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Fri Mar 26 14:59:46 GMT 2010

Clearly the best solution and if we could get that to happen, and allow the experts to manage their fields of expertise without prejudice (i..e. Doing the right thing without regard to the reimbursement issues) then we would all be in a better place.....and we could hold our progress out as an example for all to emulate!
Ron

Typed (poorly) with my thumbs on my Blackberry!

----- Original Message -----
From: trauma-list-bounces at trauma.org <trauma-list-bounces at trauma.org>
To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>
Cc: trauma-list at trauma.org <trauma-list at trauma.org>
Sent: Fri Mar 26 10:51:24 2010
Subject: Re: Medical Helicopter Down

What about the Feds, The Industry, and the medical professionals,
including EMS working TOGETHER ?

Kenneth Mattox (iPhone)

On Mar 26, 2010, at 6:42 AM, Krin135 at aol.com wrote:

> Ron, the Feds are the only ones who can do it from three stand
> points:
>
> 1: many of these outfits cross state lines, either in the course of
> their
> normal duties, because they contract the airframes and pilots from
> PHI or
> another big operator, or because the company itself is a multi state.
>
> 2: The FAA and NTSB already have primary responsibility for
> regulation and
> prevention of problems in the air.
>
> 3: the federal aeromedical services (mostly military and Coast Guard)
> already have an enviable safety record, even including combat losses.
>
> what is not needed is a patchwork of state or local regulations, but
> reasonable requirements that are enforced....including the right of
> the
> pilot/crew to refuse a mission without loosing their job. I don't
> know if  the
> tradition still lives, but 'back in the day,' it was understood that
> the  only
> time a commander could order a MEDEVAC flight to take off in a non
> combat
> situation was if he (there were few female pilots and no female
> commanders at
> the time) was willing to be the Pilot in Command on the mission
> himself.
> Since  even an Aviation Battalion Commander could not be a Command
> Pilot
> without the  concurrence of several of his senior (then CW4) pilots,
> we had very
> few Command  Pilots who were too macho to refuse a mission when the
> weather
> consisted of  sucker holes.
>
> Yes, we got caught out occasionally...like the mission where we  were
> flying home IFR at 5000 feet and about the time we were warned
> about  'embedded
> thunderstorms,'  the aircraft dropped 3000 feet in a very few
> seconds...there were several missions where we ended up coming home
> in a State  Highway
> Patrol cruiser, because our bird was iced up at a remote site.
>
> in the three plus years I was at Ft Sill with the DUSTOFF unit, we had
> *one* major inflight malfunction, which resulted in CW4 Ross
> receiving a
> 'Broken  Wing' Award as he successfully autorotated to a landing,
> converting a
> potential  Class A accident with four souls on board to a Class C
> "you need to
> change the  skids" situation. We had maybe a half dozen precautionary
> landings, mostly from  chip detector malfunctions.
>
> This was with UH-1H/V helos all of which had airframes at least 10
> years
> old (the oldest was a 1966 model, IIRC). We averaged about 10 medical
> missions a  week, and about 30 flying hours for pure training per
> week, so spread
> 60  to 80 hours per week over our 6 aircraft.
>
> It can be done, and done safely.
>
> is Aeromed needed outside of remote or combat situations? I'm no
> longer
> sure. I do know that there have been times when I have been at an
> outlying
> hospital where I was glad the weather was clear so that I could
> reduce the
> time  in transit for a patient with serious problems by using the
> helo even if
> they  were reasonably stable for ground transport.
>
> ck
>
>
>
> In a message dated 3/26/2010 06:16:48 Central Daylight Time,
> Ronald.Gross at baystatehealth.org writes:
>
> Ken has  been and is still so very right - the aeromedical industry
> needs
> regulation  and oversight.  BUT - who is gonna do it.  The LAST
> thing we want
> is  for the Feds to do it.
>
> Ron
> -----Original  Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Andrew J Bowman
> Sent:  Thursday, March 25, 2010 5:26 PM
> To: Trauma-List [TRAUMA.ORG]
> Subject:  Re: Medical Helicopter Down
>
> We had a helicopter fly a patient to our  facility last week.
