Florida Times-Union: Air ambulances illustrate that seconds really matter

By David Ebler, physician

As a trauma surgeon, I have a deep understanding of how important emergency air medical transport can be when a patient’s life is on the line.

Trauma patients often require time-sensitive care that can only be delivered by specialized or advanced medical facilities that may be miles away.

As just one example, on Mother’s Day, a young child was brought to our facility by air ambulance, transferred from a community hospital that realized it was not equipped to provide the level of care required.

Thanks to our ability to respond rapidly, I was able to have a completely different conversation with the child’s mother that day. I was able to let her know her child was alive and stable. I do not believe that would have been possible without the speed and availability of the emergency air ambulance.

However, many similar lifesaving air medical services are at risk of closing in Florida and around the country.

A large part of this financial strain is a result of the inadequate rates of reimbursement for air medical transport providers from Medicare, Medicaid and some private insurers.

Providers often don’t get reimbursed the full amount it costs to transport patients at their time of urgent need.

Air medical transport is expensive, especially when you factor in the costs of operating a 24-hour base, maintaining flight equipment and keeping experienced medical staff on standby. These expenses are necessary to deliver top-notch medical care to critically injured patients.

We cannot afford to cut corners. Clearly, policymakers at the state and federal levels need to make sure the cost of operating these services is adequately addressed by federal programs and private insurance.

While an air ambulance service is no guarantee of a full recovery, if we can make a measurable difference in the lives of most of these patients, shouldn’t we? Air medical transport is a critical part of our health care system and one that everyone should have access to, regardless of cost, in their time of greatest need.

David Ebler

Ebler is a physician, assistant professor of acute care surgery at the UF College of Medicine – Jacksonville and medical director for TraumaOne Flight Services at UF Health Jacksonville.


Source: http://jacksonville.com/opinion/letters-re...

Statement from Save Our Air Medical Resources Campaign Lauding Introduction of H.R. 3378, the Ensuring Access to Air Ambulance Services Act of 2017

Washington, D.C. (July 26, 2017) – The S.O.A.R. campaign and its partners applaud the introduction this week of H.R. 3378, the Ensuring Access to Air Ambulance Services Act, by U.S. Representatives Jackie Walorski (R, IN-02), Suzan DelBene (D, WA-01), Bill Johnson (R, OH-06), Raul Ruiz (D, CA-36), and Pete Sessions (R, TX-32). The proposal is an important step in ensuring that communities across America, particularly in rural parts of the country, have access to life-saving emergency air medical services.

“S.O.A.R. stands in full support of this important bipartisan legislation, which will help bridge the gap between rural and urban communities’ access to emergency care when it’s needed the most,” said S.O.A.R. spokeswoman Carter Johnson. “Today, emergency air medical services are being threatened by low government reimbursement rates, including federal Medicare reimbursement rate that has not been updated in 20 years, resulting in a major reimbursement shortfall. This legislation brings us one step closer to fixing that, and ensuring that all Americans, no matter where they live, can rest assured that they have access to emergency air medical transport if they ever need it.”

Medicare and Medicaid dramatically under-reimburse for air medical services, and the majority (70 percent) of patients who are transported have Medicare or Medicaid, or are uninsured altogether. A recent study shows that Medicare reimburses only 59 percent of the true cost of service. In some states, Medicaid reimburses less than half of the cost of fuel alone for a transport. Repeated extreme under-reimbursement is making it more difficult for air medical bases to remain open, and where they remain, costs are unduly shifted to the 30 percent of patients who have private insurance.

Today, one in four Americans—85 million people—can only get to a Level 1 or Level 2 trauma center within an hour if they are flown by helicopter. At the same time, hospitals—especially in rural areas—are closing at alarming rates, with 78 rural hospitals closing their doors since 2010. As a result, access to emergency air medical transport has never been more critical.

Specifically, the Ensuring Access to Air Ambulance Services Act of 2017 will:

  • Require air medical operators to collect and submit cost data to HHS so that it can develop an accurate payment system based on actual costs of providing care;
  • Establish a mandatory air medical quality reporting program;
  • Implement a value-based purchasing program to promote high-quality air medical services; and
  • Provide reasonable immediate, but temporary, relief to providers while the data collection and analysis is occurring; and
  • Designed to be budget neutral.

For more information on the legislation, see here. For more information about the S.O.A.R. campaign and the effort to preserve and protect access to emergency air medical services, see here.


WCBD-TV: 4 year old girl saved by MUSC doctors

By Colby Thelen

 A four year old girl is alive and recovering, a week after a series brain injury nearly took her life.

