Lack of Irish air ambulance service 'almost unbelievable'

Klunk001

http://www.irishtimes.com/newspaper/ireland/2011/0715/1224300763236.html

Lack of Irish air ambulance service 'almost unbelievable'

A RETIRED consultant neurosurgeon has criticised the lack of a designated air ambulance service to transport trauma patients.

Christopher Pidgeon, a retired neurosurgeon at Beaumont Hospital, said: “A country like Ireland should have an air ambulance service, considering its geographically dispersed population”.

His comments followed questioning from Dublin city coroner Dr Brian Farrell as to why Beaumont Hospital, Ireland’s designated neurological hospital, had no facilities to allow helicopters transporting patients with serious head injuries to land.

Mr Pidgeon said the hospital had repeatedly applied for landing facilities for helicopters but was turned down each time. As a result, patients with severe head injuries were airlifted to Dublin airport before being brought by ambulance to Beaumont.

“Most road accidents with head injuries occur at night. We would need to have a helipad, which would allow night landings, and there would need to be expensive floodlighting and fencing to allow this,” he said, adding that space was also a problem at Beaumont.

He told the coroner a helipad couldn’t be put on the roof as the building would need to be constructed so as to survive the crash of a helicopter loaded with fuel.

Mr Pidgeon was speaking at the inquest into the death of former Honda Ireland managing director Peter Cullen at Beaumont Hospital on September 20th, 2009, following a serious head injury.

The 68-year-old from Shankill, Co Dublin, was gardening at his holiday home in Wicklow when he fell on loose stones and hit his head. His wife Joan told the inquest he seemed fine immediately after the fall but developed a headache an hour later and began to feel unwell.

He went upstairs to bed but his condition quickly deteriorated, he became incoherent and began to lose consciousness. Ms Cullen said she called 999 and waited an hour for an ambulance to arrive.

Upon arrival, paramedics felt it could worsen Mr Cullen’s condition if he was transported via ambulance as he had a head trauma and it was a long and bumpy road to the hospital. The family waited nearly another hour before a Coast Guard helicopter arrived. Mr Cullen was then airlifted to Tallaght hospital before being transferred by ambulance to Beaumont.

At 5am, some 12 hours after his fall, surgeons carried out surgery to remove a subdural haematoma. The operation was successful and Mr Cullen was transferred to the high-dependency unit. He suffered a cardiac arrest in the unit on September 17th, seven days after the fall, and died three days later.

A postmortem carried out by Dr Francesca Brett, a neuropathologist at Beaumont Hospital, gave the cause of death as cardiac failure. Mr Cullen had a history of significant heart disease.

Counsel for the family, Dr Simon Mills, said he was surprised by the lack of a designated air ambulance service in Ireland.

Recording a narrative verdict, Dr Farrell said he would write to the Minister for Health and HSE regarding the lack of an air ambulance service in Ireland and the absence of a helipad at Beaumont Hospital.

Speaking after the inquest, the deceased’s wife, Joan, said it was “almost unbelievable” Ireland had no air ambulance service and that there was no helipad at Beaumont.

punchdrunk

the S-61 used by the Coastguard,and it's replacement which is on the way the S-92 are far too large for this kind of work,they're fine as a "second line" backups but they are way too big and heavy for a regular HEMS type service

beaumont were far more interested in building car parking than helipads
although from what I hear the approach and exit routes to the hospital aren't great they would be suitable for a smaller chopper if a pad was built

Bang Bang

Getting away from the tragic circumstances surrounding this gentlemans death for a moment, but it's ironic to think that the area initially designated for a helipad at Beaumont Hospital was instead turned into a carpark for.. Consultants!

