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Tue May 1 02:13:47 BST 2007

15 minutes to assemble the crew?
Civilian practice requires cold-boarding?

What country is that in? Surely not the United States...? At least, not in  
any of the flight programs I've dealt with... 

DB, thanks for wanting to save me from disaster... however, I pity the poor  
fool who is critically ill or injured and is poorly restrained in the back  of 
an ambulance that was designed to meet government standards that have NOTHING 
 to do with occupant safety, operated by a driver, who, all too often is 
playing  EMS because it's his hobby, using lights and sirens, driving like a 
maniac  at excessive speeds, being bounced around and dealing with the hazards of  
surface traffic. I get into the back of ambulances virtually every day to  
witness unrestrained oxygen cylinders, equipment packs, monitors, etc - not to  
mention the EMT or paramedic who REFUSES to wear their safety belt in the back  
of the ambulance because (a) they are too large for it to fit around them, 
(b)  it's not 'comfortable', or (c) the "I can't take care of my patient with  
this on" excuse. 

I've been in ground ambulance crashes. I've lost friends in HEMS crashes -  
but, I've lost more friends in ground EMS crashes. I've responded to scene  
flights and seen the pieces of an ambulance on the ground below. I'll not for a  
second say that HEMS isn't grossly overused in this country, nor will  I for a 
second deny that there are HEMS programs operating without commitment  to 
operational and patient safety - however, I will offer, without  hesitation, that 
I'd rather wait on the side of the road for  a helicopter with three (or 
more) minds committed to a safety  culture that is largely NOT reproduced by 
ground-based EMS systems or  providers, to take me to an appropriate center 
quickly,  without twisting and turning and being bounced all over the back of an  
ambulance, to be sweat on by a paramedic or EMT trying to stick  me with big 
needles while he or she is un-restrained and endangering my  life by being a 
potential human missile in the back of the ambulance.  

Are you asserting, sir, that HEMS is less safe than ground EMS transport?  
Can you prove it? Likely not, since reliable data regarding the frequency and  
severity of ground-based EMS crashes are not available. We have a great deal of 
 data about HEMS incidents and are in an era where HEMS operators continue to 
 strive to attain a level of operational safety that is not reproduced on the 
 ground.

A helicopter crashes and it makes the news. An ambulance crashes because  the 
driver was tired from working his real job and volunteering to "make a  
difference" or the yahoo was driving like a maniac to get a mechanism trauma  (both 
crashes I have been to) with an isolated extremity injury to the trauma  
center, kills a patient and/or the crew, and it hardly gets any media attention  
outside of the local market. 

It strikes me that perhaps some people that  have previously posted don't 
realize the reality that most of us don't live  within a reasonable drive to a 
trauma center.

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