Medevac OR Medevac??

[hz2p]

if the patient kicks the bucket in the hold while Jazz is shooting the approach because I didn't file medevac status, then who looks bad?

Jazz, because they ran off the end of the runway again.

[cyeg66]

I spent far too long, flying Air Ambulance flights. If the average Taxpayer knew the colossal waste of money, a large number of these are, there would be a huge outcry.

Half of the ones I used to do were nothing more than a Kentucky Fried Chicken and Beer run.

Free ride to the Big City, short stop at the hospital and a free ride home.

Hockey Bag full of KFC and Beer, thanks to the Canadian Taxpayer.

Anything north of Edmonton (to a lesser degree), Saskatoon (to a greater degree), and Winnipeg (to the greatest degree) operates in that fashion. Nothing new there.... I've the feeling that Quebec, armed with its one or two CHALLENGERS flying constantly, is most wasteful, but we needn't discuss that triviality. Abuses abound, coast-to-coast. In practice, the Medevacs I tend to accord greatest priority to are STARS choppers, followed by Lears and various other fast jets (most flying in like a bullet from the States), followed by non-standard point-of-origin Medevac flights, followed by once/twice/thrice daily Schedevac flights. Only the last ones do I "bone" and not accord any official special handling. They get on the localizer as quick as any other regular plane in the sky, but no sooner.

[ArcticKat]

I don't exactly understand the reasoning of your higher ups. Paramedics driving the ambulance know all the time when their patient requires an urgent or a non urgent transport. They are professionals, just like you, and if they act irresponsibly while driving the ambulance, they should be held accountable. Just like a pilot. If they are told their patient is critical and they act irresponsibly because of it, they lack professionalism and common sense. I thought pilots were in ultimate control and responsibility for what happens on the aircraft. Not knowing the status of your passengers would be a serious breach, would it not?

Is your employer saying then, that you, as a pilot, can not retrain yourself and fly in a responsible manner when you are told that the patient in the back is near death? Then sir, I would say that you should not be flying Medevac missions and leave the occupation to someone who is capable.

[skysix]

COM - 5.0 RADIO COMMUNICATIONS
Maybe we need a different call sign for non priority medevac. Maybe when on a medical transport that does require priority sequencing we should clearly identify that it is required.

Not everyone flying around calling themselves medevac is abusing the system, perhaps they are using the system how it was intended and some people don't fully understand that, or maybe they don't fully understand when to use the term since it is to my knowledge not clearly defined.

Agree x 2

[skysix]

I don't exactly understand the reasoning of your higher ups. Paramedics driving the ambulance know all the time when their patient requires an urgent or a non urgent transport. They are professionals, just like you, and if they act irresponsibly while driving the ambulance, they should be held accountable. Just like a pilot. If they are told their patient is critical and they act irresponsibly because of it, they lack professionalism and common sense. I thought pilots were in ultimate control and responsibility for what happens on the aircraft. Not knowing the status of your passengers would be a serious breach, would it not?

Part of it comes from the US where a "Mission Mentality" exists, especially in HEMS. the thought was that if the PIC did not know the pt status prior to accepting the flight then safer decisions (less pressure) would be made. Can't say if that's true anymore - nowadays there is far more corporate pressure to fly anything in order to keep flight volumes / revenue up. In any case, this morphed into quasi-official regulators and industry associations pushing it as a Safety SOP. Management often draws with paint rollers instead of drafting pens - so even after the flight is accepted by the pilot as legal and safe, and by the med crew as safe and appropriate, they want no knowledge of one sphere to cross the "cockpit curtain" into the other.

Where I work we do things differently - once those previously mentioned two (separate and simultaneous) decision are made, we get together and then decide as a CREW if we will accept or not. Sometimes we decline for aviation issues that will adversely affect the pt (turbulence, required cabin altitude, refueling stops needed etc) and sometimes for medical issues that will adversely affect the flight operations (pt wt/balance, psych status, SARS etc)

All have input, the PIC gets to be the one who relays the final decision to dispatch. "One to say no" applies - and no matter who calls it, if the concerns can't be quickly resolved to everyones agreement, WE decline. And it can be as little as a 'gut' feeling by one of the crew. Sounds a bit more like what you are referring to? (swap staging and so on where appropriate for weather concerns...)

