becoming a flight paramedic

[usafmedic45]

are you saying that there is a higher risk associated with civilian air evac operations than military ones?

I am saying the crash rates are comparable, especially if you exlude military crashes due to enemy action. That statement is based upon conversations I have had with US Army and US Air Force safety researchers with whom I have dealt in the course of my work (I work in aviation safety research as my primary occupation, although I practice clinically as a respiratory therapist on the side to make extra money).

If you any reputable evidence to show that the fatal crash rate for military operations (on a crashes per X missions or crashes per X hours flown basis) is higher, then I would be happy to look at it, but I do have a nearly complete tally of military helicopter crashes (in combat zones) since the start of the Afghanistan campaign and the numbers have been very similar when one takes into account the far greater number of missions flown by military helicopter units. The loss of life is also higher, but that is to be expected when you are dealing with CH-46s and MH-53s compared to the Dauphins, Sikorsky S-76s and other smaller helicopters commonly used by HEMS operations. It's like comparing the crashes of airliners to the crashes of Cessnas in terms of lives lost.

but i would not say that his death was "pointless" that is an insult upon him and all of those who serve this great country... he died for what he believed in and he died defending me and you and everyone else. but what does this have to do with the topic anyways?

Sorry to hear about your friend. I've lost several friends in Iraq and Afghanistan as well. If you ever need an empathetic ear, I'm more than happy to provide one.

I was not speaking of military operations. I was speaking of civilian HEMS crashes. Most flights are of little to no benefit to the patient. That is the definition of a pointless risk.

were/are you in the air force? PJ?

I was in the Air Force but I was not special operations.

and whoo said that i was in it for the rush of the helicopter, and for profit from the employer?

I was not implying that and I apologize if it came across that way. I just know a lot of people- myself included really enjoy the excitement of helicopter operations.

As for the profit of HEMS operators, remember they are by and large for profit operations and most of them act exactly as such where safety is a secondary priority. This has been documented time and again in crashes where pressure was put on pilots to take missions by the company when they had no business flying.

im in it because i care for people, and i love medicine.

Then I recommend you look at how much impact you will actually have on people's lives as a flight paramedic. It is not the same impact you have in a combat setting where helicopters save lives. In the civilian world, they are expense flashy flying billboards that in very few settings may make a difference. I can count these settings on one hand. Most (>90% by some estimates) of flights have no valid medical impact on patient outcomes.

As I was trying to point out in my first post, those who fly for most services are taking their lives in their hands out of concern for their fellow man or whatever other reasons that lead them to work in the field, but the actual effect they have on their patients is minimal at best. At some point, the question has to be asked: When is the return (the benefit to the patient) not worth the risk (the very real chance of dying in a crash)? One research project put the chance of being involved in a fatal civilian HEMS crash during a 20 year career at higher than one in three.

There are ways to care for people that actually save far more lives and are much less likely to result in your death.

 

[HNcorpsman]

i can understand that probably some of the calls that these flight paramedics, RNs, and pilots go on are probably not needed, but what about those calls where a helicopter is truly needed??? you cant just drop the fact that having a helicopter can be one of the best solutions to a dyeing PT... what if the hospital is more than 4 hours away, and that PT has a tension pnuemo thorax, or a abdominal evisceration??? how can you just tell your self that helicopters are not essential and that they cause pointless deaths... how? ambulances transfer PTs that DONT need medical aid, all the time, probably a good 70% of the time. working in an ambulance as a paramedic/EMT might even be more dangerous than working a bird.... but just like the bird they are completely and utterly essential in the treatment of those other 30% of people.

dangers of flying civilian medevac
1. helicopter malfunctions
2. pilot error
3. weather

dangers of flying military CASEVAC/MEDEVAC
1. helicopter malfunctions (alot higher because in the marine corps we get to use good ol CH-46 from the Mesozoic era) (also our mechanics are 20 years old) (not sayin much, im 20)
2. pilot error ( its hard to fly a plane when your shot in the head)
3. weather (the weather is bad, guess what your still goin out)
4. enemy fire (shall i say no more?)

so your telling me im safer or just as safe flying on a 1972 CH-46 in afghanistan where 1000 upon 1000s of insurgents would love to chop my head off than flying on a 2006 S-76 in arizona? you might as well say that going to afghanistan to fight for your country is actually safer than driving to work everyday, after all there is a traffic collision every 6 seconds in the united states....

 

[akflightmedic]

you might as well say that going to afghanistan to fight for your country is actually safer than driving to work everyday, after all there is a traffic collision every 6 seconds in the united states....

Statistically it is....

 

[usafmedic45]

(also our mechanics are 20 years old)

They are also arguably better trained and have better oversight than their civilian counterparts.

alot higher because in the marine corps we get to use good ol CH-46 from the Mesozoic era

Care to provide some reputable evidence to this fact?

PT has a tension pnuemo thorax

Arguably, flying them with an unrelieved tension pneumo is going to make things worse. Also, you have to remember that a tension pneumo is something that is an immediate life threat and can not wait for a transfer.

what if the hospital is more than 4 hours away

This would be one of those handful of settings that I mentioned where helicopters have some value in the civilian world.

but just like the bird they are completely and utterly essential in the treatment of those other 30% of people.

