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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The FemInEM Story
Phoebe Adams, , 2016, The Talks smaccDUB 2016, feminem, feminism, SMACCDub, women in medicine, 0
We accept that knowledge translation is critical to the practice of emergency medicine, yet when it comes to the...
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Cooling the Injured Brain
Ka, , 2016, The Talks smaccDUB 2016, tbi, traumatic brain injury, 0
Evaluating the evidence supporting Hypothermia after severe brain injury.
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Mallemat: Get Your Tech On
Ka, , 2016, The Talks smaccDUB 2016, Drone, robotics, technology, telehealth, 0
Technology is advancing many facets of our lives, yet healthcare seems to be behind the curve.
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Tactical Medicine in Response to the Active Shooter
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Active Shooter, Crisis, ems, HEMS, heroism, high pressure situation, Human Performance, Performance Psychology, PHARM, prehospital, safe, Safety, SMACCDub, 0
Cops and robbers, cowboy and Indians, and military movies have filled the minds of generations of healthcare providers with...
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Confined Space Airway Management
Ka, , 2016, The Talks smaccDUB 2016, Airway, airway management, austere, confined space, disaster, HEMS, intubation, prehospital, remote, 0
Locations, challenges, options, techniques and evidence behind managing airways in confined spaces and austere places.
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How I use inhaled Nitric Oxide -iNO
Ka, , 2016, The Talks smaccDUB 2016, critical care, iNO, intensive care transport, nitric oxide, NO, prehospital, Resuscitation, retrieval, 0
Inhaled nitric oxide is extremely usefull for creating a "bridge" to other options as well as in resuscitation on...
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DNR Should Be The Default: PRO – Alex Psirides, CON – Sara Gray
Phoebe Adams, , 2016, The Talks smaccDUB 2016, CPR, default, DNAR, DNR, Do Not Resuscitate, End of life, End Of Life Care, Ethics, Futility, Resuscitation, SMACCDub, 0
Alex Psirides – PRO The application of ‘CPR-for-all’ is the ultimate evidence drift. A treatment that is completely appropriate...
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The challenges in the prehospital management of sick kids
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Uncategorized, paediatics, prehospital, SMACCDub, Trauma, 0
Fight, Flight and (more commonly) Freeze are common reactions when faced with the critically ill child. In this talk...