.
Join Date: Oct 2003
Location: Over here
Posts: 1,030
Likes: 0
Received 0 Likes
on
0 Posts
The FAA doesn't even mandate dispatchers for EMS, (or any other Part 135 operation, for that matter) much less any certification or training standards. Only Part 121 requires dispatchers. The last Part 135 revision took several years, and involved a lot of wrangling. I was involved in the helicopter rewrite to some extent, and it was done by the big operators, with not a lot of EMS input or thought. I don't expect another major revision soon, and requiring dispatchers would be a very major change.
I am always amazed that fingers get pointed at dispatchers in these discussions. I recognise that a growing trend in US flight safety is to take the decisions out of the hands of pilots. This trend extends into risk management protocols that require pilots to fill out a form before dispatch, or juggle some numbers into a go/no summation.
This trend is not confined to the US. In some parts of Australia, it is now prohibited to do a night primary landing scene without it first being identified and established by ground ambulance. There are no training qualifications given to the ambulance personnel (other than another SOP).
Why don't/can't we admit that we don't know everything and identify training and education shortfalls that would equip us to make better decisions? Why do we react by moving all our decision processes to "tasking agents" or risk management formulae? The outcome of this trend is to reduce the decisions pilots are making and thus leave them singularly inexperienced and under prepared for the difficult in flight decisions that are really what makes HEMS a profession. Very few dispatchers and risk spreadsheets are available to you in the air.
Lastly, can I observe from outside the US HEMS industry that they are by far the busiest HEMS sector in the world, and will thus often be represented in HEMS accidents - that does not necessarily translate into an extreme of danger - it is a twist on statistics. Like the amount of R22 accidents not translating into evidence that the R22 is dangerous.
Despite MANY examples of fixed wing transport mid airs (even whilst in controlled airspace) and the attendant huge cost in lives lost, there is no knee jerk call to ban passengers from aircraft! Why do we always face a call to ban HEMS with each accident?
This trend is not confined to the US. In some parts of Australia, it is now prohibited to do a night primary landing scene without it first being identified and established by ground ambulance. There are no training qualifications given to the ambulance personnel (other than another SOP).
Why don't/can't we admit that we don't know everything and identify training and education shortfalls that would equip us to make better decisions? Why do we react by moving all our decision processes to "tasking agents" or risk management formulae? The outcome of this trend is to reduce the decisions pilots are making and thus leave them singularly inexperienced and under prepared for the difficult in flight decisions that are really what makes HEMS a profession. Very few dispatchers and risk spreadsheets are available to you in the air.
Lastly, can I observe from outside the US HEMS industry that they are by far the busiest HEMS sector in the world, and will thus often be represented in HEMS accidents - that does not necessarily translate into an extreme of danger - it is a twist on statistics. Like the amount of R22 accidents not translating into evidence that the R22 is dangerous.
Despite MANY examples of fixed wing transport mid airs (even whilst in controlled airspace) and the attendant huge cost in lives lost, there is no knee jerk call to ban passengers from aircraft! Why do we always face a call to ban HEMS with each accident?
Dispatchers
To answer Shawn, most HEMS dispatch centres in the US are staffed by the "customer".
Except for those large 135 operators with a wide fleet of "community based" helicopters (as in PHI, AMC and AEL) where they have their own dispatch centres staffed by specialist and where there are pilots in a "flight supervisor" capacity.
Here's the normal process:
1) A 911 call is received requesting medical EMS
2) depending on the severity or mechanisms at least one (usually the best PRd) EMS program is extended a phone call and a helicopter is put on STBY or launched.
3) Some programs scan the airwaves with their radios and launch on their initiative (jump the call).
4) The race against time... and competitors is on...
Except for those large 135 operators with a wide fleet of "community based" helicopters (as in PHI, AMC and AEL) where they have their own dispatch centres staffed by specialist and where there are pilots in a "flight supervisor" capacity.
Here's the normal process:
1) A 911 call is received requesting medical EMS
2) depending on the severity or mechanisms at least one (usually the best PRd) EMS program is extended a phone call and a helicopter is put on STBY or launched.
3) Some programs scan the airwaves with their radios and launch on their initiative (jump the call).
4) The race against time... and competitors is on...
NEMSPA NVG survey link and AAMS Avweb pod cast
Here is a link to the National EMS Pilots Association. They completed a survey on NVG use in EMS. NVGs are not a silver bullet by no means, but interesting demographics IMHO and of course surveys have limits to what you can really find out.
http://www.nemspa.org/Shared%20Docum...urvey_0508.pdf
Chris Eastlee of AAMS Addresses Medevac Safety Concerns
http://www.nemspa.org/Shared%20Docum...urvey_0508.pdf
Chris Eastlee of AAMS Addresses Medevac Safety Concerns
Last edited by havoc; 7th Jul 2008 at 22:44.