No, they are not. There is no reliable evidence to indicate it is even 1% of cases in which helicopters are "utterly essential" in, let alone thirty percent. You can not cross-apply between military aeromedical transport and civilian HEMS in this situation which is what you seem to be doing.

working in an ambulance as a paramedic/EMT might even be more dangerous than working a bird....

Actually it's not. The CDC did a study on ground ambulance crash fatality rates and fewer people die in ambulance crashes annually on average than die in HEMS crashes.

so your telling me im safer or just as safe flying on a 1972 CH-46 in afghanistan where 1000 upon 1000s of insurgents would love to chop my head off than flying on a 2006 S-76 in arizona?

As AKFlightMedic said, statistically yes. This is for several reasons partly because of the better maintenance oversight in the military, dual pilot operations, and better redundancy in systems (there is something to be said for designing an aircraft to withstand being shot up).

weather (the weather is bad, guess what your still goin out)

That's the attitude of a lot of HEMS operators as well. The difference is that the military is a lot safer in their approach to helicopter IFR operations.

 

[HNcorpsman]

ahhh statistics, statistics, statistics, every argument is solved with a statistic. fine so be it... statistically i am wrong.

C'mon you know im just kidding about the ch-46s but the last time they were made was 1972 sooo they are still pretty old...

well of course tension pneumo is an immediate life threat, and of course you would do your needle decompression, but they need that chest tube.

anyways, i really dont care... unless they do away with HEMS, which they wont anytime soon... i am still going to go for it and get to that position.

 

[VentMedic]

well of course tension pneumo is an immediate life threat, and of course you would do your needle decompression, but they need that chest tube.

On some teams you may be doing the chest tube insertion.

 

[HNcorpsman]

another reason why i wanna be flight paramedic... i definitely would never do a chest tube on a PT in an ambulance... but i would get the opportunity to do it on the bird, and alot of other procedures.

 

[VentMedic]

another reason why i wanna be flight paramedic... i definitely would never do a chest tube on a PT in an ambulance... but i would get the opportunity to do it on the bird, and alot of other procedures.

Just get a solid education foundation so the agencies that have a broad scope of practice will know you are in it for more than the cool "skills". Without the education, you could end up at a company that just wants to know your uniform size and you "fly real fast" to the hospital.

 

[usafmedic45]

ahhh statistics, statistics, statistics, every argument is solved with a statistic. fine so be it... statistically i am wrong.

How else are we supposed to judge what we should or should not be doing? If you have a better approach, there's likely several major awards coming your way that would look good on your application to any job your heart desires in health care.

unless they do away with HEMS, which they wont anytime soon

The number of services is likely to drop considerably once the FAA gets their teeth into them with the new safety regulations coming down the pike. That and increasing awareness among physicians and EMS providers about the lack of benefit and -more directly- a suggested decrease in the reimbursement practices regarding aeromedical transport (especially scene transport) will decrease the number of flights which will in turn decrease the number of helicopters kept ready to go 24/7 and thus decrease the number of positions available. The end result is making all the education that VentMedic and others so wisely suggested all the more vital in competing against other extremely competent providers.

Without the education, you could end up at a company that just wants to know your uniform size and you "fly real fast" to the hospital.

*cough* AirEvac Lifeteam *cough* *cough* Maryland State Police Aviation *cough*

i am still going to go for it and get to that position.

Right, and I'm not trying to stop you. I just want you to go in with your eyes open and your head clear. Beyond that, my colleagues conducting aviation safety research and I will do anything and everything in our powers to improve the chances of you and your colleagues coming home to your families safely at the end of each and every shift. Best of luck, be safe and thank you for your service to our country.

 

[Ridryder911]

another reason why i wanna be flight paramedic... i definitely would never do a chest tube on a PT in an ambulance... but i would get the opportunity to do it on the bird, and alot of other procedures.

Actually, most will not perform many procedures such as this in the air either. Really do you think you can hear lung sounds with a jet engine behind you? Again, another mythical illusion that many of these so called special procedures are performed while in transit when in fact one should perform it before lifting off.

As the old saying goes if you think that it should be done, you should have already done it.

True there are some that allow chest tube insertions but in recent years that has dropped remarkably as better chest decompression sets have been developed. Again, many flight services have no more advancement than aggressive EMS in fact maybe less.

Nothing against HEMS by far but let's be truthful.

R/r 911

 

[HNcorpsman]

i did a chest tube on a live pig, with gunshots going off around me... wasn't too bad. its not saying much, im sure its ALOT different with a human.

 

[VentMedic]

i did a chest tube on a live pig, with gunshots going off around me... wasn't too bad. its not saying much, im sure its ALOT different with a human.

Just like putting plastic down someone's throat, it is a skill but both have serious complications. It is little more than just poking holes. The teams that do chest tubes which are primarily IFTs and often they are Specialty teams. You won't find any FD HEMS doing many advanced skills in this country that I know of. Again, it is the education that sets them apart for them to know when it is also not appropriate to do the skill. The actual "skill" will only be a small part of what they do.