skyward medevac

[Schlem]

As "medevac" you get more direct routing and you will have preferred handing in terminal airspce. As "priortiy medevac" ATC will move planes out of the way to make sure there is not one second of delay in getting you and your patient on the ground.

So let's say, coming in from the north, you have a patient in the back and the medic or nurse isn't to worried so you avoid the medevac tag and are number 5 for the ILS 36 into YWG being slowed down and strung out well south of the airport on a shitty IMC day.

Something goes wrong back there, the patient goes south and now here you are stuck in line with a deteriotrating patient behind you. You land the the patient further suffers or the illness/injury is worsened considerably due to the delay in getting on the ground.

How do you explain this to the patient, his/her family, the health board paying you, and potentially the laywers?

If you are an air ambulance with a patient on a stretcher or a sick baby in arms... use the advantage of medevac status because you never know what might happen. After all... it's the patient's care that is number one on the trip and it has nothing to do with what you think is right or wrong in how you file your flightplan.

But... don't abuse the "priority" option if it isn't required and don't use the medevac tag when you are repositioning with a cabin full of Old Dutch.

[confuzed]

This is what i'm talking about schlem, but how is this a problem? If your patient starts to deteriorate in the back it's a simple call to center/terminal/arrival whoever stating that things are getting worse and that you are now a priority medevac. Guess what, now you go from #6, to #1 as you now have priority over everyone else. Unless this happens, why bother calling it?? Also the comment about getting direcet routing, well quite a few of the companies that I know doing medevacs these days have their GPS' IFR certified. Even if it's only certified for in flight navigation and not approaches you shouldnt have a problem with direct routing. Why sit there and advertise who your passengers are, WHO CARES! unless something is seriously wrong in the back. Then by all means, fill your boots and call yourself medevac as you need priority. ATC generally knows what outfits are medevac and have a pretty good idea which planes are which. They know that 795 or the chopper, or BTI, or 911 are medevac aircraft. Why say XXX medevac? Again, who cares unless you have someone that is seriously ill on board. Like someone else pointed out, not all the ATC guys/gals are on the ball so even if you're not priority and you're calling yourself XXX medevac you may still GET priority. How do you explain it to your passenger and lawyers (as schlem brought up) that you had to hold because someone else was coming in under medevac status and we had to hold for x amount of minutes. To top it all off, xxx medevac didn't even have a patient on board! or their patient was only something trivial. Someone else pointed out that land ambulances don't always drive around with their sirens and lights on, then why should we? Calling yourself medevac is basically the same thing. Just a thought.

[quote]So let's say, coming in from the north, you have a patient in the back and the medic or nurse isn't to worried so you avoid the medevac tag and are number 5 for the ILS 36 into YWG being slowed down and strung out well south of the airport on a shitty IMC day.

Something goes wrong back there, the patient goes south and now here you are stuck in line with a deteriotrating patient behind you. You land the the patient further suffers or the illness/injury is worsened considerably due to the delay in getting on the ground. [end quote]

[Schlem]

This is what i'm talking about schlem, but how is this a problem? If your patient starts to deteriorate in the back it's a simple call to center/terminal/arrival whoever stating that things are getting worse and that you are now a priority medevac. Guess what, now you go from #6, to #1 as you now have priority over everyone else.

How is it a problem?

When your patient's health turns for the worse, you have already eaten up valuable time because now you are number three in line, slowed down, and have traveled much farther then you would have had you used "medevac" in the first place. How can you predict when your pateint turns? Your example is when you are still approaching terminal airspace and are inbound from the north.

I have a friend that works terminal airspace and If you have gone from number 6 to number 3 when your patient turns, ATC is still going to land the aircraft ahead of you on the ILS because you won't save time by having ATC have them depart the approach at that point.

My point is... why create an opportunity for risk to the patient if you don't have to.

Many medevac companies make it their policy to use the "medevac" tag whenever a patient is in the back and I'm sure that both the patient and the health board prefer it that way.

What exactly do you gain by not using the "medevac" tag?

[clearmyside]

people: schlem does not know what he's talking about.

I encourage everyone to call center and ask what their duties are when an aircraft calls themselves a MEDEVAC. there's no levels i.e. a) no medevac b0 medevac and c) priority medevac.
you are either medevac or not. those who pay attention read in one of my earlier posts, that when an aircraft calls themselves a medevac it's like the ambulance on the street with lights ans siren turned on. do you know what that means???
once again: a medevac aircraft is currently transporting a patient who does need to get to a hospital asap. if the situation developed before the patient was loaded the a/c takes off as medevac, if the situation develops during flight the pilot (supposedly the one with the brains) calls the controller to inform him of now being a medevac, requesting priority.

i encourage everyone to violate anyone who abuses the medevac status: it's not a right of yours just because your are transporting a patient. however it is a priviledge. with that comes responsibility and anyone transporting a broken finger or positioning back to base as medevac should be punished.

you guys make me f*@#ing mad!!!

