In other words, they’re paying insurance.
I’m going to pay my fee and use the hell out of that any time there is traffic on the road.
(Just kidding; I hate those Spinning Blades of Death machines with a passion, and would fly in one now only if the alternative was being consumed by lava or hunted by a bunch of dinosaurs some maniac bred from DNA fragments because he didn’t listen to my lecture about the lack of humility before nature and chaos theory.)
Stranger
Well, a helicopter was recently called to a bad car crash in my town. I think the ambulance crew called for it. The first responders picked up the guy, and drove him to the nearest open space, a school athletic field, where they were meet by a medical helicopter, which took the guy to a nearby trauma center.
He died anyway. It probably was expensive. I suppose the dead guy had insurance and an estate to bill.
The local Air Evac Lifeteam service lost a security officer at their landing pad in 2001. He accidentally walked into the tail rotor.
[Moderating]
This is not the thread to debate the merits or lack thereof of the American health care system. There are plenty of threads about that in the political forums. Stick to the facts.
Most people would be shocked at how often this happens, or the tail rotor gets caught on an unseen line. I honestly don’t understand while helicopter manufacturers haven’t gone exclusively to shrouded rotors or directional thrust systems.
Stranger
I should pay attention to their current helicopters to see if they still have the exposed tail rotors. My wife works for the hospital where it happened, so I go by the landing pad fairly often.
This.
All sorts of possibilities exist, and if you can imagine a way for it to be run, there’s probably an agency somewhere doing it.
The person calling for med-evac from a pre-hospital emergency scene might be a lone first responder who drove to the scene, first-aid kit in hand. Much (MUCH) more often it’s the on-scene incident commander, with input from the senior medic present.
Or it’s an E.R. physician in a small hospital faced with a patient too critical for the limited resources she or he has at hand.
Emergency services will probably have guidelines and protocols guiding such decisions, at the state or county level, or even at the level of the individual service. When I was doing med-evac in Virginia, it was often at the level of a given hospital’s catchment area. That is, on-scene personnel had to request permission from their area’s hospital before calling for med-evac.
(Lots of other ways it happened. It could be large industrial facilities, remote farms, you name it.)
Usually the patient’s insurance. We were adamant that those who called us should consider the patient’s welfare first and not worry about the bill. It meant we operated at a loss. But ours was a hospital based helicopter, as were many at that time. (I have no idea if this has changed much.) Those patients came to our O.R. or various ICUs and paid hospital bills for a long time We were also a (very expensive) flying billboard for the hospital.
LZ training may have evolved since then, but in my med-evac days we traveled around the state, doing landing zone training, teaching EMS services or hospital staff how to set up a landing zone, what frequencies to use to talk to the pilot or the crew, what information we needed, when it’s safe to approach the aircraft, what criteria to use when considering med-evac, etc.
It’s fueled and ready 24-hours a day. It might go out of service briefly for inspections or mechanical issues, but if these are expected to last too long a reserve craft is put in service. Or not. Different agencies have different resources.
The territory is going to vary extremely widely depending on population density, how many hospitals are in the area, etc. Also, I’m sure, by what sort of agency is operating it (hospital based, private company, county government, etc.)
Yes, in reality this could and did take place, although I don’t ever remember it being cards. Much more likely it was a movie, or in my case, a nose in a book. More often, though, we were kept busy with patient follow-up, liaison with referring agencies, etc. Also - every day - inventories of every piece of equipment or vial of medication in the aircraft. And training. Training on a vast number of possible emergencies, as well as the use of our specific equipment and meds.
And at times we worked in the Emergency Room, praying that we wouldn’t get called out while we were in the midst of something critical with a patient there.
Indeed. You can get more information about their operations from their own website. There is basically no cost for air ambulance services for Ontario residents covered by the OHIP insurance program. The Ornge website has a section discussing invoicing, but that’s only for non-residents.
As to how much they’re utilized, I have no idea, but I appear to be under a flight path for medevac helicopters from northern Ontario to major Toronto hospitals. I know this because I occasionally hear the deep “thrum” of a big helicopter heading south, and if I’m outside can see its distinctive orange colour. But it’s very rare – maybe once every couple of months.
About 20,000 transports a year. Their latest data is available up to Monday, where they transported 72 patients.
My Brother needed a Medevac once. The local Helicopter was already transporting someone else. But luck was with him. The Army was doing exercises and had a military medevac helicopter open. They put my brother in an ambulance and drove about 2 miles to a parking lot. The ambulance and helicopter both reached the parking lot at the same time.
@Broomstick gave some really good answers, let me add my 2¢ in as well. First, just like there isn’t one color for fire trucks or one style of the “POLICE” decal (font, size, color) on the side of cop cars, answers may vary by company, town, county, or state; especially when it comes to protocols. I’ve called for a helo before, I’ve physically put patients into a helo & I’ve done stand-bys for a helo landing, all multiple times. The specifics that I know may or may not be identical to what happens where you live.
Typically a crew of three, pilot, flight nurse, & flight medic.
There may be multiple companies involved in the operation of a helo/fleet; they may or may not be separate-but-related companies:
- Company that owns the asset / helo
- Company that maintains it
- Company that staffs the pilots
- Company (or hospital) that staffs the medical personal aboard
It is not uncommon for there to be one company that has a fleet of helos & multiple contracts so when you’re local hospital’s helo goes in for maintenance they provide a different one, it might not be painted with the name of your local hospital but everything else on the inside is the same,
Yup. Factors going in to calling for it include time of day (I can drive to a trauma center faster at 2am than in the heart of rush hour). distance/time to trauma center, damage/intrusion to the vehicle &/or other deaths in same vehicle, weather, & even patient cooperativeness (they can make you go ‘bye-bye-sleepytime’ where we don’t have those meds aboard the ambulance.) I’ve heard of patients who were flown, by protocol, being released from the hospital before our shift ended.
