AAMS comments on NTSB hearings about Medically Appropriate Uses of Medevac Helicopters
The Association of Air Medical Services (AAMS) thanks the National Transportation Safety Board (NTSB) and Board Inquiry Chairman Robert Sumwalt for providing the opportunity to shed light on the many medically appropriate uses of medevac helicopters in our nation's health care system.
The testimony provided by today's Patient Transport Request Processes technical panel calls into question common public assumptions concerning the alleged overuse of medical helicopters for patient transport. As the chairman acknowledged, the hearing helped illuminate the reasons behind medical decisions for using medevac helicopters whenever a patient's condition indicates the potential for serious illness or injury.
During panel testimony, Dr. Jack Davidoff, president of the Air Medical Physician Association (AMPA), and Dr. Daniel Hankins, co-medical director of Mayo Clinic Medical Transport, noted that physicians are obligated under the federal Emergency Medical Treatment and Active Labor Act (EMTALA) to stabilize patients to the maximum of their ability, and to assure continuation of a high level of medical care if transport to a tertiary-care facility is required. Both physicians also noted that EMTALA considerations factor significantly in interfacility transport decisions made in rural and other underserved areas, which may lack specialty or tertiary-care centers.
Moreover, as Dr. Hankins testified, dispatching a medical air transport helicopter can in some instances serve as the medical equivalent of sending potentially life-saving critical care directly to the patient, by providing in a much swifter manner the necessary medical resources - such as intubation and balloon pumps - which many primary care centers cannot provide.
Dr. Hankins further explained that 24-hour discharge from a hospital is a poor measure of inappropriate utilization of helicopter emergency transport because in today's health care system, patients with significant injuries or illnesses can be diagnosed, treated, stabilized and ultimately discharged in 24 hours.
As further evidence, a 2005 study published in the Journal of the American Medical Association (JAMA) by Branas has demonstrated that nearly one-third of the U.S. population is dependent on air medical transport to reach trauma centers within one hour, which is typically referred to as the "golden hour."
In addition, a statewide study in Massachusetts that was designed to examine the potential overutilization of medical helicopters demonstrated that, to the contrary, medevac services actually were underutilized, and patients died as a result. The study was presented in 2004 and published in the Air Medical Journal. .
AAMS was invited by the NTSB to participate in the helicopter safety hearings, which are being held through Feb. 6, 2009.
By Sandy Kinkade, President, Association of Air Medical Services
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