[clearmyside]

everyone please read jackalopes post on bottom of page 2 this thread.

now there's a guy who understands the systemand has common sense.

thank you, thank you

[Schlem]

people: schlem does not know what he's talking about.

I encourage everyone to call center and ask what their duties are when an aircraft calls themselves a MEDEVAC. there's no levels i.e. a) no medevac b0 medevac and c) priority medevac.

Umm... afraid you sir are wrong... I have witnessed it first hand for over 4 years.

As a "medevac", ATC will expeditiously get you on the ground but will not start moving other aircraft around to get you in if they are ahead. If a medevac King Air is inbound and a Metro is showing the same arrival time, ATC will slow the metro down to put it behind the King Air which will ensure the King Air is not held up due to separation requirements.

When you approach terminal airspace, the controllers will normally ask if you are a "priority". If you say "yes", then they will move other aircraft around to make sure you get the patient on the ground with no delay. "lights and sirens" woud be a "priority medevac".

We always asked the nurse if we needed "priority" handling and it was their call. 8.5 times out of 10 we didn't need it.

This is YWG terminal and as you can see there are 2 "medevac" handling procedures for ATC whether they are in their MANOPS or not.

[C-206]

I have to say there Schem, I think you are a little off base, just because you and Winnipeg centre use the word "priority" doesn't make you right. I have never see the words "Priority Medevac" in the CARs or the AIP, and asking the nurse if it is a priority....why? Doctor sent them on a medevac, doctor is responsible, Medevac is always priority.
C-206

[beer]

here is my two cents. Flew Medivac's in Northern Saskatchewan for two years and this is the first time I ever eveny heard of this code system. If you have a nurse and her patient in the back they have deemed it too serious to stay in the comunity. That being said who are we as pilots to decide how serious or trivial the sitiuation is. It is actualy Sask's policy to not tell the pilot how serious it is so it does not sway a pilots decision to go when he/she would normaly not. Therefore whenever you have a nurse and a patient in the back there is nothing wrong with using the medivac sign

[...]

If you were a woman on her back............
BD

STOP right there........

At the risk of appearing to be nice... that was a nice thing 'Bandaid' said on the first page about medivac pilots. I don't fly medivac but from what I hear the paramedics seem to rub in the fact that they make large coin compared to their pilot co-workers. Driving up in 2004 SUV's while co-joes barely make it into work on their 1972 Vespa scooter...summer as well as winter!!!

Anyway....that was a nice gesture Bandaid to give 'props' to your pilot colleagues.

(now I'll go back to being a pain)

[bandaid]

I can honestly say that I have never heard a Paramedic bragging about the coin we make to pilots. We have to suffer through the ALS guys telling us how we could make way more money if we became the god like medic that they are. I am what is considered a BLS medic, I won't bore you with the differance between the two, if you want to know PM me. If you were to do a search on Paramedic wages throughout Canada you would probably see that a lot of our medics make the same or less than you pilots. We do okay in B.C. but that came with 30+ years of negotiating. Should any of you pilots be subjected to some pompous paramedic bragging about the money they make, take them around the corner and kick them in the a$$ or key their expensive ride.
Bird dog, I think that is the first compliment that I have seen you make and I am humbled. I ment what I said about the medevac pilots that I have had the honour to fly with over the years.

[confuzed]

[quote]Umm... afraid you sir are wrong... I have witnessed it first hand for over 4 years.[end quote]

Ok, so you're saying that clearmyside didn't call and ask center what the procedure is? You're saying that you've witnessed the way it's been done for over 4 years, but who says it's been the RIGHT way for 4 years??

[quote]As a "medevac", ATC will expeditiously get you on the ground but will not start moving other aircraft around to get you in if they are ahead. If a medevac King Air is inbound and a Metro is showing the same arrival time, ATC will slow the metro down to put it behind the King Air which will ensure the King Air is not held up due to separation requirements.[end quote]

So if you declare an emergency in the air, they're not going to start clearing airplanes out of the way for you? I'd expect if I called a fuel emergency that I have to land RIGHT now or if my patient is about to die they're going to make me fly around and let them die? WHATEVER! If I declare that I am now PRIORITY MEDEVAC that they're going to accomodate me no matter where I am since if they don't the patient will die! Come on now schlem can you even imagine the legal implications to that! "Sorry your honor but my wife was condemned to death because the tower guy already had a guy on the approach and didn't want to inconvience the other guys that had already begun the approach". Get real here.

