Around the country, there are numerous air ambulances in service. The University of Michigan has its own, and I regularly see it cruising the local skies.
I assume the advantage of a helicopter for transporting emergency patients is to save time, but I’m wondering how much it saves. So I gots me some questions.
First, how do road-bound ambulances work? are they lurking around the countryside, waiting for a need to arise in their immediate vicinity? There are EMTs and ambulances stationed at firehouses which in turn are scattered all around the countryside, so it seems to me that they can arrive (for example) at the scene of a car crash pretty quickly, but then it might take some time to get them to the nearest major hospital.
OTOH, if a helicopter is going to pick someone up, it’s parked at the hospital downtown, and it’s going to take the flight crew several minutes to get to it, get it started, and get it up in the air. Then there’s the flight time to the scene of the accident out in the countryside. Then they have to find a clear space to land, which may or may not be within a convenient distance of the car crash. Finally, they can pick up a victim or two and bring them to the hospital. Do all hospitals have helicopter landing facilities, or do they have to bring the victims back to their home-base hospital?
I know helicopters can hustle once they’re in the air (160+ MPH), and they get to travel in a straight line between the hospital and the car crash site. But does this make up for the other delays? Does a patient really get to treatment that much faster?
I think so, in most cases. As far as I know, ambulances are usually stationary until called into action, so the first two points you post (mounting of vehicle and arrival) should be the same for all types of transport. I imagine that a helicopter wouldn’t necessarily have to land at the accident site or hospital, but it probably could at most hospitals, anyway. I don’t really know, though.
My mother went to the local hospital a few months ago and, based on her symptoms, they decided that there was a significant possibility she might be experiencing a heart problem which could kill her dead in a matter of minutes or hours. They decided to send her to a bigger, better hospital which was 30 miles away. Sending her in a conventional ambulance would have taken approximately 30 minutes. They already had a helicopter sitting on the pad at the local hospital, where she was, so they fired it up and got her to the bigger hospital in only 15 minutes. Turns out she was fine. She didn’t really need to go to the bigger hospital at all.
I suspect the decision making process went something like this…
[1] There’s a 5% chance that this patient has a cardiac emergency.
[2] If that’s true, saving 15 minutes increases the patient’s survival rate by 30%.
[3] If we don’t take action and she dies, we could get sued for $60,000,000.
[4] The helicopter costs us $18,000 per day whether we use it or not.
[5] Paying for the pilot and the fuel only adds another $1,000.
[6] The risk which is much bigger than the cost, so use the helicopter.
I can certainly imagine situations where the helicopter would actually be slower. I’m sure they take this into consideration. The estimate travel time by the different options and try to assess the severity of the patient’s condition to see if it’s worth it to spend $1,000 to save 15 minutes.
Ambulances are usually at the firehouses, and air ambulances are at their helipad or airfield.
The main differences are most apparent when there’s traffic or a long distance to cover. From my house, road ambulances are almost certainly the fastest, considering that there are 2-3 fire stations within 5-10 minutes, and 2 major hospitals (Medical City & Presbyterian Dallas) within 15 mins. Unless the helicopter is actually stationed at the hospitals, it would probably take longer to spin it up and fly to my house, and find somewhere to land nearby, which might actually take longer to transport me from my house to the helicopter than for the ambulance to show up.
However, if I was on US 75 in a rush hour wreck about 5 miles north of my house, chances are that a helicopter at Baylor Medical Center (10 miles south) could spin up, fly to the accident scene, land, collect me, and fly back to Baylor faster than a nearby ambulance could drive there, collect me, and drive to Medical City, just because the helicopter doesn’t have to deal with traffic or roads, or anything other than flying in a straight line at 150-200 MPH.
They’re stationed within eyesight of the helicopter. In my city we have several of them and they are distributed around the area for better coverage.
And yes, a 160 mph helicopter flying in a straight line can significantly reduce transportation time over a land vehicle that has to negotiate roads and traffic.
From numerous fly-on-the-wall TV shows here, the helicopter with it’s medical team and equipment is called in by the paramedics on scene. When they arrive, there will be ambulances and police and probably fire and rescue already there. They may still be cutting someone out of a wreck, or treating a casualty on the ground.
The primary reason for the helicopter is to get the team, with a consultant specialising in trauma on scene asap. Getting the patient to hospital is secondary, and many times, once stabilised, the patient is sent off in an ambulance. They use the helicopter if they need to go to a specialist unit that may be some distance.
