What determines STAT flight request

[mfkap 0]

ANYONE CAN REQUEST MEDIVAC. Whether it is PD, FD, CFR, EMT or MEDIC.

According to the protocols posted by alsfirefighter at http://www.wremsco.org/REMAC_PROTOCOL_DOCs...dB(pg76-85).pdf (which were a good read BTW) this is not exactly correct. It says that ALS can request it, BLS can request it if ALS is delayed, and PD/FD/CFR can request it if EMS is delayed.

I remember a few years ago we had a large fire in our village. We called several mutual aid EMS agencies due to the size of the fire, and one of the agencies put "the bird on standby" before they were even on-scene. Not only were there no patients for "the bird" but we, the mutual aid requesting agency, didn't even find out for hours. People like saying "I put the bird on standby" so much, it is just silly. My question is, if you put the bird on standby, are they committed to you? Or if another incident requests that they launch, did you just save the other guys a few minutes of warm-up time?

[Remember585 815]

According to the protocols posted by alsfirefighter at http://www.wremsco.org/REMAC_PROTOCOL_DOCs...dB(pg76-85).pdf (which were a good read BTW) this is not exactly correct. It says that ALS can request it, BLS can request it if ALS is delayed, and PD/FD/CFR can request it if EMS is delayed.

I think I did say that BLS, ALS, FD and PD can call.... which is what you posted as well.

Again, from the time I have sat in their training and time spent working there, I was told over, and over, and over again that any of the above can call. I don't really care what the opinion of WREMSCO is, they don't decide on STAT or LifeNet's policy.

I will agree that it does seem to get over used, but like I said and as it should be with any other specialized resource out there - GET TRAINED ON IT.

[Guest alsfirefighter]

According to the protocols posted by alsfirefighter at http://www.wremsco.org/REMAC_PROTOCOL_DOCs...dB(pg76-85).pdf (which were a good read BTW) this is not exactly correct. It says that ALS can request it, BLS can request it if ALS is delayed, and PD/FD/CFR can request it if EMS is delayed.

I remember a few years ago we had a large fire in our village. We called several mutual aid EMS agencies due to the size of the fire, and one of the agencies put "the bird on standby" before they were even on-scene. Not only were there no patients for "the bird" but we, the mutual aid requesting agency, didn't even find out for hours. People like saying "I put the bird on standby" so much, it is just silly. My question is, if you put the bird on standby, are they committed to you? Or if another incident requests that they launch, did you just save the other guys a few minutes of warm-up time?

Any person in the absence of EMS can make the request, but again I have to point out that just because its called doesn't mean it still needs to come. Once an EMS provider arrives on scene the patient(s) should be evaluated and the need for air evac re-evaluated and cancelled if not needed.

I'm surprised they didn't attempt to follow up on that scenario you discuss. When on standby they are yours until asked for or cancelled. I'm willing to bet that either they got cancelled by another person on scene or they called dispatch to find out somehow. They won't sit there forever.

Also why would someone put the "bird" on standby for a large fire anyway?

[TAPSJ 30]

My guess would be for a possible burn victium. Also, I don't believe the helicopter is yours if you put it on standby. If someone that really needs like now I think they just change thier assignment. I remeber a call that IC put one on standby and another call went out in the Hudson Valley area and they needed it and it got launched to them. The IC finally said, launch the bird and they had to wait for one to come back in service, because of the other call. Now I could be wrong, but i do remeber this incident. So I hope that helps.

Thomas

[Bnechis 3,961]

Also why would someone put the "bird" on standby for a large fire anyway?

Lack of training

Lack of Supervision

Lack of QI/QA

And why would someone put the "bird" on standby for someone elses incident? If it might be needed shouldn't the host be the one requesting it. Does the MA dept. know if the host has specific requierments? I.E. some communities mandate a fire response to set up an LZ. Now a MA EMS agency may be committing fire resources away from the fire.

[mfkap 0]

Also why would someone put the "bird" on standby for a large fire anyway?

I think it is because people feel cool saying that they did it. It is a combination of ego, lack of training, ego, and ego. I know that people in the Emergency services very rarely do the incorrect thing to look cool, but Stat flight has a aura of coolness around it. When it goes out, everyone knows. People talk about a call they were on when they had Stat flight, even if it was 10 years ago. If someone sees Stat Flight taking off, and there isn't an IA about it, there is a post on here asking where they are going. They aren't perceived as just another ambulance. They are "Stat Flight" (with dramatic echo effect).

