How To Utilize The Capability of Medical Aircrafts

MEDICAL MONDAY

By: Sean Barnette

In today’s #MedicalMonday, we are going to discuss when and how to utilize the capability of medical aircraft. As with any of my articles, you must follow your local protocols and guidelines. Surprisingly, there are many agencies that do not allow you, the law enforcement officer to request a medical helicopter. If you have attended my course, Life Saving Medical Tactics for Law Enforcement, you may recall that one aspect of medicine that I preach about is the common sense aspect. You do NOT need to be an EMT, or a doctor to arrive to a scene and think to yourself “this looks bad,” or “this person is really fucked up!”

ESPECIALLY in the more rural settings, if you HAVE to wait for EMS to arrive so that they can request a medical helicopter, your agency NEEDS to revisit that policy! People that need a medical helicopter do not have the time to waste in waiting for ground EMS to arrive to FINALLY request a helicopter. Patients that have multi system trauma need a trauma surgeon in the smallest amount of elapsed time from incurring the injury as possible. It is asinine to think that you are trusted with a police vehicle, a gun, and have the authority to serve and protect your community, BUT you aren’t smart enough to use your eyes and your brain to decide that a medical helicopter needs to be launched to your scene.

With those points out of the way, what are the BENEFITS to having a medical helicopter respond to your scene? The first benefit is the reduction in time that the patient will make it to what is referred to as “definitive care.” Not all hospitals are created equal or have the exact same capabilities. A helicopter crew will have the knowledge of exactly where the patient needs to go for the correct treatment. Secondly, the responding medical helicopter crew members have hundreds if not thousands of hours of advanced training, advanced certifications, and advanced skills competency. Typically, at the very minimum, two paramedic level practitioners with be part of the make-up of a helicopter crew, however most likely it will be a flight paramedic, and a flight nurse. Even if the patient can’t be flown for whatever reason, I have personally seen instances where the flight crew will ride in the back of the ground ambulance to assist with patient care. The third best reason to consider launching a medical helicopter is because of the additional medical treatments, medications, and interventions that are available for the helicopter crew to utilize. As an example, many services can insert chest tubes for thoracic trauma, and many services carry fresh whole blood which can absolutely make the difference between whether a patient lives or dies.

Here are some GENERAL guidelines of WHEN to launch a medical helicopter. Again, you must follow your local guidelines.

• A person who has obvious massive trauma AND ground EMS transport will be longer than 30 minutes.

• A person is critically ill or injured AND entrapped in the vehicle where extrication time is expected to last greater than 20 minutes.

• The patient immediately requires specialized medical treatment such as a field amputation.

• Mass casualty incident with multiple patients who are critically ill or injured.

Here are some general guidelines / drawbacks to utilizing a medical helicopter:

• Availability. EMS helicopters are not only restricted in the amount of aircraft and crews available, but can only fly in favorable weather conditions.

• Cost. The STARTNG point for the cost of transport in a medical helicopter is roughly $40,000. If you live in a rural setting and there is a medical helicopter service near you, I very highly recommend purchasing the annual membership that most services offer.

I could do another entire Medical Monday about setting up a landing zone, but I will mention just a few tips:

• It is preferable to land a helicopter on a hard surface such as a road.

• As a general rule, the landing zone should be 100ft X 100ft.

• Ensure that there are no overhead obstructions such as wires.

• If you must land the helicopter in a field, (and I know this will be unpopular) request fire department assistance so that they can wet the dirt down minimizing the amount of dust that will be blown into the air as the crew lands.

• Remove your hat, or any other loose items before the arrival of the helicopter

• DO NOT APPROACH the helicopter. Wait for crew member instructions!!! They will come to you.