>
> We are a at best 50 bed community ED in a  midwestern state (okay,
> it's
> Indiana, soon to be home to at least 23 air  medical helicopters).
>
> The patient  had
> diverticulitis!
> !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
> !!
>
> He  did not require ICU, was stable , stable, stable.
>
> BUT....
>
> He  had......
>
>
>
>
> MONEY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
>
> And so  he flies to a hospital closer to home.
>
> Andrew
>
> On Thu, Mar 25,  2010 at 5:22 PM, <KMATTOX at aol.com> wrote:
>
>> As I have reviewed  the tragic air ambulance helicopter crashes with
>> fatalities during the  past 3 decades, virtually all  of them were on
> flight
>> missions  where the patient had a condition which did not merit this
>> expensive
>> modality.   We learned in a very eloquent  presentation by a
>> person  whose
>> hospital has a very active air  ambulance service that:
>>
>> 1.   Air ambulance transport  for similar patients from similar
> distances,
>> the GROUND  transports are FASTER in getting the patient from
>> injury  to
>> hospital
>>
>> 2.   There is NO survival advantage to the  air ambulance  transport
>>
>> 3.   Ground ambulance  transport and care have improved
>>
>> 4.   The costs of  air ambulance are from 10 to 25 times that of
>> ground.
>>
>> It  is past time that this industry be regulated for safety and
>> indications.
>>
>> Kenneth L. Mattox, MD
>> Houston
>>
>>
>> In a message dated 3/25/2010 4:16:17 P.M.  Central Daylight Time,
>> nmcswai at tulane.edu writes:
>>
>> Did  the  patient need the aero atraof nsportation?
>>
>> Norman
>>
>> Norman  McSwain MD
>> Professor, Tulane  School of Medicine
>> Trauma Director, Spirit  of Charity Trauma  Center
>> norman.mcswain at tulane.edu
>> 504 988   5111
>>
>>
>> -----Original Message-----
>> From:   trauma-list-bounces at trauma.org
>> [mailto:trauma-list-bounces at trauma.org]  On  Behalf Of Stephen Richey
>> Sent: Thursday, March 25, 2010 4:13  PM
>> To:  Trauma &amp, Critical Care mailing list
>> Subject: Medical Helicopter  Down
>>
>> *Poor decision-making  in the aeromedical industry strikes  again.
>> Three
>> dead
>> this time during an attempted positioning flight  into a  heavy
>> rainstorm.
>> *
>> *Looks like they haven't learned  their  lessons after  all.*
>>
>>
>>
>> http://www.wmctv.com/Global/story.asp?S=12201786
>>
>> BROWNSVILLE,  TN (WMC-TV) - A Hospital Wing helicopter has
>> crashed   near
>> Brownsville.
>> Tennessee Emergency Management Agency  spokesman Jeremy  Heidt in
> Nashville
>> told the Associated Press it  was a medical flight that  crashed
>> into a
>> field
>> shortly  after 6 a.m. CDT during a rainstorm near  Brownsville.
>> Heidt said  the Hospital Wing helicopter had flown a patient to  a
>> Jackson
>> hospital and was returning to its base in Brownsville when it  went
> down.
>> All
>> those aboard were crew members.
>> According to  Bob Parks at  the Haywood County EMA, three people
>> died in
> the
>> crash.
>> The company's  Web site says it flies the Eurocopter Astar  AS350B3
>> model,
>> which is capable  of carrying a three-person crew  and one patient.
>> Statement from Hospital  Wing
>> 3/25/10
>>
>> A Hospital Wing helicopter crashed at approximately  6  a.m. this
>> morning
>> just
>> east of Brownsville, Tenn.  Three crew members were  on board. No
>> patients
>> were on board. The  National Transportation Safety  Board and the
>> Federal
>> Aviation  Administration are on the scene and the  crash is under
>> investigation.
>>
>> Hospital Wing was founded in 1985 and  is  a non-profit air medical
>> transport
>> service with direct  alliances with  the Methodist Le Bonheur
>> Healthcare,
>> Baptist  Memorial Hospital, The MED,  St. Francis Hospital in
>> Memphis and
>> Crittenden Memorial Hospital in West  Memphis, Arkansas.
>>
>> "Nothing like this has ever happened in our  history," said Allen
> Burnette,
>> program director and Chief Operating  Officer.
>> =========================================
>> *It may not have   happened to them, but it's happened to plenty of
>> other
>> services....they  need to learn from other's mistakes because crews
> don't
>> live long enough to  make all the mistakes  themselves.  *
>> ================================
>> BROWNSVILLE, Tenn. (AP) - A medical  helicopter crashed in a rainy
>> field
> in
>> western Tennessee early Thursday,  killing three crew members  on a
