Hotloading (especially non-dedicated)

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

Just an observation. Training of ground support AND flight crews a must. Both Medical and Aviation. Even in dedicated programs with frequent use of the same local ground services it is a good idea. When responding to situations without, ANYTHING can happen and it is better to shut down. 

An example: I have witnessed a captain leave his helicopter running on a taxiway, (zero pitch with rotors parallel to ground) and get out, leaving aircraft with patient and RN inside then walk under tail boom to open door to assist ground staff in un-loading an intubated/manually vented patient of a Cessna crash. The patient had been loaded into chartered BH-206 with head forward so RN was sitting above patien's head and scrunched into windshield with her feet by the collective of the still running, unmanned, aircraft. The RN bagging had accompanied patient throughout flight from scene to nursing station where RSI performed then back in again for hop to taxiway to await our arrival. Single "D" cylinder had run out, they had been waiting 25+ minutes-still running. No equipment on board used by RN was connected to helicopter power (monitor not even applied to patient or turned on). Note that the RN was not flight or EMS or ER trained. 

The Captain wasmost annoyed when I requested he shut down so we could unload, transfer pt to my Falcon-10 with my partner and re-load a more unstable patient for 6 minute return hop with me to the nursing station where he could be properly stabilised for fixed wing C-130 evacuation (using military SAR bird) to tertiary centre 2.5 hours away. Pt had been left on ground at side of taxiway attended by Vol. FF with 1st Aid only and was still in rotor wash. 

Our arrival on-scene was approx. 1 hour after extrication from wreckage suspended in trees on steep riverbank 2 miles short of runway, and 3 hours post crash. Both patients survived despite each requiring RSI with basal's/pneumo's and multiple significant fracture's with #2 also an open depressed (and now contaminated) skull #. 

Fly Safe. 
Ken L-W CCEMT-P/WMT

"If in the last few years you haven't discarded a major opinion or acquired a new one, check your pulse. You may be dead."
- Gelett Burgess 

"Medicine is the only profession that labors incessantly to destroy the reason for its own existence."
- James Bryce

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