[AOW]

COM - 5.0 RADIO COMMUNICATIONS

A MEDEVAC is a flight responding to a medical emergency for the transport of patients, organ donors, organs or other urgently needed life-saving medical material. This can also apply to certain medical flights, including helicopters, which may be designated as Air Ambulance Flights.

do you honestly read that as saying that all air ambulance flights are MEDEVAC priority?

[Doc]

A buddy of mine works for Ornge and he said it's SOP to file medevac on every flight unless they are repositioning.
As well, I am told that the pilots are not told what code the patient is anymore, so it could be a 1 or a 4. Since they don't know, they file medevac every time.

The pilot should know the patient code as a matter of course. A pilot flies. That's it. He/she has their published minimums. Period. Any pilot who operates any differently on a medevac, than they would going to pick up any group of passengers, has NO business flying ANY any airplane.
If it's not an EMERGENCY it's NOT a MEDEVAC! Ornge files medevac on every trip as SOP= abuse.

[r22captain]

If it's not an EMERGENCY it's NOT a MEDEVAC! Ornge files medevac on every trip as SOP= abuse.

call TC and get them to change the AIM?

Do you know that Ornge fixed wing has that in their SOP's?
the RW side sure doesn't.

[Doc]

If it's not an EMERGENCY it's NOT a MEDEVAC! Ornge files medevac on every trip as SOP= abuse.

call TC and get them to change the AIM?

Do you know that Ornge fixed wing has that in their SOP's?
the RW side sure doesn't.

I admit I was quoting another poster. The fact I've never heard Ornge (fixed wing) fly without the "medevac" tag, seems to support this. The RW side of things, flies as often as not without the status.

[pilotincommand]

Seen it tonight in YXU. so called "medevac" requests vectors for 15, getting priority over everyone coming in for 33. yet we all watched that crew sit on the ground for 15 minutes waiting for their passengers to arrive.

and that folks is what grinds my gears

PIC

[Les Habitants]

I agree, keep medevacs for urgent cases where the minutes count-not for old fat joe who can't walk because of a really bad leg injury.

The problem is that I have no idea on the condition of the patient when I am flight planning. The explicit policy is that I am not to be told the patient condition in advance, as someone else mentioned, so that my go/no-go decision is not influenced. Even once the person is loaded into the airplane, I am not in any position to make a judgement of their physical state. Often it is evident, if they have tubes sticking out of every orifice, but many times it's not so obvious. So if the patient kicks the bucket in the hold while Jazz is shooting the approach because I didn't file medevac status, then who looks bad?

yeah, but you can change in the middle of your flight to "medevac" status. Pilots do it all the time. "XXX, your company has called asking you to divert to XXX to pick up a passenger, are you now medevac status?" "affirm"

[Les Habitants]

I spent far too long, flying Air Ambulance flights. If the average Taxpayer knew the colossal waste of money, a large number of these are, there would be a huge outcry.

Half of the ones I used to do were nothing more than a Kentucky Fried Chicken and Beer run.

Free ride to the Big City, short stop at the hospital and a free ride home.

Hockey Bag full of KFC and Beer, thanks to the Canadian Taxpayer.

Hit the NAIL on the head!! This is the exact and unfortunate truth. As a pilot, I like this, but as a tax payer, it absolutely BLOWS my mind the amount of money wasted on medical transport for Northern Canadian patients. This is obviously not always the case, and in fact, I would say it probably is more often than not not the case, but the number of medevac flights I have seen for Joe Blo who is in a wheelchair and too fat to fit on a chair lift to go down to the big city to see a doc for his cold numbs my mind. The US doesn't have these kinds of problems! Their taxes are significantly lower because they don't waste them!

[fish4life]

I spent far too long, flying Air Ambulance flights. If the average Taxpayer knew the colossal waste of money, a large number of these are, there would be a huge outcry.

Half of the ones I used to do were nothing more than a Kentucky Fried Chicken and Beer run.

Free ride to the Big City, short stop at the hospital and a free ride home.

Hockey Bag full of KFC and Beer, thanks to the Canadian Taxpayer.

Hit the NAIL on the head!! This is the exact and unfortunate truth. As a pilot, I like this, but as a tax payer, it absolutely BLOWS my mind the amount of money wasted on medical transport for Northern Canadian patients. This is obviously not always the case, and in fact, I would say it probably is more often than not not the case, but the number of medevac flights I have seen for Joe Blo who is in a wheelchair and too fat to fit on a chair lift to go down to the big city to see a doc for his cold numbs my mind. The US doesn't have these kinds of problems! Their taxes are significantly lower because they don't waste them!

