Torstar series on Ornge

[ploughboy]

A recent interesting series in the Star on the Ontario air ambulance system. Enjoy. pb

 

http://www.healthzone.ca/health/article/609875

 

http://www.healthzone.ca/health/article/610046

 

http://www.healthzone.ca/health/article/610295

[leviathan]

Thanks for the links. One thing about helicopter services is that they have a high rate of crashes + fatalities, for no proven benefit to patients. Just throwing a bit of controversy out there...

[Bede]

leviathan,

 

I have to disagree. Heli does have a higher risk associated than fixed wing, but this is the result of the environment they are working in (unprepared landing surfaces with obstacles as opposed to certified airports). In the US, many of the crashes have been in helicopters operating in IFR conditions (bad weather) with a single pilot. This puts a huge amount of workload on the pilot. In Canada, all the air ambulance that I know of are operated by 2 crew, and in my opinion have far more oversight than their US counterparts.

[Jochi1543]

Yeah, we have 2 pilots on all our air ambulances (both fixed and rotary). STARS (our rotary) won't fly after dark, apparently - at least that's what their PR man told us at an info session a few weeks ago. However, I distinctly remember getting to work at 11 PM one night in January and seeing the STARS crew package a pt. Maybe they only fly to hospitals at night and just don't do scene landings?

[leviathan]

leviathan,

 

I have to disagree. Heli does have a higher risk associated than fixed wing, but this is the result of the environment they are working in (unprepared landing surfaces with obstacles as opposed to certified airports).

No prob, I made the post to be adversarial.

 

It doesn't matter why there is a higher risk, there just is. And it may be hard to stomach that risk for no proven benefit. Some places in the US will fly patients for almost any reason. We have it a bit better in Canada (at least BC where I am familiar), and will try to only transport patients where the "golden hour" may apply. Even still, I have gone out with the BC Air Ambulance service, and we transported pretty sick patients, but still patients that weren't in any critical condition who probably could have gone by ground.

[Bede]

I used to work fixed wing air ambulance in N. Ontario. Unfortunately, the vast majority of patients we flew were ambulatory or transfers. We were really a glorified taxi service.

 

I do agree with you though about a lot of rotary wing flying. I think the big advantage of rotary wing is not the transport aspect, but getting a critical care crew on scene faster than transporting the patient to the nearest ER. I would think that the initial actions, lines, tubing, etc. can be done by the paramedics, which is all that's going to happen in the first 10 min after admission anyways. I would think the breakeven would be around a 20-30 min drive from ER. Anything longer is good, anything shorter is a waste of resources.