New helicopter air ambulance service to be introduced

Klunk001

According to the Sunday Business Post

http://www.sbpost.ie/news/air-ambulance-service-planned-to-cope-with-ae-closures-58196.html

Vorsprung

Good thing they kept the helipads at most of the large specialist centres.

Oh wait...

savagecabbages

I'm not too well up on emergency hospital treatment, so feel free to tell me shut up/correct me! But from my limited understand, the real advantage to a helicopter air ambulance is the ability to get the most seruiously injured of patients directly to one of the most suitable/best hospitals immediately.

Lets a patient seriously injured in south Kerry or west Cork can be brought by road ambulance to a general hospital in 90 mins, or to a regional/university hospital in Cork/Limerick 2 hours. We often hear of this patient then being transferred to a more specialised one in Dublin soon thereafter for further treatment. (I'm assuming (not stating!) the regionals cant provide whatever specialised care is required). Basically it may be several hours before the patient begins receiving treatment at the specialised unit.

An EMS helicopter could have the patient from the roadside to the same specialised Dublin hospital in 90+- mins, obviously a massive saving in time.

So once the few hospitals earmarked for receiving EMS patients are covered, the service could work. These being the Western regional/university hospitals for the less serious cases, and possibly one or two specialised centers in Dublin able to cover the eastern side of the country where road ambulance travel times aren't as big a problem as the west...


The nay sayers will always announce that not every hospital has a helipad, but in reality once the issue has been looked at from a macro level, not every hospital needs one!

savagecabbages

Oh and by the way I'm not in any way advocating the closure of any A&E departments. The politicians seem to be saying that the introduction of an EMS service will make up for the 10 A&E departments to be closed...

I'm simply saying that not EVERY hospital in the country need be helipad equipped, as some people like to think...

Hooch

savagecabbages wrote: »

I'm simply saying that not EVERY hospital in the country need be helipad equipped, as some people like to think...

Totally correct.....however....most centres of excellence have built over thier heli pads!! (Bar Limerick Regional)

savagecabbages

NGA wrote: »

Totally correct.....however....most centres of excellence have built over thier heli pads!! (Bar Limerick Regional)

Which is a disgrace....
Out of interest, how many of these former helipads were able to accommodate larger helicopters like those the Coast Guard use? In fairness the Coast Guard have more or less the only organisation bringing casualties in by helicopter for many years now, and having a helipad unable to accommodate an S-61 is basically as bad no helipad!!

Hooch

savagecabbages wrote: »

Which is a disgrace....
Out of interest, how many of these former helipads were able to accommodate larger helicopters like those the Coast Guard use? In fairness the Coast Guard have more or less the only organisation bringing casualties in by helicopter for many years now, and having a helipad unable to accommodate an S-61 is basically as bad no helipad!!

All were. And dont forget the Irish Air Corps do most of the air ambulance transfers at present. IrCG only deliver from rescues or when IAC is not available.

iceage

About bloody time really, seems they're being shamed as well by others who have beaten them to the punch. Bond already by all accounts operate a service out of Cork Airport.

http://www.airambulanceireland.net/

savagecabbages

NGA wrote: »

All were. And dont forget the Irish Air Corps do most of the air ambulance transfers at present. IrCG only deliver from rescues or when IAC is not available.

Not so sure about ALL of them, Waterford being one example, but I'm not well up on all the hospitals so can't say for sure myself...
I hadn't forgotten the Air Corps, but are they not primarily concerned with fixed wing air ambulance transfers, with the patients brought to Baldonnell?

DesertCreat_15

Great news ! But it's a bit late for the 100's of lives that could have been saved if there was such as a thing as a government funded aircraft a few years back !

Out of interest I wonder will the likes of that charity heli-air ambulance in Cork recieve funding as a result of this new promise?

TylerIE

iceage wrote: »

................ others who have beaten them to the punch. Bond already by all accounts operate a service out of Cork Airport.

http://www.airambulanceireland.net/

Really????

johngalway

Google Earth shows a great big H at the back of UHG, but the image is from 2007 so it may well not be there anymore.

There also appear to be some "Irish solution" helipads near some other hospitals, sports fields, parks etc., the "sure it'll be grand" solution.

goldie fish

iceage wrote: »

About bloody time really, seems they're being shamed as well by others who have beaten them to the punch. Bond already by all accounts operate a service out of Cork Airport.

http://www.airambulanceireland.net/

Bond operate an aircraft servicing the Kinsale Gas rigs. They have only one machine based in cork, They used to Have a Dauphin, I think its an EC135 now.