Cross lake to Thompson 2 hour drive with a stupid number of medevacs per day
Dauphin to Winnipeg 3 1/2 hour drive yet they send almost everyone that needs to go to Winnipeg in the ambulance

Why is this the case?... pure BS politics due to reserves

[turbine works fine]

Numerous times when the phone rings and its for a medevac we are told from dispatch that the customer (company representing the hospital) estimates the organ to be ready at such and such time, therefore the departure time is set in accordance with that time. Whether or not the organ is ready upon our arrival is out of our control. Therefore we wait. I have yet to do a medevac flight and be gone by the time they estimated, but at least we are there waiting and someone gets great gift at the of it all.

cheers

[cdnpilot77]

The US doesn't have these kinds of problems! Their taxes are significantly lower because they don't waste them!

Lets not go too far, thats a whole other discussion

[Rowdy]

We can all attest to the misuse and abuse of the medevac system...

Heres my take.. most of the controllers, fss etc. KNOW the local machines and are familiar with the pilots and the movements. I laughed when asked by a certain yfb'er if this was another igloolik skedevac. Obviously, in that case, we are not going to request priority. They also USUALLY ask when there are other aircraft in the vicinity if we'd like priority. Kudos to them for keeping everyone honest.

We were still filed and using the medevac callsign. This happens for simple reasons. The first being that the aircraft is there for the regional health boards usage for transportation of patients. If it is 'in service' and in the air.. on a low priority trip (broken fingers, tummy ache etc) it is now busy and should complete the trip in a sensible albeit prompt manner so that it can return to the ready state for a potential Priority. The following has happened on numerous occasions. Both the primary and secondary machine are out on routine patient transfers etc, when the call comes in for a priority. Now, I'm not fluent with the policy and length of trips in ontario, but in that part of the world where i operated, it can be upwards of 3-6hrs before the machines have returned. Try a YRB or grise fjord trip for much, much longer. Yarg. Those aircraft which are dedicated to air ambulance/medevac usage should at all times receive maybe not top priority, but at the very least the most expedient concurrent with conditions.

[mbav8r]

fish4life
Cross lake to Thompson 2 hour drive with a stupid number of medevacs per day
Dauphin to Winnipeg 3 1/2 hour drive yet they send almost everyone that needs to go to Winnipeg in the ambulance

Ever driven that 2 hr drive? Not likely, also if the ambulance is gone to Thompson, what will they use to pick up the next patient. I believe there was a time where the ambulance did attempt the trip and they hit washboards, went in the ditch and injured the patient even worse. Dauphin also has a hospital not a nursing station. It's not always political and I have seen alot of waste, the so called beer and KFC runs.
The point was also made, operate every trip as though it's a priority until someone(nurse) says otherwise and quicker back, quicker you're available for the next. I suggest unless you've lived the medevac life, you won't get it, and you'll just end up on here bitching about something you won't get.

[sakism]

This discussion is ridiculous.

If I'm in an ambulance I want to get to the hospital.
I do not want to have to wait for a parade of healthy people on their way to Cuba to cross the route that my ambulance is taking to the hospital.

If a person has been deemed to need Medevacing they should ABSOLUTELY have priority over every healthy person on the other aircraft at the airport. This has nothing to do with whether they are dying or not.

Scheduled service carrying people for medical appointments are not Medevacs at all and shouldn't use the call sign.
Repositioning flights are not Medevacs, and should not use the call sign.

All flights to pick-up a patient, or with a patient on board, should be Medevac.

[Doc]

This discussion is ridiculous.

If I'm in an ambulance I want to get to the hospital.
I do not want to have to wait for a parade of healthy people on their way to Cuba to cross the route that my ambulance is taking to the hospital.

If a person has been deemed to need Medevacing they should ABSOLUTELY have priority over every healthy person on the other aircraft at the airport. This has nothing to do with whether they are dying or not.

Scheduled service carrying people for medical appointments are not Medevacs at all and shouldn't use the call sign.
Repositioning flights are not Medevacs, and should not use the call sign.

All flights to pick-up a patient, or with a patient on board, should be Medevac.

If they NEED a medevac, I'd agree with you. Problem is, most don't NEED a medevac. Most walk on the airplane, and walk off. Some are going for appointments. Some simply missed the sked. Some have tooth aches. You have virtually no idea of what you speak. I've flown medevacs at 3:00 am in the middle of the winter in the Arctic for a fish hook in a finger. I flew from YFB to Nanisivik, then to Montreal with a kid who had a cold....in a 44 seat airplane. Believe us....most are NOT NEEDED. It is one of the most abused services in the country.
In fact, during the years, I can actually remember flying FOUR trips that were really NEEDED! Truth.

