By Jamie Thompson
FireRescue1 Senior Editor
LAS VEGAS — Medical helicopters are an important part of the EMS system but have become “out of control,” Fire-Rescue Med was told Monday.
“It’s an industry out of control but an industry we need to rein in,” Bryan Bledsoe told the conference in Las Vegas.
Dr. Bledsoe, professor of emergency medicine at the University of Nevada School of Medicine, outlined the huge increase in the number of medical helicopters across the United States — as well as HEMS operations — over the past decade during the presentation.
One of the main issues related to air medical safety, Dr. Bledsoe said, relates to the lack of regulation in the United States.
“The helicopter industry can’t be touched because it falls under the Airline Deregulation Act, so states cannot really regulate medical helicopters,” he said.
The rise in the number of air medical operations in the past 10 years follows a trend over the decades of specific medical industries becoming out of hand, with Dr. Bledsoe citing the “boutique” psychiatric and substance abuse facilities of the 1980s and home health care agencies of the 1990s.
The number of medical helicopters has more than doubled in the past decade, the session was told, and emergency personnel are feeling more pressure to use them — often unnecessarily — as more of them scramble for business.
Dr. Bledsoe outlined the results of several studies that examined the use of air medical transport in both the United States and overseas.
These included a UK study in 1996 of the London Helicopter Emergency Services, which was a prospective comparison of seriously-injured patients transported by HEMS and GEMS.
It concluded “as there is no evidence of any improvement in outcomes overall for the extra cost, HEMS has not been found to be a cost-effective service.”
One of the most recent studies, Dr. Bledsoe said, came last year with Helicopter Evacuation of Trauma Victims in Los Angeles: Does it Improve Survival?
Among the conclusions was “in a metropolitan Los Angeles trauma system, EMS helicopter transportation of injured patients does not appear to improve overall adjusted survival after injury. There is, however, a potential benefit for severely injured subgroups of patients due to the shorter prehospital times.”
However, while there is a large volume of literature from both sides on the subject, the quality “isn’t great,” according to Dr. Bledsoe.
But what there is, he told the session, seems to show no or only limited benefit of using air medical transport in many scenarios.
Dr. Bledsoe said in many articles there is a virtual statistical “leap of faith” to justify air medical transports.