KNAU and Arizona News
3:25 am
Fri July 4, 2008

Flagstaff Helicopter Crash Sparks Concerns About EMS Flights

Flagstaff, AZ – Host Intro:

When two helicopters collided in mid air over Flagstaff last Sunday, the deafening boom of the crash echoed like a cannon shot across town. It was followed by shock and sorrow. Some of the six victims rescue workers pulled from the burning wreckage were people they knew and worked with. As Arizona Public Radio's Daniel Kraker reports, the crash has raised wider concerns here and elsewhere about the dangers of emergency flights.


In Flagstaff Medical Center's Emergency Department, this is a sound doctors and nurses here quite a bit.

Bring up sound of EMS alert

It means medical transport, this time a helicopter, is on its way.

Some ambi of doc responding to call

(Start sneaking up helicopter sound under this track and actuality) On a typical day about three medical choppers touch down here, ferrying patients from far-flung rural communities, from the Grand Canyon, to Lake Powell, to the Hopi and Navajo reservations. Over the past two decades, it's become a much more common sound. Emergency medical flight hours have doubled in that time nationwide, and the Flagstaff hospital has seen a huge increase as well.

AX1: It's crucial and it does save lives.

That's Bill Ashland, a former flight nurse and now manager of Flagstaff Medical Center's trauma program. He says helicopters have become even more important as small, rural hospitals close emergency rooms and cut expensive, high-tech treatments.

AX2: That's why we have trauma centers, in order to get those patients there in a rural area like Northern Arizona it's just prohibitive to load them on an ambulance, on a backboard, with possible neck fractures, internal bleeding

Helicopters are also staffed with medics and nurses with more advanced training than ambulances typically carry.

(fade out helicopter ambi) But as the number of medical helicopters has increased there are now over 800 nationwide so have the number of accidents involving air medical transport. Just two days before the collision over Flagstaff, a medical helicopter crashed near Ash Fork, injuring all three crew members. Nationwide there have now been 10 crashes so far this year, with 16 fatalities. That puts the industry on pace for its deadliest year ever.

AX3: We are extremely concerned with the high number this year particularly of EMS accidents, that we are being required to investigate.

That's National Transportation Safety Board Chairman Mark Rosenker. At a press conference in Flagstaff after the crash, he said the numbers were disturbing, and called on the Federal Aviation Administration to adopt new safety regulations for the fast-growing industry for example more training for dispatchers, and mandating more high tech equipment like night vision goggles.

But critics of the industry say stricter safety measures may not go far enough. Bryan Bledsoe is an emergency physician outside Dallas.

AX4: The medical evidence fails to show really any benefit whatsoever from helicopter transport, granted, there may be a very, very small subset of just extremely ill patients who benefit, but the vast majority of literature shows that these patients would do just as well when transported by ground.

Bledsoe published a study two years ago that found as many as a quarter of patients flown to hospitals have injuries so minor they're not even admitted.

AX5: We've got to get the physicians and paramedics on the scene to really use the helicopters only for those patients where the benefits exceed the risks.

AX6: What we are doing in those cases, is erring on the side of doing what's best for the patient.

Dr. Jeff Daniel is director of EMS services at Flagstaff Medical Center.

AX7: You have to look at it on the front end, on what is the suspicion that we have a patient who's critically injured, regardless of what ultimately happens with that patient.

While the cause of the crash above Flagstaff is still under investigation, what is known is that the Grand Canyon community lost two critical emergency workers. Tom Clausing was a longtime paramedic at the Canyon who died in the collision. Mark Yeston is a Grand Canyon backcountry ranger who knew him well.

AX8: In 26 years that I've been in EMS I've lost a total of now 8 friends and professional colleagues in helicopter crashes. That's a lot.

Yeston says everyone in the industry knows there's risk involved. But the reward, the chance to save lives, he says, is worth it. Still, every time he goes in the air, he says a little prayer before take off, and gives thanks, when the helicopter touches down.

For Arizona Public Radio, I'm Daniel Kraker in Flagstaff.