[xfirefighter484x 234]

My guess would be for a possible burn victium. Also, I don't believe the helicopter is yours if you put it on standby. If someone that really needs like now I think they just change thier assignment. I remeber a call that IC put one on standby and another call went out in the Hudson Valley area and they needed it and it got launched to them. The IC finally said, launch the bird and they had to wait for one to come back in service, because of the other call. Now I could be wrong, but i do remeber this incident. So I hope that helps.

Thomas

The problem with doing that is there are so many "what-if's". Every time an MVA gets toned out, will they put a helicopter on standby, just because there is "the possibility for a serious injury" even though the dispatch info did not disseminate that? I mean, yes, there are many times that a low-priority MVA gets dispatched, and it ends up being something a lot more serious, but come on, where do you draw the line??

I have the pleasure of seeing the StatFlight/LifeNet crews often, working at Saint Francis, and they are a great bunch of men and women, but I think people over-use their services, as so many have pointed out here.

I have seen an older flyer from StatFlight, before LifeNet took them over, with guidelines for calling them. I will see if I cannot make a copy and post it on here.

[Guest LizzyTish65]

The view may be nice, but with the current fuel costs it is probably $6-8000 these days. Make sure it is warranted, I have heard of insurance companies bouncing the expense as unneeded, leaving your pt with a pain in the neck/back and wallet.

this is in response to what smwells stated above

My daughter is an EMT that was critically injured on 4/14 in Rockland County NY. We just recieved the bill for her flight to WCMC the base fee was $10,364 with the price per mile being $95.00 for an 8 mile flight. While to some people this may seem high priced to me this is nothing compared to the fact that my daughter is still with us. I would like to thank the flight crew that responded to this call if it wasn't for them and the medics that where on scene with her that day the out come would have been very different.

Edited May 31, 2008 by LizzyTish65

[Guest alsfirefighter]

Lizzy, your daughter is a tremendously brave person whom I have tremendous respect for and many prayers and I wish her, yourself and the rest of your family a peaceful and serene future.

when dicussing the price for medevac what many of us are referring to, are the instances unlike your daughter's, where its use isn't warranted and the lack of need is apparant by all except the person(s) whom call it. Wasting a critical resource that could be actually needed somewhere else and also costing patients, families etc a signficant finacial impact. The system worked the way it was supposed to work the day your daughter needed it, good treatment on the ground and the use of the helocopter to get her as immediately as possible to the regional trauma center for further care. It is a compliment to all involved, god willing it all came together and because of your daughters will. God bless her.

[emt301 4]

The problem with doing that is there are so many "what-if's". Every time an MVA gets toned out, will they put a helicopter on standby, just because there is "the possibility for a serious injury" even though the dispatch info did not disseminate that?

There was a situation here in Dutchess a year or two ago, where a helicopter was requested for a reported motorcycle accident on one of the area highways. The helicopter was requested by a responding unit...before any FD/EMS/PD personnel had actually arrived on scene for a size-up. It ended up being a disabled motorcycle - a motorcycle that had run out of gas. Seems to me that someone (FD/EMS/PD) needs to actually assess the scene before a helicopter is put on standby or launched - this was a total waste of a valuable resource, a resource that someone else may have legitimately needed at the same time.

Edited June 1, 2008 by emt301

[Guest paramedico987]

Did they also say that once the aircraft has identified the landing zone and is coming in to land all flashing/rotating lights should be turned off (especially alternating headlights aimed directly into the LZ)? Strobes and the newest generation of LED's can be very disorienting and the last thing you want is a pilot getting disoriented as he's putting the helicopter on the ground. The alternating headlights are generally right at the pilot's eye level, that's why they should be off.

I participated in an on site lecture by STAT-FLIGHT a few years ago in northern Westchester... they came in with the bird, did a little film presentation etc.

It's NOT the emergency beacons which concerned them, rather they said that the flashing lights often help them find the LZ. Thier concern is any spotlights. They don't want US to ulliminate the LZ because the spotlight will blind the pilot and spotters. They said that they'd much prefer to light the LZ with their own landing lights.

