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How Many Medical Personal For One Helicopter


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#1 jpd9191

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Posted 03 March 2010 - 05:25 AM

Hello,

I know there are few flight programs that support only one helicopter.

How many medical personal are required to staff only one helicopter?
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#2 Mike Mims

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Posted 03 March 2010 - 05:45 AM

It depends on the shift work.

Usually you'll need 8 full-time medical personne with schedules like; 24 on 72 off, 7 on 7 off etc.....

However, if you're working a 24 on - 48 off, you'll need 6 full-time medical personnel.

Also, 2 - 4 part-timers, for vacation, personal leave, education etc....
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#3 Midwest Rotor Medic

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Posted 03 March 2010 - 07:19 AM

We run helicopter staffed with a medic and nurse. We have multiple nurses and they work either in the ICU or the ER when they are not flying (taking patients). For medics we have three full time medics....40 hours per week...combination of 8 and 12 hour shifts....One weekend night guy. A full time director who fills openings and three part time guys. Hope this helps
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#4 jpd9191

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Posted 03 March 2010 - 07:03 PM

Thank you for your help


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#5 Thinking

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Posted 03 March 2010 - 10:23 PM

We use eight full time rotational medics working 12 hour shifts, with two full time "swing" medics who cover vacation, training and other time off for the rotational folks. So a total of 10 people per aircraft or truck. There is also a third coverage person who is usually shared between two or three vehicles. This doesn't completely eliminate OT opportunities, but they are reduced.
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#6 USDalum97

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Posted 05 March 2010 - 04:37 PM

We use 6 (3 medics, 3 nurses) and work 24 hour shifts. You work every other day for 4 work days, then get 4 off. Then every other day for 4 work days, and get 6 days off. Repeat. This is the same shift the city fire department near us works.

There is a 48 hour variety also. Work 48, get 48 hours off. Do that for 4 shifts, then get 8 days off. Repeat. This is the same as our county fire department.
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#7 Thinking

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Posted 05 March 2010 - 05:15 PM

We use 6 (3 medics, 3 nurses) and work 24 hour shifts. You work every other day for 4 work days, then get 4 off. Then every other day for 4 work days, and get 6 days off. Repeat. This is the same shift the city fire department near us works.

There is a 48 hour variety also. Work 48, get 48 hours off. Do that for 4 shifts, then get 8 days off. Repeat. This is the same as our county fire department.


Do you have any safety concerns with working 24-48 hour shifts? Right or wrong, we are limited to 16 hours of duty day with the rationale that if you are working past a certain point, then the risk of making an error are significant. In aviation fatigue kills pilots and crews, but in medicine it kills patients.
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#8 USDalum97

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Posted 05 March 2010 - 10:26 PM

Do you have any safety concerns with working 24-48 hour shifts? Right or wrong, we are limited to 16 hours of duty day with the rationale that if you are working past a certain point, then the risk of making an error are significant. In aviation fatigue kills pilots and crews, but in medicine it kills patients.



Nope. Not at all. Programs need to look at their call volume and the trends in what times the calls come in. For our program, there are many days with 0-1 call. A few with 2-3. And an occasional day with 4. We are 80% 911 calls. So they tend to be fairly short calls.

Like most things, you can't paint the whole industry with one broad stroke. If a program is running 4-7 calls per day as the norm, I would not want to be on a 24 or 48 hour shift. I would definitely advocate for 12's.

Employee retention tends to be fairly high here. We have great medical and aviation equipment. There is NO pressure to fly from the medical or aviation side. While we would all love to fly more, the volume is what it is and we don't push it to get one more call for the month.

As for "working past a certain point", what do you consider work? I would argue that on average, I can get more rest during the day at work than most night shift employees working 1900-0700 get at home during their "rest time".

I made the following argument in the past and got blasted for it, but I will do so again. DISCLAIMER--I know the role of HEMS is different than the fire department, but bear with me on the analogy.

If the human body cannot "work" as efficiently after 16 hours (your time limit), why do FD's routinely work 24-48 hour shifts? An average fire fighter can be expected to do patient care, drive much bigger vehicles than the average EMS system, are relied on to go INSIDE a burning building with limited field of view (mask) in near blacked-out (smoke) conditions to rescue people, may need to use extreme physical labor to save themselves or someone else, use 30' ladders that weigh 100#'s, and operate Hurst tools within inches of trapped victims extremities and their head. If 48 hours shifts were so dangerous, why would the city governments allow their towns to be put into such a position of liability?

My thought is that if the fire department can show that their personnel are able to get quality rest while on duty, there is no disadvantage to working these shifts. Same here.