Annie Nichols arrived at MUSC Children’s Hospital in critical condition, with little time to spare. She was lethargic with one pupil was dilated, the result of an epidural blood clot that was pressing on her brain.

It formed after an accident on Saturday afternoon. She and her younger brother were playing in the pool and a little bit of water leaked into the family garage. While running through the garage Annie slipped and hit her head on the concrete.

A little shaken up, she was brought inside and watched closely. A nurse, and friend of the family, checked for a concussion, but she seemed to be doing fine. Her father Billy says that she even got up and came outside with him while he grilled out.

45 minutes later she began screaming that her head hurt and wanted to close her eyes. Her parents knew it was time to take her to the hospital. They arrived at the Waccamaw Community Hospital and were immediately taken back for a cat scan.

Billy says what happened next was surreal.

“They immediately came out and said this is big, were going to need to airlift her to MUSC,” he said.

Turning to prayer, the family waited for the helicopter to arrive. It was a ride that was nearly unable to make it. It was booked for a call elsewhere, but that trip was canceled. It also appeared as if a storm would block their path, but it stalled in Florence long enough for them to pass.

“All those were signs from God for us,” says Billy.

When the helicopter arrived Annie was immediately rushed into the O.R. which was prepped and opened by the team of neurosurgeons, led by Dr. Stephen Kalhorn.

“She was as close to dying as you can get,” recalls Kalhorn. “She was knocking on deaths door.”

Removing the blood clot is a common procedure in their field, but he says removing it from the brain of a child with so much life ahead of her was a daunting task. But the staff moved quickly and efficiently, pulling back a small section of her skull, removing the blood clot and stopping the rapid flow of blood coming from a tiny puncture in her brain.

“I’d say within 15 minutes we had the epidural blood clot out of her head,”  says Dr. Kalhorn. His eyes fill with tears as he goes on to talk about the efforts of his staff. “one of the most impressive concerted efforts to help a patient than I’ve ever seen,” he added, “it’s why we do what we do. It’s what we’re called to do.”

Annie has a long road to recovery ahead of her. It could be weeks or even months of rehabilitation and therapy.

Her dad now wears her favorite necklace around his wrist, waiting for the moment she is able to ask for it back, which he says she won’t hesitate to do when she is well. He says they are still amazed at the heroic efforts of all the parties involved. He now describes them as his miracle team.

As for Doctor Kalhorn, he says the operation’s success was like pitching a no hitter in the last game of the world series. He says he will be forever amazed by the staff and network of MUSC.

From here, Annie will go to a children’s hospital in Charlotte where she will undergo rehab. Her parents now pray that they’ll soon see their funny, happy child smiling and back to normal, and they say if this experience has taught them anything it’s the power of prayer.

Source: http://counton2.com/2017/07/08/4-year-old-...

San Antonio Express-News: Celebrate freedom and service on July 4

By Neil Murray

For our family, the Fourth of July holiday is one of our favorite days of the year.

It’s a day when everyone of us shows our pride in our country. We visibly shed all doubt about the promise of freedom that our nation still provides the world. And we truly understand, if only for this one day, the deep obligation we have as the most powerful force for good the world has ever seen.

For those of us who served in the armed forces, it’s yet another opportunity to not just wave the flag but to remember those who served with us overseas, fighting for the freedoms we enjoy, and to think of those who never made it home.

I’m asked from time to time “why we do it.”

As a veteran, I can tell you that those who join up do so for their own reasons, from a desire to defend country and Constitution, to stuff that’s much more deeply personal.

My story in the Air Force began right after 9/11. I was drawn to the military’s unrelenting drive for excellence in everything it did. As a combat medic in Afghanistan, deploying in support of an elite team of special operators, I had to know my medicine, had to be ever mindful of safety, and had to make good decisions in times of stress. That’s what lured me, in addition to love of country and a desire to defend our way of life against the terrorists who struck at us, killing 2,996 when the towers fell.

While we may join for different reasons, we stay and we fight and we give our lives for one. That’s love for one another, for the brother or sister who’s next to us in the foxhole or, in my case, the helicopter.

That may surprise some people. The notion that love keeps us in the service. But it does.

When you prepare for war together, you get to know people. You know their spouses, you know their kids, you’ve heard conversations with family back home when those on both ends of the phone call shed tears.

I can tell you that there is nothing more worth fighting for than to make sure your brother or sister in uniform gets home to see those children. And there’s nothing more heartbreaking than losing a friend and picturing the reactions of the children left behind when they learn of it.

