Air Ambulance / Life Flight Immediacy?
10-23-2012, 05:36 PM
#1
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Joined APC: Feb 2011
Position: Window Seat, C-172
Posts: 29
Air Ambulance / Life Flight Immediacy?
Hello all. This is one of my (if not very) first posts on this site. I have been lurking and reading along for a while but something finally struck me enough to post, so here goes:
I was at a Flight Club meeting tonight at my local FBO and the guest speaker was a FO of a Beechjet for a company that does Life Flight in the area. He was talking about how they fly surgeons around that need to do surgery in another city to obtain an organ. He started talking step by step about how he gets assigned a flight like this and he said dispatch calls him up and asks him how long it'll take him to get to the airport. He told us he lived 15 min. from the field and that he tells the dispatcher it'll take an hour to get there or an hour and half if he's eating... is there no immediacy to a Life Flight charter? I mean, obviously someone's life is on the line if a hospital or a group of doctors feels it necessary to rent a plane @ $2200/hr to perform surgery. Is this guy in the right or is he just a bad apple? Maybe he was just saying this to get a rise out of the audience but that really stood out to me and probably the other young airmen in the group.
Any input? Keep in mind this is a flight club of a university.
I was at a Flight Club meeting tonight at my local FBO and the guest speaker was a FO of a Beechjet for a company that does Life Flight in the area. He was talking about how they fly surgeons around that need to do surgery in another city to obtain an organ. He started talking step by step about how he gets assigned a flight like this and he said dispatch calls him up and asks him how long it'll take him to get to the airport. He told us he lived 15 min. from the field and that he tells the dispatcher it'll take an hour to get there or an hour and half if he's eating... is there no immediacy to a Life Flight charter? I mean, obviously someone's life is on the line if a hospital or a group of doctors feels it necessary to rent a plane @ $2200/hr to perform surgery. Is this guy in the right or is he just a bad apple? Maybe he was just saying this to get a rise out of the audience but that really stood out to me and probably the other young airmen in the group.
Any input? Keep in mind this is a flight club of a university.
10-23-2012, 06:21 PM
#2
Gets Weekends Off
Joined APC: Jul 2007
Position: Former Lear F/O
Posts: 181
We never did doctor transfers but when I was flying air ambulance (Lears) we had a 1 hour callout and the patient never had to wait on us. Usually we showed up and waited for 30 min to 2 hours for the ambulance and patient to show up. I think the only real rushes in airmed is the helo guys going from an accident to the nearest ER.
10-23-2012, 08:38 PM
#3
Disinterested Third Party
Joined APC: Jun 2012
Posts: 6,008
Response time varies with the type of operation and the operator. I've had response times with employers that ranged from five minutes to a half-hour, to an hour in some cases. I've also worked for companies that, depending on the type of stand-by or reserve duty, gave up to 10 or 12 hours to respond. There are many factors involved.
If one lives fifteen minutes from the airport, one still has to get ready, get to the airport, prep the aircraft, preflight, flight plan, meet up with passengers or mission personnel (medics, nurses, etc), possibly a patient, and go fly. The pilot may live fifteen minutes away, but he doesn't sit by the phone 24 hours a day waiting for the call. If he's not at home, he may need to go home to get his gear, or he may carry it with him.
I made a habit of preflighting the aircraft at the start of the shift, and filing a flight plan as I drove to the airport, sometimes as I was opening the hangar door. I could have the airplane outside and one engine turning by the time the medical crew showed up, and be taxiing as soon as they closed the door. Not every operation works that way.
Bear in mind that a medical flight is a Part 135 charter...one doesn't make decisions regarding the flight with the patient in mind. That is, the patient's needs and conditions don't change the safety of flight decisions or actions one takes.
I've turned around enroute, with a heart team on board, and gone home, based on safety of flight needs. Perhaps the heart was lost, perhaps someone died. Those aren't pressures needed when making safety of flight decisions, and consequently I don't consider them. I wouldn't do anything with the patient involved that I wouldn't do without the patient...nobody should. The public has a misconception that somehow a medical patient changes things, and that's wrong. One doesn't do anything extra or different simply because a patient may be critical or in need. I've turned down a number of flights in times past when someone was calling for an aircraft and crew for a critical patient, when I determined that making the flight was unsafe due to airport condition, weather, facilities, etc. That's just the way it is, and that's what we're all paid for as flight crew...sound judgement.
Medical crews worry about the patient. Flgiht crews worry about safety of flight.
If one lives fifteen minutes from the airport, one still has to get ready, get to the airport, prep the aircraft, preflight, flight plan, meet up with passengers or mission personnel (medics, nurses, etc), possibly a patient, and go fly. The pilot may live fifteen minutes away, but he doesn't sit by the phone 24 hours a day waiting for the call. If he's not at home, he may need to go home to get his gear, or he may carry it with him.
I made a habit of preflighting the aircraft at the start of the shift, and filing a flight plan as I drove to the airport, sometimes as I was opening the hangar door. I could have the airplane outside and one engine turning by the time the medical crew showed up, and be taxiing as soon as they closed the door. Not every operation works that way.
