Guest guest Posted January 19, 2002 Report Share Posted January 19, 2002 Wouldn't it be interesting to study the fatality rate of air ambulances compared to ground ambulances? I would bet that the number of crew deaths per patients transported is exponentially higher for aeromedical personnel compared to personnel on ground ambulances. The numbers to check must include the number of patients transported. What is the true risk? What is the risk/benefit ratio? It is important to remember that aeromedical helicopters were developed to provide speed and enhanced patient care. Now, with the advent of specialized ground ambulance critical care teams, critical care patients, where speed is not of the essence, can be transported by ground in greater comfort and safety. When looking at the aeromedical risk/benefit ratio, you cannot and should not include patients who can be transported by ground. I love to ride in helicopters and have spent hundreds of hours in them. But, that doesn't make it a cost-effective and safe modality. Food for thought.... Bledsoe, DO, FACEP, EMT-P Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2002 Report Share Posted January 19, 2002 I heard, once upon a time, that helicopter EMS is the most hazardous civilian aviation group due to factors like questionable landing zone security, poor weather decisions, etc. I haven't seen any official information on this, however. stay safe - pr --- " Dr. Bledsoe " wrote: > Wouldn't it be interesting to study the > fatality rate of air ambulances > compared to ground ambulances? I would bet > that the number of crew deaths > per patients transported is exponentially > higher for aeromedical personnel > compared to personnel on ground ambulances. > The numbers to check must > include the number of patients transported. > What is the true risk? What is > the risk/benefit ratio? It is important to > remember that aeromedical > helicopters were developed to provide speed and > enhanced patient care. Now, > with the advent of specialized ground ambulance > critical care teams, > critical care patients, where speed is not of > the essence, can be > transported by ground in greater comfort and > safety. When looking at the > aeromedical risk/benefit ratio, you cannot and > should not include patients > who can be transported by ground. I love to > ride in helicopters and have > spent hundreds of hours in them. But, that > doesn't make it a cost-effective > and safe modality. > > Food for thought.... > > Bledsoe, DO, FACEP, EMT-P > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2002 Report Share Posted January 20, 2002 I don't know any specific numbers but I would venture a bet that he is right. 10 years ago Flight programs were utilized as much for there speed as well as for their practice of medicine (extra skills, better tools all used to better patient care). Now most of those skills/tools are utilized by much better train ground crews (then 10 years ago) and I think the helicopters are primarily used for transport time reduction only. This is not to say that they are not beneficial, just a change in how they are used. I have the luxury of having 4 helicopters almost at my disposal and they are utilized sometimes effectively and sometimes not. Look forward to seeing any stats... Re: Air Ambulances > Wouldn't it be interesting to study the fatality rate of air ambulances > compared to ground ambulances? I would bet that the number of crew deaths > per patients transported is exponentially higher for aeromedical personnel > compared to personnel on ground ambulances. The numbers to check must > include the number of patients transported. What is the true risk? What is > the risk/benefit ratio? It is important to remember that aeromedical > helicopters were developed to provide speed and enhanced patient care. Now, > with the advent of specialized ground ambulance critical care teams, > critical care patients, where speed is not of the essence, can be > transported by ground in greater comfort and safety. When looking at the > aeromedical risk/benefit ratio, you cannot and should not include patients > who can be transported by ground. I love to ride in helicopters and have > spent hundreds of hours in them. But, that doesn't make it a cost-effective > and safe modality. > > Food for thought.... > > Bledsoe, DO, FACEP, EMT-P > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2002 Report Share Posted January 20, 2002 Warning - Long Post Dr. Bledsoe, I must respectfully disagree with some of your points. I believe you a probably right about the fatality rates. Of course I also believe you would need to factor in the number of ground medics who are injured/killed on the job in non-traffic related incidents. Because of the structure of how most air-med programs function, we are not exposed to some of the same dangers these individuals face because of the dangers inherent in their working environments. And let's not forget all us nurses working in those friendly and 'safe' hospital environments. We never are exposed to risks there. Complacency has no place in the hospital either - there are plenty of dangers lurking in the ER and ICU, but we don't frequently debate them, so they are less dramatic, less 'newsworthy' and provoke less publicity. My biggest disagreement is with your comparison of specialized ground transport teams to air-medical transport. Again, partially true, but largely applicable only to essentially urban/surburban areas. At my flight program a very large percentage of the flights originate in what are considered rural, if not frontier areas, and there may not even be ALS/MICU capable ground ambulances, much less 'critical care teams' available. These wonderful people do the best they possibly can with the equipment, knowledge, and time available to them, but frequently do not have the knowledge and/or skill resources to deliver the kind of treatment the patient needs NOW, not 1-3 hours later after a prolonged ground transport. Nor are medical emergencies exempt from this. Would you want one of your patients to ride for 3 hours with an IABP in place accompanied by someone who sees once maybe once every 1-2 years, and has never had experience in their care? Too extreme? Okay, how about a patient who 'only' has 2+ vasoactive drips being actively titrated? Trust me, an hour+ is a long time (been there, done that), and the most 'stable' patient can easily go south in a hurry. Time does count. Oh well, the hospital can just send a nurse along. Sure, and we have such a nursing EXCESS, that won't present any kind of problem, right? I also believe your statment about 'be transported by ground in greater comfort and safety' is false. 