Pedestrian vs Auto w/ Medvac - Rte 9 I/F/O Alpine Commons 8/17/08

[Guest Photounit]

The Hughsonville FD, Trans Care/Town of Wappinger Medics, Stat-Flight Air 2, and the NYSP operated early this morning at a person struck by a vehicle on Rt. 9 I/F/O Alpine Commons Shopping Center in the Town of Wappinger. The female victim suffered severe trauma and was transported by Stat-Flight Air 2 to Westchester Medical Center.

TOW/Transcare medics and HFD firefighters treat the victim.

Personnel prepare to move the victim to the cot.

Stat-Flight Air 2 on final approach.

The crew from Air 2 makes their way to the patient.

Air 2 on the ground.................

[Guest Photounit]

Firefighters retrieve the landing cones in preparation for Air 2's departure.

The patient is loaded into Air 2.

Loading complete.......

Air 2 prepares for lift-off.

Air 2 is up and off to Westchester Medical Center.

[Guest]

Nice legs, is that for real?

[Goose 188]

Nice legs, is that for real?

Gotta love it. Can't make this stuff up.

Any idea why the patient didn't go to St. Francis first?

[ems-buff 81]

Bill as always thank you for sharing those amazing pictures.. again I think you are one of many members here on EMTBravo, That have the gift of taking great photos. I am willing to bet that yours, and others photos posted by other members here are one of the many reasons why EMTBravo is so great..

[xfirefighter484x 234]

Great shots Bill, as always!!

Now my question is, WTH was someone doing walking in the middle of Route 9 at such an hour as that??

Edited August 18, 2008 by DOC22

[minivac 0]

wow nice pics. Did she Make it?

[grumpyff 1,159]

Excellent photos!!! Did Stat Flight shut down the engines? it looks like several people were near the rear rotor of the aircraft. Normally the pilot stands guard near the rear wings/fin. IIRC the speed limit in the area is 45 mph.

[Guest Photounit]

Thanks guy's..... I don't know what her status is........She appeared to have significant injuries from what I saw............. The engines to Air 2 were turned off once they landed and remained off until the patient and crew were all aboard......................

[jack10562 414]

Excellent idea of pointing hand-lights inside the traffic cones to delineate the LZ perimeter.

Everyone should put that trick into their "Tool-Bag"

Night landings can be difficult enough due to limited visibility, and bright scene lighting can impair that even further.

[50-65 205]

We always put handlights inside the cones for night LZ's. Usually though, we lay the cones with the "point" facing the center of the LZ.

Good job guys.

But like, Goose, I would question why she didn't go to Saints. With the wait time for the helo, she could've been in cat scan by the time they left the scene. I started a thread a while ago about what seems like a lot of trauma's passing Saints for other hospitals but didn't get any feedback. This is another example.

[Guest Photounit]

The cones may have been pointing in originally I don't know.........They all did move from the down-wash as Air 2 landed ..... Once they landed, the pilot came over to me thinking I was with HFD and said "We did a great job with the landing zone" and thanked me...... So I guess he was pleased which is what counted..... From my knowledge of LZ's I thought they did a good job including their communications with the pilot...... And in the one photo, it looks as if the crew member from Air 2 is combing his hair...... He's not..... He has something in his hand and he apparently was scratching his head..... I just figured I'd mention that before someone else does......

Edited August 18, 2008 by Photounit

[64FFMJK 21]

Poughkeepsie Journal story

http://www.poughkeepsiejournal.com/apps/pb...NEWS03/80818009

"A Wappingers Falls woman was hit by a car early Sunday morning while crossing Route 9.

[MoFire390 118]

Nice photo's. What about the little landing markers? Does anyone alar have them for night landings? Both stat flight landings we have had here in montrose the fd has used them, and they are awsome and work very well.

Does anyone know if stat flight still does the classes for the landing zones?

I remember my dad and a few guys talking at the fd and remembered when they wanted a 50x50 during the day and 100x100 at night. Has it changed or is it still the same?

[JRS2817 1]

great pictures and there rescue truck

[WAS967 97]

I remember my dad and a few guys talking at the fd and remembered when they wanted a 50x50 during the day and 100x100 at night. Has it changed or is it still the same?

That changed a while back. I'm not sure if it still stands but when they became Air Methods, they wanted 100x100 regardless of time of day. Not sure if that has been extended at all for night landings.

