1	Keeping It Safe Jason McMullan, EMT, MD Asst Med Director, Forest Park Fire Flight Physician, University Air Care
2	Objectives “Helicopter Shopping” Getting There Safely Being There Safely
3	Not covered Landing Zones Helicopter Safety PPE Combative Patients
4	Disclaimers Clips and photos may be distressing Clips and photos are taken from the public domain but without expressed permission from the author or photographer
5	Helicopter Shopping RegionOne Helicopter Service Spartanburg, SC
6	21-July 2004 Jalapa, SC 04:20 911 Called for “woman screaming” at I-26 Rest Stop 04:24 EMS Toned 04:29 CareForce on standby 04:38 EMS Arrival 04:39 CareForce launches
7	21-July 2004 04:20 911 Called 04:38 EMS Arrival 04:39 CareForce launches 04:47 CareForce aborts 04:48 EMS “Get whichever helicopter can fly”
8	21-July 2004 04:20 911 Called 04:38 EMS Arrival 04:47 CareForce aborts 04:48 MedTrans declines 04:49 LifeReach called 04:50 RegionOne called
9	21-July 2004 04:20 911 Called 04:38 EMS Arrival 04:47 CareForce aborts 04:48 MedTrans declines 04:52 LifeReach declines 04:58 RegionOne accepts 05:24 RegionOne lands
10	21-July 2004
11	21-July 2004 04:20 911 Called 04:38 EMS Arrival 05:24 RegionOne lands 05:35 RegionOne lifts 05:36 911 Called “Helicopter crashed in the woods” 06:28 RegionOne located
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15	Helicopter Shopping Calling multiple HEMS services for same patient Calling serial HEMS services after others refuse Sometimes, this is okay
16	Helicopter Shopping Calling serial HEMS services after others refuse Ask “Why are you refusing/aborting?” Ask yourself “Can something be changed?” Ask yourself “Is flying still best?” Tell next agency all circumstances
17	Getting There Safely Lights, Sirens, and Speed
18	Does Speed Matter?
19	Lights and Sirens: Speed Rural Environment 8.5 v 12.1 minute response Urban Environment 1) 106 sec faster (-210 to +425 difference) 2) 43.5 sec faster Mixed 11.1 v 14.9 minute response Of 75 patients, 4 “may have benefited”
20	Lights and Sirens: Speed Of all EMS runs, ~5% need ALS skills Of these, ~10% are time critical Of these, <50% are MD critical
21	Lights and Sirens: Speed We are all judged by response times, but do they really matter?
22	Lights and Sirens
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27	Lights and Sirens
28	Lights and Sirens
29	Lights and Sirens
30	Lights and Sirens: Crashes Crash situations Distracted driver 12-6pm Straight roads Dry roads Clear weather Emergency traffic Crash locations 4-way intersections Traffic signals Prevalence 46/100K trips >50% EMT’s 8% had injuries 1% injured patient
31	Ambulance Crash Fatalities Unrestrained riders (2.5x risk) Patient compartment (2.7 x risk) 2/3 don’t strap in on bench seat EMS Deaths 12.7/100K year 5/100K public
32	Good or Bad?
33	Good or Bad?
34	Good or Bad?
35	Good or Bad?
36	How Safe Are You? Do you buckle up? Do you use lights and sirens only when appropriate? Do you have a priority dispatch system to rate patient distress? How many vehicles run emergency traffic per call?
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38	Wake Effect
39	Wake Effect Lead company clears traffic After passage, traffic very turbulent Huge impediment to second company Civilians 4x more likely to be in accident after first unit passes
40	Outrunning the Siren How far does siren effectively project? Urban v suburban? Straight v intersection?
41	Outrunning the Siren How far does siren effectively project? 8-12m Urban v suburban? No difference Straight v intersection? No difference
42	Outrunning the Siren What is safest intersection entry speed? Do sirens work?
43	Outrunning the Siren What is safest intersection entry speed? 10mph Do sirens work? “Sirens will never become an effective warning device” (DOT)
44	No Nonsense Tips STOP at signals and stop signs Make eye contact with opposing drivers Buckle up Limit distractions Be defensive, not offensive Ask “why do I need to run hot?”
45	Being There Safely Tim Hayes, EMT-P
46	23-Jan 2003 Charlotte, NC Mid-day Winter storm has dropped 8.5” snow >100 accidents on I-77 in 24 hours Medic-13 responds to minor 2 car MVC No injuries
47	23-Jan 2003 Medic-13 responds to minor 2 car MVC No injuries Ambulance positioned in emergency lane, angled to protect scene “Looky-loo’s” keep traffic slow Awaiting PD arrival to clear scene
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52	Tim Hayes, EMT-P Returned to MEDIC Motivational Speaker Star of Life Award Highest civilian honors Mecklenberg County State of North Carolina
53	Being There Safely What are your SOP’s for traffic control? People, vehicles, cones, flares? How much of interstate do you block?