The response time targets for the serious emergencies are:
75 percent of all Red 1 patients must be reached in 8 minutes
95 percent of all Red1 patients must be reached within 19 minutes
In the UK, neither patients or their insurances, are charged, however they are treated. The medical staff on a helicopter are paid by the NHS, and rotate within a hospital trauma unit. The helicopter and all its crew and expenses are paid from public donations and they regularly have fundraisers.
The thing is, the landing requirements for a helicopter are very minimal. They can land on roads, on fields, on the roof of a building… What is needed is adequate clearance for the spinning rotor(s). Even if the surface is a bit unstable or uneven the helicopter doesn’t, strictly speaking, actually have to land, it can hover an inch or two above the surface, low enough for workers to climb aboard and get the patient on board, too.
While these days most hospitals I’ve seen do have a designated helicopter area it’s not required. Really, all you need to do is shoo everyone off a sufficiently sized patch of the parking lot and the helicopter can land there. Right outside the entrance of the ER if, as I said, there is sufficient clearance for the rotors.
Yes, particularly in urban areas with heavy traffic congestion.
That’s one way they work. Around here we have lots of private ambulance services that cover a variety of towns. They may be very close to the scene or may have to travel longer distances. The dispatchers try to work that out.
I think any hospital with a trauma designation of I,II, or III has to have a heli pad. And a good pilot can get one in the air really fast. Not much longer than it takes the firemen or paramedics to get it together.
For traumas, minutes do count. Here is a map of the areas of the country that are within an hours drive of a level 1 or 2 trauma center. The white areas really need some air support.
One of the best reasons for helicopters. The last thing a burn victim needs is a 4 hour road trip. And also hospitals like to pass off real expensive patients to other hospitals, and owning a helicopter makes this easier.
Helicopters do not have to worry about clearing the traffic jam. And they have more options over which hospital to take a patient to.
Also, they are dead useful when I run out of platelets in the blood bank.
When my father had his cerebral hemorrhage, they had to take him to a hospital an hour away by roads. The helicopter got him there in a half hour (including flying out to pick him up). With something like that, the half hour makes a big difference.
My wife’s ex-husbands was medivaced after a motorcycle accident. The bill was $1000 per minute. The flight was twelve minutes and they were charged $18,000 for the flight.
Good: they had insurance
Bad: insurance company claimed that the air ambulance that transferred him wasn’t a “preferred provider”, so they only covered $4,000 of the charge.
Moral: be sure to ask the paramedics to only call a “preferred provider” before hauling your unconscious carcass on the helicopter.
Total medical cost were over $4,000,000.Insurance covered 80%. Hospital suggested they setup an easy payment plan. Lets see, $800,000 at $10 a month…
Helicopters will be staffed with a fhttp://www.flightnursing.com/light nurse, too, who is going to be able to provide a different level of care than a paramedic or EMT (who would arrive with an ambulance) as they are full-blown RNs with extra training. Flights can also have an assisting paramedic, and even doctors.
So it’s not even just a matter of speed, it could be a matter of severity. It might not be worth it to take the patient to the nearest trauma center when they need to be at a bigger hospital further away.
Those few minutes saved by helicopter also saved my life after rupturing my aorta in a car accident and needing to get to a hospital more than 70 miles away for emergency surgery. Those few minutes were crucial in saving my life, as ruptured aortaes are very usually fatal injuries.
I live in a rural area West of St. Louis. The roads out here are all two lane and twisty. A straight line distance to town might be 3 miles and a 6 mile road trip. Then it’s another 20 miles to the hospital. Theres a helicopter stationed at the fire station just North of town. Once in the air they can be at my house in about 3 minutes. When they leave my house they can be at the hospital in about 11 minutes or so.
We are members of an organization that covers the cost of the helicopter if we need it. I believe we pay $100 a year just in case.
Where I live, medical copters take patients to either Houston or San Antonio. Both are about 100 air miles, and Google calculates the driving time as 2 hours when no traffic considerations are present. So, consider red light and siren, but urban traffic to the hospital, nearly two hours in any case. A little faster to Houston, where there is a freeway, but I think the copter’s default hospital is San Antonio. Medical helicopters have a typical cruising speed of 150 miles an hour, so the rooftop to rooftop flight is about 40 minutes.
A helicopter might not have to worry about traffic jams, but they do have to worry about the weather and in many cases its the weather that caused the accident in the first place.
Plus arent most ambulances better equipped than the inside of helicopters?
Finally in the US many times ones insurance wont pay for helicopters since they are often over $20,000.
Didn’t realize that air ambulances flew patients to San Antonio or Houston from the Schulenburg/Hallettsville/Weimar general area. I always thought they were more for very local sorts of traumas.