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Comments inserted, because I just couldn't let this one pass...

" So it's ok for Dudley to be sick of hearing about how dangerous ground

EMS is, but it's not ok for air EMS to be sick of hearing the issues? "

I wasn't debating with Dudley. I was debating with you. Actually, it was

more along the lines of wondering why you're so defensive than an actual

debate.

" The problem is not that you, or or anyone else for that matter

have issue and point out problems with the industry, it is that you all

start doing it the second there is a crash pointing fingers at all the

horrible air ems folks out there, making rash statements about how

unnecessary air EMS is, yet each of you today in this thread have agreed

with me that air EMS is necessary in the rural areas. "

It would help to actually read the replies, rather than just project

your own defensiveness. Nowhere did I say - nor anyone else, for that

matter - that helicopter EMS is unnecessary. Hell, it may even be

necessary - on a limited basis - in urban areas, too, given traffic

congestion and variability in resources. What *many* of us have said, is

that far too often, helicopter EMS is used *unnecessarily.* Do you not

recognize the distinction? I'd hope you do, because it's a big

distinction, but the tone of your replies suggests that you do not.

" Don't bash the crews and what they do, bash the greedy service owners

who have created the problem by only putting helos in metropolis areas

where the big bucks are. "

How did we get from a discussion on the need for greater safety

standards and regulation of HEMS to the suggestion that I'm bashing

flight medics? Dude, I *was* a flight medic (albeit only as a relief

medic). The only time you'll *ever* hear me bash another provider is

because they're idiots, not because of what vehicle they use to get to

and from the scene. And you know 's point about the dilution of

skill sets and experience with the proliferation of helicopter EMS? It's

a damned good point. There was once a time when flight medics were the

cream of the crop. That is still true in some areas. In others, where

HEMS abuse is rampant, the primary job qualification seems to be Pulse,

Patch, and Pounds weighed...although not necessarily in that order.

I'm assuming you're a flight medic, Rick. In that vein, I can see how

these HEMS accidents hit very close to home, and the resultant brouhaha

smacks of dancing on the graves of your brother and sister flight

medics...but still, it has to be said. Because very simply, those greedy

service owners aren't going to rein in the cash cow on their own, and

your surviving brothers and sisters in the flight services ain't

bitching loud enough to be heard. Whether that is because they don't

have the audience that Bledsoe does, or because they fear for their

jobs, remains to be seen. But what would help is if the flight medics

and nurses themselves rallied together behind someone like Bledsoe,

rather than getting unreasonably defensive every time something negative

is said about HEMS practices. Like you, for example.

" How many ground EMS CEO's do you think are out there that wouldn't

fight against safety regulations that would add $20,000 to the cost of a

box, regulate the ability to work a crew for 24 or 48 hours or

increase training requirements. "

Pretty much all of them. Of course, much of that may be that Medicare

reimbursement for ground EMS transport currently runs at about 70% of

the actual *cost* of doing said transport. I strongly suspect the same

is not true of HEMS...otherwise there wouldn't have been such a

proliferation of flight services in recent years. There would be no

money in it.

" Sometimes draconian regulations by outside people are exactly what is

needed. You say it like it's a bad thing. "

It *is* a bad thing, if the people drafting the regulations don't

understand the fundamentals of providing EMS. Right now, it seems we

have a binary solution set: Either remove much of the reimbursement

incentive from HEMS, and see many of the fly-by-night (even when they

shouldn't, and pun intended) fold, leaving only the better services left

to run HEMS, or keep reimbursement as it is, and require (preferably,

from within the industry) those greedy service owners to spend some of

those profits on all those expensive regulations, training and flight

safety doodads.

Which do you prefer?

--

Grayson, CCEMT-P

www.kellygrayson.com

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wrote, " Whether that is because they don't have the audience that

Bledsoe does, or because they fear for their

jobs, remains to be seen. But what would help is if the flight medics and

nurses themselves rallied together behind someone like Bledsoe, rather than

getting unreasonably defensive every time something negative

is said about HEMS practices. "

Several points:

1. I am lucky to have an " audience " and I understand the responsibility

that goes along with that. I owe this to a " plan " Jim Page laid out for me

10 years ago.

2. Such an " audience " can be used for the greater good and I will

forever use it for that.

3. The article on EMS1.com this month was hard on the HEMS people. I

received over 100 emails and not a single negative one. Most were from

flight crews. I even received an apology from a flight nurse who questioned

my motives. I have stayed on-point and on-message on HEMS-not just post

crash. But, post-crash is when the media seeks you out and you must talk

when the opportunity is presented.

4. The response from the flight medicine community to me has been

cordial, respectful, humble, and thankful. They are a good lot.

5. There is a lot of emotion in this. We have to stick to the science.

There is a role for HEMS. We need to work together to define it.

Everybody watch the NBC Evening News with tonight and see how

big an ass I made of myself. At least you can peek into my study.

This has the media's full attention. I did an interview with AP, National

Public Radio, the New York Times, and three Arizona radio stations (in

addition to NBC). I am supposed to do something later with the BBC. The

overall message is that HEMS is important, yet abused. It should be a part

of the EMS system. The flight crews are somewhat victims. My words on this

are very measured.

