med copters collide

[CyBerg66 at aol.com]

There are two seperate issues here. One is the medical appropriateness of  
the flight which is for the medical community to determine. The other is  safety 
of flight which is the domain of pilots and safety offices in the  agencies 
that conduct HEMS missions. Addressing the former only ensures that  people who 
die in crashes will have had a reason to be in the aircraft. 
 
Forward progress in reducing crashes requires improvement in a number of  
factors that influence flight safety, including mission rules and inflight  
procedures. There are conditions under which flight operations are extremely  
hazardous. I'd be interested to hear the comments about flying in these  conditions 
from pilots and their agencies. Is the safety climate one that  endorses 
flying only when proven unsafe rather that when proven safe? Do the  mission rules 
for HEMS agencies tacitly endorse a policy of trading the lives of  their 
flight crews to save a patient's life?
 
Are there people who get flown who may not need it? Absolutely, and there's  
room for improvement there. But the medical community might make more progress 
 in HEMS safety by looking beyond protocols for what patients fly to put heat 
on  the organizations to improve flight safety.
 
 
 
In a message dated 7/2/2008 2:12:34 AM Eastern Daylight Time,  
TimothyHar at ialch.co.za writes:

Pret

I hear you, but I think what Bill is calling for is a set  of
quazi-evidence-based callout criteria that are patient focused  rather
than income-focused as most of the apparently commercial programs  seem
to be (my take on the recent discussions). Also there would need to be  a
system similar to what Mark Rustuccia suggested to collate calls so  that
one service is not played off against another - maybe a central  Medical
Director based dispatch per region rather than  Hospital-based???

Just my suggestion
Tim
Dr Timothy C  Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS  (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical  Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli  Central Hospital / UKZN
800 Bellair Road
Mayville, Durban

Postal:  PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu  Natal

timothyhar at ialch.co.za 


-----Original  Message-----
From:  trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On  Behalf Of Bjorn, Pret
Sent: 01 July 2008 22:04
To: Trauma &  Critical Care mailing list
Subject: RE: med copters collide

Dr.  Bromberg,

I take it that I'm the scolder to whom you refer.

I  don't recall anybody ever arguing that medical helicopters are safe,
nor  that they're used appropriately even most of the time.  I  emphasized
that some programs are much better than others.  Indeed, if  asked, I'd
eagerly support any reasonable efforts to enforce mission  standards and
safe practices.  All the same, it remains that there are  many Mainers
who owe their lives directly to our helicopters, and who would  take
harsh offense to the suggestion that their sorry skins weren't  worth
your arbitrary and obtuse quantification of the risks in play.   I
remember merely asserting that we shouldn't be so quick to soil  the
sacrifices of good individual men and women through  ill-informed
guesswork as to the causes and conditions of their tragic  deaths. 

Something like a hundred firefighters will die in the United  States this
year, most in the process of rescuing evacuated (or  altogether
abandoned) physical property.  Some of these -- perhaps  even most --
will be downright senseless wastes of life, by any  accounting.  Yet we
don't line up on the Trauma-List to collectively  ridicule them with
shallow evidence and anecdote.  What the hell are  all those guys doing
on the roof anyway?

Nor do we take any time at  all to give credit those cases in which
helicopters bring otherwise  inaccessible skills and tools to remote
crash scenes or rural emergency  departments, or cut the transit times of
critically ill and injured  patients by minutes or hours.

You seem quick to radically regulate  medical helicopters in order to
save a dozen peers and patients per year --  this criminal litany.  I'm
curious: would you as soon place reasonable  restrictions on firearms,
and save hundreds more?

Pret Bjorn,  RN
Bangor, ME USA






-----Original  Message-----
From:  trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On  Behalf Of William Bromberg
Sent: Tuesday, July 01, 2008 1:30 PM
To:  trauma-list at trauma.org
Subject: RE: med copters collide


Every  time something like this happens, someone points out that medical
flights  are being overused and that there is poor data to support it's
efficacy in  general. The next posting scolds the original questioner for
the question,  usually pointing out that you should not  "hurt the
feelings" or  trivialize the sacrifice of the victims and that it's "not
the right time"  to have the discussion.  Then it's forgotten about until
a few weeks  later when the next aircraft goes down. The cycle continues
and the  conversation is never held.

Fine - I want a date. If now isn't the  right time I propose we set a
date to discuss the appropriate use of  aeromedical transportation in the
civilian setting because frankly I'm sick  of these stories and I'm sick
of my flight crew being called out in all  kinds of weather for
uninjured, intoxicated patients. For times when the  ground crew is about
to go off shift and don't want to drive the hour round  trip. For a dog
bite to the foot. And it goes on and on and on.

Each  death is a tragedy. The unending litany of deaths is a crime.

But  that's just my opinion..
Bill Bromberg

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