[Les Habitants]

This discussion is ridiculous.

If I'm in an ambulance I want to get to the hospital.
I do not want to have to wait for a parade of healthy people on their way to Cuba to cross the route that my ambulance is taking to the hospital.

If a person has been deemed to need Medevacing they should ABSOLUTELY have priority over every healthy person on the other aircraft at the airport. This has nothing to do with whether they are dying or not.

Scheduled service carrying people for medical appointments are not Medevacs at all and shouldn't use the call sign.
Repositioning flights are not Medevacs, and should not use the call sign.

All flights to pick-up a patient, or with a patient on board, should be Medevac.

Have you actually ever flown Medevacs? It doesn't really sound like it. Doc and other posters are absolutely right, a very large number of "medevac" flights are not very urgent (never mind the number that are actually "needed"). Do you consider a patient who has to sit in a wheelchair and is too large to fit on a lift to make the scheduled flight a "medevac?" IMO, it's just a charter that requires special equipment to get him into the plane, and NOT a medevac.

If the flight is urgent, than yes it should be a medevac, if not, than no it should not be a medevac. An ambulance only turns his sirens on and parts the traffic when he urgently needs to pick someone up/drop them off (ie, minutes count). The same should be for "medevac" call signs.

[NO LINK*]

Try as I may to drop the "Medevac" on my empty legs, I no sooner get passed to the next sector or terminal or tower and they are adding it on to my callsign. And then sometimes, from out of habit, it just slips on the end of my radio rant. It should not be a part of my callsign on regular basis.

Course the other part that bugs me is when ATC questions if I am 'priority' or not. Is this defined anywhere in the AIM?

Agreed with the one post about where the term MEDEVAC actually comes from. - and its misuse. All Air Ambulance operators in this country, save for rotary(on-site) response are merely patient transfer services. By local Health policy these patients are to be transfered when stable. And the transfers are usaully initiated from from a health facility where care is being provided. Or sure there may be times when a patient goes unstable--as there may be times when an aircraft goes unstable. This would be an appropriate time to request emergency priorrity handling.

[fish4life]

fish4life
Cross lake to Thompson 2 hour drive with a stupid number of medevacs per day
Dauphin to Winnipeg 3 1/2 hour drive yet they send almost everyone that needs to go to Winnipeg in the ambulance

Ever driven that 2 hr drive? Not likely, also if the ambulance is gone to Thompson, what will they use to pick up the next patient. I believe there was a time where the ambulance did attempt the trip and they hit washboards, went in the ditch and injured the patient even worse. Dauphin also has a hospital not a nursing station. It's not always political and I have seen alot of waste, the so called beer and KFC runs.
The point was also made, operate every trip as though it's a priority until someone(nurse) says otherwise and quicker back, quicker you're available for the next. I suggest unless you've lived the medevac life, you won't get it, and you'll just end up on here bitching about something you won't get.

Staffing and buying a few more ambulances in cross lake would more than pay for itself in the first year compared to how many $2000+ 15 min medevac's done, also Norway House has an hospital albeit not a great one... Hell the one year on Christmas eve the YTH radio guy told us we were the 26th Cross - Thompson medevac that day, explain how that can be justified costs for medevacs when you might as well charter a greyhound and you could have put 90% of those stable patients on. If the general public knew how much money was spent on medical care for these (non tax contributing) communities I think there would be a world a change. Besides what is the difference from a ambulance going into a ditch or an airplane in a crash, it can still happen. The road may not be the greatest but they could improve it and they'd still come out ahead by driving them on an ambulance compared to medevac'ing these people out. Don't get me wrong some people need the medevac flight and the difference between 2 hours and 15 minutes can be huge but for over 95% of what I've seen that is not the case.

[ArcticKat]

288

[Doc]

We should buy a Dash 8 "litter ship", 10-12 beds on board, and just "cruise" slightly north of the reserves twenty minutes after the last sked has flown the coop, and wait for the calls to come in. We'd probably have to make two trips for Christmas shopping and whenever WalMart has a sale going on. We wouldn't even need to declare "medevac" status.
Not only would we fill the puppy every night.....we'd save the system a bloody fortune!

[NO LINK*]

Easy scheduling...every second Friday..