Vorsprung

DesertCreat_15 wrote: »

Great news ! But it's a bit late for the 100's of lives that could have been saved if there was such as a thing as a government funded aircraft a few years back !

Do you have a s ource for that figure you mentioned?

TylerIE

savagecabbages wrote: »

I'm not too well up on emergency hospital treatment, so feel free to tell me shut up/correct me! But from my limited understand, the real advantage to a helicopter air ambulance is the ability to get the most seruiously injured of patients directly to one of the most suitable/best hospitals immediately.

Lets a patient seriously injured in south Kerry or west Cork can be brought by road ambulance to a general hospital in 90 mins, or to a regional/university hospital in Cork/Limerick 2 hours. We often hear of this patient then being transferred to a more specialised one in Dublin soon thereafter for further treatment. (I'm assuming (not stating!) the regionals cant provide whatever specialised care is required). Basically it may be several hours before the patient begins receiving treatment at the specialised unit.

An EMS helicopter could have the patient from the roadside to the same specialised Dublin hospital in 90+- mins, obviously a massive saving in time.

So once the few hospitals earmarked for receiving EMS patients are covered, the service could work. These being the Western regional/university hospitals for the less serious cases, and possibly one or two specialised centers in Dublin able to cover the eastern side of the country where road ambulance travel times aren't as big a problem as the west...


The nay sayers will always announce that not every hospital has a helipad, but in reality once the issue has been looked at from a macro level, not every hospital needs one!

I agree with you on the Level 1 Trauma Centre issue, one West, One South, One / Two Dublin, possibly Midlands and North West or a link with the NHS for some services in Altnagalvin (spelling?) in Derry.

However, and while this is a significant change in my position to what I originally would have felt, is this the best use of scarce financial resources?

I dont know how much it would cost per year to keep a HEMS service operational, but if we throw out there a conservative estimate of €2.5m. That would put eight more road ambulances in service 24/7, which IMHO would do a lot to improve community care. Add in more CFR style schemes (already community funded), examine it being done at EFR level and suddenly we have a much better emergency care service, with rapid community BLS and ILS coming from our HSE Ambulances.

I worked in the States and the main Level I trauma center I was in covered a geographical area probably twice the size of the Irish Republic. We had 2 EMS aircraft associated with our hospital, and a third associated with a level II centre (literally) across the road. I can only recall one patient being brought in by HEMS that actually even might have benefited from same.
The rest of the calls were where HEMS was routinely dispatched or requested due to possible prolonged transport/ MOI / possible extrication delays etc.

I could ramble but what is happening in the States is a move towards very judicious use of HEMS. There are almost weekly crashes involving Air Ambulances, with deaths of Crew and sometimes patients. EMS dispatchers are sending choppers based on protocols (The same type of protocol that would require an AP to attend a drunk) and medics are requesting them prior to arriving on scene "in case". Yet rural areas are left with one ambulance because "they have the chopper if they need it".

I looked at the stats from one Level 1 Trauma Centre and the % of patients whose prognosis was improved by using HEMS was tiny. I forget the exact details but it was ridiculous for the costs / risks involved.

Part of me now thinks is it a case of we have come to see HEMS in other countries, so its just a public perception that "we should" have it?

Notwithstanding the above I would like to see a better provision for interhospital transfers!

999nobody

lst wrote: »

There are almost weekly crashes involving Air Ambulances, with deaths of Crew and sometimes patients.

Whilst I agree with a lot of what you say, the above statement is ridiculous. Can you provide a link to these weekly fatal crashes?

TylerIE

I didnt say weekly fatal, I said weekly crashes. Some of these involve deaths of crew and/or patients. I was originally going to say one fatal crash a month, but that doesnt reflect the number of non-fatal incidents/near misses.


I may stand corrected re almost weekly, but its still VERY high, Id seen editorials along those lines following similar discussions on my states EMS list.

The only figures I can get (and I explain why below) is the following:

A 2005 USA Today Article cites approx 15 per year, although implies thats just the ones involving fatalities.

The industry's trade group estimates that, since 2000, the number of air ambulance helicopters has climbed 50%, from
500 to about 750. The average number of crashes climbed even faster, from about five per year during the early and mid
1990s to more than 15 per year since 2000 — a 200% increase

Other sources referenced on Wikipedia quote 55 Air Ambulance accidents between January 2002 & January 2005, of which 41 were Helicopters - ie approx 14 per year > back then.

My understanding, which is open to correction, is that the number of air ambulances has increased further since.

