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Accident numbers raise questions about safety? What
numbers? What accidents? You make a rather striking statement to start off with
and then give nothing to back them up. Apparently you are trying to
sensationalize something out of nothing. your paper is filled with "they say" or
some say" - give us the facts, nothing but the facts. You statedsome facts
regarding numbers of deaths caused by EMS helicopter accidents, but did not
state your source nor did you compare that to ground ambulance
accidents/deaths.
Additionally, we may as well call off the NTSB if
you have already determined that "a gust of wind" was the cause of the accident
in Cleveland.
As stated by an earlier reply, the purpose of a
flight has no bearing on whether or not it is safe.
----- Original Message -----
Sent: Saturday, February 02, 2002 1:32
PM
Subject: Accident numbers raise
questions.....
From another list
News
Accident numbers raise questions
about safety, necessity of airlifts
02/02/02
Diane Solov and Roger Mezger
Plain Dealer Reporters
The calendar had barely rolled over to
Friday, Jan. 18, when the MedEvac helicopter crew scrambled into action.
Doctors requested a helicopter transport
for an elderly man at LakeWest Hospital with gastrointestinal bleeding.
MedEvac 8, stationed atop University Hospitals' Lerner Tower, was the fastest
way to the Cleveland Clinic.
Minutes after accepting the assignment,
MedEvac 8 was on the radio, reporting "three souls" on board, then liftoff.
The crash came moments later.
Nearly two
hours would pass before the patient arrived at the Cleveland Clinic. He came
by ground, not air, and was discharged from the Clinic three days later.
The familiar sound of rotor blades
slicing through air as a helicopter swoops to the scene of an accident has
become synonymous with lives saved. But most flights that medical choppers
make these days are hospital-to-hospital transfers, like the one that ended in
tragedy last month.
Just after liftoff,
a gust of wind pushed the helicopter toward a wall. The pilot tried to
compensate, but the helicopter glanced off the side of the building, clipped
the edge of the building and plunged 12 stories, killing pilot Bill Spence,
51, and nurse Kelly Conti, 38, and seriously injuring Joe Paoletta, a
paramedic. The falling chopper just missed six floors filled with patients.
An investigation continues into the cause.
In critical care, speed matters. The
military learned it in Korea and perfected it in Vietnam, where wounded
soldiers evacuated by choppers were more likely to survive. Hospitals began
using helicopters in the early 1970s.
But medical helicopters also take lives
at a rate that some find alarming. Since 1998, they have been involved in at
least 57 accidents and incidents that have killed 43 people and injured 33,
according to an analysis of National Transportation Safety Board and Federal
Aviation Administration data.
Some say
the accident rate, the worst since the mid-1980s, simply reflects the fact
that there are more helicopters flying more hours. Medical helicopters
actually have a better safety record than choppers in general, they say.
As the number of local flights heads
skyward, critics contend that medical helicopters are overused, sometimes
picking up patients whose conditions do not warrant air transport or flying at
night or in bad weather, when conditions are riskier.
They say that competition, marketing and
the need to cover costs are powerful reasons explaining why medical
helicopters are such frequent flyers. And they say no hard scientific data
supports the notion that delivering a patient by air - at about $5,000,
roughly four times the cost of a ground critical-care ambulance - is likely to
improve a patient's outcome.
"We're
taking the most expensive transport modality and we're starting to want to use
it for anything," said Dr. Bryan Bledsoe, an associate professor of emergency
medicine at the University of North Texas Health Sciences Center in Fort
Worth. "It's time to reassess the whole thing. We've got to stop killing our
nurses and medics."
No one has suggested
the chopper shouldn't have been dispatched the night of the crash. Whether a
medical helicopter or a ground ambulance is the right choice for a sick
patient can be a tough call.
For
hospital-to-hospital transfers, doctors have to consider the seriousness of a
patient's condition and how quickly treatment is needed. Emergency resources
also are considered. A ground transfer that could keep a critical-care
ambulance out of service too long may be bumped to the skies.
At accident scenes, medics tell time by
the so-called "golden hour" - the critical period during which a patient with
a traumatic injury must get treatment. Miss the window and you miss the chance
to pull a critical patient from the brink of death.
Calling for a helicopter when ground
transport might do is not uncommon. "It is intended to protect the patient and
must be accepted as a part of air medical service," according to the
Association of Air Medical Services.
Around the country, it happens 10 to 15
percent of the time, according to Dr. William Fallon, medical director of
MetroHealth's Life Flight.
In hindsight,
he said, "it's a lot easier to see if someone should have been flown."
A matter of minutes
Today more than 300 companies provide
helicopter service to hospitals nationwide. In Northeast Ohio, three companies
keep five medical choppers at the ready. All three figured into how events
unfolded the night of the crash.
Doctors
caring for the LakeWest patient called MedFlight of Ohio at 12:15 a.m.,
seeking transport from Willoughby to the Clinic. Columbus-based Med Flight
stations a helicopter at Lodi in Medina County, a 23-minute flight to the
patient.