E. Bledsoe, DO, FACEP

Midlothian, Texas

Mark Your Calendars!

EMStock 2008

September 25-28, 2008

http://www.emstock.com

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So why does Texas DPS, New Mexico DPS, AZ DPS, the Cities of Tucson, El Paso,

Fort Worth (just the places I drove last week and saw them) still use them?

Tucson's just down the road where one of the Crown Vic disasters occurred,

burning the entire face off the officer who, thankfully survived, and is now a

homicide detective. Phoenix switched, but Tucson hasn't.

Is this because folks are inherently stupid or what?

GG

>

> It took 2 tragic deaths of peace officers to virtually ban Crown Vics from

> patrol service.....I

> ____________ ________ ________ _

> From: texasems-l@yahoogrotexasem [texasems-l@yahoogrotexasem] On Behalf Of

> lawrence verrett [lgverrett@...]

> Sent: Sunday, June 29, 2008 11:40 PM

> To: texasems-l@yahoogrotexasem

> Subject: Re: Food for thought

>

> At some point the FAA and the NTSB need to step in and say enough is enough.

> If this was any other sector of commercial aviation they would have already

> done so. This crash raye would not be aceptable in the millitary so why is it

> so in the civilian sector? I shall contact the FAA and ask them about this.

> Enough is enough.

>

>

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I am wondering when the flight grunts, the pilots, medics, and nurses, are

going to rise up and demand that their corporate masters get a clue?

It is they who get killed, not the bastards in Armani suits sitting around

counting their money.

I have had at least three friends get fired from HEMS jobs in the last three

years because they refused to fly with a pilot who was inexperienced and

dangerous. I know one medic who almost got fired because she happened to

refuse

to fly in a bird that had a puddle of diesel fuel in its belly.

I lost a friend in a flight that never should have happened. The competing

service refused it because of weather, but his service wanted to prove that

their ship had big balls hanging down from it, and three innocent people died.

In all these cases, it was the damn SUITS who applied the pressure to make

the flight. It was THEY who hired inexperienced pilots. It was THEY who fired

those who complained.

I currently have at least 5 friends flying, and I worry about them every day.

I worry about them because the services they work for are lax in

maintenance, continually put pressure on them to fly in inappropriate weather,

use birds

that are 30 years old and unequipped for IFR, night vision, and so forth. I

have one friend who survived TWO hard landings that essentially totalled the

bird.

I used to fly and I loved it. I still get a thrill when the bird lifts off.

But I quit after two forced landings. One of my favorite pilots used to

say that a helicopter is 100,000 parts held together by hope. The older the

bird, the stronger the hope has to be.

HEMS is dangerous. GEMS is dangerous, but you have a hell of a better

chance in a ground ambulance than you do in a helo in an emergency.

Yes, HEMS has a place, but it's in rural America, not in the urban areas for

the most part. Here in Tucson, they send the bird 5 miles, spend 20 minutes

on scene, and the ground ambulance transporting the " stable " patients gets to

the trauma center before they do. What kind of self-deception drives that?

Why are there an armada of helos in the Dallas-Ft Worth area, all competing

with each other to the death (of their crews, not them). Because it's all

about MONEY.

As much as I hate state regulation, it is time that something is done to

control not only HEMS but also ground EMS. Why in God's name should there be

over 100 ambulance services in Dallas County?

Thank you, Bledsoe, for your guts and courage in standing up for what

is right. Now, let's get behind and make something happen. Write,

call, email your Congressmen and your state representatives. Talk to the

Governor. Write to GETAC. Write to Maxie, not to convince him (he doesn't

need

convincing) but so that he can hold up your message when he testifies to the

legislative committees and say how many of you have contacted him about this.

There may very well be little that DSHS can do to regulate the HEMS industry.

There are serious questions about jurisdiction. Fine. Let's still keep

the pressure on.

I want you all to think about this. How many patients have been killed in

HEMS accidents who didn't even need HEMS to begin with?

For those of you who fly, how many of your patients got discharged before you

got back to base?

We all know this.

The whole EMS industry is like a bunch of teenagers trying to enact rules for

sex and drinking. We are still young and immature, but we need to grow up.

GG

>

> " Could it be because every time a helicopter crashes, the " ground

> pounders " raise up in arms with the " here we go again, when will someone

> step in and stop all this air ambulance madness " . "

>

> Not to piss in your Wheaties, Rick, and that is really not my intent...

>

> ...but that's *exactly* what we should be doing. Someone needs to raise

> a hue and cry about the HEMS industry - not that it isn't a needed

> component of EMS overall, because it is - but because the safety record

> is abominable. And rather than have HEMS industry insiders leading the

> charge for stricter standards, they're resisting it at every turn. That

> leaves the ground pounders to point out the problems, who are then

> accused of having an ax to grind by those recalcitrant HEMS industry

> insiders.

>

> You rightly point out that ground EMS has its safety issues as well. RLS

> responses, long shifts, shoddy ambulance design - both in handling and

> crew safety features - are *all* things ground EMS needs to address.

