State Helicopters Are Flying Much Less After Fatal Crash in Pr. George’s – washingtonpost.com

State Helicopters Are Flying Much Less After Fatal Crash in Pr. George’s – washingtonpost.com
Maryland has seen a dramatic drop in the number of patients flown to hospitals since the September crash of a Maryland State Police helicopter killed three rescue workers and a patient.

If the trend holds, there will be fewer than 1,700 air transports in the 12 months following the September crash, compared with about 4,100 in fiscal 2008. The state’s aeromedical director, Douglas J. Floccare, told the experts yesterday that he worries that a “skittishness” among ambulance crews might have led them to avoid necessary air transports.

So, either patients aren’t being flown who should be now, or patients who shouldn’t have been were being flown before.  (Alternately, there are fewer injuries and illnesses than before, but that’s unlikely).  My money is on overuse, but we’ll probably never know.


Comments

  1. There are enough people paying attention to this that there will be questions asked about the effects of the decreased flights.

    I expect that the trauma fatality rate will not increase, even though flights are expected to be down by more than half.

    The ground medics will develop more experience assessing and treating trauma patients. The ground medics will improve the care they deliver, because they will be spending much more time focused on the patient, rather than preparing the patient for helicopter transport.

    The abuse/overuse of Helicopter EMS takes place in a lot of other places, too.

  2. I’m glad for the questioning of this issue. I read the stats on crashes once and was shocked at the numbers.

  3. Less driving with higher fuel prices, at least until the collapse of oil prices. Accident rates have fallen as well, ergo fewer helicopter flights. This may confound your interpretation of a stable case fatality rate, if that is the case.

  4. CHenry,

    In Maryland, they have required that EMS crews contact medical command for transport decisions on those patients with minor injuries. This has cut the flight rate by about 60% since the new rule went into effect. It is unlikely that fuel prices and any modest decrease in motor vehicle collisions has had much to do with this. How much are crashes down over the last 7 weeks? Or are you suggesting that crashes are down anywhere near 60%. Traffic is certainly not dramatically less congested since the end of September, at least not where I am.

    If those in charge (Dr. Bass and Dr. Scalea) follow the recommendations of the panel, we should have some data worth looking at to see what has really changed.

    Flying patients with minor injuries is something that Maryland is notorious for. It would be nice to see them base transport decisions on medical criteria, rather than scare tactics.

  5. RogueMedic:

    I am all too familiar with practice in Maryland. I worked literally right beneath the final flight path to one of the hospitals serving two of the major interstates in Maryland. I believe there is overuse of helicopter transfers, at least from my observation. Many transfers could have been done just as safely for the patient–and certainly less expensively– by ground ambulance than by helicopter. But that doesn’t refute the observation that reduced transfer by helicopter may be also a result of overall reduced traffic and traffic accidents following the hikes in gasoline prices in the past half-year. There may indeed be fewer flights because of additional pre-flight approval processes, but there are other trends at work at the same time.

  6. CHenry,

    I don’t know anything about the amount of decrease in patients, other than what was reported. The news reports are that the past 7 weeks have produced flights at a rate that would work out to 1,700 over a year. The previous year had 4,100 flights. Some of the doctors involved have expressed concern about the dramatic decrease in flights since the crash. I am optimistic that this decrease is a result of the need to contact medical command to fly patients with minor injuries.

    Wholesale gasoline prices have not been this low since the end of 2004 (I do not have numbers on prices at the pump, but I am paying less than half of what I was back in July. The effect of the dramatically dropping prices of gasoline and oil since early July of this year is unlikely to have had much of an effect to decrease driving. It would be expected to increase driving. I do not have any statistics on the amount of miles driven in Maryland over the past 7 weeks, or the rest of the year, but gasoline prices have dropped by even more than the apparent drop in the rate of helicopter transports.

    Limiting helicopter scene flights, and interfacility flights to seriously injured patients is something that should not have taken a bunch of fatalities to accomplish. The data to support flights for minor injury and mechanism only patients does not exist. This is a system that has put the lives of patients and flight crews on the line to support a vision of a trauma system that is not evidence based.

    Keeping the current limitations on flights, should be maintained for a long enough period to come up with some useful data. This will only be a retrospective data sample, so not optimal. Still, there is no reason to believe it will support returning to the treat-the-vehicle method of triage that had been used. There never was a reason to believe this was in the interest of the patients. Unless evidence changes, flights should continue to be restricted.

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  1. [...] which makes some people wonder if they are used too often. This issue is being investigated, and the use of air ambulances is down. So either the number of serious illness and injuries are down (doubtful) or the choppers are [...]