[Guest alsfirefighter]

In addition to the engines being shut down, keep in mind that the model used for air 2 has an enclosed tail rotor which increases the safety factor and it was nice to finally see they got a model with it.

Also as far as not going to Saints...I am a Paramedic and I don't question it at all. I'm sure the Paramedic on scene had their reasons as to why they felt a Level 1 Trauma Center was the appropriate choice versus a Level 2 for this patient. Transport decisions based on injuries is a common and important part of patient care, particularly when you operate in a close vicinity of a Level 2. You must know their limitations and what criteria when present dictates the need for Level 1 and in Trauma there is discretion for Paramedic interpretation of injuries also so I'm not sure what this is an example of. We don't know what the injuries were, what the patient status was and what the interpretation and impression these injuries and associated conditions with them was by the Paramedic in charge of patient care. Just because its there and it is an "area trauma center" doesn't mean its the best fit for every patient.

WAS is correct 100 x 100 is the standard. Having pre-designated LZ's also helps so everyone may be on the same page when it comes to their usage.

[tdc202 0]

Nice photos again Bill. I was wondering if the lady in the first couple of pictures in scrubs was the driver or someone who just happened to pass by?

[Guest Photounit]

Nice photos again Bill. I was wondering if the lady in the first couple of pictures in scrubs was the driver or someone who just happened to pass by?

Thanks....I think she was the driver but I am not sure......

[ny10570 745]

ALS, I completely agree that closest isn't always best, however this patient required zero extrication. Flight time of what, 20 minutes each way, plus start-up, packaging and assessment. How long are you going to sit there looking at someone before you send them somewhere closer where they can pump you with some packed cells and maybe stop the bleeding.

[NWFDMedic 58]

Also as far as not going to Saints...I am a Paramedic and I don't question it at all. I'm sure the Paramedic on scene had their reasons as to why they felt a Level 1 Trauma Center was the appropriate choice versus a Level 2 for this patient. Transport decisions based on injuries is a common and important part of patient care, particularly when you operate in a close vicinity of a Level 2. You must know their limitations and what criteria when present dictates the need for Level 1 and in Trauma there is discretion for Paramedic interpretation of injuries also so I'm not sure what this is an example of. We don't know what the injuries were, what the patient status was and what the interpretation and impression these injuries and associated conditions with them was by the Paramedic in charge of patient care. Just because its there and it is an "area trauma center" doesn't mean its the best fit for every patient.

You couldn't have said this better ALS. I was working that night and unfortunately I was moved to Orange Co. earlier in the night and wasn't paying attention to the UHF radio that intently. The helicopter may have been called for by the FD before the ambulance got there because as I understand it, there was some delay with the ambulance getting there as they originally went to 9D and Alpine Drive instead of Route 9 and Alpine Commons. I have also been told that despite the call being a pedestrian struck, there was some "extrication" from the vehicle to be performed. If you can get the helicopter there or close while you're doing extrication and rapid trauma assessment at the scene and the patient needs a Level 1, then it's the right call. Without all of the information, nobody can Monday morning a medic deciding to send a patient to a Level 1 over a Level 2.

[Oswegowind 17]

Excellent idea of pointing hand-lights inside the traffic cones to delineate the LZ perimeter.

Everyone should put that trick into their "Tool-Bag"

Night landings can be difficult enough due to limited visibility, and bright scene lighting can impair that even further.

Oh, those are handlights, I am going to patent the light up traffic cone using LED's...SWS can you produce them???? Seems like this may be a good idea...just point the white light away from the helo so the pilot doesn't get blinded!!!!

1: In addition to the engines being shut down, keep in mind that the model used for air 2 has an enclosed tail rotor which increases the safety factor and it was nice to finally see they got a model with it.

2: Also as far as not going to Saints...I am a Paramedic and I don't question it at all. I'm sure the Paramedic on scene had their reasons as to why they felt a Level 1 Trauma Center was the appropriate choice versus a Level 2 for this patient.

3: WAS is correct 100 x 100 is the standard. Having pre-designated LZ's also helps so everyone may be on the same page when it comes to their usage.