I’m one of the lucky ones. I returned from Afghanistan after having served there in Helmand Province from 2013 to 2014. I had a chance to serve in a unit that literally rewrote the book on air medical qualifications, training and certification for the entire Army, based on experiences overseas. And today, I love my job working in the air medical services industry as a flight nurse here in San Antonio.

I get the chance every day, when we get the call, to deploy with my team, several of whom are also veterans, and save lives. We get to deliver the highest quality of care that exists on the planet to local residents who may be suffering from traumatic injuries or having a heart attack or stroke and need medical evacuation.

Some 85 million Americans live more than an hour away from the critical care facility they need, and air medical transport can be their only hope for survival.

Those of us on my team and throughout the air medical transport world, an industry that provides a perfect landing spot for many veterans, get to “win” each day. We get to rewrite those stories we carry with us from combat, where not everyone made it back, and replace them with stories here at home where everyone gets to take another breath and see their families again.

But we must not forget those who didn’t make it home. And we must mourn our losses on behalf of our military families, husbands, wives, mothers, fathers, sons and daughters who carry the burden of war for all of us.

This Fourth of July, I’ll be thinking about a brother-in-arms, 18-year old Pvt. Errol Milliard. He was hit by an RPG on July 4, 2013, four years ago. He died a hero.

His story motivates me every day to give nothing but the best and to strive for excellence.

Most of us in San Antonio have some connection to the military. I challenge you to find a story to tell this Fourth of July of a hero you knew and the family he or she left behind. And to never forget that we live in the land of the free because of the brave.

Neil Murray is a registered flight nurse for Air Methods at the AirLIFE 6 Base in Laredo. He served in Afghanistan as a combat medic.

Source: http://www.mysanantonio.com/opinion/commen...

Paris Extra: Reno toddler who almost drowned meets the people that saved her life

By Lea Emerson

What started out as a normal Sunday afternoon quickly turned into a nightmare for local mom, Haley Trammel.

Haley had taken her children to their grandparent’s house for the afternoon, planning to enjoy the sun and swim in the pool. Her girls, Brynlee (3 years old), and Brystlee (4 years old) suited up to swim while their Mom finished applying sunscreen to her youngest child.

Trammel stated, “The girls ran ahead to the backyard to play before we came out. The gate to the pool is always locked, so I didn’t think there was anything to worry about. Right away my four-year-old came running inside just as I was headed out to meet them. She told me that Brynlee had fallen in the pool.”

“I didn’t have time to think, I just ran to the pool and jumped in for her. She was already at the bottom, facing up. I pulled her out, and her lips were blue. I started CPR and she coughed up some blood and water. She wouldn’t talk or anything, just lifeless.”

Trammel then called 911 and the ambulance and helicopter arrived right away. Shortly after, Brynlee was transported to Children’s Medical Center of Dallas.

Paris EMS Paramedic, Rachele Estes, responded to the incident. She told us that Brynlee was conscious but weak and very lethargic. “It was necessary for her to go to Children’s Medical so they could keep an eye on her and make sure everything was okay,” said Estes.

Earlier this week, after returning home, Brynlee asked her Mom if she could meet the people she saw on Sunday that saved her life.  On Friday at 10 a.m. she met the team along with her sister Brystlee who Trammel said is her hero!

“My four-year-old daughter, along with the people here, saved Bynlee’s life. Brystlee is a hero, even though she doesn’t fully understand how important of a role she played in this,” said Trammel.

Brynlee is still recovering at this stage, and will head to Children’s Medical again for a follow up due to a cough and increase in temperature.

Source: https://eparisextra.com/blog/2017/06/30/re...

Watertown Daily Times: Gouverneur Rescue Squad promotes SOAR campaign

The Gouverneur Volunteer Rescue Squad and the Adirondack Rafting Co. have joined the Save Our Air Medical Resources (SOAR) coalition. SOAR is a national campaign dedicated to preserving access to emergency air medical services for Americans across the country.

In the event of critical illness, severe injury or trauma, emergency air medical services provide transportation for patients, particularly in rural communities with limited access to hospitals, emergency rooms or trauma centers.

Source: http://www.watertowndailytimes.com/news05/...

The Capitolist: Searching for Solutions to the High Price of Air Ambulances

By John Lucas

It was Super Bowl weekend 2001.

Tampa was playing host to the big game between the Baltimore Ravens and the New York Giants.

As 41- year-old Robin Powell left work that Friday night, she warned her coworkers to be cautious on the roads. Little did she know they were words of caution that would apply to her the following Saturday morning.

“I did not know when I left the house about 10 in the morning, I did not know my life was going to change in less than two hours later,” says Powell.

