Air ambulance to return

Eagle Air Med hopeful to have services ready by April 16

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— A Utah company plans to bring air ambulance service back to Steamboat Springs two years after local service was discontinued in the wake of a crash that killed three people.

Joseph Hunt, president of Eagle Air Med in Blanding, Utah, said Friday his company intends to base a King Air C90B twin-engine turboprop air ambulance at Steamboat Springs Airport by April 16.

Eagle Air Med officials began talking with Yampa Valley Medical Center and Steamboat Springs city officials about six months ago about coming to Steamboat after basing a similar plane in Alamosa. The company also operates air ambulances in two small northeastern Arizona cities - Chinle and Kayenta.

"We recently based a plane in Alamosa, and Steamboat Springs seemed like a logical place to put a second aircraft," Hunt said. "We think Steamboat is in need of an air ambulance because it's a pretty rural area."

Karl Gills, the hospital's chief executive officer, said he is "pleased" to have an air ambulance return to the Yampa Valley because of the benefits it provides the community.

"It will return the local availability of emergency patient transfer to tertiary care centers when the patient condition requires transfer," he said. "It puts us at a higher level of service than most rural hospitals in the state and nation."

Air ambulance service halted after a Yampa Valley Air Ambulance crashed Jan. 11, 2005, near Rawlins, Wyo., in wintry weather. Three of the Steamboat Springs-based crew, including a pilot and two medical personnel, died during the accident. A fourth crew member sustained serious injuries, but survived the crash.

Despite the lack of a local air ambulance, medical patients continue to be flown from Yampa Valley Medical Center to other facilities around the state by air ambulances out of Denver.

Christine McKelvie, spokeswoman for the hospital, said 143 patients were transferred via air ambulance from Steamboat in 2005 and 132 patients were transferred in 2006. On average, 11.5 patients are transferred a month using air ambulance services.

Paula Golden, director of emergency and outpatient services at Yampa Valley Medical Center, said having access to a local air ambulance lessens the time patients have to wait for transfer.

"Time is of the essence when you're running against the clock," she said. "The sooner you can get a patient where he or she needs to go is key in improving or enhancing outcomes."

Helicopter ambulances from Denver can take up to two or three hours to reach Steamboat because they travel slower and a greater distance to reach patients, Hunt said.

"Our goal is to decrease the amount of time a patient waits for air medical service," he said. "With crews locally based, we're able to respond in about 15 or 20 minutes."

Eagle Air Med has been interviewing some local pilots and medical personnel to staff the air ambulance, Hunt said.

Air ambulances are most often used to transport patients suffering from severe trauma, cardiac or neurological problems or other medical issues the hospital is not equipped to handle, Golden said.

City officials said they have not received an official proposal from the company to base at the Steamboat Springs Airport.

Airport Manager Mel Baker said the company would have to go through a licensing process before it would be able to begin operating.

"We would have to wait and see what kind of agreement (Eagle Air Med) has made with the hospital before we'd move on anything," he said. "They've been in town a few times looking at our field, and there doesn't appear to be any problem with them flying out of here."

Eagle Air Med officials are in the process of preparing necessary paperwork to move forward, although Hunt did not know when anything would be finalized.

Comments

danaeka 7 years, 8 months ago

"Helicopter ambulances from Denver can take up to two or three hours to reach Steamboat because they travel slower and a greater distance to reach patients, Hunt said."

Mr. Hunt might want to recheck his numbers and the location and flight time of these "helicopters" This is simply not true. When you take into consideration the time involved of transferring a patient by ground ambulance to and from an airplane, helicopters in fact in this scenario, geneally provide a faster delivery of the patient because of their ability to fly door to door with a patient.

I also don't know where he is getting the "greater distance" number from. Last time I looked, the two helicopter programs in Denver are located closer to Steamboat than the airports. In addtion, helicopters can generally fly direct routes where fixed wing must conform to some type of approach pattern at the busy front-range airports.

In addition, travel time to hospitals from the airport in Denver can be dangerously delayed due to rush hour (which is most of the time), either resulting in a delay in care because a patient sits in the back of an ambulance on the freeway or having to call a helicopter to the airport to transport the patient.

I don't have a problem with Mr. Hunt wanting to put a base in, but do have a problem with him giving inaccurate information about the fine programs who have been providing a service to this community.

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id04sp 7 years, 8 months ago

Danaeka,

Are you a helicopter pilot? I am.

