Michael Schumacher HEMS Task
 

A big thumbs up to the HEMS crew involved in the retrieval of retired F1 driver Michael Schumacher from the ski fields a few days ago.

Reports in the media suggest that from the time of the incident, he had Paramedics on scene within 2 minutes, a HEMS crew on scene in 8 minutes and was in hospital 10 minutes later. (if anyone can clarify those times please do)

From my perspective as a Flight Paramedic and EMS pilot, that time-frame is an outstanding example of both the positive contribution of the helicopter to minimising delays from injury to definitive care, and also of the excellent standards of clinical judgement for the clinicians who resisted the temptation to faf about at the scene but got the guy to a critical care facility in the most expeditious manner. Some of the systems in Australia could learn from this example!

Well done that team.:ok:

It was probably this helicopter ;)

Photos: Eurocopter EC-135T-1 Aircraft Pictures | Airliners.net

Video here.

I/C

Nothing special in Euro-land…

Especially in skiing-areas, the helicopters are never far away...

I'm afraid I'm with Hueyracer. The only 'heroes' for me in all this are the pisteurs who got to him quickly and recognised the symptoms of brain trauma.

Can't tell from the photo or the video, but are there any bear paws on the skids? Done a few picks off ski hills, and when it starts to tilt back in soft snow you'll wish for that 135 fenestron.

This EC135 has snow skid, no bear paws ;)

Is it normal practice for the helicopter shut down on a ski slope?
In the image below it is hard to be sure that the rotors are not running, the tips appear softer than the root.
For the paramedics to move across the snow make an assessment and presumably fit a neck brace then stretcher patient back to helicopter, depart scene and land at hospital all within 10 minutes is fast work.



http://i.dailymail.co.uk/i/pix/2014/...34_634x401.jpg



Mickjoebill

HEMS crew on the ground in 8 minutes,then hospital 10 minutes later =18 minutes.

Al wrote Well said. There can be a place for taking time, but the "scoop and run" is often a very good procedure. Amazing how time flies when dealing with a casualty, and everybody always feels what they are doing is vital to get done before moving the patient. Also a problem in the hospital casualty department (sorry, ER).

Surely the point we want to get across, assuming a common interest in promoting HEMS, is that other forms of transport would not have been possible and that the helicopter allowed the rapid provision of expert care.

I would be cautious about discussing or promoting scoop and run vs stabilise unless you were actually there and examined MS. Reports suggest a lucid period when transfer without intervention would have been ideal, but subsequent CT scans were reported as significant intracranial haematomata and in that situation elective anaesthesia on scene would have been indicated.

Sorry to go medical on a rotorheads thread, but scoop and run with an unconscious head injury is one of the few HEMS manoeuvres shown to be medically disadvantageous. We don't want an own goal

Rad girl - I agree with your post BUT you need someone on scene who can administer and manage an anaesthetised patient. If you do not have this your best option is clear WX and a helicopter to the nearest site that has.

DB

According to some news reports they had some specialist on board, because they landed on the way to the hospital to intubate MS, obviously his condition deteriorated rapidly after the fast pickup, which is not unnormal after such head injuries.

skadi

Skadi intubation is a procedure that paramedics are normally authorised to perform. An anaesthetist is usually required to stabilised a serious head injury.

DB

Was not actually promoting HEMS or anything else, but was acknowledging the excellent work done by this crew on this case - and by crew I include the 1st responders, the 1st paramedics, the HEMS team, the assisting bystanders, the receiving facility and all the ongoing specialist care.

I am not aware of any credible studies done anywhere in the world that show an improved outcome from unnecessary interventions on scene. The whole point of the exercise is to minimise the time between the injury and the definitive care, which for this patient was a neurosurgeon and a suitable hospital. Which is what happened. Ergo, again, well done that team. :ok:

Let's not tangent off into a esoteric discussion on the relative merits of what one system promotes by way of stabilisation against another system - or if that's of interest, take it to the Medical Forum. 'K? :)

I'm an anaesthetist with neurosurgical anaesthetic experience. However I would like to ask our Alpine flyers 'is it sensible to fly a predominently white helicopter in Alpine areas?'.

Safe flying

G-BHIB C182

Intubation
 

Why couldn't intubation be performed while airborne? Combative with brain bleed?

No - a paramedic (UK) can only carry out an intubation if the patient is GCS3 - ie non responsive. An RSI requires the use of paralysing drugs that only a doctor can administer or be given under their supervision.

Too much noise, vibration and lack of space. A controlled RSI requires the doctor to be behind the patients head using the laryngoscope to position the tube.

Getting a bit medical but

Intubation in flight is quite feasible if the aircraft is designed with the doctor at the head of the patient. However, the definitive treatment would not have been a neurosurgeon but an anaesthetist and anaesthesia. So if you are at 1000 feet over open ground it makes sense to land and intubate, if only so as to be able to lay out drugs and equipment with the certainty that they are not going to shoot off around the cabin. Once this is achieved you have bought significant time for imaging and if necessary the neurosurgeon!

Getting a bit medical but

Intubation in flight is quite feasible if the aircraft is designed with the doctor at the head of the patient. However, the definitive treatment would not have been a neurosurgeon but an anaesthetist and anaesthesia. So if you are at 1000 feet over open ground it makes sense to land and intubate, if only so as to be able to lay out drugs and equipment with the certainty that they are not going to shoot off around the cabin. Once this is achieved you have bought significant time for imaging and if necessary the neurosurgeon!

It is gratifying to see a HEMS mission where it appears a life was truly saved. Lets hope the final outcome is not as bad as we fear.