Join Date: Sep 2007
Location: US
Posts: 186
Likes: 0
Received 0 Likes
on
0 Posts
Gomer
Quote: ""If you walk in thinking you're an aviation god, you're going to meet medical gods and goddesses. If you go in as a human being, you'll likely meet other human beings. At least that's been my experience.""
Absolutely, one gets what one gives. Its about we doing our thing, and they doing theirs, and working as a cooperative team to enjoy work and get the job done, ideally. After more than ten years at our operation it simply just hasn't quite worked that way. Still looking for that silver bullet, or olive branch!
C'est la vive.
WIII
Quote: ""If you walk in thinking you're an aviation god, you're going to meet medical gods and goddesses. If you go in as a human being, you'll likely meet other human beings. At least that's been my experience.""
Absolutely, one gets what one gives. Its about we doing our thing, and they doing theirs, and working as a cooperative team to enjoy work and get the job done, ideally. After more than ten years at our operation it simply just hasn't quite worked that way. Still looking for that silver bullet, or olive branch!
C'est la vive.
WIII
Last edited by WhirlwindIII; 9th Jul 2008 at 17:32.
"Just a pilot"
First, I have to object to the inflammatory position of the OP.
Poor aviation decision making, obviously. No amount of engines, avionics, gauges, dispatchers, or other 'stuff' fixes the issue. All the gear variations make diddly squat difference in the industry- they crash at about the same rate, Except NVGs...
If the very real possibility of killing oneself by accepting dispatch doesn't stop the flight's launch, what can you expect from regulation? Okay, some new laws could quash a lot of flight activity... I'm assuming that that is a different issue entirely, this is about SAFETY, yes?
Better data, more data, more easily accessible and available to the pilot, in cockpit and in the office- weather data uplinks; "fish finders"; even most cockpit ergonomics are challenges instead of assets...
The companies need to accept that Part 135 is inadequate, especially if the legal minimums are an acceptable objective. Example- the minimum training specified by that Part is patently inadequate.
The industry as a whole works against the model of safe HEMS- but that too, is a separate issue...
Poor aviation decision making, obviously. No amount of engines, avionics, gauges, dispatchers, or other 'stuff' fixes the issue. All the gear variations make diddly squat difference in the industry- they crash at about the same rate, Except NVGs...
If the very real possibility of killing oneself by accepting dispatch doesn't stop the flight's launch, what can you expect from regulation? Okay, some new laws could quash a lot of flight activity... I'm assuming that that is a different issue entirely, this is about SAFETY, yes?
Better data, more data, more easily accessible and available to the pilot, in cockpit and in the office- weather data uplinks; "fish finders"; even most cockpit ergonomics are challenges instead of assets...
The companies need to accept that Part 135 is inadequate, especially if the legal minimums are an acceptable objective. Example- the minimum training specified by that Part is patently inadequate.
The industry as a whole works against the model of safe HEMS- but that too, is a separate issue...
Bryan Bledsoe, MD, position on US HEMS
IMHO interesting opinion:
Background and recent thread on EMS website:
Air Medical Professionals - FlightWeb Forums
Dr. Bryan Bledsoe is an emergency physician and EMS author from Midlothian, Texas. He entered EMS in 1974 as an EMT and attended one of the first paramedic programs in north Texas. Dr. Bledsoe worked for several years in Fort Worth as a paramedic and went on to become an EMS Instructor and Coordinator. Dr. Bledsoe has a B.S. from the University of Texas and a D.O. from the University of North Texas. He completed a residency at Texas Tech University Health Sciences Center and at Scott and White Memorial Hospital/Texas A&M College of Medicine. He is board-certified in emergency medicine.
Dr. Bledsoe has served as the Medical Director for two hospital emergency departments as well as for numerous EMS agencies in north Texas. He is the author of numerous EMS textbooks including: Paramedic Care: Principles & Practice, Paramedic Emergency Care, Prehospital Emergency Pharmacology, Anatomy and Physiology for Emergency Care, and many others. He is a frequent contributor to EMS magazines and presenter at national and international EMS conferences. He is married and lives in Midlothian, Texas. He enjoys salt-water fishing.
Dr. Bledsoe is affiliated with the University of Nevada, Las Vegas in Las Vegas, Nevada. He is co-chair of the Curriculum and Education Board for the United States Special Operations Command (USSOCOM) at MacDill AFB, FL.
