RE: transport time (school assignment)/simultaneous dispatch

[SUllrich@att.net]

I would like to address interfacility transports.  I 
feel the same rationale should be applied to 
interfacility transports as is applied for scene 
flights.  Many have stated that if activated early, the 
helicopter can be effective from a scene.  I think this 
is magnified to a greater degree for interfacility 
transports.  Many times hospitals do not call for 
transfer until the patient is ready to leave the 
facility.  Often this can be one to two hours after 
arrival at their facility.  Again, with good planning, 
the helicopter can be enroute to the transferring 
facility while stabilization is in progress and the crew 
can be at the bedside when the patient is ready for 
transport.  Then in every case, the helicopter will 
provide the faster mode for transport.

Steve Ullrich
> Most Pilots ( and most Part 135 Operators require) that a pilot be able to
> determine wind direction, lz hazards, and general safety of the landing
> operation prior to landing off-airport or at an unapproved helipad.  That is
> generally pretty easy during the day-- but night usually prevents one from
> determining necessary information to land safely.  Having a night sun often
> improves your nighttime assessment of an LZ.  A pilot should be able to
> determine LZ surface, size, hazards (to include people and animals), wind
> direction and speed,  and be able to secure the LZ upon landing with its own
> crew while the rotors are still turning. Some rural helicopter programs
> often are the first to the scene.  We can land if we can ascertain the
> critical landing zone information from the air and insure safety after
> landing.
> 
> I would agree with many in this thread that often the delay in launching a
> helicopter on scene calls is due to ground crews, protocols and dispatch
> systems that alert the helicopter service only after LZs are established
> and/or many minutes after fire, police ambulance, and even the press has
> arrived. This can usually be resolved by education and diplomacy. The use of
> "standby" or launching on "standby" can alleviate some of the delays.
> Sometimes it is quicker and in the patient's best interest for a equally
> qualified ground unit to transfer the patient themselves.  Some helicopter
> crews should try to shed some of the ego and realize that there are highly
> competent ground services out there who have the patient's best interest in
> mind and can do the math.
> 
> As far as inter-hospital times, usually one-way transport with an ambulance
> is as fast or faster ( even at the speed limit) than a helicopter coming
> from a distance unless programs have trained hospitals and ambulance crews
> to hot load or unload and the pickup and destination helipads are proximal
> to the patient's pick-up and destination hospitals. Often a fixed wing
> transport is a far better choice at greater distances. Some combination of
> ground, fixed wing, and helicopter offer a solution if crews are willing to
> rendezvous at half-way points and transfer the patient "hot".  Sometimes
> legal or "level-of care" constraints get in the way of the most efficient
> patient transfer options. Some programs shoot themselves in the foot by
> treating very qualified ground teams, hospital personnel, and others with a
> "better-than-thou-attitude."  What goes around comes around...
> 
> Ed
>   -----Original Message-----
>   From: flightmed-admin@flightweb.com
> [mailto:flightmed-admin@flightweb.com]On Behalf Of Lisa Heinz
>   Sent: Wednesday, March 27, 2002 10:29 PM
>   To: flightmed@flightweb.com
>   Subject: Re: transport time (school assignment)/simultaneous dispatch
> 
> 
>   ok.... here's my $0.02 on simultaneous dispatch:
> 
>   Interesting idea....... but if the helicopter arrives to the scene first:
> who sets up the LZ for them???
> 
>   remember:  SAFETY FIRST!
> 
>     Jeremy Hawk <akulahawk@earthlink.net> wrote:
> 
>     Just gotta throw in my (dwindling) $0.02...
> 
>     I find it really hard to believe that TRANSPORT times are that fast
>     in favor of the ground ambulance. Either the aircraft is that slow,
>     or you're looking at different data points.
> 
>     In a county where I used to work, there are simultaneous dispatch
>     areas for ground and air providers. This means that when there is ANY
>     call in these areas, BOTH are dispatched at the same time. Once the
>     helicopter is in the air, it will catch and pass the ambulance at
>     about 7-10 miles from the base, and often is first on scene in those
>     areas. If the patient needs to be flown out, even assuming the ground