Helicopters did land at Beaumont for a number of years, they used the playing fields which lay close to the public carpark. There were increasing problems with drainage but work was carried out to prevent flooding. I'm unsure as to why the service of flying helicopters into Beaumont was stopped.

kub

In fairness, I think now with all the talk of centralising hospitals and closing down rural a&e's, it is only fair and probably a cheaper option to get some air ambulances into operation.
I wonder, we currently have emergency S&R crews working out of Dublin, Waterford, Shannon and Sligo. Would it be possible to perhaps also base some suitable air ambulances at these locations and perhaps have the same crews operate both services.
Then perhaps make sure that every part of the country is well within 1 hour of where one of these choppers is based. So that obviously should there be a necessity help is close at hand.

999nobody

kub wrote: »

In fairness, I think now with all the talk of centralising hospitals and closing down rural a&e's, it is only fair and probably a cheaper option to get some air ambulances into operation.
I wonder, we currently have emergency S&R crews working out of Dublin, Waterford, Shannon and Sligo. Would it be possible to perhaps also base some suitable air ambulances at these locations and perhaps have the same crews operate both services.
Then perhaps make sure that every part of the country is well within 1 hour of where one of these choppers is based. So that obviously should there be a necessity help is close at hand.

S&R and air ambulances should be separate entities, both are specialised.

kub

999nobody wrote: »

S&R and air ambulances should be separate entities, both are specialised.

I can see where you are coming from, what I am thinking is, the medic in the S&R is surely qualified to be a medic in an air ambulance as well.
The pilot is a pilot, granted, perhaps a different machine which may require a bit of training.
The necessary infastructure is already at each site.
Now obviously I would expect extra personnel at each site.
Is it not a bit like DFB s crews operating both Fire & Rescue and Ambulances?
Do I make any sense at all? Or is it the way that I just do not understand, please fell free to help me out on this.

Klunk001

kub wrote: »

The pilot is a pilot, granted, perhaps a different machine which may require a bit of training.

In this case it wouldn't work. Pilots flying SAR on the 61 spend most of their time staying current on type. It would be asking alot to try and stay current, more importantly competent on two different types I would think.

resus

SAR guys are going to be used much much more for primary inland response. They already do it! It is part of this governments stated agenda for them to do even more. KUBs argument is not actually that daft, if you take the point a bit further, ie. the utilising of existing SAR bases, engineers, hangers, fuel supply, governance structures, management etc. etc. etc. to save costly reproduction of these support services. I do however take the very valid point that the existing and new helicopters are not ideal for HEMS.

I personally believe that another form of HEMS is coming in the next decade; but not as most posters here would like to see it. It will probably be born out of private industry. Likely intensive care inter-hospital transfers in the 1st instance and develop from there. Pretty much how most services around the world developed. Remember that Ireland already has a dedicated Intensive Care fixed wing jet in the private sector for international transfers.

donkey balls

Klunk001 wrote: »

In this case it wouldn't work. Pilots flying SAR on the 61 spend most of their time staying current on type. It would be asking alot to try and stay current, more importantly competent on two different types I would think.

A bit like having a fixed wing boy current on a B737&B747 at the same time and from memory a pilot can stay current only on two types of acft,Yet all major airlines have their crew current on one type
only except for my aul crowd as the older aircraft (DC10 3 CREW) had the FD avionics replaced with newer ones from the MD11 (2 CREW) which later became MD10.
I know with the likes of Roscomon hospital closing down it's A&E, people are saying that an Air Ambulance should be set up question is how many should we have and where should they be based?
Take the EC135 they would be around $4/5 mil USD roughly then the added medic equipment, the heli pads and a secure location for the fuel bowser under ADR regulations, not to mention if their IFR equiped and even if they are I'm all most certain even the S61 has a limitation for flying through fog/mist which could hinder the heli getting to the place there needed at.

savagecabbages

I can see this falling right into CHCs hands here, they already provide EMS in several countries outside of Ireland, and could (fairly) easily run extra EMS helicopters out of some of the Irish bases.

True the S61 does have limitations in icing/fog conditions, but they are all scheduled to be replaced by S92s in the near future. Still way too big for EMS role though...

Fishtits

As I understand it the biggest problem is agreeing protocols with the HSE.

Someone needs to seriously sort that outfit out.