Helicopter Shopping

     Over the last three decades, the air medical helicopter transport industry has grown to include hundreds of air medical transport helicopters nationwide. Thirty years ago, if the local, and solitary, air ambulance provider turned down or aborted a flight request due to weather, that was the end of it. Today, if a program turns down or aborts a flight for any reason, it is easy for EMS or hospital personnel to request an alternative aircraft from a variety of surrounding locations. The nationwide availability of multiple aircraft has created a situation in which EMS agencies may continue to call air medical resources until one responds. This situation has become so common it is known as "helicopter shopping."

     The majority of fatal air medical helicopter accidents since 1998 have occurred at night, in bad weather, or both. While helicopter shopping is not the cause of these accidents, the International Association of Flight Paramedics (IAFP) believes it is a contributing factor. To clarify, we do not believe the request of additional air medical resources is an inherently hazardous event. "Helicopter shopping" creates an additional risk for crews and patients because of the way it is carried out. Poor communication and lack of information sharing between requesting agencies and air medical helicopter transport organizations is at the center of this issue. The IAFP believes that if one helicopter is unable to respond or has to abort a request for a patient transport, under certain conditions, another helicopter may be able to complete the mission safely.

Eliminate Shopping Around
     The IAFP recommends the following practices to eliminate "helicopter shopping":

•      Establish an organized dispatch system in order to coordinate all helicopter requests in a particular region.

       This dispatch system should be recognized by the EMS agency responsible for the same region. This system can be set up by individual county, regional area, state or any other boundary that defines the area of a geographic or service region. The boundaries are not important. What is important is that all agencies involved in the transport of air medical patients understand how the system works and agree to the process. A single air ambulance dispatch system or network from each region will improve communication and eliminate the need for repeated requests for air ambulances, especially in areas serviced by more than one provider. All requests for air ambulances from law enforcement, fire, ambulance and all other legitimate requesters in the area would be directed through the designated dispatch network. Any emergency agency may be designated to perform this coordinating duty. The type of agency that coordinates this air ambulance dispatch may vary from region to region. The dispatch network makes it easier for requesting agencies to call for air medical transport. This same network makes it easier for multiple air medical service providers to exchange information. If multiple air medical transport service providers operate in one region, especially if service areas overlap, they should openly communicate and share flight information.

•      Educate ground EMS agencies about the helicopter dispatching network.

       The responsibility for educating ground EMS providers and associated agencies will fall to air medical transport service personnel. It is crucial that EMS and first responder personnel understand the necessity of allowing the regional helicopter dispatch network to locate and request the most appropriate mission-specific air ambulance provider and to understand why helicopters may not be able to complete the mission. The educational information should include weather minimums, weather behavior, appropriate patients and helicopter performance issues.

     Communication between air medical transport service providers and ground emergency service programs is paramount to improving the safety of the air medical community. Helicopter shopping, like any other potential safety risk, is not the sole reason for the unsatisfactory air medical safety record over the last few years. However, the increasing number of air medical helicopters available and the willingness of requesting parties to "shop" have created a situation that must be mitigated in order to enhance the safety of the community. Establishing safe helicopter dispatch networks to be used for dispatching scene and interfacility requests for transport will help make helicopter shopping unnecessary and unacceptable. These dispatch networks will be supported by educating the requesting parties and their personnel regarding capabilities and limitations of air medical transport aircraft and crew. Open communication about weather and flight factors is the key to safer, more efficient operations.

     Adapted from Cliff Larrabee's Position Paper on Helicopter Shopping, www.flightparamedic.org/docs/HelicopterShopping.pdf.

National Paramedic Survey Coming Soon
     The International Association of Flight Paramedics (IAFP) has identified the need to further investigate the expanding role of the Critical Care Transport Paramedic.

     The IAFP has approached Creighton University to recommend it conducts a national survey to collect data from paramedics involved with critical care transports. The survey will be a randomized sampling of paramedics throughout the country that would build from previous studies performed in the critical care transport environment.

     Why is this important? The data will be used to create a definition of a Critical Care Transport Paramedic. The data will also help EMS organizations develop new critical care and education standards as the IAFP works with NAEMT, NAEMSE, NREMT, NAEMSP, ACEP and BCCTPC.

     Surveys will be sent out via USPS on February 1 and all completed surveys need to be returned no later than March 1, 2008.

     Don't miss this opportunity to actively participate in the future development of critical care transport.

     For more information, go to www.flightparamedics.org.

Jonathan Gryniuk has been active in EMS since 1985 and is a 15-year veteran of helicopter EMS, completing more than 2,000 air medical missions. He is a past president of the International Association of Flight Paramedics and has served on its board of directors for the past 10 years.

Don Leatham's career in EMS has spanned more than 30 years. Over the last 12 years, he has worked as a flight paramedic with Life Flight at Saint Patrick Hospital in Missoula, MT. He has served on the board of directors of the International Association of Flight Paramedics and on a regional level as the organization's Montana State Delegate.