They also mentioned that we shouldn't use flares to mark an LZ since the rotor wash will blow those incendiary devices God knows where...

Incidentally I've "raced" the helicopter [with other patients] from all corners of Westchester county and beaten or tied them by ground almost every time.

The helicopter is a great resource for VERY LONG TRANSPORTS but is generally overutilized in suburbia. That being said, I've landed the bird twice in Yonkers with extended extrications.

[Guest emtb23]

Interesting thread. I've got a few clarification questions:

1) I was always under the impression that "stand-by" for Stat Flight means sitting in the helicopter and getting ready to launch, but not actually being in the air. Is this not true? It sounds dumb, but I'd feel a lot less bad about putting them on standby as a BLS provider if I knew that all I was doing was getting them from their office and into their helicopter.

2) I work at a BLS VAC with a medic intercept. If I'm on scene with a patient that meets flight criteria and I have no reason to think that the medic will be delayed in arrival (but is not on scene), I wait for him/her to arrive to launch the bird, right?

3) If situation #2 happens and I'm on scene but fire hasn't been dispatched, should I call to dispatch them, or wait until we launch?

[helicopper 1,050]

I participated in an on site lecture by STAT-FLIGHT a few years ago in northern Westchester... they came in with the bird, did a little film presentation etc.

It's NOT the emergency beacons which concerned them, rather they said that the flashing lights often help them find the LZ. Thier concern is any spotlights. They don't want US to ulliminate the LZ because the spotlight will blind the pilot and spotters. They said that they'd much prefer to light the LZ with their own landing lights.

They also mentioned that we shouldn't use flares to mark an LZ since the rotor wash will blow those incendiary devices God knows where...

Incidentally I've "raced" the helicopter [with other patients] from all corners of Westchester county and beaten or tied them by ground almost every time.

The helicopter is a great resource for VERY LONG TRANSPORTS but is generally overutilized in suburbia. That being said, I've landed the bird twice in Yonkers with extended extrications.

My point is that once the LZ is located and identified by the helicopter (and you'll know this because they're circling it with their landing lights on), all unncessary lights should be extinguished to preserve the flight crew's night vision. With all the strobes and LED's on a vehicle bouncing all over the place it can be very disorienting to a pilot. White lights (headlights, etc.) should also never be aimed at the aircraft.

[Guest alsfirefighter]

Interesting thread. I've got a few clarification questions:

1) I was always under the impression that "stand-by" for Stat Flight means sitting in the helicopter and getting ready to launch, but not actually being in the air. Is this not true? It sounds dumb, but I'd feel a lot less bad about putting them on standby as a BLS provider if I knew that all I was doing was getting them from their office and into their helicopter.

2) I work at a BLS VAC with a medic intercept. If I'm on scene with a patient that meets flight criteria and I have no reason to think that the medic will be delayed in arrival (but is not on scene), I wait for him/her to arrive to launch the bird, right?

3) If situation #2 happens and I'm on scene but fire hasn't been dispatched, should I call to dispatch them, or wait until we launch?

#1. I believe it depends on the distance. I'm not sure if its still in effect but at one time any flight beyond a certain distance and they will get under way to reduce flight time if called. Secondly, I don't know what it is you'd feel bad about. That is their job...if you have dispatch information that you feel is leading to the possibility of needing the resource put it on standby...you can cancel it if you don't need them. If you don't and you do need it, it may get called somewhere else. Also if they launch when put on standby by distance, again that is their policy and not your problem. It is only better for your patient if they do to decrease their inbound time.

#2: Would you wait for the medic to arrive with an unstable or critical medical patient if he was still enroute? NO. This is no different, if you feel you need it, you are the one on scene and hence the one who can make that call. The medic upon arrival should re-evaluate and either have the flight continue or cancel if they feel necessary.

#3: I'm not sure what you mean here. If put on standby you have no LZ yet. Once you call to launch you will have to give them an LZ and the FD should have a dispatch policy for that scenario. You might want to ensure they are dispatched unless you are using a designated LZ that FD response isn't needed. If its an extrication I would imagine the FD would be there, other MOI's that occur that are not pure FD response, ie falls, penetrating trauma, etc. then dispatch should generally know how to handle that.