I also believe that there is a significant number of near misses (E.g. near misses with power cables) / minor minor incidents which dont get reported on as there is no body responsible for HEMS in the States - each state is responsible for the medical licensing, while the FAA looks after the flying end of it.

These dont include when foreign objects interfere with the choppers (E.g. one recent incident where a chopper was shot in the states - while unlikely for shots to be fired here there was a recent incident in National Media where the Garda Air Support unit had a laser shone at it).

EMSCHAP

savagecabbages wrote: »

Not so sure about ALL of them, Waterford being one example, but I'm not well up on all the hospitals so can't say for sure myself...
I hadn't forgotten the Air Corps, but are they not primarily concerned with fixed wing air ambulance transfers, with the patients brought to Baldonnell?

The helicopter landing pad in WRH is physically capable of taking a S61 as happened in the past. The IRCG have chosen not to use it and have recently issued a statement that it was their decision whether to use any landing facility or not even if it is a properly built and equipped pad as this one is. They land at a nearby rugby pitch instead but only if the casualty has serious injuries. The IAC still use it for both helicopter types which they operate.

Klunk001

Here's a link to a discussion on AA flights in the US. The only reason I'm putting it up here is because it's being discussed here. What's being proposed here is a completely different animal to what is provided in different states in the US.

http://www.pprune.org/rotorheads/346122-ntsb-says-ems-accident-rate-too-high.html

Hopefully there will not be too much thread drift.

goldie fish

EMSCHAP wrote: »

The helicopter landing pad in WRH is physically capable of taking a S61 as happened in the past. The IRCG have chosen not to use it and have recently issued a statement that it was their decision whether to use any landing facility or not even if it is a properly built and equipped pad as this one is. They land at a nearby rugby pitch instead but only if the casualty has serious injuries. The IAC still use it for both helicopter types which they operate.

Is the helipad on the ground or rooftop?

Klunk001

I believe it's on the ground.

EMSCHAP

Klunk001 wrote: »

I believe it's on the ground.

Yes it is on the ground, near the ambulance station. An ambulance is still required to transfer the patient the few hundred metres to the ED.

Bill G

TylerIE wrote: »

I didnt say weekly fatal, I said weekly crashes. Some of these involve deaths of crew and/or patients. I was originally going to say one fatal crash a month, but that doesnt reflect the number of non-fatal incidents/near misses.

I may stand corrected re almost weekly, but its still VERY high, Id seen editorials along those lines following similar discussions on my states EMS list.

Maybe not weekly, but certainly monthly, which is very high indeed:

NTSB Report

Any certainly something to consider for any Irish Air Ambulance service given the weather here.

medic51

All I can say about this topic is there will not be any Air Ambulance in Ireland til at least 2020,
The coast gaurd in Ireland do most medical Transfers[RESCUE 115, RESCUE 117] and with the Irish Army Airforce doing most abroad medical transfers.

In the UK they use Air Ambulance all the time, that is were i did my training, over there the service is called HEMS.

Ireland is behind the times when it comes to Pre-hospital treatment and it will only get worse as no investment is being put into healthcare,

Im sorry to say in comes down to the paramedics on board the ambulance and the level of treatment the patient gets that will save their life.

resus

medic51 wrote: »

Ireland is behind the times when it comes to Pre-hospital treatment.

Absolute Rubbish !

Ireland is certainly NOT behind the times with its pre-hospital treatment, it actually is a world leader in terms of a modern structure and training programme.

The only reason we are in the dark ages is resource NUMBERS. We don't have the funds or numbers of practitioners that we need to run our modern system properly.

savagecabbages

resus wrote: »

Absolute Rubbish !

Ireland is certainly NOT behind the times with its pre-hospital treatment, it actually is a world leader in terms of a modern structure and training programme.

The only reason we are in the dark ages is resource NUMBERS. We don't have the funds or numbers of practitioners that we need to run our modern system properly.

We have a poorly performing pre-hospital medical service. End of.
Blame whoever, but its not working...

Bang Bang

savagecabbages wrote: »

We have a poorly performing pre-hospital medical service. End of.
Blame whoever, but its not working...