Helicopters do not have the anti-icing capabilities of fixed wing airplanes, and cannot climb above the weather to escape icing conditions. Further, they are not pressurized (don't need to be), and exposing patients to the low oxygen levels at 12,000 to 14,000 feet to get over the mountains is dangerous. Sometimes even healthy people suffer from going to those altitudes. Giving them supplemental oxygen is not the answer because of the lower atmospheric pressure. There is quite a big difference between the partial pressure of O2 getting to the patient at a cabin altitude of 8000 feet (usually what you find in a pressurized aircraft) versus 12,000 or 14,000 feet.

Turbulence due to winds over the peaks is also much worse in a helicopter, because they cannot fly high enough to avoid it.

Also, helicopters have to slow down at higher altitudes because the air is less dense. The forward speed has to be reduced to avoid "retreating blade stall" which, if it occurs, can rip the rotors and transmission right off the airframe. Not a good idea, huh?

You may have seen the video of a National Guard Blackhawk helo crashing on Mt. Hood or somewhere in Oregon or Washington state because of the high altitude and low air density which puts the machine on the very edge of controllability. A Blackhawk is about as capable a machine as you can get for high-altitude work, and no doubt better than anything the emergency medical services are flying. Sure, some helicopters can go to 20,000 feet, but nobody talks about what they have to do to get there. Believe me, you don't want to be in a helicopter at 14,000 feet if you're trying to get to a hospital. It's different if you only need to get to the cemetery.

A pressurized, fixed wing turboprop airplane capable of speeds over 200 knots would have significant advantages over a helicopter from YVRA to Denver almost any day of the year. On days with bad weather (icing), the airplane "might" make it. The helicopter would not make it at all. This is because the airplane can climb into colder air where it's too cold for icing (because the water droplets are frozen and won't stick to the airframe), while the helicopter has to fly right there in it and will pick up ice quickly.

Oh, and also, helicopters cost roughly 3 times more to operate than a fixed wing aircraft with a comparable payload.

So, what about heli-skiing? They take a light load and fly slower, and only operate when the weather is good (favorable winds, no icing, etc.).

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danaeka 7 years, 8 months ago

I responded once, but it didn't seem to show up. Apologies if this gets posted twice!

id04sp,

The point of my comment was to dispute Mr. Hunt's statement that helicopters coming from the Denver area take 2-3 hours to get to Steamboat. This is just not true. Of course the aircraft you are describing is faster than the helicopters. I'm not talking about a direct comparison of flight times, but the "bed to bed" time for a critical patient. The patient has to get from the hospital to the airport and once at the other airport, has to get to the hospital. This can significantly extend the transport time depending on MANY factors including traffic, location, etc. Moving a patient in and out of different vehicles has inherent risks as well.

I am well aware of flight physiology and any competent air-medical professional will weigh the risks and benefits of the different modes of transportation. Factors taken into consideration include time and what type of emergency condition exists in the patient. Certainly there are conditions where considerable time at altitude is detrimental. A few conditions require a pressurized aircraft.

I also never claimed that it was appropriate to fly a helicopter in icing conditions. A helicopter is clearly not a choice in adverse weather. Sadly, as this community has experienced, fixed-wing can have issues with icing as well. The front range programs also have fixed wing capability including a Lear jet.

Comparing what the air-medical companies in the state do with the tragedy on Mt. Hood is not a fair comparison. These companies do not participate in the type of high altitude rope rescue that crew was attempting on the day of the crash. These companies do not accept, nor do they fly those types of missions.

Transport or any treatment for that matter should be a careful balance of risks and benefits. Cost is certainly important, but should not be the deciding factor when time is an issue. If we want to compare costs, then you should include the cost of ground transport. (And no, I am not saying ground transport is appropriate for every patient.)
Dana D.

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dundalk 7 years, 8 months ago

Having summoned Flight for Life Helis for patients at YVMC, I can attest that it doesn't take 2-3 hours to have the flights arrive at the hospital.

In fact, we had one coming from Summit County which arrived at least 20 minutes before we epxected its original eta.

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id04sp 7 years, 8 months ago

It is INDEED fair to compare a helicopter air-evac operation to the Mt. Hood tragedy (thanks for clearing up the location for me). Mt. Hood is 11,249 feet at the peak. The Eisenhower Tunnel is at 11,158 feet.