1-3 hours in the back of a ground unit, whose staff may or may not be able to provide any and/or adequate analgesia is excrutiating for any significantly injured patient. Even non-lifethreatening ortho injuries become torture when bounced along even average roads. And most of the roads in rural Texas don't see average very often. (By the way, I worked for a ground service as a medic, and our average transport time for severe trauma was in excess of 45 minutes, so I have seen this from both sides.) The noise and vibration are diffirent, but I doubt the finer vibration versus the bangs and bumps are harder to take, and the noise is mitigated with hearing protection - something not done for the patient who is in a unit screaming Code III down the road for a protracted period. Stressful - you better believe it - I once had a patient come back and tell me that he thought hearing the sirens meant he was dying, and he spent the whole trip wishing he had taken care of things diffirently. Yes, there is some degree of over triage to air transport. Good! That means that hopefully those that NEED to fly are doing so. We must have reasonable and responsible assignment of need, and not waste this expensive resource, but is is needed; interestingly enough I think most cases of overtriage come from hospitals, not the field. Whether on a scene or in the hospital, in the middle of a crisis, with very limited resources and personnel, it's always better to err on the side of the patient and choose to fly them, rather than wish you had later. Triage inherently is a non-scientific process, and multiple studies show you need approximately 10-15% OVER-triage to assure you get all those that really need to be classified as critical included in the first tier. And finally, yes - my job is probably dangerous to some degree - but so is working on high power lines. And like the guy doing that, I DO make a diffirence. A healthy component of fear is just that - healthy. It keeps you alert, and wards off complacency, a sure helicopter killer. You cannot be paralyzed by the fear, but you must be cognizant of the risks, so you can do everything possible to mitigate them. Safety must ALWAYS be the number one priority in getting the job done right. BUT . . . the job DOES need to be done. And I will argue any day that while the risk/benefit ratios and numbers affected may not be all that impressive . . . we DO make a diffirence . . . lives are saved because of air-medical transport. Those numbers are only insignificant until it is one YOU love who is in need of the service. Then, I'm fairly certain, it becomes a truely essential service. Is it worth it? To me, yes. Respectfully, Bennetsen RN BSN CFRN CEN CCRN EMT-P L & M Consulting L.L.C. San , TX " Searching for Knowledge. Finding Answers. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2002 Report Share Posted January 22, 2002 While this topic has not generated much debate on THIS list, it has been cross-posted to the Flightmed Flightweb list where it is receiving a lot of attention. In a message dated 1/19/02 7:00:03 PM Central Standard Time, bbledsoe@... writes: > Wouldn't it be interesting to study the fatality rate of air ambulances > compared to ground ambulances? I would bet that the number of crew deaths > per patients transported is exponentially higher for aeromedical personnel > compared to personnel on ground ambulances. The numbers to check must > include the number of patients transported. What is the true risk? What is > the risk/benefit ratio? It is important to remember that aeromedical > helicopters were developed to provide speed and enhanced patient care. Now, > with the advent of specialized ground ambulance critical care teams, > critical care patients, where speed is not of the essence, can be > transported by ground in greater comfort and safety. When looking at the > aeromedical risk/benefit ratio, you cannot and should not include patients > who can be transported by ground. I love to ride in helicopters and have > spent hundreds of hours in them. But, that doesn't make it a cost-effective > and safe modality. > > Food for thought.... > > Bledsoe, DO, FACEP, EMT-P > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2002 Report Share Posted January 22, 2002 Just the general arguments concerning time, money, patient care, safety, prestige............ This topic has generated 30 - 40 post. You can read the archives at http://www.flightweb.com/archive/flightmed/index.html In a message dated 1/22/02 9:34:03 PM Central Standard Time, bwiseman@... writes: > , > > What is the discussion like on the other site? > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2002 Report Share Posted January 22, 2002 , What is the discussion like on the other site? Re: Air Ambulances > While this topic has not generated much debate on THIS list, it has been > cross-posted to the Flightmed Flightweb list where it is receiving a lot of > attention. > > > > > In a message dated 1/19/02 7:00:03 PM Central Standard Time, > bbledsoe@... writes: > > > > Wouldn't it be interesting to study the fatality rate of air ambulances > > compared to ground ambulances? I would bet that the number of crew deaths > > per patients transported is exponentially higher for aeromedical personnel > > compared to personnel on ground ambulances. The numbers to check must > > include the number of patients transported. What is the true risk? What is > > the risk/benefit ratio? It is important to remember that aeromedical > > helicopters were developed to provide speed and enhanced patient care. Now, > > with the advent of specialized ground ambulance critical care teams, > > critical care patients, where speed is not of the essence, can be > > transported by ground in greater comfort and safety. When looking at the > > aeromedical risk/benefit ratio, you cannot and should not include patients > > who can be transported by ground. I love to ride in helicopters and have > > spent hundreds of hours in them. But, that doesn't make it a cost-effective > > and safe modality. > > > > Food for thought.... > > > > Bledsoe, DO, FACEP, EMT-P > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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