In our July 8, 2008 Patient Safety Tip of the Week “Medical Helicopter Crashes” we discussed the “epidemic” of crashes of helicopters and other medical rescue aircraft in the recent past. Since that column there have been two more medical helicopter crashes. In August a small plane on a medical mercy mission crashed in Easton, Massachusetts, killing a cancer patient and his wife plus the pilot. The plane was flying the cancer patient from Long Island to the Dana Farber Cancer Institute in Boston. Then last weekend a medical helicopter crashed in Maryland, resulting in four more deaths. Details about the former crash are not available at this time but the Maryland crash apparently occurred in foggy weather. In our previous column we noted medical helicopter flights are often riskier because of conditions such as night flying and inclement weather, both of which were present for the Maryland crash. We also talked about Dr. Bryan Bledsoe’s work that had questioned how many medical helicopter flights were truly indicated. Details about the Maryland crash are sketchy but apparently the planned trip was to a hospital only 25 miles away. A recent state audit of Maryland’s MedEvac helicopters, which are run by the Maryland State Police, had also uncovered a number of issues and questions.
It is very difficult to second guess the people on the ground (or at the helicopter control site or the regional emergency response center) who have to make on-the-spot decisions about appropriate triage of accident victims. However, each such incident should have a post-event analysis that includes an assessment as to whether the type of transportation used was the most appropriate one. We would expect that ultimately a checklist of a short series of questions (eg. What is the distance to the trauma center? What is the anticipated drive time? What are traffic conditions like at this time? What are the weather conditions like at this time? What is the condition of the accident victim(s)? etc.) would probably help the on-site and emergency response personnel quickly make a good decision about the type of transportation most appropriate for the situation.
Update: See also our Patient Safety Tips of the Week for February 3, 2009 “NTSB Medical Helicopter Crash Reports: Missing the Big Picture” and September 1, 2009 “The Real Root Causes of Medical Helicopter Crashes”.