the 100% directionless thread

VFlutter

Flight Nurse
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Fatal helicopter crash today has me second guessing my interview. I know they arent anything new. Just makes me think about it more now.

You are still more likely to die in a car crash driving to work than you are on the helicopter
 

Qulevrius

Nationally Certified Wannabe
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Not even 8pm yet, and it’s already hard to breathe.
 

CALEMT

The Other Guy/ Paramaybe?
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Holiday pay days are almost impossible to get extra time on as a full timer and today and tomorrow are 2x. Managed to find an opening for tomorrow getting 2x today and 2.5x for a shorter day tomorrow due to OT. Time to get that sweet college loan money.

I get DT today and tomorrow. Hard to beat the free thanksgiving meal and the paycheck being in medic school.
 

DesertMedic66

Forum Troll
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I get DT today and tomorrow. Hard to beat the free thanksgiving meal and the paycheck being in medic school.
Thought I saw your broken Toyota in the parking lot haha
 

Carlos Danger

Forum Deputy Chief
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Im over it now. Shared my feelings with my wife and she basically told me not to be a female sex organ. I love that woman.
This is exactly what is wrong with the HEMS industry. People act as though the risks aren’t there, or as though the risks are worth because heroism or something.

Things don’t change for the better because even if crashes happened every single day there’d still be a long line of paramedics willing to compete tooth and nail with each other for the chance to wear a flight suit.
 

Carlos Danger

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“How dangerous is flying in helicopters compared to driving a car or an ambulance?” is the wrong question to ask. It is difficult to make meaningful comparisons because the nature of these activities are so different, and objective data is actually pretty hard to come by. Dr. Ira Blumen has really good presentations on this stuff but readily admits that the data is far from perfect.

One thing we know is that commercial aviation is consistently ranked in the top 10 most hazardous professions, and that HEMS is probably a lot more dangerous than the greater commercial aviation industry. So take that for whatever it’s worth.

The right questions to ask are:

- Does the HEMS industry do everything reasonably possible to keep their crew members and patients as safe as possible?
- Is the additional risk to crew members and patients and huge additional cost justified by improved patient outcomes?
- Why are the answers to the first two questions what they are?

The answers are: not even close, pretty clearly not, and profits.
 
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EpiEMS

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I’m curious if anyone has analyzed how likely you are to die in a helicopter crash vs an ambulance crash.

Considering how many people don't wear a seatbelt, I don't like those odds.

Some naiive estimates...

NHTSA claims there are an average of "29 fatal crashes involving an ambulance, resulting in an average of 33 fatalities annually" (roughly 4,500 ambulance accidents/year). So let's say 0.67% of ambulance accidents (?) result in a fatality compared to something like 40% for HEMS crashes. That said, I would be shocked if the 'risk per mile', if you will, is even comparable - I'd bet it's safer to fly than drive, on a per mile basis. @Remi, do you agree with my contention on a per mile basis?
 

GMCmedic

Forum Deputy Chief
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This is exactly what is wrong with the HEMS industry. People act as though the risks aren’t there, or as though the risks are worth because heroism or something.

Things don’t change for the better because even if crashes happened every single day there’d still be a long line of paramedics willing to compete tooth and nail with each other for the chance to wear a flight suit.

We both know the risks, and heroism has nothing to do with it. She knows that if I don't at least attempt to venture into a critical care role, Ill spend the rest of my career unhappy.


If we had a critical care ground program I would do that, but we don't and I dont see the ICU treating me like anything other than a tech anytime soon.
 

NomadicMedic

I know a guy who knows a guy.
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We both know the risks, and heroism has nothing to do with it. She knows that if I don't at least attempt to venture into a critical care role, Ill spend the rest of my career unhappy.


If we had a critical care ground program I would do that, but we don't and I dont see the ICU treating me like anything other than a tech anytime soon.

You can always move to an area that does ground CCT. I mean, I’m really interested in moving toward more CCT, but I’m 100% NOT interested in cramming my fat frame into a helicopter.
 

SandpitMedic

Crowd pleaser
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This is exactly what is wrong with the HEMS industry. People act as though the risks aren’t there, or as though the risks are worth because heroism or something.

Things don’t change for the better because even if crashes happened every single day there’d still be a long line of paramedics willing to compete tooth and nail with each other for the chance to wear a flight suit.