[quote]When you approach terminal airspace, the controllers will normally ask if you are a "priority". If you say "yes", then they will move other aircraft around to make sure you get the patient on the ground with no delay. "lights and sirens" woud be a "priority medevac".[=end quote]

They SHOULDN'T have to ask if you're a priority, that's what the call sign MEDEVAC means!!! By going under the term medevac it means get out of my way this person is having serious difficulty. I mean even if you read the AIP in the flight priority it says "a MEDEVAC flight", not a PRIORITY MEDEVAC flight. The term MEDEVAC means that they need priority over everyone else!

That's also the way things are done for whoever mentioned that sask ops don't tell if it's a code 4. Well, when a call comes up the medics or MATC (the ones who give you the business) determines if you should file as MEDEVAC status. If they need it they tell us, and bang guess what we're MEDEVAC status. If they don't need it, we don't use it, UNLESS things change in flight and they now require it. Again, how do you justify using that term, I mean YWG has 2 handling procedures?!? Shouldn't there be just one, are you priority (hence that's we're calling ourselves MEDEVAC) or not? By aircraft calling themselves MEDEVAC all the time they're abusing services that should reserved for those who REALLY need it. If the controller doesn't ask if you're priority then they're going to treat as such and you get priority. Just a thought

[...]

Bird dog, I think that is the first compliment that I have seen you make and I am humbled.

Let's just keep it on the down-low, don't want any of these people on here to think I am getting soft....WHICH I"M NOT!!!!

However, for the record...I would like to know the diff between the ALS and BLS? I get confused with all the Medical lingo. But I find it Mesmerizing to see all those cool shiny sizzors in all those pockets you folks have...Which isn't it dangerous to have them all hanging loose like that during flight?

[bandaid]

We always keep the sharp things in front of us. The thinking is if we have a sudden stop they will all fly towards the front of the aircraft.
You should see the way things are secured in the back of an ambulance! The main differance between ALS and BLS is the number of toys and the amount of pharmacy that we can use. ALS stands for Avoid Lifting Stretcher or always leave sleeping. I have way more fun doing my job than the water walkers have doing theirs.
You can always tell a new medic to by the number of things that he has attached to his belt. The more things the newer the medic.

[Ben Dover]

Man has this been beaten to DEATH. I don't care what anyone else uses or doesn't, but our company does it and will continue to use the term. So I guess you'll have to deal with it whether you LIKE IT OR NOT. So stop wasting your breath.

enjoy,

Ben

[Ranger]

This thread is killing me......one way is the way we've been doing it in Manitoba for as long as I know....medevac and priority medivac and in Ontario it is either medevac or not. So now that a medevac company from Manitoba is in Ontario you guys think we abuse the use of the medevac call sign. Well all the companies in Manitoba use it like Skyward does and center asks us if we are priority or not and it seems to work. Is it wrong?? I don't think so, it works. It's just different than how MATC wants it used. I'll tell the guys in 911 to read this thread and to get out of the habit of calling themselves medevac whenever a patient is on board and we can put this to bed. Maybe someday we will have a medevac system as good as the one in Ontario.

[Schlem]

I have to say there Schem, I think you are a little off base, just because you and Winnipeg centre use the word "priority" doesn't make you right. I have never see the words "Priority Medevac" in the CARs or the AIP, and asking the nurse if it is a priority....why? Doctor sent them on a medevac, doctor is responsible, Medevac is always priority.
C-206

Might be different where you fly... that's how it is/was there.

BTW... for example, the difference between a "priority" and a "non priority" medevac is the difference between a a person with head trauma who needs to be in the air as short a time as possible coming down from the arctic circle or a person with a broken leg, in stable condition, coming down from northern Manitoba.

Until you understand the physiological effects of taking an injured person in the air, you might not understand why it's important to have them in the air for as short a time as possible.

[Schlem]

Man has this been beaten to DEATH. I don't care what anyone else uses or doesn't, but our company does it and will continue to use the term. So I guess you'll have to deal with it whether you LIKE IT OR NOT. So stop wasting your breath.

Agreed!

It is/was company policy in my case... I flew medevacs worldwide where patients would be in the back of the plane from Hong Kong to Toronto.

BTW guys... if you fly medevacs, on a dead leg, go have the RN or medic strap you down in the stretcher for the flight... then imagine being in pain and then decide on whether or not you wish the pilots up front would do something to limit the time you have to spend in that position. After all, the time in the plane usually follows the time in the health center being poked and proded for hours in some cases.

It seems to me that too many of you only care THAT you are flying the plane and not WHO you are flying.

Don't forget that on top of the trauma the patient has suffered, in a lot of cases they are VERY afraid to fly which adds to their misery so you not filing as a "medevac" and accepting to be number 6 on approach in shitty weather with a mechanical turbulance is only hurting them more...

but hey... at least you didn't have to hold up a few inbound sched aircraft.

[bandaid]

Now see what happens dog, you say something nice and the rest of the guys get bored.

[ahramin]

On wages:

In alberta here we fly with one paramedic and one emt. The paramedics' wages are comparable to the captains' and the emts' wages are comparable to the co-pilots'. Which makes sense to me.