>

> Nadine Levick lectures all over this country about ground ambulance

> accidents, vehicle design and safety issues. Her talks are popular,

> well-attended and well-received by those of us who practice ground EMS.

> She's known throughout the industry as a safety advocate with the best

> interests of EMS crews at heart. More and more people are listening to

> what she has to say.

>

> Conversely, who decries the same lack of safety standards in HEMS, with

> the same reach? *One* lonely voice - Bledsoe - and every time he

> points out the insanity, he is pilloried by everyone in flight suits as

> that outsider kook DO from Midlothian who hates EMS helicopters.

>

> Something powerfully wrong with that picture, and unless something is

> done soon from the *inside*, pretty soon you're gonna see draconian

> regulations implemented by people from the *outside*, who will make

> Bledsoe look like your best friend.

>

> Of course, YMMV...

>

> --

> Grayson, CCEMT-P

> www.kellygrayson. ww

>

>

**************

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fuel-efficient used cars.

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The comment about dual pilots is a very interesting idea. When you think

about it, the only time you see a single pilot in aviation is

recreational general aviation and some smaller charter services, which,

generally speaking, is pretty easy flying. Yet, the more challenging

aviation areas (commercial, military) pretty much all have dual pilots.

I consider HEMS " challenging aviation " , because these pilots are going

to places they've never been before, landing on fields, highways, etc,

instead of airports where they have charts.

Hmmm...........

Bledsoe, DO wrote:

>

> Dudley wrote, " Dr. Bledsoe, we need to call for a 72 to 96 hour moratorium

> on Air Medical Flights.? Ground them all, mandate some safety work and

> policy review...and the FAA needs to get off their politically insensitive

> back-sides and mandate REAL safety improvements in these

> helicopters...terrain avoidance, collision avoidance, night vision

> goggles,

> dual engines, flight recorders and maybe even dual pilots...the air

> medical

> industry wants to hide behind the Federal Airline Deregulation Rules when

> individual states try to regulate them, then have them step up to the big

> boy microphone and live by it all the time? "

>

> I mentioned the need for a national stand down on Flightweb. The responses

> seem interested. Who would call it? Would it be mandatory? I have done 4-5

> interviews this AM and mentioned it (when I can). I think people will have

> to listen now. I have spoken with some big outlets today (NPR, AP, New

> York

> Times and soon NBC). I'll relay the message. But, remember, to the

> helicopter community I am some disgruntled yahoo from Texas who hates

> HEMS.

> Actually, I love HEMS. I hate to see good people die when the benefits for

> the patient do not outweigh the risks.

>

>

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Yep. The safety concerns " came aprart. "

That's what happens in most preventable accidents.

Pilots know very well what the rules are. Yet, some of them violate them.

They do it because they're complacent, bored, and assume that nothing can go

wrong, go wrong, go wrong, go wrong......

If a regular civilian private pilot makes a big mistake in communication,

he's raked over the coals.

But if an HEMS pilot chooses to ignore the rules, bend the rules, or is just

oblivious to the rules, what happens? Well he usually ends up as a mass of

protoplasm inspected by the local medical examiner.

Where is the FAA in this? Absent.

GG

**************

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Has anyone looked at one pilot versus 2 in HEMS? NJ's state based program has

always used 2 pilots and to my knowledge never had even a " hard landing " . Does

MD fly with 2 or with 1? I've never seen a private use 2 but I've not interacted

with many.

LNM from Baku, Azerbaijan

Sent via BlackBerry by AT & T

Re: Food for Thought

The comment about dual pilots is a very interesting idea. When you think

about it, the only time you see a single pilot in aviation is

recreational general aviation and some smaller charter services, which,

generally speaking, is pretty easy flying. Yet, the more challenging

aviation areas (commercial, military) pretty much all have dual pilots.

I consider HEMS " challenging aviation " , because these pilots are going

to places they've never been before, landing on fields, highways, etc,

instead of airports where they have charts.

Hmmm...........

Bledsoe, DO wrote:

>

> Dudley wrote, " Dr. Bledsoe, we need to call for a 72 to 96 hour moratorium

> on Air Medical Flights.? Ground them all, mandate some safety work and

> policy review...and the FAA needs to get off their politically insensitive

> back-sides and mandate REAL safety improvements in these

> helicopters...terrain avoidance, collision avoidance, night vision

> goggles,

> dual engines, flight recorders and maybe even dual pilots...the air

> medical

> industry wants to hide behind the Federal Airline Deregulation Rules when

> individual states try to regulate them, then have them step up to the big

> boy microphone and live by it all the time? "

>

> I mentioned the need for a national stand down on Flightweb. The responses

> seem interested. Who would call it? Would it be mandatory? I have done 4-5

> interviews this AM and mentioned it (when I can). I think people will have

> to listen now. I have spoken with some big outlets today (NPR, AP, New

> York

> Times and soon NBC). I'll relay the message. But, remember, to the

> helicopter community I am some disgruntled yahoo from Texas who hates

> HEMS.

> Actually, I love HEMS. I hate to see good people die when the benefits for

> the patient do not outweigh the risks.

>

>

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Allow me to add two cents to this, as I have flown into that hospital as a

crewmember.

