Archives for October 30, 2008

Newsflash: Transportation is Dangerous

It’s been in the news (at least, in the medical worlds’ news) that there are a lot of EMS helo crashes this year: 

The Associated PressThe five-member National Transportation Safety Board in January 2006 urged the Federal Aviation Administration to take a series of steps to improve the safety of EMS helicopter flights.

At a meeting Tuesday, the safety board acknowledged that the FAA is working on the proposals, but not quickly enough. Over the past 11 months, nine emergency medical helicopters have crashed, killing 35 people.

Interestingly, the NYTimes is on point today with an article about the untimely deaths of politicians, musicians, etc, with the common denominator being that they’re ‘unscheduled’ (charter) flights. 

New York TimesThey fly to the next gig or the next game, to the next political rally or the next board meeting — another day, another town, and another ride in a corporate jet, chartered plane, helicopter or whatever other conveyance seems convenient, sometimes regardless of risk.

When their planes crash, the headlines name another musician, politician or athlete killed in an aviation accident: Will Rogers, Knute Rockne, Otis Redding, Hale Boggs, Rocky Marciano, Thurman Munson, Rick Nelson and John G. Tower, to name just a few. The song "American Pie" memorializes the crash in February 1959 that killed Buddy Holly, Ritchie Valens and J. P. (The Big Bopper) Richardson.

Because they are busy and prosperous, prominent people often fly in planes not operated by major airlines. By doing so, accident statistics show, they increase their chances of crashing.

(Wikipedia listing of deaths by aircraft of the rich and powerful here).

Airlines have their outstanding safety record because they work terrifically hard (and well) at doing the same thing the same way every time, managing risk, and by avoiding anything that’s been historically risky.  That doesn’t mean they’re perfect, or that accidents don’t happen, but when you’re looking for a safe transportation baseline the scheduled airlines are where to start.

EMS helos are, by definition unscheduled.  They are, with a few exceptions, expected to be available every minute of every day.  They also don’t have the luxury of flying into well lit, organized airports, they’re landing in areas with trees, wires, etc.  There are a lot of things the NTSB has recommended, and hopefully they’ll help.

So, you’ll avoid an accident if you take the ground ambulance, instead, right?  Umm, no.  EMS crashes happen as well.  Per the CDC:

MMWREMS personnel in the United States have an estimated fatality rate of 12.7 per 100,000 workers, more than twice the national average (1). This report documents 27 ambulance crash-related fatalities among EMS workers over a 10-year period.

(Before you point out that 27 isn’t a big number, read the limitations section of the paper).  Here’s a somewhat less scientific but much more inclusive list of EMS crashes, from the EMS Network.

The WSJ Health Blog points out a real concern: if a helicopter is always available, it’ll get used, sometimes when it shouldn’t be:

Medical helicopters have been under scrutiny for a while now. In 2005, the WSJ reported that air ambulances are often used to transport patients who are “minimally injured,” and who could make it to a hospital faster and more safely via ground transport.

Helos on the ground don’t pay for themselves, so there’s a bias to fly.  I understand it, but we all need to understand there are risks to everyone.

None of us like helos falling out of the sky, and it’s always going to be risky.  Steps should continue to be taken to mitigate risks in all transportation, but remember that all unscheduled travel is risky.

MedGadget’s SciFi Writing Contest Starts Today.

We are excited to announce the third annual Medgadget Sci-Fi Writing Contest! The competition is designed to present to the public talented writers, among our readers and beyond, who imagine the future of medicine through fictional stories.


Go there to read all about it.  I’ll be a judge again, and look forward to reading your excellent prose.