Re: Safety Question?

["Andrew Berry" <Aberry@nets.org.au>]

We grappled with this problem some time ago. For a time we stopped hot ops. entirely while we thought it through.

Our previous practice had been for hot ops. to be uncommon and ad hoc. They were mostly used outbound when the a/c needed to reposition for fuelling after dropping the team at the referring hospital. At that stage 'reaching' the patient is generally the most time-critical phase of the process. 
After patient stabilisation, loading the patient and unloading at the receiving hospital are not considered a time-critical issue justifying hot load/unload.

For us the factors have been:
1. Inadequate practice. We now put all our clinical staff through hot operations training and have printed documentation about the process.
2. Aircraft type/access. We currently use hot unloads for side-unloads from a BK117 but not from the clamshells. We might not be as happy with other aircraft (eg. S76)
3. Infant transport system ergonomics. We have developed equipment handling tools to take care of the weight of the systems during the load/unload. We are convincing hospital authorities that they can reduce staff levels for supervising helipads if they install an adjustable height electric trolley at their helipad (cost = about that of 2 infusion pumps / 1 heated humifidier / or 1/100th of a workers' compensation claim).
Who in industry or aviation loads and unloads >100kg loads manually?!! ... only in medicine do we accept such practices. The load and unload should be possible by 1 practised person!
4. Currency. We figure it is better to actively practice hot operations to maintain proficiency. If you are going to do it ever, practiced it regularly.
5. We often need the helicopter for a second call and would ask it to hot-unload at the destination facility to return to base to hot load a second team.
6. A video has been developed to assist in the education of hospital staff involved in LZ security and patient handling.

Dr Andrew Berry ABerry@nets.org.au
State Director
NSW Emergency Transport Service 
www.nets.org.au

Hotline    1300 36 2500   +615 0055 NETS
Office      05 005 24453   +615 005 CHILD
Facsimile 05 008 24453   +615 008 CHILD
Direct      05 005 23779   +615 005 BERRY

>>> FF2MICP@aol.com 1/12/01 10:26:55 >>>
Would you consider it a standard of the industry to do "HOT UNLOADS" at the 
recieving facility, also the helicopters home, with 150 pound isolette.  This 
as come up recently at a facility near by.  New helicopter new program and I 
am hearing that they want to do hot unloads to reduce the number of engine 
starts.  I understand the cost of engine starts, (Bell 407) but we also need 
to wory about safety.  By the way the flight crew on the teams consist of ICU 
nurses with only little helicopter safety and experience.

Any information on other facilities doing the same or have had problems with 
such please contact directly.

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