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Charles Krin cskrin2 at hughes.net
Mon Dec 29 03:44:19 GMT 2014


I agree that for distances further than the unrefueled operational
radius of the helo, fixed wing should be considered as primary... many
of the facilities I worked at did NOT have an airstrip of over 3000 feet
within 30 miles, and even those that did had *at best* a Visual Approach
Slope Indicator (VASI) system. Add in the additional transfer/transport
time from even the smaller 'downtown' air port to the receiving
hospital...and the near 'door to door' of a helo flight can cut
significant time off- one memorable trip from Ft Sill Indian Hospital to
Parkland Dallas ended up with us having to land at Love Field for some
reason, and wait for ground transport- I seem to recall that for some
reason, the Parkland helopad was occupied and could not accommodate our
Huey... since our patient was a 400 pound alcoholic GI bleeder...that
was NOT a comfortable wait for *either of us*-

In the early 1980s, our Hueys could leave Ft Sill, make a pick up at any
hospital within 80 miles or so and get to Oklahoma City or Wichita Falls
generally before a ground ambulance could go direct from the little
hospital into the city...at least partially because there frequently was
no 'good way' to get from the small hospital to OKC or WF. Additionally,
because of common weather patterns, even after civilian air ambulances
started springing up in OKC, Tulsa and WF, we would frequently get the
call, because we could sneak around a weather front and follow said
weather into the City...while the city units would have to punch through
the weather- it also helped that we were equipped and staffed to fly
dual pilot night IFR and could handle light icing, something that the
smaller JetRangers and AStars of the day were not.

I have some friends who work with an ambulance service in Northern
Louisiana- this outfit has both fixed and rotor wings, and the most
common use of the fixed wings is to take cancer patients from the
Monroe/Ruston catchment areas into Houston for care.

(While aircraft flying with "Lifeguard," "DUSTOFF," or "MEDEVAC" call
signs have relative priority over any other aircraft in the sky *except*
balloons and unpowered gliders, past practical experience has indicated
to me that it's not really smart to try to insert a KingAir or smaller
aircraft; or any rotorwing craft into a busy traffic pattern full of
'heavies' short of a truly emergent patient!)

without drawing the ire of Dr. Mattox (with whom I have locked horns
with in the past on this matter), there is a time and a place for every
form of transport, from a blanket drag to a LearJet or Gulfstream....and
consideration of the distance, patient, weather and available staff all
need to be considered to provide the best and most appropriate transport
for any given patient.


On 12/28/2014 18:45, Stephen Richey wrote:
> True but honestly, in that setting, call for a fixed wing turboprop rather
> than a helicopter.  If the patient is stable you can wait a little while
> longer for a less risky mode of transportation (especially at night or in
> marginal weather).
> On Dec 28, 2014 7:42 PM, "Charles Krin" <cskrin2 at hughes.net> wrote:
>> Stephen:
>> having worked in many rural EDs over the years, I'll point out that many
>> of those service districts are not equipped or staffed to 'lose' a
>> critical care truck for 6 to 8 hours at a time... and in many cases, the
>> only 'mutual aid' group that could help would be the regional Air
>> Ambulance service. (It used to be the Military Assistance to Safety and
>> Traffic program using (mostly) Army DUSTOFF assets...but after civilian
>> helo medical services spread out, and especially after 2001, military
>> helos are rarely available for civilian transfers.)
>> As an NR EMT-A/91B2F flight medic in the early 1980s, I cared for more
>> than a few patients this sick or sicker as we hauled them out of North
>> Central Texas and most of Southern and Western Oklahoma.
>> ck
>> On 12/28/2014 16:07, Stephen Richey wrote:
>>> All of the above.  If he's stable and it's less than four hours away by
>>> ground, why fly them?  A ground ambulance crew is just as able to
>> transfer
>>> such a case unless you're going really far.
>>> On Dec 28, 2014 4:14 PM, "Charles Krin" <cskrin2 at hughes.net> wrote:
>>>> 1: how high and how far? (fixed vs rotor, for ex)
>>>> 2: any other medical problems? (no breathing problems? Glasgow 14 or
>>>> better?)
>>>> ck
>>>> On 12/28/2014 09:35, Robert Smith wrote:
>>>>> Does anyone have a thought on the possible problems of medivac for a 78
>>>> yr old guy with a closed (presumed) skull fx and small stable epidural?
>>>>> --

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