Of the ten or so medics and paramedics i have met zero of them have had any kind of god complex. They are all uniformly nice friendly approachable easy people who their job seriously but not themselves. On the other hand, of the hundreds of pilots i know, about a quarter have said complex, think they know it all and want everyone to ooh and aah at them just because they fly a plane.

On medevacs it really does not matter what system you use as long as it is consistent. And the easiest way of keeping it consistent is to look at the book. There is no mention of priority medevacs because the term was invented to deal with companies that always file medevacs. The definition of medevac is that it is a medical flight that needs priority.

But what we have here is two levels of priority. Should a patient with a broken leg in a lot of pain get priority over a sched run? All things considered i think yes. Should a patient with head trauma get priority over the guy with the broken leg? Absolutely. And this why when i ask for a better runway atc asks me if we are a priority. ATC seems to get a feeling for us though and they have not asked that in a while. Possibly because if i am inquiring if we can get a better runway i ask "would runway xx work out alright?" but if i want a better runway for the patient i say "could we have runway xx tonight please?".

ahramin

[Mr.Potatohead]

Well, after actually having a discussion with Ontario MATC just a few weeks ago about this very subject, I can tell you their opinion on it.
A code 4 is a 'medevac', and a code 3 can be called a 'medevac', at the medics discretion. There has been quite a lot of abuse of this in this province, ie: a company with an ALS patient on board, which is stable, and possibly not even a code 3 calls themselves a medevac, while another plane with a BLS crew with a TRUE code 3 'priority' patient gets told to slow up for the 'medevac' traffic.
Anyway....that's how it is in Ontario...not sure about the rest of the country.
Oh, and at my company, the P1 medics make more than the captains, and the P2 medics make an obscene amount of money, and are not inclined to work if they don't HAVE to.....

[Northern Flyer]

I just called WPG FSS. I asked if there is a difference between filing medevac, and medevac priority. There response, no. If you call your-self medevac than automatically you are priority. In YWG medevacs are often asked if they require priority because, the classification is used to loosely by most companys.

When filing with WPG FSS, they always ask me if the flight is a medevac. I always say yes when I have a passenger on board, but unless the nurse has asked for an ambulance in YWG (instead of a medivan) I tell FSS that I do not require priority.

No FSS rep. has ever questioned me on this process, but from what the guy told me today I have been doing it wrong aswell. Anyhow, I guess all that a person can do is try to be as respectful to others shareing airspace, at the sametime as giving the best care possible to the person strapped to the streacher.

cheers

[MurtsAir]

I dont have much to say about Medevac because ive never flown them but Ive heared of medivac status on A/C flying time sensitive blood isotopes or something of that nature, were no lives are actually at risk for an extra 5-10 min off the flying time.

[Schlem]

I just called WPG FSS. I asked if there is a difference between filing medevac, and medevac priority.

I have never filed as a "priority medevac"... just "medevac".

If, after picking up the patient, it is determined by the nurse that we are a priority then when the time comes... approaching terminal airspace... when asked if we are priority then the answer is yes. Up until then, we are a medevac because enroute from the north flying direct there is nothing that can be done to expedite you.

Priority handling is only ever required in terminal airspace which is why that is where ATC asks you.

NF... call YWG ACC and ask them.

[bandaid]

Your right Potatoe head, some of the medevac paramedics do make good money not doubt. As a whole, thoughout the country our medics make very low wages. Check with the street medics on the East coast. Their is a reason that the paramedics usual job span is 8 - 10 years.
Their are some similarities to your careers and ours thoughout Canada. The wannabe paramedic spends 2-3 years in college then goes out to find themselves a job, they start at the bottom of the wage scale and work up. They may or may not, depending on the Province, pay for any upgrades they want. Those of us lucky enough to retire from this career are usually so crippled up from back and shoulder injuries that we can't even pick up our grandchildren and I have lost class mates of mine in accidents and plane crashes (PUN comes to mind.)
I'm sorry that I strayed from the original thread intention. I think that for the most part a medevac is a medevac, I might be wrong but in this province the ATC people know what aircraft are doing medevacs as it is a designated carrier. I assume it is up to the medics to consult with the pilots as to the priority of the patient in the back and that is passed along to the ATC. If that is not what is happening then it is something that should be discussed with all parties and guidelines need to be set up and adhered to.
As a street paramedic you would probably not be surprised that we get called to code3 calls (our prioity 1) only to find the patient waiting with bags packed to go to the hospital to be admitted. ATC'ers and pilots are only as good as the information they recieve from whomever is dispatching them or pulling the strings in the back.
I agree that this topic has been flogged like an old horse. Better communication seems to be the common theme here though.

[...]

It does not happen very often, however, I can say that I learned something new reading this thread. Very refreshing.