Bear in mind that a medical flight is a Part 135 charter...one doesn't make decisions regarding the flight with the patient in mind. That is, the patient's needs and conditions don't change the safety of flight decisions or actions one takes.
I've turned around enroute, with a heart team on board, and gone home, based on safety of flight needs. Perhaps the heart was lost, perhaps someone died. Those aren't pressures needed when making safety of flight decisions, and consequently I don't consider them. I wouldn't do anything with the patient involved that I wouldn't do without the patient...nobody should. The public has a misconception that somehow a medical patient changes things, and that's wrong. One doesn't do anything extra or different simply because a patient may be critical or in need. I've turned down a number of flights in times past when someone was calling for an aircraft and crew for a critical patient, when I determined that making the flight was unsafe due to airport condition, weather, facilities, etc. That's just the way it is, and that's what we're all paid for as flight crew...sound judgement.
Medical crews worry about the patient. Flgiht crews worry about safety of flight.
10-24-2012, 04:57 AM
#4
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Joined APC: Feb 2011
Position: Window Seat, C-172
Posts: 29
I agree with everything you've stated, John Burke. The pilot just made it seem like a lax affair. He said in these cases that he would be on call, meaning he should already have is stuff packed and be ready to head out the door. Maybe I'm being too judgmental, I certainly am not familiar with this operation - but if you live 15 minutes from the airport and you're picked for a Life Flight mission, I feel like you should tell them how quick you can get to the field, not how long it'll take you. But again, I am just speculating. Maybe there was more to "getting to the airport" than the pilot who spoke suggested. 
10-24-2012, 06:07 AM
#5
Disinterested Third Party
Joined APC: Jun 2012
Posts: 6,008
Again, being on call doesn't mean that one is sitting by the door in the spring-runner position, getting ready for a mad dash to the airport. A life flight operation doesn't mean that everyone runs wide-eyed and in a panic as fast as possible to make things happen. Many medical flights are done at an unhurried pace, and that includes organ transport flights.
Being on call doesn't necessarily mean one must be there five minutes from now. I've certainly worked jobs that required that...I've worked jobs that had me sitting under the wing of the aircraft, my gear hanging on the aircraft door, ready to go. Most jobs, however, are not like that. One usually isn't doing a scene-response, unless one is flying an EMS (HEMS) helicopter.
In most cases, the patient is already in the hospital, or on the way. The patient must be stabilized and prepared. The medical flight crew must be assembled and prepared, and the flight must get there. Ambulance ground transport must be arranged. A lot of paperwork is going on behind the scenes. In many cases, there are specific response times built into the contracts with a hospital or provider, and without knowing the details of the specific agreement that your speaker's company had with the contracted parties, it's really impossible to address his timeliness in responding to a call. If he had an hour to respond, then so be it.
I know medical operations that have ten hour response times for reserve on-call, because rest is built in. I used to fly a Learjet doing organ recovery and emergency medical flights, in which I lived 45 minutes away, and it could take longer with traffic. When a heart team called, it wasn't an emergency get-there-now arrangement. Generally when organs are harvested, it's done at night, when the operating rooms are more easily booked. Two OR's are needed: one where the victim-donor is located, and one where the receiving patient is located. This requires coordination and time. The donor is kept on life support to keep the organ viable while that's set up. Generally flights are conducted earlier in the day doing tissue cross-matching and blood work. One duty shift might do nothing more than fly vials of blood or medical material back and forth, while 12 hours later another team might come in to harvest the heart or liver or kidney. I've done that before, and run out of duty time just dealing with the initial testing materials.
I've landed at an alternate field because the destination where the donor was located was snowed-in, with the only surface transport being a pickup truck owned by an airport worker...the organs were transported in a medical cooler in the back of the pickup, with the medical team jammed in the cab, on icy roads at slow speeds, just to get back to the airplane. It's not picture perfect, and it's not hollywood.
Many medical flights are administrative transports. I've flown people from Nevada to Texas in a King Air, for example, who were going there to die. Cancer patients who needed a higher level of care, and the flight was booked in advance. I've arrived to pick up a patient, waited hours in the airplane, had the ambulance show up with my crew and the patient, then seen what looked like WWIII inside the ambulance as the patient came apart...and had to be taken back to the clinic again. I've also arrived to find a victim with a chainsaw to the face, gunshots, burns, dying children, you name it. Some of those were honest-to-goodness gotta-get-them-there-now flights, but many were not.
Without knowing the details of the flight and the operation and the contract and the company and the patient and the call...it's hard to pass judgement, as there's too little fact and not enough known to assess what really took place.
Being on call doesn't necessarily mean one must be there five minutes from now. I've certainly worked jobs that required that...I've worked jobs that had me sitting under the wing of the aircraft, my gear hanging on the aircraft door, ready to go. Most jobs, however, are not like that. One usually isn't doing a scene-response, unless one is flying an EMS (HEMS) helicopter.
