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Transporting Patients By Helicopter With Only One Care Provider


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#1 jimbob

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Posted 09 June 2016 - 06:04 PM

Does anyone have a policy regarding transporting patients by helicopter with only one care provider? If so, if you have a mixed crew, which care provider goes with the patient and who stays behind? I'm thinking of circumstances wherein its hot and the scene is at a high elevation and the pilot tells you that you are too heavy for patient to be transported unless one of the care providers stays behind (to be picked up later). Do you still fly the patient with one less crew member or do you load the patient up in a ground unit and transport the patient with both medical crew members in the ground unit and the pilot returning to base by him/her self? What if the terrain is such that the ground transport vehicle is no where near the patient? What if the patient has a time sensitive need (severe trauma patient, STEMI, CVA, etc.).

 

The scenarios are varied: long transport time if they choose to go by ground; no local available ground transport within a reasonable amount of time, etc. Knowing that the crew will be transporting a critical they might spend a little more time on scene to do a few more things for the patient so that the one care provider is not overwhelmed, etc., but the over all result of transporting the patient by helicopter might have a better outcome with one care provider than going by ground with two care providers with a longer transport time.

 

I'm guessing this is more of an issue for those of us who are located at higher elevations and fly among the mountains. Thanks for the answers.


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#2 dphmicn

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Posted 14 June 2016 - 08:57 PM

My program flies with one ALS provider and one other provider, who usually is ALS but may be BLS. In the ALS setting if someone is temporarily left at a scene, the ALS provider will accompany the ALS patient. I have the luxury of flying with a pilot and two crew chiefs. One crew chief is in back with myself and the patient. The other is left seat up front, working radios, observer, etc..Crew chief in back works hoist if indicated, and is second set of brains and hands. I highly value my crew chiefs and pilot.

 

Here is an example of how this recently worked. Flew to mountains to trauma single patient motorcycle accident. Ground ALS unit was there and packaging for transport. LZ set up in progress.

While orbiting we got diverted to second trauma MCA "one mile" up the roadway with bystanders only at scene. Very limited info on this 2nd trauma patient. Flew winding road and found scene several miles up. Bystanders by side of road pointing downhill and off roadway. Saw waving bystander next to unresponsive person Cleared our own LZ, set down, grabbed gear and went to assess. Pilot stayed with ship, crew chief from front stayed with ship to keep 3-4 bystanders clear. Crew chief in back (BLS that flight) also went with gear to patient. Bystander with patient gave history while assessment done. Unfortunately accident had occurred over one hour prior, CPR was done by bystander on two separate time spans but unable to continue.  Only as we got to (unrelated) first scene was other rider able to get to an area with cell phone coverage and call in it in. Did assessment and pronouncement. BLS crew chief (deputy) stayed at second scene as law enforcement until state highway patrol could get there. Meanwhile I'm in radio contact with my ship and crew. Hiked back to them and flew back to first scene, transported that patient to trauma center. Cleared from trauma center flew back and picked up crew member. Highway patrol now on scene and had jurisdiction. As soon as my 2nd crew chief was aboard we were available in service for subsequent calls.

Ground transport would have been ~ 45-60 minutes for incident #1. My flight time was 10-12 minutes get pt to trauma center. 

Hope this helped some on your questions.

Happy to learn from any discussion on this call. I'm limiting info to respect patient privacy issues.


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