>> return
>> trip from delivering a patient.  There were no  survivors.
>>
>> Tennessee Emergency Management Agency   spokesman Jeremy Heidt in
> Nashville
>> said the flight crashed near   Brownsville during a rainstorm shortly
> after
>> 6
>> a.m.  CDT.
>>
>> Heidt said  the helicopter had flown a patient from  Parsons to
>> Jackson-Madison County  General Hospital and was  returning to its
>> base in
>> Brownsville when it went  down a few  miles from its destination. All
> those
>> aboard were crew   members.
>>
>> "The pilot was not in contact with air traffic  controllers at  the
>> time
> of
>> the crash and there had been no  indication of problems," said  Lynn
>> Lunsford,
>> a spokesman  with the Federal Aviation Administration in Fort  Worth,
> Texas.
>> Lunsford said the FAA and the National Transportation Safety
>> Board  were
>> investigating.
>>
>> "They (investigators) will look  at  everything from the aircraft
>> to the
>> weather," Lunsford said.  "As the NTSB  says, 'man, machine and
>> environment."'
>>
>> Rich Okulski, a supervisor in  the Memphis  office of the National
>> Weather
>> Service, said there were   thunderstorms in the area at the time and
> weather
>> could have played a  role  in the crash.
>>
>> Okulski said the agency doesn't have  an observer in  Brownsville.
>> But at
>> the
>> time of the  crash, a thunderstorm was in progress  at McKellar-Sipes
>> Regional
>> Airport in Jackson, about 25 miles east of  Brownsville,  and a
>> line of
>> thunderstorms had cleared Memphis, about 55  miles  southwest.
>>
>> A photograph from the scene by WNWS radio in  Jackson  shows charred
>> wreckage
>> of the craft in what was  described as a wheat  field.
>>
>> Keith Holloway, a spokesman  for the NTSB, said a team was  leaving
>> Washington
>> at  midday to examine the crash site. He said the team  will be on
>> site
> for
>> three to five days and a preliminary report would be   released
>> about 10
>> days
>> later.
>>
>> The flight was  operated by Hospital  Wing, a nonprofit air medical
>> transport
>> service with headquarters in  Memphis and branches in  Oxford,
>> Miss., and
>> Brownsville. It operates five   helicopters.
>>
>> Jamie Carter, a company board member, said the  helicopter  was a
> Eurocraft
>> Astar model and one of the newest in  Hospital Wing's  fleet.
>>
>> He said it was the first company  accident since it began
>> operating in
>> 1986.
>>
>> "We  are suspending operations with the service until  we can get our
> arms
>> around what happened," Carter said.
>>
>> He did  not  know if the helicopter burned after crashing.
>>
>> The  branch in Brownsville  opened in 2004 serving 26 counties in
> Tennessee,
>> Mississippi and Arkansas,  the company Web site  says.
>>
>> The crash scene is near U.S. 70 and about 55  miles  northeast of
>> Memphis.
>>
>> Improving the safety of emergency  medical  services flights has
>> been on
> the
>> NTSB's "most wanted  improvements" list  since 2008, a year when the
>> industry
>> suffered a record number of  fatalities.
>>
>> There were 41  people killed in 11 EMS helicopter accidents  between
>> December
>> 2007 and February 2010, according to an NTSB   report.
>>
>> It said the pressure that crews face to respond  quickly during
>> difficult
>> flight conditions, like darkness or bad  weather, has led to
>> increased
>> fatal
>> accidents.
>>
>> Last fall, the NTSB urged the government  to  impose stricter
>> controls on
>> emergency helicopter operators,  including  requiring the use of
> autopilots,
>> night-vision systems  and flight data  recorders.
>>
>> Less than a month after the  NTSB released the  recommendations,
>> three
> crew
>> members died when  a medical helicopter crashed  in South Carolina
>> after
>> delivering  a patient to a Charleston hospital.  Investigators said
>> the
>> helicopter ran into bad weather and was trying to  land.
>>
>> In November, the pilot of a medical helicopter crashed into a  hilly
> area
>> near the Nevada-California state line, killing three - the   pilot,
>> flight
>> nurse and paramedic. The crew had dropped off a patient  at a  Reno
>> hospital.
>>
>>
>>
>> --
>> Stephen Richey, CRT
>>
>> "A man's moral  worth is established  only at the point where he is
>> ready
> to
>> give up his  life in  defense of his convictions."- Henning von
>> Tresckow
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