1: Definitely increases safety...I'll say that the tail rotors always made me a bit nervous when moving victims to the helo, even though you were taught to stay away, forbid the helo moving for some unknown reason and cutting down a crew...just a bad dream of course!!!! Also, do they now kill the engines routinely, or were they also on scene for a period of time and needed to do this?

2: Well, for this, how long a ride is it to St. Francis from this location? I am not as familiar with this area as Westchester although I travel this section of Dutchess regularly. In fact, I don't even know where St. Francis is, but I think it is in Poughkeepsie... If the drive time is equivalent to the flight time and the level of care is required of Trauma 1, then I see no problem with how it went. In Westchester, the Medical Center is no more than 20 minutes from anywhere except maybe 2-3 places! So, waiting in Westchester is just plain ridiculous if it means it will take longer for them to fly out and back in more time than just driving!

3: Pre-designating LZ's is great, but we normally use Helo's during emergencies so that may not always work. It is good to have a package that includes locations that could be used day/night, their coordinates (always a big help), and the frequencies to be used during operations. Telling someone to use Fireground 2 is not acceptable in my opinion because these helo crews serve too many locales and everyone has their own FG2. Each and every time they should be simply given the frequency code...i.e 453.6625 and any encoder that is assigned so there is no confusion!!!!

End transmission----

[Guest beentheredonethat]

In addition to the engines being shut down, keep in mind that the model used for air 2 has an enclosed tail rotor which increases the safety factor and it was nice to finally see they got a model with it.

Also as far as not going to Saints...I am a Paramedic and I don't question it at all. I'm sure the Paramedic on scene had their reasons as to why they felt a Level 1 Trauma Center was the appropriate choice versus a Level 2 for this patient. Transport decisions based on injuries is a common and important part of patient care, particularly when you operate in a close vicinity of a Level 2. You must know their limitations and what criteria when present dictates the need for Level 1 and in Trauma there is discretion for Paramedic interpretation of injuries also so I'm not sure what this is an example of. We don't know what the injuries were, what the patient status was and what the interpretation and impression these injuries and associated conditions with them was by the Paramedic in charge of patient care. Just because its there and it is an "area trauma center" doesn't mean its the best fit for every patient.

WAS is correct 100 x 100 is the standard. Having pre-designated LZ's also helps so everyone may be on the same page when it comes to their usage.

Exactly couldnt have explained it better. St's isnt as good as everyone thinks. The Medic and Hughsonville Fire Command did an excellent job!!!

[JetPhoto 626]

Oh, those are handlights, I am going to patent the light up traffic cone using LED's...SWS can you produce them????

FYI they already exist, a quick google search brings up many sites is one link:

http://www.fitsmybudget.com/product.php?productid=18866

FYI back to someone on the 1st page of comments The speed limit for this section of road is 55. Don't worry most people who drive that section daily don't know (can't read) that the speed changed to 55 from 40 (going south) from the village

Bill, Great shots as always, I really like the one with the chopper lifting off with the moon in front of them.

[Oswegowind 17]

FYI they already exist, a quick google search brings up many sites is one link:

http://www.fitsmybudget.com/product.php?productid=18866

SPOILED AGAIN

And as always, Bill, GREAT PHOTOS!!!

Forgot that the first time through!

[Guest wfems05]

Excellent photos!!! Did Stat Flight shut down the engines? it looks like several people were near the rear rotor of the aircraft. Normally the pilot stands guard near the rear wings/fin. IIRC the speed limit in the area is 45 mph.

The location of the accident is a 55mph speed zone.

[Goose 188]

You do what you've gotta do but if she was as bad as stated, its a straight shot to Saints ~10 minutes during that time of day (pretty much green lights right up Rt. 9). Have saints stabilize and call the chopper if it merits.

Really doesn't matter to me either way, i guess i was thinking "out loud." If FD called for the chopper (which i really don't think they should be doing) then so be it, might as well continue it in.

[pfdfirefighter01 1]

Shows you are not from Wappingers. The location of the accident is a 55mph speed zone.

are you sure, i do think grumpyff is correct, it changes to 45 right there, accually just before All Angels traffic light

[Guest Photounit]

are you sure, i do think grumpyff is correct, it changes to 45 right there, accually just before All Angels traffic light

All Angels traffic light???????????????????????????????????

[pfdfirefighter01 1]

im sorry, dont know why i said that, its not that but old hopewell rd- tired, very little sleep