Use of Medevacs in Westchester

[Billy 68]

Correct me if I'm wrong about this but it seems that there has been a definite decrease in the use of the helicopter in Westchester since Stat Flight left the Medical Center. Are there any numbers to back this up? There have been some discussions on these forums in the past about the use or misuse of helicopter landings and if there has been a decrease in calls for it, does this prove that it was sometimes being called when not really needed? Not criticizing anyone or any Department here just making an observation.

Any opinions?

[OoO 24]

My guess is that if helicopter use has decreased, it is because ground crews have decided that it would be faster to transport the patients by ground vs waiting for the helicopter to arrive from its now more distant location. Doesn't say anything about it being unnecessary before.

[JJB531 652]

There have been numerous occasions when STAT Flight was requested unnecessarily. You would really have to look at the specifics of each case to determine what made the request unnecessary. In my own personal experience, you can break it down into 3 categories.

The first category would be the "playing it safe" category. This is when an EMS provider fails to do a complete and accurate examination of the patient and simply goes by the perceived severity of the incident. The medevac request protocol should really serve as a guide, and some EMS providers base their requests on the protocol without using common reasoning. I have usually found that non-EMS providers who request a medevac typically fall into this category as well. They pull up to the scene of a horriffic MVA. They focus on the mangled cars, and not the patients, and immediately request a medevac before EMS conducts any kind of a physical exam to determine if a medevac is really necessary. I have cancelled STAT Flight on a few occasions because after conducting an exam of the patient, they were determnined them to be stable, and found there was no reason why the patient could not be transported by ground.

The second category is the "misdiagnosis" category. This would be when an EMS provider does conduct an exam of a patient and believes that there may be internal or hidden injuries which require an expedited means of transportation to the hospital. You can't fault the EMS provider if it turns out the patient has only minor injuries since the basis for the medevac decision was based on how the patient presented to the provider and their belief that expediting transport via a medevac would be the most beneficial means for the patient.

The third category is the "glory" category. Incidents where the helicopter is called because the requesting individual thinks the helicpoter is "cool" or it will make a great photo op for us to hang on our wall. Unfortunately these individuals do exist, and present a serious misuse of resources.

I think that medevacs do have their place in Westchester County, especially in the northeast part of the county where accessing major highways that lead to the Medical Center is more difficult then other parts of the County. STAT Flight can also be useful during prolonged incidents, such as pin jobs, where they are already on scene, so once the patient is extricated, they can be immediately placed into the waiting helicopter and immediately transported to WMC.

[Billy 68]

There have been numerous occasions when STAT Flight was requested unnecessarily. You would really have to look at the specifics of each case to determine what made the request unnecessary. In my own personal experience, you can break it down into 3 categories.

The first category would be the "playing it safe" category. This is when an EMS provider fails to do a complete and accurate examination of the patient and simply goes by the perceived severity of the incident. The medevac request protocol should really serve as a guide, and some EMS providers base their requests on the protocol without using common reasoning. I have usually found that non-EMS providers who request a medevac typically fall into this category as well. They pull up to the scene of a horriffic MVA. They focus on the mangled cars, and not the patients, and immediately request a medevac before EMS conducts any kind of a physical exam to determine if a medevac is really necessary. I have cancelled STAT Flight on a few occasions because after conducting an exam of the patient, they were determnined them to be stable, and found there was no reason why the patient could not be transported by ground.

The second category is the "misdiagnosis" category. This would be when an EMS provider does conduct an exam of a patient and believes that there may be internal or hidden injuries which require an expedited means of transportation to the hospital. You can't fault the EMS provider if it turns out the patient has only minor injuries since the basis for the medevac decision was based on how the patient presented to the provider and their belief that expediting transport via a medevac would be the most beneficial means for the patient.

The third category is the "glory" category. Incidents where the helicopter is called because the requesting individual thinks the helicpoter is "cool" or it will make a great photo op for us to hang on our wall. Unfortunately these individuals do exist, and present a serious misuse of resources.

I think that medevacs do have their place in Westchester County, especially in the northeast part of the county where accessing major highways that lead to the Medical Center is more difficult then other parts of the County. STAT Flight can also be useful during prolonged incidents, such as pin jobs, where they are already on scene, so once the patient is extricated, they can be immediately placed into the waiting helicopter and immediately transported to WMC.

My thinking was really along the lines of your "playing it safe" category and that it seemed that in some cases that's exactly what was happening; lets call for it "just in case." Now with the extra flight distance, that's the part that has changed the thinking of some. Glad to hear that you're willing to cancel the helicopter when not necessary.

I won't even get into the "glory" category. That would start something that would probably get the thread shut down. :lol: