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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Post-Intubation Sedation
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Post-Intubation Sedation, 0
Scott Weingart discusses Post-Intubation Sedation.
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The Perils of Peer Review
Ka, , 2016, The Talks smaccDUB 2016, bmj, iconoclastic, journals, Peer review, publishing, quality assurance, richard smith, 0
Peer review is central to science, but ironically is faith rather than evidence based in that it lacks evidence...
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Fiji Critical Care Jenga
Ka, , 2016, The Talks smaccDUB 2016, critical care, developing, Fiji, Jenga, 0
Providing critical care in a developing system is extremely challenging and can be likened to "Critical Care Jenga."
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Where is the love in critical care
Ka, , 2016, The Talks smaccDUB 2016, compassion, critical care, Family Centred Care, Leadership, Love, passion, Purpose, Resilience, Teams, 0
Critical Care is a place where love/passion and commitment must flourish, professional to patient, leaders to teams and colleagues,...
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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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Minor Injuries? Major Trauma!
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Paediatric major trauma, smaccMINI, 0
Paediatric major trauma is rare and terrifying. Seriously injured children need good care but a number of factors (the...
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Small Packages, Big Lessons: Neonatal and paediatric retrieval
Phoebe Adams, , 2016, The Talks smaccDUB 2016, neonatal, 0
Hazel Talbot provides an insightful look at neonatal and paediatric retrieval in her talk “Small Packages, Big Lessons”.
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Bad Blood
Ka, , 2016, The Talks smaccDUB 2016, ADAMTS13, HIT, HUS, non-malignant haematology, purport fulminans, TTP, X DIC, 0
Non-malignant acquired haematological disorders in critical care - DIC, TTP, HUS and other MAHAs, ADAMST13, HIT and NETosis,