My hat is off to all who toil in medical helicopters and fixed-wing aircraft. The last 2 weeks have been an uncomfortable time to be a pilot, flight medic, or flight nurse. I have been interviewed a great deal and I have hammered the helicopter EMS industry. I have been very careful to point out that I highly respect the crews and pilots. But, those words always get ediited out. Kind words do not bring television viewers or newspaper readers. Only harsh criticism does. I received over 200 emails and calls from around the world after the series of interviews following the Flagstaff crashes. Many were from flight paramedics and nurses. EVERY EMAIL AND CALL I RECEIVED FROM MEMBERS OF THE AIR MEDICAL COMMUNITY WAS RESPECTFUL, KIND, SUPPORTIVE, AND INFORMATIVE. Many apologized about how the HEMS had treated me in the past on Flightweb. One nurse personally apologized for an email she sent a year ago acusing me of being a "helicopter hater". Now, a year later, she sees where I was coming from. This speaks well of you. The collective of you--medical providers who fly--have risen above the industry mantra. The risks are real. The patients are less sick. Money is the master. Things are horrible. The media is on you. Yet, your mouthpieces talk about lives saved, the need for more helicopters, and that the safety record is not so bad when you consider the lives saved. I have had 5 phone calls from trauma surgeons (2 I knew) each echoing the same story--they could count on one hand the number of patients they felt benefitted from HEMS transport.
Safety changes have to go beyond NTSA.
We must consider:
1. Dual pilots
2. Full IFR capabilities
3. Larger aircraft with twin engine and system redundancy,
4. NVGs (the AMPA paper is very compelling).
5. Adherence to Part 135 at all times.
6. TAWS
7. Employer supplied helmets and suits.
8. Mandatory rest periods for flight crews along the same lines as for pilots
9. Centralized EMS (non-proprietary) dispatch.
10. Subscriptions must stop.
What does this mean?
1. More than half the fleet must go away. Those that remain must make a committment to safety by adding the needed equipment and rules. All should be operated as a part of a regional EMS system--not like the wrecker industry.
2. Half the current number of flight personnel will lose jobs. Sorry.
3. The more qualified members of the HEMS crew (medics, nurses, pilots) will rise to the top and take the jobs that are open in the new industry. The quality of care will return to what it used to be.
I do believe there is a subset of patients who can benefit from HEMS. We need to figure this out and revise criteria. There is no move to revise current criteria becaue doing so migh cut a few flights. Losing a few flights might hurt the stock value. But, cutting nonessential flights might also save lives.
Be verbal. Speak up. Don't walk away unless the safety issues are dangerous. One of three things will happen: 1) The FAA will step in. 2) Congress will step in. 3) Insurance companies will stop paying--no bucks--no Buck Rogers. The latter is most likely.
We Americans think we are the center of the universe. Does any other first world country boast 750-1,000 medical helicopters? I have met with HEMS officials in New Zealand and Australia where the strategy was to "avoid the Yanks problems" by setting up protocols and barriers to minimize helicopter usage. If we are the only first world country doing anything in medicine, it should give us pause and make us reevaluate the system.
Thanks for the emails and kind thoughts. We are on the same team. My resepct for you guys (and women) continues to climb.
Bryan
Background and recent thread on EMS website:
Air Medical Professionals - FlightWeb Forums
Dr. Bryan Bledsoe is an emergency physician and EMS author from Midlothian, Texas. He entered EMS in 1974 as an EMT and attended one of the first paramedic programs in north Texas. Dr. Bledsoe worked for several years in Fort Worth as a paramedic and went on to become an EMS Instructor and Coordinator. Dr. Bledsoe has a B.S. from the University of Texas and a D.O. from the University of North Texas. He completed a residency at Texas Tech University Health Sciences Center and at Scott and White Memorial Hospital/Texas A&M College of Medicine. He is board-certified in emergency medicine.
Dr. Bledsoe has served as the Medical Director for two hospital emergency departments as well as for numerous EMS agencies in north Texas. He is the author of numerous EMS textbooks including: Paramedic Care: Principles & Practice, Paramedic Emergency Care, Prehospital Emergency Pharmacology, Anatomy and Physiology for Emergency Care, and many others. He is a frequent contributor to EMS magazines and presenter at national and international EMS conferences. He is married and lives in Midlothian, Texas. He enjoys salt-water fishing.
Dr. Bledsoe is affiliated with the University of Nevada, Las Vegas in Las Vegas, Nevada. He is co-chair of the Curriculum and Education Board for the United States Special Operations Command (USSOCOM) at MacDill AFB, FL.
