The development of Helicopter EMS (HEMS, or as the Federal Aviation Administration recently coined it: “Helicopter Air Ambulance” or “HAA”) services in the United States has taken a decidedly different path in recent years compared to those in other countries. The wide spread use of single engine, VFR only aircraft, owned and operated by for profit companies is a uniquely American phenomena; at odds with most other countries who have developed HEMS programs around the world. This has resulted in significant direct competition between HEMS programs, as well as highly questionable billing practices that have started to garner attention. The origins of this development, including the use of the US “Airline Deregulation Act” to prevent states from regulating HEMS programs will be examined. More recent efforts in the US to tie reimbursement and program accreditation to the levels of care provided and minimum standards of equipment are still nascent at this time. Efforts by the US National Transportation Safety Board (NTSB) to mandate improved safety equipment standards have been met with resistance by the industry and the FAA. This has resulted in wide variability in US HEMS programs and the adoption of IFR standards, mandating NVG use, twin-engine aircraft and risk assessment strategies. There is also increasing scrutiny being placed on appropriate utilization criteria in the face of skyrocketing bills and questionable billing practices by for-profit companies.
Standards in HEMS. What standards?
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Is survival predetermined in the critically ill
Ka, , 2016, The Talks smaccDUB 2016, critical illness, Early prognostication, Novel therapy approaches, Sepsis, 0
Many, many studies show outcome can be predicted early, even in the ED - if so, do we need...
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Sepsis—The Dark Knight: Prehospital Diagnosis and Treatment
Ka, , 2016, The Talks smaccDUB 2016, Sepsis, 0
Sepsis can be subtle and elusive; diagnostic tools such as point of care lactate, end-tidal CO2 monitoring and validated...
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The Immediate Responder & The Disaster Gap
Ka, , 2016, The Talks smaccDUB 2016, bystander, disaster, disaster gap, ems, fire, first responder, immediate responder, MCI, police, preparedness, resiliency, response time, Trauma, 0
Transform education, response, and recovery in disaster response by exploring the Disaster Gap and the Immediate Responders in it.
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EM Year in Review
Phoebe Adams, , 2016, The Talks smaccDUB 2016, critical appraisal, cutting edge, emergency medicine, literature, publishing, science, SMACCDub, updates, 0
Ryan Radecki There are nearly 100 billion stars in the Milky Way – and almost that many articles published...
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Blood: Sweat & Tears – Lisa McQueen
Ka, , 2016, The Talks smaccDUB 2016, paediatric circulation, pediatric circulation, Shock, smaccMINI, smaccUS, 0
Lisa McQueen reframes what we think we know about shock in paediatric patients.
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The ICU is no place for the Elderly – PRO: Francesca Rubulotta, CON: Karin Amrein
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Elderly, ICU, 0
Francesca Rubulotta and Karin Amrein both came out swinging in this debate that universally gets people going! The crowd...
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Why your hospital is broken
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Deteriorating Patient, Medical Emergency Teams, MET, Rapid response systems, RRT, SMACCDub, 0
As patients becomes more complex, the tribal systems we use to look after them remain stuck in the 18th...
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The Golden Fleece, Golden Hour & Golden Rule
Ka, , 2016, The Talks smaccDUB 2016, gender difference, gender equality, women, 0
Myths and legends that have stood the test of time, guiding behaviors and attitudes in EM.