>     and air providers arrive at the same time) the helicopter is still
>     running, and ready to fly really quickly. From those simultaneous
>     dispatch areas, flight time to a Level 1 or 2 Trauma Center is about
>     15 minut! es. Contrast that to about 10 minutes or so for a ground
>     ambulance to reach ANY hospital, and about 30 minutes to reach the
>     closest Trauma Center.
> 
>     Oh, and scene times are about the same regardless of air/ground. Both
>     air and ground providers are basically equally fast.
> 
>     So... try this one: look at ACTUAL scene times for both air and
>     ground crews, and the elapsed time from their patient contact to
>     arrival at the hospital. Then account for some variables, such as
>     whether or not the helicopter is shut down while on scene. That will
>     lengthen times. If all other things are equal, then there has to be
>     some "soul searchng" to be done to determine when (elapsed time wise)
>     the aircaft should be alerted or actually dispatched on calls.
> 
>     I would suspect that if a ground trip for a critical patient is about
>     30 minutes, flying the patient would start making more sense.
>     Assuming, of course, that a round trip by helicopter woul! d take about
>     30 minutes from dispatch. I'd probably put the helicopter on alert if
>     I was that far out... and activate (if not done automatically) upon
>     recognition of a critical patient.
> 
>     Real World Example:
>     When I was (briefly) working in San Joaquin county, I had a call that
>     took us about 30 minutes to get to. A helicopter was automatically
>     dispatched when we were, and had to come from Sacramento. They
>     started from about 50 air miles from the scene, and beat us on scene
>     by about 5 minutes or so. The only thing that slowed them down was
>     having to choose an appropriate LZ... 100m from the patient, across a
>     soft field... It would have taken us 45-60 minutes to transport this
>     patient from the scene to the 'appropriate' hospital, whereas the
>     helicopter took only about 20 minutes from loading the patient...
> 
>     As many others have said, before embarking on this fact-finding
>     mission, design your study to account for the i! nherent differences
>     between air and ground transport. Make it compare apples to apples,
>     in a thoughtful and meaningful way. Then report back or publish your
>     study and we all will learn from you.
> 
>     And good luck in School!
> 
>     >TO: Flightmed group:
>     >From: Mark Seeloff
>     >Subject: Transport Time (School assignment)
>     >
>     >I would like to introduce myself to the group. I am nursing student
>     >at the University of Buffalo. I am also a career
>     >firefighter/paramedic with the City of Lockport Fire Department, New
>     >York. I am also a hospital corpsmen(USNR) for the 3 /25 Marine
>     >company out of Buffalo, New York. I have experience with Mercy
>     >flight (ground crew) and helicopter evacuation with the marines.I am
>     >interested in becoming a flight nurse after college. I have a
>     >question for the group that has to do with transport time.
>     >
>     >My fire department runs the local ambulance service a! nd there is a
>     >local air ambulance. I researched the department records for
>     >transport time for traumas for the past 3 years. I compared the
>     >transport time from leaving the scene to on scene at the local
>     >trauma center both by our ground transport vs air transport. Our
>     >ground time for transport was 30 minutes to the trauma center. The
>     >air transport time was 40 minutes. My department is ACLS,PALS and
>     >BTLS certified. My question is Should we wait the 10 minutes for the
>     >air transport or should we by pass the air transport for the faster
>     >time to the trauma center ? Considering the golden hour but the
>     >local protocol states that the air transport if available be used.
>     >We are certified in ACLS,PALS, and BTLS but we do not have all the
>     >fancy machines that is carried on the helicopter. I would appreciate
>     >your inputs on this subject. Thanks
>     >
>     >
>     >
>     >
>     >Mark Se! eloff
>     >Student Nurse
>     >University of Buffalo
>     >docmseeloff@hotmail.com
> 
>     --
>     ___________________________
>     Jeremy M. Hawk, BS, EMT-P
> 
>     Just an example, from the real world, that demonstrates the point.
> 
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> 
> 
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