My hat is off to all who toil in medical helicopters and fixed-wing aircraft. The last 2 weeks have been an uncomfortable time to be a pilot, flight medic, or flight nurse. I have been interviewed a great deal and I have hammered the helicopter EMS industry. I have been very careful to point out that I highly respect the crews and pilots. But, those words always get ediited out. Kind words do not bring television viewers or newspaper readers. Only harsh criticism does. I received over 200 emails and calls from around the world after the series of interviews following the Flagstaff crashes. Many were from flight paramedics and nurses. EVERY EMAIL AND CALL I RECEIVED FROM MEMBERS OF THE AIR MEDICAL COMMUNITY WAS RESPECTFUL, KIND, SUPPORTIVE, AND INFORMATIVE. Many apologized about how the HEMS had treated me in the past on Flightweb. One nurse personally apologized for an email she sent a year ago acusing me of being a "helicopter hater". Now, a year later, she sees where I was coming from. This speaks well of you. The collective of you--medical providers who fly--have risen above the industry mantra. The risks are real. The patients are less sick. Money is the master. Things are horrible. The media is on you. Yet, your mouthpieces talk about lives saved, the need for more helicopters, and that the safety record is not so bad when you consider the lives saved. I have had 5 phone calls from trauma surgeons (2 I knew) each echoing the same story--they could count on one hand the number of patients they felt benefitted from HEMS transport.
Safety changes have to go beyond NTSA.
We must consider:
1. Dual pilots
2. Full IFR capabilities
3. Larger aircraft with twin engine and system redundancy,
4. NVGs (the AMPA paper is very compelling).
5. Adherence to Part 135 at all times.
6. TAWS
7. Employer supplied helmets and suits.
8. Mandatory rest periods for flight crews along the same lines as for pilots
9. Centralized EMS (non-proprietary) dispatch.
10. Subscriptions must stop.
What does this mean?
1. More than half the fleet must go away. Those that remain must make a committment to safety by adding the needed equipment and rules. All should be operated as a part of a regional EMS system--not like the wrecker industry.
2. Half the current number of flight personnel will lose jobs. Sorry.
3. The more qualified members of the HEMS crew (medics, nurses, pilots) will rise to the top and take the jobs that are open in the new industry. The quality of care will return to what it used to be.
I do believe there is a subset of patients who can benefit from HEMS. We need to figure this out and revise criteria. There is no move to revise current criteria becaue doing so migh cut a few flights. Losing a few flights might hurt the stock value. But, cutting nonessential flights might also save lives.
Be verbal. Speak up. Don't walk away unless the safety issues are dangerous. One of three things will happen: 1) The FAA will step in. 2) Congress will step in. 3) Insurance companies will stop paying--no bucks--no Buck Rogers. The latter is most likely.
We Americans think we are the center of the universe. Does any other first world country boast 750-1,000 medical helicopters? I have met with HEMS officials in New Zealand and Australia where the strategy was to "avoid the Yanks problems" by setting up protocols and barriers to minimize helicopter usage. If we are the only first world country doing anything in medicine, it should give us pause and make us reevaluate the system.
Thanks for the emails and kind thoughts. We are on the same team. My resepct for you guys (and women) continues to climb.
Bryan
Join Date: Sep 2007
Location: US
Posts: 186
Likes: 0
Received 0 Likes
on
0 Posts
A question please. The popular validity of HEMS seems to rest on the idea of "saving lives". Where does "decreasing morbidity" through rapid transport (if this is a major reality) come to play?
My guess is doctors get nervous about patient outcome and pull the helicopter trigger in accordance with criteria that caters not only to life-saving but to decreasing morbity to assure quality of life; and such that medical liability is decreased and insurance companies possibly lose less in ongoing rehab and care. Another way of saying the dollar rules. But is that all bad? Where does the HEMS transport criteria line get redefined? Is this line medically driven or mostly a liability/insurance problem, or all three?
Completing transports obviously must not come at the expense of an accident record that can otherwise be dealt with; if all involved decide to do so.
Thanks.
WIII
My guess is doctors get nervous about patient outcome and pull the helicopter trigger in accordance with criteria that caters not only to life-saving but to decreasing morbity to assure quality of life; and such that medical liability is decreased and insurance companies possibly lose less in ongoing rehab and care. Another way of saying the dollar rules. But is that all bad? Where does the HEMS transport criteria line get redefined? Is this line medically driven or mostly a liability/insurance problem, or all three?
Completing transports obviously must not come at the expense of an accident record that can otherwise be dealt with; if all involved decide to do so.
Thanks.
WIII