Again, 24 or 48 hour shifts aren't for every program, and I fully recognize that. You can't look at a slower program through your own call volume. It doesn't work. That's how broad policies get made. For instance, the group that is pushing IFR for everyone. We have 9 months of clear blue skies and 3 months of either pretty good or absolute 0/0. IFR would be used maybe 5-10 times during those 3 months. We turn those to another nearby program that is IFR or we give it to FW when appropriate. We will also turn down flights during marginal weather so that we aren't out during times where IIMC may exist. Again, no pressure from above or within to fly. Should we go IFR? I don't think so, but some will say absolutely.

As if I haven't said it enough, scheduling is INDIVIDUAL to every base and needs to be closely monitored to be sure the crews are not fatigued and safety is not compromised. However, a broad based policy limiting shifts for everyone is wrong.
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#9 BackcountryMedic

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Posted 06 March 2010 - 12:03 AM

As for "working past a certain point", what do you consider work? I would argue that on average, I can get more rest during the day at work than most night shift employees working 1900-0700 get at home during their "rest time".


I whole heartily agree with this statement. Having worked 24's for the FD and now working HEMS 12hr nights I can speak to both sides. I feel less alert at 0300 having been awake for 10hrs after a crappy DAY of sleep then I ever did at 0300 after being woken up from a good solid REM sleep. I know about sleep inertia and all that, but overall I believe that a low volume service will be safer with 24hr scheduling. Happier too.

We should also recognize that any 0300 to 0700 call is going to be more dangerous then 1500 to 1900 regardless of schedule.

Sorry about the high-jack.
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#10 USDalum97

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Posted 06 March 2010 - 01:50 AM

We should also recognize that any 0300 to 0700 call is going to be more dangerous then 1500 to 1900 regardless of schedule.

Sorry about the high-jack.


And I couldn't agree more with this. There are some people who are "built for nights", but on the whole, humans are meant to be asleep at night.

No hijack on your part noted. I will apologize for my rant/hijack though. I stick with my answer of 6 FT though. Plus a PT'er for medic and nurse.
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#11 old school

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Posted 08 March 2010 - 05:14 PM

As for "working past a certain point", what do you consider work? I would argue that on average, I can get more rest during the day at work than most night shift employees working 1900-0700 get at home during their "rest time".


I've made this exact argument many times.

I've always said that on a 24-hour shift, unless it is unusually busy, by the time 1900 rolls around (when you would be showing up for your night shift) I've probably had more rest during the previous 12-hours than if I hadn't been at work at all that day. Many of us tend to be busier on the days that we aren't at work than on days we are. It's not like you are home in bed all day just because you have to work that night...

Obviously, call volume and the length of your transports is a big factor here. But as long as you don't average more than, say, three-2.5 hour transports (that's only 7.5 hours of actual work) in a 24-hr period, and as long as you can relax and nap during the day and sleep at night between calls, and as long as you can "time out" in the very rare case where you do get so busy that you are absolutely exhausted by the middle of the night, then 24-hour shifts are at least as safe as working 12-hour night shifts.

Some people are just absolutely convinced that 24's are inherently unsafe, though.
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#12 pureadrenalin

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Posted 09 April 2011 - 11:01 PM

Some people are just absolutely convinced that 24's are inherently unsafe, though.


What about plain old unhealthy? Ever look at the cardiac risk factors of those people working 24's? MmmHmm. Is some of it to blame on those with pre-exsisting issues such as HTN and Hyper cholestermia, coupled with lack of excercise and obeseity..sure..but, at the same time, what kind of stress level is placed on the cardiovascular system just from mental stress for HAVING to be awake at 300 after a slightly busy day 10-12 calls in either ground EMS or the FD.

24's suck in a mildly busy service. They are unhealthy, and are dangerous. And I speak from experience coming from a service who routinely ran 12-18+ calls per shift per truck, without a "timeout" policy.
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#13 USDalum97

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Posted 10 April 2011 - 08:01 PM

what kind of stress level is placed on the cardiovascular system just from mental stress for HAVING to be awake at 300 after a slightly busy day 10-12 calls in either ground EMS or the FD.


I don't know. Has there been any study that found a conclusive link, or are you just guessing that there may be one. On the flip side, what kind of stress level is placed on the CV system for the person who didn't get good sleep during the day after a busy night shift, then has to come back and do it again?


24's suck in a mildly busy service. They are unhealthy, and are dangerous. And I speak from experience coming from a service who routinely ran 12-18+ calls per shift per truck, without a "timeout" policy.


OK, so there in lies the problem. Your service was not "mildly" busy if it was running 12-18 calls per truck (IMO). Also, management did not have a policy in place to protect you (timeout policy). So I agree, a 24 hour shift would not be wise in your scenario.