The minimum enroute altitudes from Steamboat to Denver can be as high as 16,000 feet (for IFR flight). If you were going from Steamboat to Denver at night, that's how you would do it by the most direct route.

Turbine powered helicopters have been around since the 1950s. It's not a new technology. The fact that you don't find them doing air-evac in the high country already should tell you something; it is not safe or practical. If it could be done safely and economically, somebody would already be doing it.

A fixed-wing airplane that can take off from YVRA and go direct to Denver at 20,000 - 25,000 feet is a much better choice than a helicopter that may be operating on the edge of it's performance envelope and having to pick a route through mountain passes.

The helicopter option could be useful from the airport to the hospital on each end, but again, at what cost?

Are we really prepared to bear a cost of a couple of million bucks a year just to have a helcopter sitting around to take somebody 20 miles? An ambulance with a police escort is almost as fast.

On the other end, a helo from the airport in Denver to a hospital makes a lot of sense. Denver can probably support a helo air-evac service.

The Maryland State Police have a great record with helo air-evac services, but the highest mountain in Maryland is 3,360 feet.

Part of life in the mountains is dealing with the remote locations and lack of emergency medical care on short notice. People are occasionally going to die because of it. If you require quick care, or you have a high-risk pregnancy, you either have to assume the risk OR move to lower ground. It's foolish to think that we're going to have a rocket-sled ambulance from Routt County to Denver to serve a population of 20,000 people. The economics just won't support it.

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id04sp 7 years, 8 months ago

Danaeka,

Go get yourself an enroute IFR chart and a pilot with an instrument rating and look at the airways routes from Denver to Steamboat.

The MEA (minimum enroute altitude) and MOCA (minimum obstruction clearance altitude) restrictions are not arbitrary numbers. An aircraft flying on the IFR airways between Steamboat and Denver has to maintain the MEA in order to stay in radio and radar contact with air traffic control. It's a fact of life, and that's how the system operates.

There is a huge difference between operating at 7,000 or 8,000 feet along the front range and flying in instrument conditions, at night, over the Continental Divide.

I'll grant that the equipment flown by front range operators may be capable of doing the job, but if so, why aren't they pushing to do it?

You may notice that a lot of the video from Afghanistan shows the CH-47 Chinook helicopter in action. The Chinook can lift more than any other helo in U. S. Military service, and that translates into being able to fly faster and higher in the mountains because they can carry a load far below their maximum allowed gross weight and still get the job done. With helicopters, you always have to trade off the weight, airspeed and density altitude. The details are in the individual flight manuals. My point is that, while the front range operators can probably do very well at lower altitude, when you have to load the helicopter with enough fuel to make the flight, crew weight and eqiupment weight, and then add the passenger, the combination of gross weight and density altitude may require them to slow down significantly to stay within the flight envelope.

The only example I can find online is for an older helo with a VNE (velocity never exceed) of 86 mph at sea level. At The same rotor RPM, the VNE decreases to 65 mph at 6,000 feet density altitude. That's almost a 25% decrease. Your 140 knot helo at 6,000 feet may be a 70 or 80 knot helo at 13,000 feet. Add a headwind to that (from Denver to Steamboat), and your speed advantage over ground transportation may disappear. If it's going to take 2 hours to get a helo to Steamboat from Denver, and 1-1/2 hours to get back, what's the advantage of a helicopter? You'd have to base the helo in Steamboat to obtain any advantage at all.

Let me be the first to say that your idea was GREAT! I'm all for it. It's just that the realities of helo performance may not make it possible. Since that's the only reason I can think of why somebody would not be champing at the bit to provide the service, it's likely that performance is the problem.

I chose to be a helo pilot because it was a way to have a humanitarian purpose in a military career. I'm proud of what I did, and of the people I helped to save. I simply believe that helo limitations traded against fixed-wing advantages come down in favor of a fixed wing air ambulance from Steamboat to Denver.

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MC 7 years, 8 months ago

Just a thought so don't kill me on this but has YVMC thought of using St. Mary's in Grand Junction for their emergency destination? This is a state of the art facility, including cardiac care, and is only 45 minutes, by helicopter, without the altitude. Why risk flying at high altitudes to Denver when the same care is available just south of here? The facility in Craig has used the St. Mary's system for years with success and the copter lands right in the front yard of the hospital. Just a thought.

