MONENA Conference Brings Air Ambulance Progress

Safety in the utilization and transport of air medical helicopters is the focus of a cooperative effort between the Air Ambulance Subcommittee of the State Advisory Committee on EMS and the Missouri Association of Air Medical Services. The two organizations will come together at the annual conference of the Missouri National Emergency Numbers Association, held this March 15 -18 in Tan Tar A.

Originally brought up as a suggestion by Air Ambulance Sub-Committee members, the directive of the two organizations, which represent the air ambulance industry in Missouri, is to share important information with the 911 professional communicators of the Missouri chapter of the National Emergency Number Association (MONENA) to establish new protocols that will promote a safer environment for the air ambulance industry in Missouri.

“The importance here,” says Air Ambulance Sub-Committee member, Jerry Kirchhoff, “is the sharing of information which makes the entire emergency medical system, as it relates to air ambulance utilization, much more effective and safe.” Kirchoff is also an Air Evac base manager in Sedalia.

Specific objectives of the initiative include familiarizing 911 agencies with air medical providers in the state, discussing how these services should be utilized and requested appropriately and covering system-wide communications capabilities as well as issues related to air medical operations, such as multiple aircraft scenarios and early launch protocols.

Additionally, 911 communicators will be given updated information about “helicopter shopping”, air craft emergency scenarios and other safety issues recently in the news.

Air medical programs in Missouri include LifeFlight Eagle, Air Evac LifeTeam, Arch Air Medical Service, LifeNet Air Medical Service, Children’s Mercy Critical Care Transport, St. John’s MedFlight, Cox Air Care, Staff for Life, EagleMed and St. John’s Life Line.

These ten air medical services represent thirty-two EMS helicopters in Missouri, with six different helicopter models managed by five different air ambulance operators including Air Methods, PHI, Metro Aviation, Eagle Med and Air Evac LifeTeam.

These services are without doubt invaluable to Missouri residents as they make up an essential component of the Emergency Health Care System.

But as the industry looks to the future, it does so with recognition that it is young in comparison to agencies like fire and police – who have clearly had many years to learn how to interact with each other. The first air ambulance program was established in Denver, Colorado, in 1972 – just thirty-six years ago. Nevertheless, industry leaders and experts have their eyes on continued progress which translates into an ever safer and more effective air medical industry.

Front burner issues today include efforts to revise state air ambulance regulations, create guidelines for early launch protocols and effective communications for weather turn-downs.

The aforementioned “helicopter shopping” phrase essentially signifies in layman’s terms that some ground agencies requesting an air ambulance may be turned down by several air medical providers due to weather conditions, yet will continue to call other services. According to an FAA Safety Fact Sheet in August of 2006, helicopter shopping is defined as agencies calling in sequence, various operators until someone agrees to take the flight assignment, without sharing with subsequent operators the reason the flight was turned down. This is an inherently dangerous practice and one the air medical industry is working diligently to stop through awareness and training.

In essence, the air medical industry in Missouri, is consciously seeking ways to set aside certain competitive impulses they might otherwise have with each other, in order to build an industry environment that gives everyone the greatest chance to go home safely at the end of each day. This means they must all be on the same page with regard to very real circumstances such as multiple aircraft responses which require that all programs communicate on the same air-to-air radio frequency. One can imagine the very real possibilities of problems if several air craft are in one area, but unable to communicate with each other.

Currently, communications within the system include Fire Mutual Aid, HEAR, Sheriff’ radios, County 911 and Missouri interoperability frequencies. Many of the air ambulance programs in Missouri have signed a Memorandum of Understanding with the Department of Public Safety on the use of interoperability radio frequencies.

911 Communications specialists will also gain an even greater understanding of the protocols for requesting aircraft. Since air medical services are used predominantly in life-threatening situations it is important to understand patient conditions and types, what local resources are available and the proximity of air medical programs.

Communication specialists will review and update themselves on how to request air medical resources based on a specific set of vital information which must be gathered and conveyed in order for the system to work effectively. The questions that must be asked to capture this information were developed by local 911 and EMS medical directors and administrators in conjunction with air medical directors.

Beyond the normal day-to-day communication issues, there are also disaster planning and response protocols under review. Helicopter Early Launch Protocols (HELP) are being updated as well for trauma and burn patients, stroke, heart attack and other time-critical patients who need a critical care team and rapid transport to a tertiary care center.

It is hoped that the presentations provided at the upcoming MONENA conference will be the beginning of new and effective relationships for the sake of safety for those in the air and on the ground. Air ambulance programs in Missouri continue to work well with each other and with the agencies that request helicopters. The net result is enhanced communication with all so that the safety of the mission is always the forethought during every leg of a patient transport.

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