IME, unless things have changed significantly in FLG, there is one approach to

the Hospital LZ due to noise abatement, both for the hospital and for

surrounding residences and businesses. From the video I have seen, where those

birds came together was in the general vicinity of that approach. It is

uncontrolled and a VFR approach (granted that may have changed with greater use

of GPS, but You never know) IOW 'see and be seen'... a high potential for

'traffic conflicts'.

Mitigation- It used to be that if there was a potential conflict, we found that

out either A. monitoring the general aircraft frequency or B. a heads up from

the ER when we gave report, usually at 5 minutes inbound. If " B " , we advised the

pilot to contact the other bird on " A " . There was no obligation to do this on

the ED's part, but a courtesy and an understood need for safety.

As with any incident, the links in the safety chain came apart and you saw one

of the potential outcomes :.(

" A prudent man foresees the difficulties ahead and prepares for them; the

simpleton goes blindly on and suffers the consequences. "

Proverbs 22:3

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Its been a while since I looked and things may have changed, but MD State

Police flew with 2 pilots. Two pilots aren't necessarily better than one but

the accident rate for 2 pilot crews is considerably lower than single pilot.

The only accident involving a two pilot crew that I'm aware of was in

Lexington, KY and that was a positioning flight. The crew flew into the

mountain in

a bad case of get-home-itis.

Want to minimize the risk for HEMS? Require 2 pilot crews with twin engine

aircraft, full IFR with flight directors, radar altimeters, and synthetic

visison. Can that requirement be supported? Probably not from an economical

standpoint.

Kirk

EMT-B

In a message dated 7/1/2008 00:06:52 Central Daylight Time, lnmolino@...

writes:

Has anyone looked at one pilot versus 2 in HEMS? NJ's state based program

has always used 2 pilots and to my knowledge never had even a " hard landing " .

Does MD fly with 2 or with 1? I've never seen a private use 2 but I've not

interacted with many.

LNM from Baku, Azerbaijan

Sent via BlackBerry by AT & T

Re: Food for Thought

The comment about dual pilots is a very interesting idea. When you think

about it, the only time you see a single pilot in aviation is

recreational general aviation and some smaller charter services, which,

generally speaking, is pretty easy flying. Yet, the more challenging

aviation areas (commercial, military) pretty much all have dual pilots.

I consider HEMS " challenging aviation " , because these pilots are going

to places they've never been before, landing on fields, highways, etc,

instead of airports where they have charts.

Hmmm...........

Bledsoe, DO wrote:

>

> Dudley wrote, " Dr. Bledsoe, we need to call for a 72 to 96 hour moratorium

> on Air Medical Flights.? Ground them all, mandate some safety work and

> policy review...and the FAA needs to get off their politically insensitive

> back-sides and mandate REAL safety improvements in these

> helicopters...terrain avoidance, collision avoidance, night vision

> goggles,

> dual engines, flight recorders and maybe even dual pilots...the air

> medical

> industry wants to hide behind the Federal Airline Deregulation Rules when

> individual states try to regulate them, then have them step up to the big

> boy microphone and live by it all the time? "

>

> I mentioned the need for a national stand down on Flightweb. The responses

> seem interested. Who would call it? Would it be mandatory? I have done 4-5

> interviews this AM and mentioned it (when I can). I think people will have

> to listen now. I have spoken with some big outlets today (NPR, AP, New

> York

> Times and soon NBC). I'll relay the message. But, remember, to the

> helicopter community I am some disgruntled yahoo from Texas who hates

> HEMS.

> Actually, I love HEMS. I hate to see good people die when the benefits for

> the patient do not outweigh the risks.

>

> [Non-text portions of this message have been removed]

>

>

------------------------------------

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Ah but is it not how MD, DE and NJ do their state wide systems? How is it that

NJ up until very recent had no non-state owned HEMS operating from within its

boarders? Now understand PA, DE, NY and MD birds flew routinely but to NJ but

only when dispatched by a regional state based center which choose what birds

went where.

LNM from Baku, Azerbaijan

Sent via BlackBerry by AT & T

Re: Food for Thought

The comment about dual pilots is a very interesting idea. When you think

about it, the only time you see a single pilot in aviation is

recreational general aviation and some smaller charter services, which,

generally speaking, is pretty easy flying. Yet, the more challenging

aviation areas (commercial, military) pretty much all have dual pilots.

I consider HEMS " challenging aviation " , because these pilots are going

to places they've never been before, landing on fields, highways, etc,

instead of airports where they have charts.

Hmmm...........

Bledsoe, DO wrote:

>

> Dudley wrote, " Dr. Bledsoe, we need to call for a 72 to 96 hour moratorium

> on Air Medical Flights.? Ground them all, mandate some safety work and

> policy review...and the FAA needs to get off their politically insensitive

> back-sides and mandate REAL safety improvements in these

> helicopters...terrain avoidance, collision avoidance, night vision

> goggles,

> dual engines, flight recorders and maybe even dual pilots...the air

> medical

> industry wants to hide behind the Federal Airline Deregulation Rules when

> individual states try to regulate them, then have them step up to the big

> boy microphone and live by it all the time? "

>

> I mentioned the need for a national stand down on Flightweb. The responses

> seem interested. Who would call it? Would it be mandatory? I have done 4-5

> interviews this AM and mentioned it (when I can). I think people will have

> to listen now. I have spoken with some big outlets today (NPR, AP, New

> York

> Times and soon NBC). I'll relay the message. But, remember, to the

> helicopter community I am some disgruntled yahoo from Texas who hates

> HEMS.