I must mention that to the recent successful cardiac arrest resusitated patient we had, that person is now alive and doing well, it must be something to do with this quote "poorly performing pre-hospital medical service" end quote, we have here.
I'll also pass on the same sentiments to the many people whose lives have changed due to pre-hospital interventions by Paramedics here too, and the many trauma and medical patients who had comfortable extrications and pain free transports to hospital due to the said "poorly performing" service... :rolleyes:

mediwheel

Ireland is still years behind most civilised countries when it comes to pre-hospital care. There isnt a hope of having an air ambulance when the ground ambulances are such a mess. We have a situation now when a patient requires an advanced paramedic they are either not available or we have to wait on an off duty officer to be called, and i have seen this delay contribute to patients deaths.

savagecabbages

Bang Bang wrote: »

I must mention that to the recent successful cardiac arrest resusitated patient we had, that person is now alive and doing well, it must be something to do with this quote "poorly performing pre-hospital medical service" end quote, we have here.
I'll also pass on the same sentiments to the many people whose lives have changed due to pre-hospital interventions by Paramedics here too, and the many trauma and medical patients who had comfortable extrications and pain free transports to hospital due to the said "poorly performing" service... :rolleyes:

You can also mention the absolutely scandalous waiting times for ambulances in many parts of the country. But that would be pushing the thread further off topic.

Having to wait nearly 2 hours for an ambulance to arrive, and then scramble an air ambulance to the scene to get the patient to a hospital wont work. Response times need to be cut first, then look at getting the patient to a specialist hospital in hte fastest way possible after that.

medic51

resus wrote: »

Absolute Rubbish !

Ireland is certainly NOT behind the times with its pre-hospital treatment, it actually is a world leader in terms of a modern structure and training programme.

The only reason we are in the dark ages is resource NUMBERS. We don't have the funds or numbers of practitioners that we need to run our modern system properly.

Yes Ireland is behind the times in healthcare, A&E's all over Ireland are being shut down to save money, We need more beds not less, I agree that the training Programme is great ive done it, but hospitals are under staffed, waiting times are too long. Over in the Uk they will have an ambulance with a patient in 9 mins and they do it without any trouble. As a healthcare provider I believe there needs to be huge changes to our system.

TylerIE

medic51 wrote: »

Yes Ireland is behind the times in healthcare, A&E's all over Ireland are being shut down to save money, We need more beds not less, I agree that the training Programme is great ive done it, but hospitals are under staffed, waiting times are too long. Over in the Uk they will have an ambulance with a patient in 9 mins and they do it without any trouble. As a healthcare provider I believe there needs to be huge changes to our system.

In England they have a population density of over 1000 people per square mile, versus our 190 per square mile. Its hard to compare our response times and chopper availability to that. The higher population density means there can be more hospitals, etc.

Their 8 minute response time is for a response, not an ambulance - so that could be an EFR, A Rapid Response Medic or an off duty medic.

I unfortunately agree with A&E closures, having read the Hanley Report, and worked in the States (where as I said earlier we had one Level 1 trauma centre for a massive area).

It is in the best interest of seriously ill patients that they go to Centers of Excellence where their special needs can be met by experienced teams, not XXX General Hospital where the consultant sees 1 major trauma every 2/3 months. I do feel that our Ambulance Crews should be (as can be done in the states) given training (where needed - ie somewhat protocol based) and subsequent discretion as to the most appropriate Emergency Department, and/or the use of GPs in rural areas (For minor injuries).

The rural hospitals should of course be used as step-down for patients from the specialist centres, thereby freeing up beds, and reducing ambulance delays.

Both of these steps require more ambulance crews, and that would be a priority over HEMS.

EMSCHAP

TylerIE wrote: »

In England they have a population density of over 1000 people per square mile, versus our 190 per square mile. Its hard to compare our response times and chopper availability to that. The higher population density means there can be more hospitals, etc.

Their 8 minute response time is for a response, not an ambulance - so that could be an EFR, A Rapid Response Medic or an off duty medic.

I unfortunately agree with A&E closures, having read the Hanley Report, and worked in the States (where as I said earlier we had one Level 1 trauma centre for a massive area).

It is in the best interest of seriously ill patients that they go to Centers of Excellence where their special needs can be met by experienced teams, not XXX General Hospital where the consultant sees 1 major trauma every 2/3 months. I do feel that our Ambulance Crews should be (as could be done in the states) given training (where needed - ie somewhat protocol based) and subsequent discretion as to the most appropriate Emergency Department, and/or the use of GPs in rural areas (For minor injuries).

The rural hospitals should of course be used as step-down for patients from the specialist centres, thereby freeing up beds, and reducing ambulance delays.

Both of these steps require more ambulance crews, and that would be a priority over HEMS.

What you say makes great sense. Also in the UK, their air ambulance services are supported by massive fund raising campaigns and corporate sponsorship (except in Scotland) which we would find very hard to match in this country.

searescue

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