In most cases, the patient is already in the hospital, or on the way. The patient must be stabilized and prepared. The medical flight crew must be assembled and prepared, and the flight must get there. Ambulance ground transport must be arranged. A lot of paperwork is going on behind the scenes. In many cases, there are specific response times built into the contracts with a hospital or provider, and without knowing the details of the specific agreement that your speaker's company had with the contracted parties, it's really impossible to address his timeliness in responding to a call. If he had an hour to respond, then so be it.
I know medical operations that have ten hour response times for reserve on-call, because rest is built in. I used to fly a Learjet doing organ recovery and emergency medical flights, in which I lived 45 minutes away, and it could take longer with traffic. When a heart team called, it wasn't an emergency get-there-now arrangement. Generally when organs are harvested, it's done at night, when the operating rooms are more easily booked. Two OR's are needed: one where the victim-donor is located, and one where the receiving patient is located. This requires coordination and time. The donor is kept on life support to keep the organ viable while that's set up. Generally flights are conducted earlier in the day doing tissue cross-matching and blood work. One duty shift might do nothing more than fly vials of blood or medical material back and forth, while 12 hours later another team might come in to harvest the heart or liver or kidney. I've done that before, and run out of duty time just dealing with the initial testing materials.
I've landed at an alternate field because the destination where the donor was located was snowed-in, with the only surface transport being a pickup truck owned by an airport worker...the organs were transported in a medical cooler in the back of the pickup, with the medical team jammed in the cab, on icy roads at slow speeds, just to get back to the airplane. It's not picture perfect, and it's not hollywood.
Many medical flights are administrative transports. I've flown people from Nevada to Texas in a King Air, for example, who were going there to die. Cancer patients who needed a higher level of care, and the flight was booked in advance. I've arrived to pick up a patient, waited hours in the airplane, had the ambulance show up with my crew and the patient, then seen what looked like WWIII inside the ambulance as the patient came apart...and had to be taken back to the clinic again. I've also arrived to find a victim with a chainsaw to the face, gunshots, burns, dying children, you name it. Some of those were honest-to-goodness gotta-get-them-there-now flights, but many were not.
Without knowing the details of the flight and the operation and the contract and the company and the patient and the call...it's hard to pass judgement, as there's too little fact and not enough known to assess what really took place.
10-24-2012, 08:15 AM
#6
Gets Weekends Off
Joined APC: Aug 2007
Posts: 191
Flaps, if you want a career in aviation you should first learn how to keep from judging others actions until you yourself have actually done it. You may THINK its possible until you are being rushed into a very bad decision, then your choices become very limited, if you even have a choice. Med air flights have a very bad history of killing those only trying to help because they thought they could "make it". Unintended consequences usually stem from inexperience.
As an aviator humility, knowing the limitations of humans, and learn to not judge will provide you a solid base to build on. Ground schools dont teach the latter but they should.
As an aviator humility, knowing the limitations of humans, and learn to not judge will provide you a solid base to build on. Ground schools dont teach the latter but they should.
10-26-2012, 08:09 AM
#7
Gets Weekends Off
Joined APC: Aug 2006
Position: 'Bus Driver Right Seat
Posts: 523
A good friend of mine used to fly Pilatus' for NativeAir out of AZ. He told me they had a policy that the pilots were never told of a patient's condition. That way their ADM was not affected by external factors.
10-27-2012, 07:32 AM
#9
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Joined APC: Sep 2007
Posts: 26
John Burke, runionfumes, frieghtdog,
all three of these guys are correct. I used to fly Lears and an MU300 doing the same thing. Most often we were never told the condition of the patient, and RARELY did we ever fly someone who was so critical that we had to be there in less than an hour. Our company call out was 2 hours. It takes a lot of work to prep a Lear to fly from Boston to California in two hours. Flight planning, fuel stop planning, getting to the airplane, making sure fire/rescue is available at each stop if you have to fuel with a patient on board, the list goes on. Most of the time the patients were stable and going somewhere for better care. As far as the organs go, I currently fly for an airline, and we have organs onboard ALL the time. And we are ALWAYS delayed so there must be a pretty good window for them to make the transplant.
Now the Helicopter guys, they are a different story. Often they are on call on site. And typically they are called out when time is critical. Again why they are on call on site.
The main point is, rushing does no good, when you rush and emotions get into play accidents happen. And then the whole exercise is a failure.
all three of these guys are correct. I used to fly Lears and an MU300 doing the same thing. Most often we were never told the condition of the patient, and RARELY did we ever fly someone who was so critical that we had to be there in less than an hour. Our company call out was 2 hours. It takes a lot of work to prep a Lear to fly from Boston to California in two hours. Flight planning, fuel stop planning, getting to the airplane, making sure fire/rescue is available at each stop if you have to fuel with a patient on board, the list goes on. Most of the time the patients were stable and going somewhere for better care. As far as the organs go, I currently fly for an airline, and we have organs onboard ALL the time. And we are ALWAYS delayed so there must be a pretty good window for them to make the transplant.
Now the Helicopter guys, they are a different story. Often they are on call on site. And typically they are called out when time is critical. Again why they are on call on site.
The main point is, rushing does no good, when you rush and emotions get into play accidents happen. And then the whole exercise is a failure.
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