> Actually, I love HEMS. I hate to see good people die when the benefits for

> the patient do not outweigh the risks.

>

> [Non-text portions of this message have been removed]

>

>

------------------------------------

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I spoke with the FAA just now and talked to a person in the 200 Division which

handles HEMS . The person I spoke with person ( name with held) and he told me

that this morning at 7 :00 am EST the hammer dropped from on high about the HEMS

issue. They are now looking into it and because it is a crash investigation at

it onset he could 1. not comment on it because he is a staffer and 2. He had no

information to give even if he could other than to say 'We are looking into it.'

.. He did point me towards the FAA Public Affairs page where a document is either

inplace or will be that explans what the FAA has done so far and certain

recomendations that the FAA has issued. He stressed to me that he is not a

manager type so he was not 100% correct on what the document may or maynot say

but thought it would be a good thing for people to read. If anyone wants the

number to the Aviation Transportation Division 200 Branch here it is.

. I am not a helo medic but know people

who are. Like you all, I have whitnessed times when a helo was called and used

when GEMS would have been beter or no change in the out come.

The only thing I can say is that for supervisor types, review your companies

policy as it pretains the HEMS, train your medics on when to call. Hospital

types should do the same. Lastly, and I beleve this is the most important group

but they are not on the website, the helo companies themselves need to take a

long hard look at how they are flying and ask if they are doing it right.To get

to the PA office I had to search the FAA website to find it. I did not see any

such dicument but that means nothing.

Lawrence

wegandy1938@... wrote:

I am wondering when the flight grunts, the pilots, medics, and nurses,

are

going to rise up and demand that their corporate masters get a clue?

It is they who get killed, not the bastards in Armani suits sitting around

counting their money.

I have had at least three friends get fired from HEMS jobs in the last three

years because they refused to fly with a pilot who was inexperienced and

dangerous. I know one medic who almost got fired because she happened to refuse

to fly in a bird that had a puddle of diesel fuel in its belly.

I lost a friend in a flight that never should have happened. The competing

service refused it because of weather, but his service wanted to prove that

their ship had big balls hanging down from it, and three innocent people died.

In all these cases, it was the damn SUITS who applied the pressure to make

the flight. It was THEY who hired inexperienced pilots. It was THEY who fired

those who complained.

I currently have at least 5 friends flying, and I worry about them every day.

I worry about them because the services they work for are lax in

maintenance, continually put pressure on them to fly in inappropriate weather,

use birds

that are 30 years old and unequipped for IFR, night vision, and so forth. I

have one friend who survived TWO hard landings that essentially totalled the

bird.

I used to fly and I loved it. I still get a thrill when the bird lifts off.

But I quit after two forced landings. One of my favorite pilots used to

say that a helicopter is 100,000 parts held together by hope. The older the

bird, the stronger the hope has to be.

HEMS is dangerous. GEMS is dangerous, but you have a hell of a better

chance in a ground ambulance than you do in a helo in an emergency.

Yes, HEMS has a place, but it's in rural America, not in the urban areas for

the most part. Here in Tucson, they send the bird 5 miles, spend 20 minutes

on scene, and the ground ambulance transporting the " stable " patients gets to

the trauma center before they do. What kind of self-deception drives that?

Why are there an armada of helos in the Dallas-Ft Worth area, all competing

with each other to the death (of their crews, not them). Because it's all

about MONEY.

As much as I hate state regulation, it is time that something is done to

control not only HEMS but also ground EMS. Why in God's name should there be

over 100 ambulance services in Dallas County?

Thank you, Bledsoe, for your guts and courage in standing up for what

is right. Now, let's get behind and make something happen. Write,

call, email your Congressmen and your state representatives. Talk to the

Governor. Write to GETAC. Write to Maxie, not to convince him (he doesn't need

convincing) but so that he can hold up your message when he testifies to the

legislative committees and say how many of you have contacted him about this.

There may very well be little that DSHS can do to regulate the HEMS industry.

There are serious questions about jurisdiction. Fine. Let's still keep

the pressure on.

I want you all to think about this. How many patients have been killed in

HEMS accidents who didn't even need HEMS to begin with?

For those of you who fly, how many of your patients got discharged before you

got back to base?

We all know this.

The whole EMS industry is like a bunch of teenagers trying to enact rules for

sex and drinking. We are still young and immature, but we need to grow up.

GG

>

> " Could it be because every time a helicopter crashes, the " ground

> pounders " raise up in arms with the " here we go again, when will someone

> step in and stop all this air ambulance madness " . "

>

> Not to piss in your Wheaties, Rick, and that is really not my intent...