At 11:45 a.m. the car that Powell was riding in was hit head-on by a 21-year-old woman who had worked overnight and decided to spend the morning drinking.

“I could hear all the screams in the background with tears and all of that,”  Powell clearly recalls that morning. “My son would not leave my side. I couldn’t talk with him. I couldn’t say baby it is going to be okay. I couldn’t tell him I love him.”

Her neck was broken. Time was of the essence. Traffic was heavy because of the big weekend.

Paramedics decided to call in an air medical service to airlift Powell to a nearby hospital. It was a decision that she’s convinced saved her life.

“To this day I owe them my life.”

Medical experts say access to a Level I or Level II trauma facility within an hour after a person suffers a major medical problem is critical to ensuring a positive outcome.

With the current network of ground and air ambulances, most Floridians are within an hour of a Level I or Level II facility.

But, emergency air medical services are facing a financial strain that threatens their survival both here in Florida and across the nation.

There are about 30 air medical service bases in Florida. Two bases, covering the Key West and Tallahassee areas, were recently forced to close.

“I think it’s in a fragile state right now,” said Paul Webster, an air medical service based in Colorado. “The services exist and the access exists for 98 percent of Floridians. But, that is at risk because of reimbursement challenges in terms of covering costs.”

Webster is working with emergency air ambulance services across the country to secure their financial existence.

He says it takes about $3 million a year to operate an air medical services base.

The median cost of an emergency air transport is $10,200.

The problem is that seven of every 10 emergency airlifts involve patients who are covered by Medicaid, Medicare, or don’t have insurance at all.  In those cases, emergency air medical transportation services get little or no compensation.

Medicaid reimburses air medical services in Florida about $1200. Medicare covers about $5000 of the costs. In the case of those with no insurance, the air ambulance service is left holding the entire bill.

Webster says there is a basic question facing air medical services, “At the end of the day, when the dust settles, is the provider able to collect enough reimbursement to cover the cost of having that access in that community?”

That’s a question also being asked by the Emergency Medical Transportation Working Group that was created by Florida’s Office of the Insurance Consumer Advocate. The group, which includes representatives from air ambulance providers, insurers, patient advocates, doctors, and local governments, is studying the issue of reimbursement rates for air ambulance transportation service.

The group is spending a year gathering information and analyzing data on how best to address the needs of air medical services, the insurance industry and consumers.

The issue comes down to money. How much should emergency medical air services be compensated for the work they perform?

But, for Robin Powell the debate goes beyond money. She sees the issue in a different context and asks what the cost might be if there is no air medical service available in an emergency situation.

“The odds are you may never need it in your lifetime. But what if you need it one time. I’m 57 years old now and I didn’t know back when I was 41 years old that I would need it one day. Thank God it was there for me."

Source: http://thecapitolist.com/searching-for-sol...

Valley News: Emergency responders need air medical services to save lives

By Hemet Fire Chief Scott Brown

As the fire chief of Hemet, we never know when our firefighters and paramedics will need to be deployed to respond to an emergency, but we’re always ready. When families in our community face an unexpected incident or medical emergency, we will be there as quickly as possible to ensure they get the appropriate level care they need from the nearest hospital.

During any medical emergency, every decision we make can mean the difference between life and death.  For many who live in the rural pockets of Southern California – up to 100 miles away from the nearest hospital – emergency air medical services is the only option. In fact, across the country, there are 85 million Americans who live in a rural area that is more than an hour from a Level 1 or Level 2 trauma center if driven by ground ambulance.

As a former flight paramedic and having served as a firefighter and paramedic for the Orange County Fire Authority for 18 years, I saw firsthand the difference air medical services could make for patients. In the air, patients receive critical care from highly-trained flight doctors, nurses and paramedics. From strokes to car accidents to heart attacks to other traumatic injuries, we always knew that getting patients the right care in the right amount of time was imperative for saving their lives.

While the benefits of these air services are clear, they are increasingly threatened across California and the nation. The reimbursement rates provided by Medicaid and Medicare fail to cover a significant portion of the cost to operate these services, which is alarming when you consider that 70 percent of transport patients are covered by government insurance or have no insurance at all.

We need Congress to address this funding challenge, or Californians may have to face serious consequences when they or their families face medical emergencies. Just a few months ago, an Air Methods base recently closed in Hazard, Kentucky, and they were forced to shut down because of the cost deficit from Medicare and Medicaid reimbursement rates.

Thankfully, efforts are underway to preserve emergency air medical services. Initiatives like the “Save Our Air Medical Resources” campaign are working to educate the public on the problems and possible solutions surrounding continued air medical services. There are also leaders in Congress, like Rep. Raul Ruiz, D-CA 36, a former emergency room doctor, who understand the importance of these services in saving patients’ lives.

