15 November 2007

Go! Stop! Go!

I wish I had a quarter every time this has happened in the two decades I've done this job...

Dispatch calls-
"Weather check for P-Ville, please... it's a scene flight."

I check closely 'cause I drove through schmutz coming to work.
"Yeah, I can do P-Ville."

"Okay, you're on standby for an MVA (Motor Vehicle Accident) on Interstate ## just North of P-Ville."

We all dash to the John as a precaution, then wait for the phone to ring again, which will either cancel us or force us to push the "pause" button on the TIVO.
And we wait.
And we wait some more.

My Paramedic says "this is taking too long, we're not goin' anywhere" just as the phone rings...
"Your flight is a GO."

We quickly move to the aircraft, get both engines started and take off. We've just gotten high enough to see above the treeline when Dispatch crackles over the radio...
"Your flight is cancelled."
I make one circuit of the traffic pattern and land.

Bein' cancelled is aggravating for several reasons.
I'ts expensive... starting the aircraft is the hardest thing you can do to it. I just shocked and expanded some pretty exotic metals within two combustion chambers, waking two engines and bringing them from ambient temperature to 700 degrees centigrade in just a few seconds. There are limits on the number of times you can do that before you have to throw out the old exotic metal and buy new exotic metal. $$$$$!
Starting the engines costs money. I just did it for no revenue.

Over the intercom to my crew I wonder out loud...
"Okay, how long do you think it'll be before we are called for a flight to the hospital at P-Ville?"

Scene flights are cancelled for several reasons...
-Upon arrival at the scene, the ground crew finds everyone is okay.
-The patient(s) is/are DRT, (Dead Right There. We don't use the helicopter to transport corpses.)
-Our ETA is excessive. Sometimes it's quicker to transport the patient to the closest hospital for evaluation where the decision may be made to call us again. This happens OFTEN!

An hour passes. The phone rings. I pick up the receiver and don't even give our dispatcher a chance to speak...
"Lemme guess... we're goin' to P-Ville for the victim of an MVA."

And my dispatcher laughs out loud.

I guess there's comfort in things that never change.


Detail Medic said...

I'm so glad I found your blog - or rather you found mine. I've always wondered about the mysterious world of the flight crew. I got to fly my first shift in the field and didn't stop grinning all day. I'll give anyone a chance to go, but he who hesitates loses their seat to ME!

The Flying Flemings said...

I'm not sure what part of the country you're in but I had to laugh at the similarities.
What I hate is when we depart the airport "Lifegaurd" and they stop everyone to let us depart (we have ATC at our airport), then about 15 seconds into my flight I'm having to sheepishly ask to come back.
Oh well what can ya do?

elay said...

hi greybeard!
ahhh...these things do happen! and it does kind of gets frustrating when it happens after you've already started the engines..and if it happens too often..

i'm currently stuck with a few years of contract with where i am. but i am looking at different 'step up' career options and ems does sound like a great idea..

thanks for the video, i was surprised! had a great time watching it. =)

Ian said...

I find your perspective interesting from a land ambulance perspective. I have worked both land ambulance and air ambulance in the province of Ontario. For years, Air Ambulance service for scene responses were underused. In recent years, the organization that contracts air ambulance services for the province has encouraged calling for a scene response prior to even arriving at the scene, and then if the patient turns out to be less critical, cancel the flight. The number of calls the helicopter received obviously went up which was their goal, but they are often canceled. The reasoning behind this was to discourage thoughts that perhaps the patient wasn't critical enough to spend thousands of dollars. The end result is that sure the helicopter gets worn, but overall patient care is improved. In your system what kind of relationship do you have with the land ambulances services in your coverage area?

Greybeard said...

Thanks for questioning and giving me a chance to expand.

Calling us and putting us on standby if there is ANY chance we'll be needed is encouraged. It saves a few minutes "when seconds count".
My problem comes from calling and having us at the ready, then sayin' "we need ya!", which I've indicated causes us to take some VERY expensive action, (but this expense truly shouldn't be a factor in the decision whether or not to launch us), only to call a few minutes later and say "Nevermind". What transpired between the "we need ya!" and the "Nevermind!" phone calls?

There are other questions that go through our (the helicopter ambulance services) mind...
Did someone decide to bring the patient to the hospital so procedures/tests could be run to bring in revenue? (That's called the "Wallet Biopsy" in our circle.)
Many of our smaller hospitals are running on fumes,trying to justify their existence. Bringing the patient within their doors generates numbers for them.
As I suggest in my post, that action is frequently in the patients best interest if our ETA is unacceptable... at least the patient is brought into a stable, clean, well-lit environment where further evaluation can be done.
But "When seconds count" means something to us... it's the reason we exist. If I were King of the World I would suggest getting the helicopter on the way while you transport your patient to the hospital... get them in a safe environment, but also save part of that "Golden Hour" by having us on the move.

Our ground ambulances answer to their "Medical Control". Sometimes they are required by protocols to do things they may not agree are in the patients best interest. Anyone thinking politics doesn't play a role in everything we do...
is fooling themselves.