Requesting and pre-alerting Helicopters

[Veneficus]

MAYO 1 bird is auto dispatched all the time depending on what the first caller says about the accident. and that's what Mayo wants. faster responce times. all ways can get called off.

That is because HEMS is about money, not patient care.

 

[rescue1]

That is because HEMS is about money, not patient care.

While I am aware a huge amount of 911 helicopter transports are probably unneeded, there has to be benefit to some patients for the comparably more rapid transport. Maybe out in the boonies, for example.

 

[Handsome Robb]

We have certain calls that will auto-launch a helicopter if they are a set distance away. Mainly major traumas (ie rollover, ejection, entrapment, difficult access such as dirtbike or snowmobile accidents) or severe medicals in remote areas (cardiac arrests, legit sounding chest pain or stroke calls) other than that it's our discretion.

Anyone here can request a helicopter whether it be us, PD or Fire, I'm the only one that can cancel it though. Just like Linuss, it's not my big head, it's a SOP. The comms supervisor can on their discretion but they generally won't because they've been burned by it before. "Medic 24, fire is on scene advising CF is not needed, would you like us to continue them for now or have them stand down?" In those cases I'll generally ask which department is on scene and what Engine/Truck/Rescue it is and decide from there if I want to go off what they're saying or if I want to wait to cancel them until I arrive on scene and make patient contact.

I can count on less than one hand the patients I've flown while working as an I or a Medic. In my area it really isn't needed,99% of the time ground is going to be just as fast if not faster.

We have two options for requesting them. We can request a ground standby, which is basically a pre-alert. Gets the crew back into their office and suited, pilot goes to the bird and preflights it but doesn't spin up or an airborne standby where they actually launch and start coming to us. Then we will either put them on a "Go" or "No Go" once we arrive on scene. Until we put them on a "Go" that chopper can be diverted and then they will activate a second helo for the original standby request.

I listened to an interesting podcast about HEMS the other day on iTunes U. I'll have to find it again but it was saying how with "average" spin up times the only way HEMS is faster than ground is >10 miles by ground with simultaneous dispatch or >45 miles by ground when requested from the scene. Otherwise ground is going to be faster.

 

[jgmedic]

Helicopters are never auto sent out by dispatch. The only people who are able to request a helicopter is the on scene fire personal.

It's not the best system. If we arrive on scene first we have to wait for fire to get on scene before the heli is requested. 90-110% of our burn patients get flown due to the burn center being 60-160 miles away.

Really?, I've requested Mercy more than a few times via our dispatch and never been told I have to wait for fire to do it. And back when I worked for Hall, there were certain dispatch criteria, usually in the outlying areas that would auto-launch Medevac 1(Hall's bird)

 

[DesertMedic66]

Really?, I've requested Mercy more than a few times via our dispatch and never been told I have to wait for fire to do it. And back when I worked for Hall, there were certain dispatch criteria, usually in the outlying areas that would auto-launch Medevac 1(Hall's bird)

Check policy 5201

"In order to provide for a uniform system of dispatch of EMS aircraft, and to prevent potential problems with
the dispatch of more than one EMS aircraft, the Riverside County Fire Department is designated as the Coordinating Agency for the dispatch of EMS aircraft. Requests for an air ambulance or rescue aircraft will be made through the Emergency Command Center (ECC)"

 

[jgmedic]

Check policy 5201

"In order to provide for a uniform system of dispatch of EMS aircraft, and to prevent potential problems with
the dispatch of more than one EMS aircraft, the Riverside County Fire Department is designated as the Coordinating Agency for the dispatch of EMS aircraft. Requests for an air ambulance or rescue aircraft will be made through the Emergency Command Center (ECC)"

So I'm curious then. I'll ask our sups about this. I usually have requested when running with HFD. So if not running with CDF, how does this work? I would guess that AMR dispatch contacts the ECC but I'll be damned if I'm going to wait for an engine, or if I've cancelled the engine response, then need a bird if I am going to wait around for them or re-respond them.

 

[DesertMedic66]

So I'm curious then. I'll ask our sups about this. I usually have requested when running with HFD. So if not running with CDF, how does this work? I would guess that AMR dispatch contacts the ECC but I'll be damned if I'm going to wait for an engine, or if I've cancelled the engine response, then need a bird if I am going to wait around for them or re-respond them.

My guess would be that our dispatch would contact county fire/ECC who would in turn contact HEMS.

It used to be we would just call HEMS by cell phone and give them a location but now everything has to go thru county fire.

 

[Household6]

I know this is a month old thread, but it's stuck in my craw..

Every level of EMS is permitted to dispatch AirCare here.. Many moons ago, I asked my Med Director why even lowly FRs/EMRs can dispatch birds, when the other states have to wait.. He told me first that we're eons ahead of the rest of the country in our emergency care (<_<) then he said that the Golden Hour was more important than the Fire Chief's ego.

