Why Do It?

The answer I most often give when people ask me about the risks associated with HEMS is- of course the job involves risk, so we as a company, as a crew, and I personally, take the appropriate measures to mitigate as much of that risk as we can. This involves regular training, education, and open communication between all crew members. Sure, you can not mitigate all of the risk away, but I believe we do as much as we can, and the remaining risk is acceptable. The moment that risk level rises above an acceptable level, we turn around, go home, land somewhere in between if we have to, or stay on the ground in the first place.

As far as the question of why fly? I simply can not think of any other profession that allows me to work with such a diverse group of professionals and provides the kind of opportunity to fly in the kind of equipment we do, while still allowing me to provide for my family and maintain a lifestyle that I enjoy.
 
Even knowing the risks of the job I would have a hard time giving it up. I like my 911 job, but I would miss the opportunity to take care of critically ill patients with a high degree of autonomy. I think I would be just as happy pursuing Nursing and eventually advanced practice / CRNA , but that's never going to happen for financial reasons so basically it's flight or a lifetime of 911 only. I've made my choice but I do understand that over a career there is good chance I'll be killed. I try to be open about this with my family and put as much money away so that there will be some financial stability when I die.
 
I'm too old these days for adventures or even investing the time and money to shoot for paramedic, but if I were 20 years younger... That being said, I suspect people do it as part of a self drive to be the best, to be at the pinnacle, so to speak, of the profession. You see it in folks that go on submarines, fighter pilots, swat guys, door kickers, etc. And it isn't limited to testosterone overflowing males.
 
Old Tracker said:
I suspect people do it as part of a self drive to be the best, to be at the pinnacle, so to speak, of the profession.
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Certainly holding yourself to that standard is a driving force, but I think a lot of guys and gals don’t really possess consistent motivation once they get here.

In other words, just like many things it becomes a “show and tell”, which I find quite pitiful.

I would never consider what I do as a pinnacle only because that sounds too arrogantly defining (IMO). Maybe the highest level of paramedic field care, but then that means constant drive. But again, constant drive is hardly innate with most people though.
 
Why fly...

That is a very good question. The first time I ever flew was because I wanted to fly. So I did whatever it took to land that flight job. I focused on that so much I overlooked the one thing I needed most: self confidence. I was overwhelmed and was unable to come off of orientation. So back home I went with my tail tucked between my legs.

The second time I flew I had gotten the desire to simply be in the air out of my system and my desire was to be able to do the job I wanted: to have the autonomy, protocols, and the equipment to do what the patient needed.

I don't fly anymore. Not because of the crash, not because of the injuries, not because of the pain and suffering during the 8 months of physical therapy and the emotional healing that inevitably came with it. But because of what happened AFTER I came back. Because of what happened AFTER I climbed back into the left seat.

The industry is over saturated... WAY over saturated. And ground EMS isn't nearly as advanced as it needs to be. The only time a helicopter should be utilized is if time is the ONLY thing that ground EMS cannot provide. But those birds are constantly in the air. They are flying more and more stable patients. Why? Simple. Flight volume. PR. The almighty dollar. When hospitals and ground crews call these companies for whatever reason, if they don't fly these amazingly stable patients then the requesting agency with get their feelings hurt and call another service. So they'll say, "Oh, just call us for your airmedical needs."

See, at 6 months into my 8 month intensive PT to get back on the line I discovered that the patient I almost died pinking up got drunk again and wrecked the car in almost the same spot. Then after I returned to the line I found that there were several flights that I was unable to take because my aircraft was already enroute to a PR and we were loaded down with pizzas and t-shirts. I held out for a few years hoping it would improve but it never did and I had had enough. I got tired of feeling dirty and wanting to vomit over some of the business practices. And it wasn't with just one service. I tried another one. And it was even worse. I was having to fly patients as a flight medic that I wouldn't even start an IV on as ground medic. And I was told to smile and thank them for the flight.

HEMS definitely has a place. It is needed. But not to the current extent that it is being used.

The only time a ground paramedic should use HEMS, IMHO, is if your patient needs to get there a h3ll of a lot faster than your highway gear can get them there.

The only reason I ever became a paramedic in the first place was so I could become a flight paramedic. Now you couldn't pay me to do that again.
 
MSDeltaFlt said:
The only time a ground paramedic should use HEMS, IMHO, is if your patient needs to get there a h3ll of a lot faster than your highway gear can get them there.
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I agree, to an extent, in a perfect world. But do you really think that HEMS does not offer anything over ground EMS in most places in the US? Blood, Txa, RSI, etc
 
A couple of months ago, I was speaking to a retired Baltimore (MD) County medic supervisor, and he said they used to call for medevac all the time; not because they needed the bird, but rather for the flight medic; ground medics couldn't RSI, while flight medics could. and this was 15 years ago.

Once you throw in for profit agencies into the HEMS 911 world, things got a lot shadier.... especially if the ground EMS and the HEMS were the same agency. HEMS usage increased, because there is big money to be made in HEMS. And there are plenty of stories about shady stuff happening involving for profit companies when they were trying to secure a new contract, or make the existing contract holders happy.

20 years ago, there were 2 helicopters covering all of NJ. Now there are 10 or so, with all but 2 being for profit entities (and one of them shut down due to lack of call volume due to over saturation).

I once had a dream of becoming a flight medic... but learning that a former coworker died in a medevac crash, and then the duke life flight crash, made me think that maybe it's better for me to not take that risk, because I want to go home to my family at the end of every shift.
 
If your patient actually requires blood or Txa then your patient is in a serious time sensitive situation that only two things can fix: hot lights and cold steel.

As far as RSI goes, there are ground crews that can RSI. And there still others that can DAI. If blood pressure is a concern then start pouring the fluids to them as you are getting the DAI drugs ready to push.

If the blood pressure is too low for DAI then that is why God created pressors. If the pressors don't work then they are in a serious time crunch that my aforementioned highway gear can't fix.
 
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