Whether by ground ambulance, air medical transport or on the scene, we need all treatment and transport options available because we know every choice we make counts.  It is essential we do everything we can to protect and preserve access to emergency air medical services so that they remain a realistic, life-saving option for everyone.

Scott Brown is the Hemet fire chief and has served as a paramedic for the Orange County Fire Authority for 18 years.

Source: http://myvalleynews.com/opinion/emergency-...

Austin American-Statesman: Stroke awareness month shows need for lifesaving health care

By Dr. Justin Fairless

May is National Stroke Awareness Month. It was elevated for recognition by former President George H.W. Bush for a significant reason.

A stroke occurs in the United States approximately once every forty seconds and remains the leading cause of long-term disability that Americans face.

Consequently, almost everyone has a connection to someone who has had a stroke, whether it be a friend or family member. Strokes can be terrifying for those who suffer them, either personally or for loved ones as well.

Strokes occur when blood flow to the brain is stopped, either from a hemorrhage within the brain or because of a blood clot. The brain literally starts to die one cell at a time.

The unfortunately result of a stroke is something we see in our daily lives. We have all seen those individuals in public, displaying the signs of a previous stroke; limited bodily function and mobility in their arms, legs, and face.

None of us wants to suffer this fate. The good news is that strokes are largely preventable, treatable, and beatable if treated quickly.

Since around two million brain cells die each minute that a stroke goes untreated, every minute counts and awareness and quick treatment are crucial to minimizing the debilitating, long-term effects.

This May, a coalition of medical professionals known as “Save Our Air Medical Resources” (SOARcampaign.com) is working hard to ensure that access to air medical helicopter transport, a crucial piece of the puzzle when it comes to treating sudden events like stroke and heart attacks, is not jeopardized here in Texas or across the country.

Twenty-two percent of our country’s hospitals have closed since 1990 and unfortunately this vital service is threatened by the same economic and political vice grip that has affecting many aspects of healthcare.

Thankfully, Texans are leading the way to making sure this service is not lost for those of us who need it.

In our Texas State Legislature, Dr. John Zerwas (R-Richmond), who serves as Chairman of the House Appropriations Committee, has filed House Bill 935 to address keeping this vital service alive and well in our state.

On the national level, in the last Congress, Texas Congressmen Pete Sessions (R-Dallas), Will Hurd (R-San Antonio) and Blake Farenthold (R-Corpus Christi) led the way in supporting H.R. 822 to improve and update Medicare reimbursements for air medical transport services. While H.B. 822 fell short, new legislation will be filed that aims to preserve this vital service nationwide.

Life-threatening emergencies, such as strokes, heart attacks, and major trauma urgently demand the right care and the right facility. As hospitals continue to close their doors and distances between patients and the critical care facilities become greater, air medical transport is more important than ever.

At present, eighty-five million Americans — only one in four of us — can reach a Level I or Level II trauma care facility within an hour of an accident happening only if they are flown by helicopter. The same can be said for specialty cardiac and stroke centers when these emergencies occur.

Fortunately, air medical transport professionals (flight nurses and paramedics) are trained to manage and treat stroke patients and get them to the right facility, a stroke center capable of treatment — quickly.

National Stroke Awareness Month is an important time each year to raise awareness about how to prevent and treat strokes, and to focus on the life-saving care that thousands of stroke patients require. Preserving emergency air medical services is a critically important piece to this puzzle.

Fairless is a clinical assistant professor of emergency medicine at the University of Texas Southwestern Medical Center in Dallas and currently serves as the medical director for Native Air Texas and New Mexico Air Ambulance (Air Methods Corporation.)

Source: http://www.mystatesman.com/news/opinion/op...

Tallahassee Democrat: Need for quick emergency care in rural communities critical

By Laura Hampson and Sarah Catalanotto, Florida Rural Health Association

Picture this: A loved one suffers a medical emergency or has an accident that leaves them in desperate need of professional medical attention. For many Floridians in rural counties with limited access to trauma centers, that can be a startling, scary reality.

During a medical emergency, it is absolutely critical to get access to quality care as quickly as possible. That’s why air medical services are so crucial for Florida’s more rural counties, including those that surround the Tallahassee area.

Consider, as just one example, the recent major car crash involving a drunk driver in Gadsden County. Five individuals were seriously injured and required fast emergency medical transportation, including an air ambulance. Incidents like this emphasize the critical need for emergency air medical services to protect our communities.

Source: http://www.tallahassee.com/story/opinion/2...