“How dangerous is flying in helicopters compared to driving a car or an ambulance?” is the wrong question to ask. It is difficult to make meaningful comparisons because the nature of these activities are so different, and objective data is actually pretty hard to come by. Dr. Ira Blumen has really good presentations on this stuff but readily admits that the data is far from perfect.

One thing we know is that commercial aviation is consistently ranked in the top 10 most hazardous professions, and that HEMS is probably a lot more dangerous than the greater commercial aviation industry. So take that for whatever it’s worth.

The right questions to ask are:

- Does the HEMS industry do everything reasonably possible to keep their crew members and patients as safe as possible?
- Is the additional risk to crews members and patients and hugely additional cost justified by improved patient outcomes?
- Why are the answers to the first questions what they are?

The answers are: not even close, pretty clearly not, and profits.

****ing bingo!
 

SandpitMedic

Crowd pleaser
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Im over it now. Shared my feelings with my wife and she basically told me not to be a female sex organ. I love that woman.
She must know they have a great life insurance plan. My lady would definitely not tell me that if I voiced concerns for my life safety vs career choice.

All this "less dangerous than" yada yada is ********.

According to the Association of Air Medical Services, as of Sept 2017, there are 908 aeromedical bases with rotor wing aircraft in the US. At those bases there are a total of 1,049 air medical helicopters (including spares).

According to the FAA the latest estimates on a medical aircraft crash is about 3.19 accidents per 100,000 flying hours, but admit it is hard to accurately measure flight hours or medical transports (go figure). Their records show in 2016 there were 109 air medical aircraft crashes and of those 17 were fatal. There is no official data on the year 2017 yet.

There are currently 908 bases, 109 crashes, 17 fatal incidents (not fatalities) ... extrapolated out, that's a roughly 12% chance of being involved in an air medical crash. I could not find data on the exact number of fatalities through the FAA, NTSB, AAMS, or other citable sources. We can estimate that there were 17 fatal crashes and generally all 3 crew die, we'll say 2.5 over time. So we'll call it ~40-42 fatalities per year, giving you about a 4-5% chance of dying in an air medical crash this year. That data is pretty raw, but it is backed up by FAA and other data.

In 2016, Aerossurance released data and a report concluding the rate of air medical crashes are slightly down over the last couple of years. Their data up to 2015, from the NTSB and International Helicopter Safety Team, had a board member averaging one air medical accident every 40 days since 2005. That data ranged from about 7-12 fatal accident per annum from 2010-2015.

In 2016, Dr. Ira Blumen released an update:
In 1980, a HEMS crewmember had a 1 in 50 chance of being in a fatal accident; today that number is 1:850.

From 1972 to 2016 there were 342 helicopter EMS accidents…123 of those 342 resulted in at least one fatality. Some 1,053 personnel were involved in those accidents; 328 died, 116 sustained serious injuries, 136 had minor injuries and 473 were uninjured…

Unfettered competition has allowed the nation’s HEMS fleet mushroom ....to 852 today. If you add in dual-purpose aircraft, the number is 979, and it could be as high as 1,048 if you count non-operational spares.

…the average aircraft flew 600 hours between 2003 and 2008, at which time flying dropped precipitously after the accidents of 2008 and the ensuing negative publicity. “People said, ‘We are not sending our patients in helicopters,’” Blumen noted. Now the number of flight hours per helicopter is moving up again, averaging 490 in 2016.

So, in 2017, while the risk is 1-5% of being in a fatal crash and 10-12% in a crash in an air medical transport setting, general aviation statistics are drastically lower with thousands times more aircraft, passengers, and flight hours.

This job is dangerous. Inherently dangerous. The competing agencies, implied pressures to fly, and compromises in safety do not help.



Sources:

http://aams.org/member-services/atlas-database-air-medical-services-adams/

https://www.faa.gov/news/updates/?newsId=87406

http://aerossurance.com/helicopters/us-hems-accident-2006-2015/

http://www.ihst.org/portals/54/symposium/2016/Presentation IHST-CIS_2016.pdf
 

EpiEMS

Forum Deputy Chief
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This job is dangerous. Inherently dangerous. The competing agencies, implied pressures to fly, and compromises in safety do not help.

What's the fix? Municipal or state HEMS? And reducing the use of HEMS for indications where there is little value added?
 
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