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dundalk 7 years, 8 months ago

YVMC utilizes several high trauma-level hospitals in and around the state of Colorado. For instance, if the route of Rabbit Ears and due east traffic is too dangerous because of winds, St Mary's will be utilized.

For instance, some head traumas may be sent to Sweedish in Denver when a unstable C-Spine patient might go to St. Mary's, Denver Health or St. Anthony's. St Anthony's has a Heli based in Summit County.

Some profound burn injuries (3rd degree) will go to Greeley, CO because they have top knotch burn doctors.

Our local flight avenues are to call "Flight for Life" (which is the service) and then find out from our admitting physician where they would like the patient to be sent. Alot of this depends upon the severity of patient and/or injury. After establishing what hospital we want patients to go to, we then need to contact the hospital itself and see if a physician will "accept" the patient, and has a bed for that patient.

Poudre Valley in Ft. Collins has a good grasp on cardiac patients and often times we will send patients there. However, say Poudre couldn't take the patient, then we might go to DG instead.

Flight for Life has both Heli and fixed wing contracts and one of the advantages of having a Heli land at the hospital is that they usually get to us quickly and there is no need to utilize the fire department to transport the flight crew from the airport to the hospital.

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danaeka 7 years, 8 months ago

id04sp wrote:

"It is INDEED fair to compare a helicopter air-evac operation to the Mt. Hood tragedy (thanks for clearing up the location for me). Mt. Hood is 11,249 feet at the peak. The Eisenhower Tunnel is at 11,158 feet."

Ido4sp- If you are really a helicopter pilot, you would know there is a significant difference between HOVERING in rotorwash right above the ground at 11,000 feet with a rope dangling below, compared to flying at 140k several thousand feet above the terrain. There is a significant difference between what that program was doing and what the air-medical programs in this state do. Perhaps you should read the report on the cause of the accident and the details before you compare it to the type of flying the programs do here.

id04sp wrote: "Are we really prepared to bear a cost of a couple of million bucks a year just to have a helcopter sitting around to take somebody 20 miles?

Umm.....I don't ever recall saying this community should bear the cost of putting a helicopter in Steamboat or an airplane for that matter. It is not a good choice, especially when there are very good options available in the state already which are MORE than capable of handling the 120 patients a year that come from the area. Again, you are launching into subjects that had nothing to do with what my post was about. I also don't recall that the community has agreed to pay for any type service. One-hundred patients a year is not justification for any multimillion dollar aircraft plus crew and training.

I personally believe the air-medical should be left to the companies operating THOUSANDS of flights a year, not 100. The staff is trained to handle all types of emergencies and deal with a significant enough case load to be current in their care and skills. Yes, Eaglemed is a CAMTS program and they do operate a number of bases however, they indicated they would use local staff. The programs in Denver are large enough to have specialty pediatric, obstetrical and neonate programs.

MC - yes, sometimes St. Mary's is a good choice. Like Dundalk said, it really depends on the type of patient as to what is the most appropriate facility.

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id04sp 7 years, 8 months ago

Yes, I certainly do know the difference between hovering out of ground effect and flying at 140 knots.

How about you going and learning about retreating blade stall and density altitude, and see how all of that effects performance at 16,000 feet.

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danaeka 7 years, 8 months ago

The flight programs do not fly at 16,000 feet in their rotorwing aircraft although their aircraft are capable of doing so. The aircraft are more than capable of performing in the capacity they are used for and for you to indicate otherwise, is erroneous. To accuse these programs of "operating on the edge of it's performance envelope" is wrong.

Ok ...done posting about fictious material that does not accurately describe what any of these front range programs do.

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id04sp 7 years, 8 months ago

Danaeka,

responding to your private e-mail . . .

From the time you call Denver to dispatch a helicopter, how long does it take to get the patient to the hospital down there? I'm still guessing it's 2-1/2 to 3 hours for the helo to go round trip. That was my point. If it's a 3-hour round trip, what's the advantage to the patient to wait for a helicopter versus going direct from Steamboat to Denver by fixed wing.

If it's ME, take me by fixed wing, period. Much safer than a helicopter in the mountains any day of the year.

As for "VFR" only and all that, sure, it's great if you can work it.

As always, getting the patient to the required level of care ASAP is the most important thing.

Is the problem that calling a helo from Denver cuts into the fixed-wing revenue? That may be a viable reason to go fixed wing if, on the average, it benefits a greater number of patients in the long run.

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