Wednesday, July 14, 2004

As Dr. Shazam keeps us up to date with her air ambulance adventures she and the crew have all done well. That is not always the case. From the Orangeburg, SC Times and Democrat: Four die when medical helicopter with accident victim crashes
The crash was so muffled early Tuesday morning, most people at the rest area along Interstate 26 thought it was just another wreck on the highway.
But trucker Johnny Williamson knew it was the crash of the medical helicopter he had watched take off less than a minute ago, carrying a woman with a broken leg to a Spartanburg hospital.

The woman, along with three medical workers from the Spartanburg Regional Healthcare System, were killed when the helicopter went down.....The medical helicopter crashed about 5:40 a.m. on a hiking trail behind a rest area along I-26, Newberry County Sheriff Lee Foster said. It was in the air less than a minute, the sheriff said.....The incident began around 4:30 a.m. when a state trooper found a woman in the median of I-26 who said she had been hit by an 18-wheeler. Her leg was broken and she had some bruises and scrapes to her chest. Paramedics checked her out, decided she needed to go to a trauma center and called for a helicopter, Foster said.

That isn't unusual in Newberry County, Foster said. Routinely, helicopters are called in when an ambulance might get stuck in rush hour traffic. Also, emergency workers can get patients to the hospital faster by flying and that's critical in trauma cases, the sheriff said.
The number of helicopter crashes are on the rise according to The Journal of Trauma Medical Helicopter Accidents in the United States: A 10-Year Review. (abstract free)
From the discussion:
In all medical endeavors, safety of the patient and medical personnel has been a paramount concern. We initially reported a worrisome trend in U.S. medical helicopter accidents for a 5-year period. 5 Our study shows a marked increase in the number of medical helicopter accidents for the 10-year study period. In particular, over half (52%) of all accidents in the study period occurred during the last 3 years of the study (2000-2002). These results appear reflective of a trend first identified by the NTSB in 1988. The NTSB recognized an alarming increase in medical helicopter accidents in the 1980s. Specifically, there were 14 major medical helicopter accidents in 1986 that destroyed or significantly damaged 9% of the U.S. medical helicopter fleet. After this, they undertook a safety study of helicopter air operations and found an accident rate almost twice that of nonscheduled air taxi helicopters and a fatal accident rate 3.5 times greater. 6 After publication of their study, an improvement in medical helicopter accident rates occurred.
See the graph:

Posted by Hello

Some research is asking the question: Is this trip really necessary?
The increased number of medical helicopter accidents we have reported is noteworthy in that several recent studies have shown that medical helicopters in the United States and other countries are overused. Shatney and colleagues reported a retrospective review of 947 consecutive trauma patients transported to their trauma center in the Silicon Valley of California, where they found that only 22.8% of study patients possibly benefited from helicopter transport. They further found that 33.5% of patients transported by helicopter were discharged from the emergency/casualty department and not admitted to the hospital. Eckstein and colleagues retrospectively evaluated helicopter transport of 189 pediatric trauma patients in the Los Angeles, California, area. They found that 85% of patients were considered to have minor injuries. Of the patients transported by helicopter in their study, 33% were discharged from the emergency/casualty department and not admitted to the hospital.
The abstracts are here and here.
Despite the questions I believe that the use of helicopters for emergency medical transport of all kinds will increase over time. As smaller hospitals close entirely or close their ED's patients will have to be transported a greater distance to receive medical care. The increasing regionalization of trauma, cardiac and neurosurgical services will play a role as well.
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