But back to the topic, this was about a single helicopter program. I would guess that most single helicopter programs are not running 12-18 calls per shift. Blanket statements of "24 hour shifts are dangerous" are just plain wrong.

I am 6 hours into my 24 hour shift, I have already had a 3 hour nap. I like to play golf, but watching the Master's just doesn't do it for me. I guess I'll do my homework, take another nap, then watch the Yankees kick the crap out of Boston again later. That is, if my wife doesn't bring the kids out to the station for dinner and a visit.
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#14 pureadrenalin

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Posted 10 April 2011 - 11:05 PM

There have been studies done. And no, I doubt that there are HEMS services running 12-18 calls a shift. But, having said that, why do we need 24's? What does a system gain by running people ragged. Even three, or four heavy workload calls can mentally exhaust someone to the point of making mistakes...some things just don't need a shift schedule like this, regardless of how much "rest" you get.
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#15 USDalum97

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Posted 12 April 2011 - 06:12 PM

There have been studies done. And no, I doubt that there are HEMS services running 12-18 calls a shift. But, having said that, why do we need 24's? What does a system gain by running people ragged. Even three, or four heavy workload calls can mentally exhaust someone to the point of making mistakes...some things just don't need a shift schedule like this, regardless of how much "rest" you get.


There are studies that compare the HEMS provider who has to mentally prepare themselves to get up at 0300 for a call and those that don't? I don't get it. I guess I need to see the studies you refer to.


Who is run ragged on a 24 hour shift? If that is what is going on at someone's company, I would advocate for a change, 100%, absolutely, every-time. Same goes for a 12 hour shift. I know there are plenty of studies that show a 12 hour hospital shift leads to more errors than an 8 hour hospital shift. Should we conclude that it is the same for HEMS? Let's ban 12 hour shifts. That's what the study shows, right?


"Rest"? What's with the quotes? It was 3 hours of uninterrupted, permissable sleep. That is some good rest if you ask me.


In the end, every company should be allowed to do what works for THEIR program. I don't want, or need, big brother to tell me how to do my job. Maybe I am in the minority here but if our employees went to the manager and asked for 12 hour shifts, we would get it. It has been openly discussed with out manager and he said we are free to work the schedule however we want, even it includes having to hire more staff. He feels this way due to OUR safety. If ever we feel that we are usafe to work 24 hour shifts, we will change the schedule. We used to do 48 hour shifts. The employees were much happier with 48's than 24's and we never had a problem with fatigue.


It is all about individuality and what works for the program. You cannot look at your call volume or schedule and think that it is the same for everyone. It just doesn't work that way. Call volumes are different, flight times are different, job duties when not flying are different, etc.


Thanks for the discussion.
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#16 old school

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Posted 13 April 2011 - 09:56 PM

What about plain old unhealthy? Ever look at the cardiac risk factors of those people working 24's?


So there are studies that show that people who work 2-24 hour shifts a week, and get sleep whenever they want at work and sometimes have to get up for a few hours during the night are less healthy than the general population? I'd like to see that research and how it was done.

Even if that data does exist, I'd argue that there is much more evidence that working 12-hour night shifts is unhealthy. I think you will find it impossible to prove that folks who do 24's are less healthy than folks who do 12 hour night shifts.

So what are we to do, not provide service between 2100 and 0600?

When I worked 24's for a program where we rarely did more than 2 or 3 flights in a 24 hour period, I honestly got more rest during an average day at work then I got during an average day at home. Now that I only do 12-hour night shifts for a busier program where I get no rest at work, I am tired all the time and I know I'm less healthy.
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#17 USDalum97

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Posted 19 April 2011 - 12:47 AM

While they have a different job then we do, I think the recent attention on air traffic controllers is interesting and timely to this discussion. Night shifts are tough, no matter what the position.

I saw the Transportation Secretary said allowing naps during the shift are absolutely out of the question (even though it is proven to be helpful). Got to love government logic.

http://www.google.co...026bcc8f375a88d
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#18 jimbob

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Posted 09 June 2016 - 02:50 PM

We staff with 5 nurses and 5 paramedics for one aircraft (both fixed wing and rotor). We work 12 hour shifts. Everyone works three 12 hour shifts each week. In one week there are 14 shifts for each position to be filled which results in 1 nurse and 1 paramedic not being needed to cover one of the shifts each week (it doesn't fall on the same nurse and paramedic, nor on the same day of the week). This slight over hire is for covering sick and vacation and allowing time clinical rotations, training, projects, outreach, etc. so that throughout the year everyone has built in time to perform those other duties without having to work overtime. It doesn't mean we don't have overtime, we just don't have as much of it.


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