>

> ...but that's *exactly* what we should be doing. Someone needs to raise

> a hue and cry about the HEMS industry - not that it isn't a needed

> component of EMS overall, because it is - but because the safety record

> is abominable. And rather than have HEMS industry insiders leading the

> charge for stricter standards, they're resisting it at every turn. That

> leaves the ground pounders to point out the problems, who are then

> accused of having an ax to grind by those recalcitrant HEMS industry

> insiders.

>

> You rightly point out that ground EMS has its safety issues as well. RLS

> responses, long shifts, shoddy ambulance design - both in handling and

> crew safety features - are *all* things ground EMS needs to address.

>

> Nadine Levick lectures all over this country about ground ambulance

> accidents, vehicle design and safety issues. Her talks are popular,

> well-attended and well-received by those of us who practice ground EMS.

> She's known throughout the industry as a safety advocate with the best

> interests of EMS crews at heart. More and more people are listening to

> what she has to say.

>

> Conversely, who decries the same lack of safety standards in HEMS, with

> the same reach? *One* lonely voice - Bledsoe - and every time he

> points out the insanity, he is pilloried by everyone in flight suits as

> that outsider kook DO from Midlothian who hates EMS helicopters.

>

> Something powerfully wrong with that picture, and unless something is

> done soon from the *inside*, pretty soon you're gonna see draconian

> regulations implemented by people from the *outside*, who will make

> Bledsoe look like your best friend.

>

> Of course, YMMV...

>

> --

> Grayson, CCEMT-P

> www.kellygrayson. ww

>

>

**************

Gas prices getting you down? Search AOL Autos for

fuel-efficient used cars.

(http://autos.aol.com/used?ncid=aolaut00050000000007)

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" One other question, when you bash another medic because he/she is an

idiot, is that because you personally witnessed that idiocy or is it

based on a one sided news report about the incident? "

If there is anything I have learned in my years in EMS, it's that

everyone is an expert about someone else's patient.

Based on that observation, I limit my provider bashing to the incidents

I have personally witnessed.

--

Grayson, CCEMT-P

www.kellygrayson.com

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Guest guest

Has anyone taken into consideration that one of the major reasons

that there are so many HEMS, and that maybe one of the reasons that

they take some of the risks that they do is the almighty dollar. I

don't know for certain that they are getting pressure from (as Gene

put it the suits) but I feel quit comfortable in saying that HEMS are

probably pushing very hard for all of the transports they can get. At

some point Medicare, and the insurance companies need to take a long

hard look at helicopter transports, because this costs to everybody,

especially in terms of higher insurance premiums. Just my thoughts.

> I am wondering when the flight grunts, the pilots,

medics, and nurses, are

> going to rise up and demand that their corporate masters get a clue?

>

> It is they who get killed, not the bastards in Armani suits sitting

around

> counting their money.

>

> I have had at least three friends get fired from HEMS jobs in the

last three

> years because they refused to fly with a pilot who was

inexperienced and

> dangerous. I know one medic who almost got fired because she

happened to refuse

> to fly in a bird that had a puddle of diesel fuel in its belly.

>

> I lost a friend in a flight that never should have happened. The

competing

> service refused it because of weather, but his service wanted to

prove that

> their ship had big balls hanging down from it, and three innocent

people died.

>

> In all these cases, it was the damn SUITS who applied the pressure

to make

> the flight. It was THEY who hired inexperienced pilots. It was THEY

who fired

> those who complained.

>

> I currently have at least 5 friends flying, and I worry about them

every day.

> I worry about them because the services they work for are lax in

> maintenance, continually put pressure on them to fly in

inappropriate weather, use birds

> that are 30 years old and unequipped for IFR, night vision, and so

forth. I

> have one friend who survived TWO hard landings that essentially

totalled the

> bird.

>

> I used to fly and I loved it. I still get a thrill when the bird

lifts off.

> But I quit after two forced landings. One of my favorite pilots

used to

> say that a helicopter is 100,000 parts held together by hope. The

older the

> bird, the stronger the hope has to be.

>

> HEMS is dangerous. GEMS is dangerous, but you have a hell of a

better

> chance in a ground ambulance than you do in a helo in an emergency.

>

> Yes, HEMS has a place, but it's in rural America, not in the urban

areas for

> the most part. Here in Tucson, they send the bird 5 miles, spend 20

minutes

> on scene, and the ground ambulance transporting the " stable "

patients gets to

> the trauma center before they do. What kind of self-deception

drives that?

>

> Why are there an armada of helos in the Dallas-Ft Worth area, all

competing

> with each other to the death (of their crews, not them). Because

it's all

> about MONEY.

>

> As much as I hate state regulation, it is time that something is

done to

> control not only HEMS but also ground EMS. Why in God's name should

there be

> over 100 ambulance services in Dallas County?

>

> Thank you, Bledsoe, for your guts and courage in standing up

for what

> is right. Now, let's get behind and make something happen.

Write,

> call, email your Congressmen and your state representatives. Talk

to the

> Governor. Write to GETAC. Write to Maxie, not to convince him (he

doesn't need

> convincing) but so that he can hold up your message when he

testifies to the

> legislative committees and say how many of you have contacted him

about this.

