Good evening readers. Today I want to discuss a topic that has been in EMS journals and the news frequently. Lately it seems that EMS helicopters are being used way more than they should. This applies to both emergency and inter-facility transfer calls. I do feel that helicopters are a vital resource to EMS, however it is a tool that should be used wisely.
As part of my job as a field supervisor I investigate calls where a helicopter was used on a daily basis. This includes the patient outcome, reason for deployment, time savings, care rendered prior to airship arrival and risk factors. People often use mechanism of injury as a decision on whether or not air transport should be utilized. I completely disagree with this practice.
Determining the mechanism of injury is great for assessing injuries, but not so great for transport decisions. A physical assessment should be the number one tool used to determine the severity of injuries and whether or not a patient could benefit from air transport. The old “better safe then sorry” routine has got to stop. As paramedics and EMT’s, we are trained to detect life threatening injuries. Launching a helicopter because “they might have internal bleeding” is not an example of a good assessment. Sure if the patient presents with poor skin signs, a distended abdomen, bruising, tachycardia and severe pain after rolling his car 3 times, then launch the helicopter if it will save time. But don’t do it just because his car looks “really bad”.
Being a patient advocate is not purely a medical role. Some other emotional and financial factors play into the positive outcome for the patient. Your patient will likely have a negative opinion on you and the service that you provide when they receive a $15,000 bill that the insurance company just rejected for his air-ambulance ride when he only had a broken arm. Something like this can greatly impact a persons life in a very negative way. All of this can be avoided by performing a good thorough assessment before making the decision to transport by air.
Your decision to use an air-ambulance may not just affect your patient, but other patients as well. When you take a helicopter out of the system, you may be denying that resource to a critically injured person that can actually benefit from the time savings.
Helicopters are a great tool and can really make a difference when time matters. As EMS providers we have an obligation to make sure that our resources are used responsibly.
As always, questions and comments are always welcomed. Please feel free to e-mail me.