Looking for a faster
alternative, the MedFlight dispatcher called Metro's Life Flight, which keeps
a chopper in Highland Heights, a six-minute flight from LakeWest. That
helicopter was not available, Life Flight advised, but the chopper based at
MetroHealth Medical Center could get there in 15 minutes.
At 12:16, the MedFlight dispatcher
checked with MedEvac, which said it could reach the patient in 11 minutes from
UH and took the job. MedEvac 8 crashed on takeoff at 12:24.
MedEvac called MedFlight back at 12:48,
asking it to make other arrangements because there had been "an incident,"
said MedFlight dispatch supervisor Jerry Bandy. MedEvac offered no details.
MedFlight then placed its second call of
the night to Life Flight, which agreed to make the run. But Life Flight soon
called back with news of the crash. Life Flight thought its choppers might be
needed to transport injured UH patients and asked MedFlight to handle the
LakeWest job itself.
By this time,
however, Med Flight's pilot in Lodi, a friend of the MedEvac pilot killed in
the crash, was too distraught to fly.
So
at 1:10 a.m., MedFlight contacted LifeStar, an ambulance service that has an
advanced level of care similar to the chopper's.
Ten minutes later, LifeStar rolled from
its base at St. Vincent Charity Hospital in downtown Cleveland. It delivered
the patient to the Clinic at 2:15 a.m. - exactly two hours after the initial
call to MedFlight.
By ground or by
air
Because the hospitals will not
discuss the patient, citing confidentiality rules, it is not clear why doctors
thought he needed to go by air. Had he been moved by ground at the start, he
could have been at the Clinic within an hour.
Moving patients from one hospital to
another has become the staple of the medical helicopter business, accounting
for about 60 percent of flights nationwide.
In Greater Cleveland, transfers make up
an even larger share of the runs. Nearly all of MedEvac's 692 flights last
year were from one hospital to another. Two-thirds of MedFlight's 3,824
chopper runs statewide flew patient transfers.
Even Metro's Life Flight, based at the
state's busiest trauma center, logged just 30 percent of its 3,112 flights
last year plucking victims from accident scenes - the reason hospitals started
flying 30 years ago.
The business of
health care has helped drive the shift from trauma to transfers, said Ed
Marasco, vice president of CJ Systems Aviation Group, which operates the
choppers that fly under the MedEvac name.
Sprawling health-care systems frequently
move patients among distant hospitals, some two counties away.
New medical technology that can ride
along on helicopters has made flights more useful for moving non-trauma
patients, particularly cardiac arrest cases. And swift treatment is needed for
patients to benefit from advances in treating stroke.
"A fair number of patients we transport
[by air] are strokes or suspected strokes," said Dr. Catherine Keating,
director of clinical operations at UH.
But marketing also is a reason why
helicopters are flying more patients.
Nothing conveys quality care like video
of a helicopter lifting off from the scene of a wreck on the evening news.
With the name of a hospital emblazoned on its sides, the helicopter has come
to represent the highest level of care imaginable.
"It's a flying billboard," said Dr.
Kenneth Mattox, vice chairman of surgery at Baylor University's medical school
and chief of surgery and chief of staff at Ben Taub General Hospital, a top
trauma center in metro Houston. "Huge marketing, huge marketing, huge
marketing."
Public relations visits with
community rescue squads are part of any chopper service's routine, along with
standing offers of ride-alongs. Life Flight has invited the news media to
cover "reunions" of trauma survivors, with the helicopter as a backdrop.
Medical choppers touch down at the Cleveland National Air Show and at
community fairs, where stroller-pushing families can tour the treatment bay.
Marketing aside, medical helicopters
play an important role in critical care. They can be a lifeline in rural
communities, where medical resources are limited, and in urban areas, where
traffic can delay ambulances. They also offer more sophisticated care than
community EMS squads.
"I truly believe
that aeromedical services probably benefit a group of critically injured
trauma patients," said Dr. Jeffrey Salomone, a trauma surgeon at Grady
Memorial Hospital in Atlanta, which anchors the largest public hospital system
in the Southeast.
Still, he said, "There are a lot
of scientific questions that we should be asking."
At the top of the list is the question
of when it makes medical sense to call for a chopper.
Guidelines seem clearer for trauma
victims than transfers between hospitals, whose mode of transport is
determined by the patients' physicians.
Fallon, who also directs Metro's
division of trauma, burns and critical care, said all Life Flight runs are
reviewed for appropriateness. Any run to pick up a patient who was well enough
to leave the hospital three days later - as the LakeWest patient did - would
"absolutely" trigger a review at Metro, he said.
With each call, a calculated decision
must be made: Does the patient's predicament warrant the risks of sending a
chopper?
"We who are medical directors of these
programs have this in the back of our mind, that we are putting people in
harm's way," Fallon said. "Nobody wants to put them in harm's way."
Plain Dealer Washington bureau reporter
Elizabeth Marchak contributed to this report.
Contact Diane Solov at:
dsolov@plaind.com, 216-999-4133
Contact Roger Mezger at:
rmezger@plaind.com, 216-999-4446
© 2002 The Plain Dealer.
Used with permission. » Send This Page | » Print This Page
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