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Sun Oct 14 18:09:27 BST 2007

Perhaps you are asking the wrong question.    If you ask the  question one 
way, you will acquire nothing but enemies, as I well  know.     If you actually 
approach the development of a  helicopter service as a business center you 
will have lots of  support.     Hospitals put the budget for the helicopter  
services under some "losing" cost center in the hospital, but know that it  brings 
in lots of paying patients and publicity.   Thus their  support.     I do not 
know of anyone that has ever shown a  survival advantage or a decrease in 
complications, or an increase in organ  recovery following use of helicopter use 
compared to ground transport to a  trauma center.     Benefit has been shown 
when the  helicopter is used for high rise, off shore and wilderness rescue, 
and as was  used in New Orleans during Katrina for rescue.   That was not  
aeromedical use.    

I would love to debate this subject sometime on a national forum and be  able 
to bring into the debate the cost comparisons, the crash data, the pain and  
suffering, and the "out of control" aspects of some of the helicopter  crews.  
  From a strictly cost, survival, complications, and  organ procurement 
standpoint, I do not believe anyone can support or justify  urban or suburban air 
ambulance use.     I recently was a  guest speaker in a state where I flew into 
an airport at one corner side of the  state.   I rode in a private car to the 
hospital where the conference  took place.  It took about 37 minutes from 
airport to hospital.  The hospital was in the center of the state.  I was then 
presented  many cases (with relatively minor injuries that could have been 
managed at a  Level II or Level III trauma center, or even a non trauma center), 
but were  transported by helicopter to the central university Level I trauma  
center.   The shortest time from time to decide to fly the patient  until 
arrival was 4.5 hours and the longest was something over 19  hours.    Something 
does not compute here.    

Good luck in your survey and in your research.   I do hope you  are able to 
acquire some meaningful data.  

k

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