Even with just an ambulance call, no one is taking the time at the side of the road to figure out if you have insurance (I don’t carry my wallet when I run or bike, nor would a minor necessarily know any info about their parent’s insurance), if this ambulance is in/out of network, what the limits on your policy are, etc.
The helo companies around here to outreach/training with the local fire depts, teaching what their minimums are & how to give them an advanced report of what they’re coming into (field size & layout - surrounding trees, wires, towers, buildings, etc) If it’s really sketchy, they may ask us for a different site before they ever lay eyes on it. There is a nearby business with a helipad; to get approval to put it in, the town made them make it available to medical flights; since they don’t leave their helo there, only dropoff/pick up execs it literally doesn’t cost them anything. The medical helo pilots like that location in that it is a ‘regular’ LZ with published entry & egress paths & they know they don’t have to deal with issues like wires or trees
Those are management decisions based upon population & terrain; there probably more territory covered in rural Montana than central NJ, just on the basis of assuming one flight per day for every x thousand population.
Most first responders (are required to) do a rig check when they start their shift, whether PD, FD, or EMS. For them - is it fueled, are there any maintenance issues, weather checks, any NOTAMs to be aware of, do they have all of their required meds, is the O2 bottle at least ½ full, etc.
I remember one bad car accident; we could have loaded the patient into the ambulance for a couple of hundred yard drive to the nearest open field or about 1½ miles the other way to the airport where they were launching from. By the time they finished their preflight, we were putting the patient in the back for them to fly off to the hospital which was ultimately quicker to get the patient into the trauma bay & OR that they needed.
Helos are typically setup for medical or rescue (external winch to pull someone up from a gorge/crevasse but not both. However, in an “Oh, shit!” situation you make due with what you have.
MD & NJ (if I remember correctly) are handled by State Police helos that are setup for both.
That was a free benefit at the hospital where I worked in Illinois. However, you had to use that company’s services to be covered.
A related tangent. Trying to find a news article from years ago. Author was a doctor that was invited to a wedding of a girl he had treated. She had been in an accident, air evac on military chinook helicopter to the hospital the doctor was at. Sounded like a T Rex as it approached.
AI couldn’t find it, but Dopers prolly can. 
Just been checking some of the UK’s services. Scotland - geographically biggest and some wildest terrain - had just short of 1000 callouts last year. London treated over 2000 patients, Yorkshire just over 1000, East Anglia (the service Prince William was a pilot in) about 2500. All depend on charitable fundraising (lotteries, events, merchandise as well as the usual legacies and donations). They’re operationally integrated with NHS ambulance services, but apparently not funded by them (at least as regards the machines: I don’t know if the clinical staff are seconded from the base hospital - I see one of their websites says their job is to take the hospital to the patient, as much as the other way around).
There are private commercial services advertised, but I guess that’s not for immediate response emergency services
Of course Ontario residents will remember that Ornge was mired in controversy due to a CEO who treated it as his own personal piggy bank (kickbacks, giving his girlfriend a cushy job, subcontracting to companies that he controlled, etc.).
Wut’s that you say? Society is not perfect? Ontario is not Utopia? Quick, take me to my fainting couch!
Retired New York State E.M.T. chiming in. Similar to other states.
There’s some warmup time involved in putting the bird in the air. So, depending on the severity of the call going IN to the 911 call center, a so-called STATFlight might be put on standby to fly. That gets the crew to the bird and they start their warmup and check procedures.
They don’t fly until told to. When I was working, early 2000s, it was $ 10,000 to do a helicopter transport. I was in Orange County, NY and that meant that the first choice was Westchester County Medical Center, the closest Level 1 Trauma Center.
If the 911 call center doesn’t make the call, assessment is made pretty quickly when the Paramedics show up. EMTs are Basic Life Support. If we took a call and advanced Paramedic-type life support was required, we’d call them in. Frequently to save time and lives ( of course), they’d be simultaneously dispatched and we would work out who did what on site. The truth is that you know within 90 seconds of facing a patient if they need to fly or not.
In an extreme case, an EMT might want to call for a flight. The crew might be sent to warm up the bird but a Paramedic would be on site before that 15-minute warmup time was close to expiring to make the call.
A lot of the time, we’d transport to the closest hospital to stabilize AND a helicopter would be sent there to transport to WCMC. It’s not the movies. Even a seasoned Flight Nurse is no replacement for a fully staffed Operating Room that’s close by.
It’s interesting the calls that do NOT result in a STATFlight event…some of the more gruesome and seemingly dire moments were best handled with a 9-minute drive at high speed and right into the OR instead of waiting for the bird and then the…20 minutes to WCMC? Maybe a bit more, all depending on where in the county you were landing.
Doing lifesaving work in the back of an ambulance that’s rocking and rolling at 85 mph is hard. Doing next-level lifesaving work in a helicopter? Much respect.
ETA: The non-fiction book Shock-Trauma by Jon Franklin is an incredible read if this kind of thing interests you. I read it quite a few times when I was in the EMT business. Passed it on to a nephew who was interested in the business.
Emphasizing that this is the case for most helicopter patient transports. The patient is likely seen and initially stabilized at a local hospital and then transported to a specialty or Level I trauma facility like Children’s Hospital of Oakland - by ambulance, helicopter or fixed-wing aircraft.
Hard to imagine there are that many cases where there’s a major traffic accident or other trauma leading first responders to conclude that ambulance transport to local hospitals is undesirable, and then having enough landing space at the site to accommodate a helicopter, especially in urban areas.
This is a big part of medevac in Saskatchewan. Low population density, so the hospital may be an hour or more away by road. And flat country for the helicopter to land and take off? Yeah, we got that covered.