Maryland boasts nation's best medical evacuation system
| • | Neighbor Isle medical transport system lacking |
| • | Military may help in emergency situations |
By Beverly Creamer
Advertiser Staff Writer
Sprawling, rural Wyoming has only one private company providing air ambulance services to a single central state trauma unit.
Mountainous Washington state has two major air ambulance systems, one with a Lear jet that can fly patients from Juneau, Alaska, to a Seattle trauma center in less than four hours.
In Delaware, the state police pick up patients in choppers.
It's the same in New Jersey, where there are two helicopters, one in the northern part of the state and one in the southern.
In rural areas of Idaho and Montana, helicopters typically are based throughout the state at major referral centers, with costs coming out of the state budget.
But it's Maryland that blows the rest of the country out of the water. The state has no fewer than 12 state-of-the art air ambulance helicopters costing $6 million apiece and fitted not just with the latest air medical evacuation equipment, but with hoists to pull people off burning buildings, infrared sensors for night rescues, and advanced life support equipment.
In its 25 years of service, the emergency helicopter system has airlifted more than 75,000 patients to trauma centers. Each year, a celebration is held to honor the service, and many former patients whose lives were saved are brought together to participate.
The cost to operate the air ambulance and rescue system is $12 million a year and comes from an $8 surcharge on motor vehicle registration.
"We don't charge for any of our transports," said Dr. Robert Bass, executive director of the Maryland Institute for Emergency Medical Services Systems.
Back in the 1960s, Maryland set the standard for trauma care with its Shock Trauma Unit at Maryland Institute of Emergency Medical Services in Baltimore, under Dr. R.A. Cowley, whose theory of "the golden hour" has been the abiding standard of care.
"It said if you got a severely injured person to a trauma center within 60 minutes, their survival rate was very much increased," said Eileen Frazer, executive director of the Commission on Accreditation of Medical Transport Systems, which certifies air and ground emergency evacuation companies nationwide.
"And the longer you went over that hour, the less the chances of survival."
Even with the Maryland example, there's nothing uniform anywhere in the country.
Seattle's Airlift Northwest, centered at the state's major trauma center at the University of Washington's Harborview Medical Center, operates four choppers and four fixed-wing aircraft including two Lear jets based at six locations and covering four states.
The choppers can scramble in 5-7 minutes and the Lear jet based in Juneau can have a patient from Alaska to the Seattle hospital in less than four hours.
Seven hospitals are part of the consortium that fund the service.
"They see it as an essential regional service," said Toni Long, associate executive director of Airlift Northwest, which is paid in full by the hospitals, which rely on insurance reimbursements.
While Maryland's system was already under way, civilian air ambulance services got a major boost in the mid-1970s when the Vietnam War ended and the military brought back en masse its helicopters used for medical evacuations. Soon after, the Army's MAST (Military Assistance to Safety and Traffic) program began.
"They decided 'Hey, we have all these aircraft; why don't we help out the local populations?' " said Army Maj. William Grimes, commander of the 68th Medical Company at Wheeler Army Airfield, which has had the longest running MAST program dating from those days.
Across the country, Vietnam-era Huey helicopters went into service to transport civilian patients. But as private air ambulance companies started up, service by the Hueys tapered off.
There's no real way to beef it up again, said Grimes, because budgets are already set and the choppers have been put to other uses.
Today, the MAST program on O'ahu flies Army Black Hawk helicopters to rush accident victims from outlying areas to downtown hospitals. The program is the largest of its kind in the country.
But it's not perfect.
There isn't even enough state money to buy radio links from the choppers to the Fire Department for use during emergency airlifts.
"We wave out the window," said Grimes.
