Calling for HEMS?

[LanceCorpsman]

I currently work on a band aid bus that provides mutual aid to a rural Fire/EMS agency. They currently only have one Basic working so every time their tones drop, we get toned as well. So we end up taking the 30 min drive to assist them.
The thing that bothers me is that they like to call for HEMS for a lot of calls, and there have been multiple incidents where it was totally unnecessary. The thing is that the chief sat that agency launches HEMS on a regular basis. I don't want to sound mean but the EMTs they have are a bit.....incompetent. They think they need the helicopter, when in reality the patients wont benefit, by getting to the ER 15 mins faster. Not to mention the $20,000+ bill they have to pay to HEMS...
What are some ideas that you guys may have to improve this situation? I literally have no control over that department.

 

[luke_31]

You just said it. You have no control over that department all you can do is bring it up to the local EMS board about their improper use of a helicopter. There isn't much that you can do if you don't have any influence with that department.

 

[LanceCorpsman]

Man that sucks, I didn't really want to make a big deal out of it. But I don't really like watching people get there lives ruined by a $20,000 bill lol

 

[CALEMT]

Man that sucks, I didn't really want to make a big deal out of it. But I don't really like watching people get there lives ruined by a $20,000 bill lol

It's not entirely that. It's more of they're utilizing a resource thats not needed that could be needed elsewhere.

 

[DesertMedic66]

The HEMS crew should put a CE class on or just a training class in general on when to launch HEMS and when not to

 

[LanceCorpsman]

The HEMS crew should put a CE class on or just a training class in general on when to launch HEMS and when not to

I've heard that the chief up there and the HEMS agency has had some conflicts in the past, but it seems to have done no good

 

[SpecialK]

These are the national HEMS response criteria

 

[LanceCorpsman]

Thats cool. I should probably give them a copy

 

[akflightmedic]

Is the HEMS agency a private company? If so, expect no support from them. They probably reinforce the unnecessary or over calling of their services.

 

[Bullets]

Wait so their one EMT calls HEMS and then you guys also respond? Just because another agency calls for a helicopter doesnt mean you have to use it. If you are transporting the patient then its your call. You can cancel the flight and just transport.

I need more info on your system. If you are doing mutual aid you can also turn down the request and just not respond

 

[EpiEMS]

Doesn't the HEMS agency have *some* degree of discretion as to responses? I'd imagine they'd rather not be out of service (yes, even though they can bill) for some sort of minor injury.

As far as the other department goes, education is all you can do. You have no control, as you said, so don't feel responsible.

 

[akflightmedic]

LOL @ discretion of responses....

Ummm in private HEMS....you call we haul.

 

[Carlos Danger]

The HEMS crew should put a CE class on or just a training class in general on when to launch HEMS and when not to

Your are 100% right.....they should. In reality though, most of these programs are little more than marketing that is actually intended to convince EMS to call as often as possible.

 

[EpiEMS]

LOL @ discretion of responses....

Ummm in private HEMS....you call we haul.

Oof. It makes (financial) sense, at least, in the context of private HEMS. But, boy, I would be upset if the HEMS resource for a county was OOS and I needed it.

 

[medicsb]

Wait so their one EMT calls HEMS and then you guys also respond? Just because another agency calls for a helicopter doesnt mean you have to use it. If you are transporting the patient then its your call. You can cancel the flight and just transport.

I would agree. The responder with the highest EMS level of training should be able to cancel the helicopter, even if the flight crew is knocking on the back doors of the ambulance as you finish your assessment. Being flown in a helicopter is not benign. I do think of the method of transportation as a medical intervention and if it is not indicated, it shouldn't be done.

 

[EpiEMS]

Prehospital Emergency Care published some guidelines in 2014:

I think they're pretty reasonable: "The panel strongly recommended that the 2011 CDC Guideline for the Field Triage of Injured Patients be used as the initial step in the triage process, and that ground emergency medical services (GEMS) be used for patients not meeting CDC anatomic, physiologic, and situational high-acuity criteria."

 

[LanceCorpsman]

Wait so their one EMT calls HEMS and then you guys also respond? Just because another agency calls for a helicopter doesnt mean you have to use it. If you are transporting the patient then its your call. You can cancel the flight and just transport.

I need more info on your system. If you are doing mutual aid you can also turn down the request and just not respond

The agency in question has one EMT Basic that responds, and when that EMT is unavailable, there ambulance is unable to respond. We are automatically on the run card because that agency has a history of not being able to staff an ambulance so all calls we have to respond as well for ALS/ILS. And lets just say that the EMT they do have is a bit incompetent. And most of the time it is not there EMT who calls HEMS, it is there chief.
I guess I could cancel the flight, but a lot of the times when the helicopter is already launched and hovering over the incident site or LZ, I am barely arriving on scene. And like I said, Im a person of no authority over that departments operations.

 

[EpiEMS]

The agency in question has one EMT Basic that responds, and when that EMT is unavailable, there ambulance is unable to respond. We are automatically on the run card because that agency has a history of not being able to staff an ambulance so all calls we have to respond as well for ALS/ILS. And lets just say that the EMT they do have is a bit incompetent. And most of the time it is not there EMT who calls HEMS, it is there chief.
I guess I could cancel the flight, but a lot of the times when the helicopter is already launched and hovering over the incident site or LZ, I am barely arriving on scene. And like I said, Im a person of no authority over that departments operations.

Wow. Seems like kind of a waste to staff an ambulance if you've only got one EMT...

Regardless, back on topic for me -- I would definitely consider cancelling HEMS if you, as the responsible patient care provider don't think it's necessary. Once you're on scene and it's your patient, I would imagine that you have the discretion to do that, no?

 

[Bullets]

The agency in question has one EMT Basic that responds, and when that EMT is unavailable, there ambulance is unable to respond. We are automatically on the run card because that agency has a history of not being able to staff an ambulance so all calls we have to respond as well for ALS/ILS. And lets just say that the EMT they do have is a bit incompetent. And most of the time it is not there EMT who calls HEMS, it is there chief.
I guess I could cancel the flight, but a lot of the times when the helicopter is already launched and hovering over the incident site or LZ, I am barely arriving on scene. And like I said, Im a person of no authority over that departments operations.

While you may have no authority over what that department does as an operation, if you are the ALS provider, then you do have ultimate authority over the patient.

 

[CALEMT]

While you may have no authority over what that department does as an operation, if you are the ALS provider, then you do have ultimate authority over the patient.

This. Why doesn't the medic on the ambulance just cancel the helicopter?