Air Ambulance Question for EMTs

[Fly-write]

Hello,

I work in the air ambulance world. I hear mixed reviews about what air ambulance helicopters and fixed-wing aircraft do. I'm curious how EMTs on this forum feel about air medical?

Good, bad, neutral, overrated? Over/Under utilized?

I'm doing an informal survey for my own interest. Most of the ground crews we work with seem to enjoy working with us, but you never know for sure. Any feedback is appreciated.

Thanks,

Fly-write

 

[rwik123]

Medical aviation defiantly has its niche. There seems to be a belief at least in the lay person world, that medflights can provide a higher level of care. As everyone here probably knows this is not the case. Some ALS skills that can be utilized in a ground transport are next to impossible at altitude due to weather, turbulence ect. Medical transports jet wise open up a whole new realm of possibilities to the patient, being able to gain access to care in an expedited fashion. Also of course HEMS does its job in expediting the transport of critical patients also. Does not replace ground transport but supplements it and gives providers a viable option.

 

[Akulahawk]

I would have to say that overall, I have a fairly positive view of HEMS. There certainly needs to be better screening as to when it's appropriate to launch. I think there's a need in certain areas of the US where fixed-wing isn't appropriate and a helicopter doesn't have the reach or the necessary speed (tilt-rotor). There are places where Helos are needed. There are places where fixed-wing is appropriate. And there certainly are places where ground transport is absolutely the best option available.

There are times when it simply makes sense to utilize a helo (non-medical) to transport a medical crew in and out with a patient to a ground unit.

To each it's own... but things have to be reviewed for appropriate usage. Where I currently work, we used to have an HEMS crew (literally) across the street. The difference in transport time to the local L1 Trauma Center was quite literally 40-45 minutes air v. ground. The companies did their review of needs and found that they could do better if they were based elsewhere. Now, that difference is down to about 20 minutes if simultaneously dispatched. Does it make sense for us to use HEMS now? Rarely. As it was, we rarely used it before...

Should it be abandoned? Not by a long-shot.

 

[Fly-write]

rwik123,

I agree most flight crews believe they provide a higher level of care. I think a lot of that perception stems from their experience level and sometimes the specialized equipment they carry, balloon pump, etc.

Whether or not they really do provide a higher level of care? I honestly don't know. I am a driver (pilot) and honestly don't know for sure. I just know that's the perception.

Thanks for the feedback.

Fly-write

 

[EMTMama]

When I first started working for my IFT company, I had been forewarned about the egos of the flight crews, and to put it politely, that they could be high-maintenance. My experience has been very different though, and with the exception of one snapping at me over something stupid, I've really enjoyed working with them and haven't found them to be any different than my coworkers personality-wise. I personally look at them as a little extra-special because they fly...I couldn't hack being in those itty bitty planes or helicopters! Turbulence freaks me out!!

Flight medicine is a definite necessity here in New Mexico due to how big our state is and most of it is very rural. We only have 1 level 1 trauma center so it's pretty common for patients from outlying areas to get flown in for a needed specialty, trauma-related or not.

 

[BEorP]

Hello,

I work in the air ambulance world. I hear mixed reviews about what air ambulance helicopters and fixed-wing aircraft do. I'm curious how EMTs on this forum feel about air medical?

Good, bad, neutral, overrated? Over/Under utilized?

I'm doing an informal survey for my own interest. Most of the ground crews we work with seem to enjoy working with us, but you never know for sure. Any feedback is appreciated.

Thanks,

Fly-write

Are you just wondering whether EMTs like working with air ambulances or whether flyiing patients generally has a positive impact on outcomes?

 

[medicdan]

Is the purpose of HEMS to get the specialized personnel and equipment to the side of those who need it (regional specialization, able to swoop in fairly quickly), or the ability to provide rapid extraction/transportation? Do you think the strength of HEMS and air-ambulances lies in scene response (whether you agree with dispatch/launch criteria or not), or Critical Care IFT?

At what point to skills become CCT-level, as opposed to IFT ALS? Meds hung that aren't normally carried on a 911 truck? Ventilator? IABP? Unstable Vitals? IJ/EJ/Central Line maintenance?