>

> There may very well be little that DSHS can do to regulate the HEMS

industry.

> There are serious questions about jurisdiction. Fine. Let's still

keep

> the pressure on.

>

> I want you all to think about this. How many patients have been

killed in

> HEMS accidents who didn't even need HEMS to begin with?

>

> For those of you who fly, how many of your patients got discharged

before you

> got back to base?

>

> We all know this.

>

> The whole EMS industry is like a bunch of teenagers trying to enact

rules for

> sex and drinking. We are still young and immature, but we need to

grow up.

>

> GG

>

>

>

> >

> > " Could it be because every time a helicopter crashes, the " ground

> > pounders " raise up in arms with the " here we go again, when will

someone

> > step in and stop all this air ambulance madness " . "

> >

> > Not to piss in your Wheaties, Rick, and that is really not my

intent...

> >

> > ...but that's *exactly* what we should be doing. Someone needs to

raise

> > a hue and cry about the HEMS industry - not that it isn't a needed

> > component of EMS overall, because it is - but because the safety

record

> > is abominable. And rather than have HEMS industry insiders

leading the

> > charge for stricter standards, they're resisting it at every

turn. That

> > leaves the ground pounders to point out the problems, who are then

> > accused of having an ax to grind by those recalcitrant HEMS

industry

> > insiders.

> >

> > You rightly point out that ground EMS has its safety issues as

well. RLS

> > responses, long shifts, shoddy ambulance design - both in

handling and

> > crew safety features - are *all* things ground EMS needs to

address.

> >

> > Nadine Levick lectures all over this country about ground

ambulance

> > accidents, vehicle design and safety issues. Her talks are

popular,

> > well-attended and well-received by those of us who practice

ground EMS.

> > She's known throughout the industry as a safety advocate with the

best

> > interests of EMS crews at heart. More and more people are

listening to

> > what she has to say.

> >

> > Conversely, who decries the same lack of safety standards in

HEMS, with

> > the same reach? *One* lonely voice - Bledsoe - and every

time he

> > points out the insanity, he is pilloried by everyone in flight

suits as

> > that outsider kook DO from Midlothian who hates EMS helicopters.

> >

> > Something powerfully wrong with that picture, and unless

something is

> > done soon from the *inside*, pretty soon you're gonna see

draconian

> > regulations implemented by people from the *outside*, who will

make

> > Bledsoe look like your best friend.

> >

> > Of course, YMMV...

> >

> > --

> > Grayson, CCEMT-P

> > www.kellygrayson. ww

> >

> >

>

> **************

> Gas prices getting you down? Search AOL Autos for

> fuel-efficient used cars.

> (http://autos.aol.com/used?ncid=aolaut00050000000007)

>

>

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Guest guest

You get pressure from all sorts of places. I do know that management will

raise a fuss when a flight is turned down. A friend of mine was launched on a

night scene. Dispatch gave them the wrong coordinates, the weather wasn't

really great although still VFR, but then the GPS started going flakey. The

medic said turn around so under the " 3 to go, 1 to stay " concept, the pilot

turned around. The patient was transported by another aircraft (same service).

All of the crew was chastised by management for turning around.

We once turned down a flight to go pick up an already deceased person. The

weather was below our operational minimums and was on the raw edge of our

operating radius. Our marketing department was pleading with us to make an

exception and the victim's family was also pushing us to go. Our decision held

and our local management agreed with us.

Then there's the " hero " aspect that has to be overcome. Pilots tend to be

mission oriented, medics tend to be " save the victim " oriented. Combine the

two and you've got a potentially lethal mix. Recognizing that, as callous as

it sounds, the victim is just another piece of cargo and that its not worth

killing more people to save a few minutes is one of those difficult lessons.

Kirk

EMT-B

In a message dated 7/1/2008 18:34:56 Central Daylight Time, markpo@...

writes:

Has anyone taken into consideration that one of the major reasons

that there are so many HEMS, and that maybe one of the reasons that

they take some of the risks that they do is the almighty dollar. I

don't know for certain that they are getting pressure from (as Gene

put it the suits) but I feel quit comfortable in saying that HEMS are

probably pushing very hard for all of the transports they can get. At

some point Medicare, and the insurance companies need to take a long

hard look at helicopter transports, because this costs to everybody,

especially in terms of higher insurance premiums. Just my thoughts.

> I am wondering when the flight grunts, the pilots,

medics, and nurses, are

> going to rise up and demand that their corporate masters get a clue?

>

> It is they who get killed, not the bastards in Armani suits sitting

around

> counting their money.

>

> I have had at least three friends get fired from HEMS jobs in the

last three

> years because they refused to fly with a pilot who was

inexperienced and

> dangerous. I know one medic who almost got fired because she

happened to refuse

> to fly in a bird that had a puddle of diesel fuel in its belly.

>

> I lost a friend in a flight that never should have happened. The

competing

> service refused it because of weather, but his service wanted to

prove that

> their ship had big balls hanging down from it, and three innocent

people died.

>

> In all these cases, it was the damn SUITS who applied the pressure

to make

> the flight. It was THEY who hired inexperienced pilots. It was THEY

who fired

> those who complained.