He has a point, most of our FD and LEOs are only trained to EMR level, what are they going to tell dispatch that they haven't already heard from the First Responders? "Yup, his guts are indeed hangin out, and he's missin an arm like they said, go ahead and send dat dere choppa.."

Our closest Level 1 is 130 miles away.

 

[Flight-LP]

That is because HEMS is about money, not patient care.

That is a slight generalization wouldn't you say?

 

[Veneficus]

That is a slight generalization wouldn't you say?

Not at all.

Providers are usually patient focused, but I have never seen management that doesn't put money over patient care.

 

[Veneficus]

He told me first that we're eons ahead of the rest of the country in our emergency care (<_<) then he said that the Golden Hour was more important than the Fire Chief's ego.

:unsure:

Those two sentences conflict, the golden hour was debunked ages ago.

 

[EpiEMS]

If anybody can find a large n study (from a dataset with few missing variables) with appropriate controls showing that helicopter transport helps survival to discharge (neurologically intact survival) for all types of patients, I'd be pretty surprised.

 

[DrParasite]

Putting them on standby saves no time or get a chopper to you faster because they always run the same pre-flight check before they take off, even if they had just landed and arent even out of the bird. Pilots are creatures of habit and they will not deviate from their checks.

yes, but with something like 8-12 helicopters in state, there are preflight stuff to do.

anyone can put a helicopters on standby. heck, in theory, you can call NJ Medivac Dispatch and request a helicopter on standby, if you have the number (it's available on the internet if you are really curious). However you need to be an on duty member of service (fire, police, or ems) to put it in the air. once in the air, only EMS can cancel it. In theory if on standby, the pilots should be going the checks and waking up the medical crews, but that's only a theory.

The biggest advantage to a standby is 1) the statewide dispatcher will know which helicopter should be receiving the assignment 2) that helicopter will check the weather, to see if they can accept the call (important because if the weather is bad, that helicopter won't fly) 3) if the first due helicopter turns down the run due to weather, the second due helicopter can be alerted to check weather. if two units decline, than the request is denied due to weather.

So if it's a clear day or night, than I agree that a standby is pretty much a waste of time. but if weather is questionable, you can find out if the resource is available without putting it in the air.

 

[Bullets]

That is a slight generalization wouldn't you say?

Outside of state funded choppers like Maryland troopers and our NJ troopers, this is exactly the case. Recently we have calls for the helo that the state turned down but the privates jumped on. This is becoming more of a thing lately as more privates get involved in air med

 

[Household6]

:unsure:

Those two sentences conflict, the golden hour was debunked ages ago.

Noted.. Looks like I have a subject for discussion in next week's trauma class, thank you! Fierce..

Military still believes it and trains for it.. It's looking more and more like making the jump to civilian medicine isn't as easy as it seemed.

 

[Action942Jackson]

Based on call information we will request standby, or if info is bad enough we have them lift. Standby does work as majority of all the helo services are private and even if you put them on standby, they will more then likely self dispatch, rotor up and head towards the scene. We love Air Methods and KY 5. Great people, great service, and an awesome bird.

 

[RocketMedic]

Noted.. Looks like I have a subject for discussion in next week's trauma class, thank you! Fierce..

Military still believes it and trains for it.. It's looking more and more like making the jump to civilian medicine isn't as easy as it seemed.

That's because military medicine is very set in its 1986 ways. Remember, IOs and intubation are mystic lore in the military medic world. Also, lots of ignorant people.

The ego trip burn that would come from a modernization of military medical doctrine would be insane. I had a squad leader tell me that he "saved a guy's life" who got shot in the belly by cricking him. I wasn't there and don't really know if it was needed, but it seems a little excessive. I have also heard secondhand of needle decompressions for anaphylaxis, so yeah...

 

[Household6]

Based on call information we will request standby, or if info is bad enough we have them lift. Standby does work as majority of all the helo services are private and even if you put them on standby, they will more then likely self dispatch, rotor up and head towards the scene. We love Air Methods and KY 5. Great people, great service, and an awesome bird.

Mmm hmm.. *nods head*

It seems like they'd rather be circling anyways.. Around here they don't get out much.. We have some awesome awesome people on the flight crew.

I forgot to add, part of the EMR/FR cert class is properly setting up a LZ.. We spent about 20 hours training with the bird AND the flight crew on the ground, doing mock hot loads.. Flight crew took over our class for those 20 hours to train us they want...Lawdamercee, what a bunch they are.

I crossed paths with them twice on calls, both calls at the same racetrack, both calls off duty. One call was a collision on the track with a pedestrian the other was a man who got struck by lightening while riding a four wheeler..

 

[cruiseforever]

MAYO 1? Who is that

Mayo 1 is based in S.E. Minn. Owned by the Mayo Clinic system in Rochester Minn..

http://www.mayoclinic.org/medical-transport/mayoone.html

 

[Household6]

Mayo 1 is based in S.E. Minn. Owned by the Mayo Clinic system in Rochester Minn..

http://www.mayoclinic.org/medical-transport/mayoone.html

Do they still run that jet around? I'm in North's Area..