I'm actually writing about the use (and misuse) of HEMS for one of my classes right now-- and doing a cost-benefit analysis.

 

[Fly-write]

BEorP,

I'm more curious how EMTs like working with the flight crews.

I get to see (or hear) about most of the outcomes. So I already know how most of the outcomes turn out.

Thanks,

Fly-write

 

[rwik123]

Is the purpose of HEMS to get the specialized personnel and equipment to the side of those who need it (regional specialization, able to swoop in fairly quickly), or the ability to provide rapid extraction/transportation? Do you think the strength of HEMS and air-ambulances lies in scene response (whether you agree with dispatch/launch criteria or not), or Critical Care IFT?

At what point to skills become CCT-level, as opposed to IFT ALS? Meds hung that aren't normally carried on a 911 truck? Ventilator? IABP? Unstable Vitals? IJ/EJ/Central Line maintenance?

I'm actually writing about the use (and misuse) of HEMS for one of my classes right now-- and doing a cost-benefit analysis.

Thats a great point to bring up..where is the line drawn between critical care transport and ALS IFT. Would that line be drawn patient to patient? The interventions and techniques of care are at the medic or nurses disposal no matter which patient it is. Both ALS IFT and CCT have similar scopes, plus or minus a few advances interventions so in my opinion it fluctuates.

 

[Veneficus]

Generally the crews are my friends. They went to flight, I went to school.

I don't find any issues at all with the crews and of course, being friends, we get along and work quite well.

My issue is with the industry. It needs to be heavily regulated as it has failed to do so itself and is completely out of control.

I think the best solution is to award exclusive contract to a given area to one provider at a time. That can be bid on competatively every X years.

Second to that idea, make it a government function.

Single organization ground ambulances in the US are given exclusive 911 rights for their areas in a majority of the cases. I can't imagine why airmed should be any different.

If you really wanted to keep multiple companies. (don't see why, but suppose you did) I would have exclusive specialty contracts. For example: a peds company or a scene company, etc. But very clear deliniation on who was getting what business.

 

[rwik123]

Generally the crews are my friends. They went to flight, I went to school.

I don't find any issues at all with the crews and of course, being friends, we get along and work quite well.

My issue is with the industry. It needs to be heavily regulated as it has failed to do so itself and is completely out of control.

I think the best solution is to award exclusive contract to a given area to one provider at a time. That can be bid on competatively every X years.

Second to that idea, make it a government function.

Single organization ground ambulances in the US are given exclusive 911 rights for their areas in a majority of the cases. I can't imagine why airmed should be any different.

If you really wanted to keep multiple companies. (don't see why, but suppose you did) I would have exclusive specialty contracts. For example: a peds company or a scene company, etc. But very clear deliniation on who was getting what business.

In your area are there competing HEMS agencies? In massachusetts its all Boston Medflight for the city and surrounding communities and Life Flight which is based out of Western MA which cover their own areas respectively.

 

[Veneficus]

In your area are there competing HEMS agencies? In massachusetts its all Boston Medflight for the city and surrounding communities and Life Flight which is based out of Western MA which cover their own areas respectively.

Where I stay in Europe, there is 1 HEMS run by the national government.

In my home town in the US there are 4 HEMS agencies. All covering the same or overlapping areas.

I have heard in the Southwest it is even worse.

 

[Smash]

I'm with vene. The crews where I work are great. Extremely competent, experienced and intelligent and generally speaking a pleasure to work with. With regards to ego, I have always found that the better the provider is, the less ego they have. My suspicion is that people with big egos are actually aware (at least subconsciously) of their shortcomings and are trying to compensate. People who are comfortable with their knowledge and abilities (and the limits of them) tend to have nothing to prove and no egos to speak of.

In terms HEMS in general, if used appropriately it is useful, if not (as we have seen in the US in recent years) it is lethal.

Proper oversight and regulation is essential, and any member of a HEMS crew should have the right to veto any flight, be it for clinical or flight safety issues. Ground providers shouldn't just get a helo because they want one.

 

[Fly-write]

Thanks to all for the feedback on my question. I appreciate it.

Fly-write