>

> I currently have at least 5 friends flying, and I worry about them

every day.

> I worry about them because the services they work for are lax in

> maintenance, continually put pressure on them to fly in

inappropriate weather, use birds

> that are 30 years old and unequipped for IFR, night vision, and so

forth. I

> have one friend who survived TWO hard landings that essentially

totalled the

> bird.

>

> I used to fly and I loved it. I still get a thrill when the bird

lifts off.

> But I quit after two forced landings. One of my favorite pilots

used to

> say that a helicopter is 100,000 parts held together by hope. The

older the

> bird, the stronger the hope has to be.

>

> HEMS is dangerous. GEMS is dangerous, but you have a hell of a

better

> chance in a ground ambulance than you do in a helo in an emergency.

>

> Yes, HEMS has a place, but it's in rural America, not in the urban

areas for

> the most part. Here in Tucson, they send the bird 5 miles, spend 20

minutes

> on scene, and the ground ambulance transporting the " stable "

patients gets to

> the trauma center before they do. What kind of self-deception

drives that?

>

> Why are there an armada of helos in the Dallas-Ft Worth area, all

competing

> with each other to the death (of their crews, not them). Because

it's all

> about MONEY.

>

> As much as I hate state regulation, it is time that something is

done to

> control not only HEMS but also ground EMS. Why in God's name should

there be

> over 100 ambulance services in Dallas County?

>

> Thank you, Bledsoe, for your guts and courage in standing up

for what

> is right. Now, let's get behind and make something happen.

Write,

> call, email your Congressmen and your state representatives. Talk

to the

> Governor. Write to GETAC. Write to Maxie, not to convince him (he

doesn't need

> convincing) but so that he can hold up your message when he

testifies to the

> legislative committees and say how many of you have contacted him

about this.

>

> There may very well be little that DSHS can do to regulate the HEMS

industry.

> There are serious questions about jurisdiction. Fine. Let's still

keep

> the pressure on.

>

> I want you all to think about this. How many patients have been

killed in

> HEMS accidents who didn't even need HEMS to begin with?

>

> For those of you who fly, how many of your patients got discharged

before you

> got back to base?

>

> We all know this.

>

> The whole EMS industry is like a bunch of teenagers trying to enact

rules for

> sex and drinking. We are still young and immature, but we need to

grow up.

>

> GG

>

> In a message dated 6/30/08 1:43:57 PM, Grayson902@... writes:

>

> >

> > " Could it be because every time a helicopter crashes, the " ground

> > pounders " raise up in arms with the " here we go again, when will

someone

> > step in and stop all this air ambulance madness " . "

> >

> > Not to piss in your Wheaties, Rick, and that is really not my

intent...

> >

> > ...but that's *exactly* what we should be doing. Someone needs to

raise

> > a hue and cry about the HEMS industry - not that it isn't a needed

> > component of EMS overall, because it is - but because the safety

record

> > is abominable. And rather than have HEMS industry insiders

leading the

> > charge for stricter standards, they're resisting it at every

turn. That

> > leaves the ground pounders to point out the problems, who are then

> > accused of having an ax to grind by those recalcitrant HEMS

industry

> > insiders.

> >

> > You rightly point out that ground EMS has its safety issues as

well. RLS

> > responses, long shifts, shoddy ambulance design - both in

handling and

> > crew safety features - are *all* things ground EMS needs to

address.

> >

> > Nadine Levick lectures all over this country about ground

ambulance

> > accidents, vehicle design and safety issues. Her talks are

popular,

> > well-attended and well-received by those of us who practice

ground EMS.

> > She's known throughout the industry as a safety advocate with the

best

> > interests of EMS crews at heart. More and more people are

listening to

> > what she has to say.

> >

> > Conversely, who decries the same lack of safety standards in

HEMS, with

> > the same reach? *One* lonely voice - Bledsoe - and every

time he

> > points out the insanity, he is pilloried by everyone in flight

suits as

> > that outsider kook DO from Midlothian who hates EMS helicopters.

> >

> > Something powerfully wrong with that picture, and unless

something is

> > done soon from the *inside*, pretty soon you're gonna see

draconian

> > regulations implemented by people from the *outside*, who will

make

> > Bledsoe look like your best friend.

> >

> > Of course, YMMV...

> >

> > --

> > Grayson, CCEMT-P

> > www.kellygrayson. ww

> >

> >

>

> **************

> Gas prices getting you down? Search AOL Autos for

> fuel-efficient used cars.

> (http://autos.aol.com/used?ncid=aolaut00050000000007)

>

>

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Guest guest

Yes.

GG

>

> So any legally require investigation such as NTSB etc would qualify yes?

>

> LNM from Baku, Azerbaijan

> Sent via BlackBerry by AT & T

>

> Re: Food for thought

>

>

> HIPAA attaches to the record, not the patient. Therefore, disclosure can

> only be done under HIPAA rules.

>

> GG

>

>

**************

Gas prices getting you down? Search AOL Autos for

fuel-efficient used cars.

(http://autos.aol.com/used?ncid=aolaut00050000000007)

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