http://www.cnn.com/2008/US/06/29/helicopter.crash/index.html

We’ll have to agree to disagree on the Helipad at SFGH.

It seems it may come down to this: folks who believe that a helipad, no matter what the cost and no matter what the need must not only be built in SF, but it must be built at SFGH.

or

those folks who understand there is no money in the budget for a helipad, there is no conclusive evidence that it needs to built anywhere in SF or at SFGH, that if there was money in the budget, that it might save more people by funding other social services and that neighborhood & safety issues are real concerns.

I’ve lived in Dogpatch for over four years, with another eight on Telegraph Hill. Both homes have seen their share of over-flights of all kinds, and the utility of such flights needs no further discussion to win my support—even if these flights are filled with total strangers from Oakland and Marin; even if these patients are not in full cardiac or respiratory arrest; even if they are wealthy—these folks have my assent to fly overhead if the $5-20K tab is justified by circumstance, or by the decision of someone in a better position than me to make the call.

Scott also notes, “… the benefits of helicopter overflights are inherently worth the nominal risks/costs/inconvenience…”. What supports this statement? Worth it to whom? Sunset residents? Marin crash victims? To Scott perhaps (not sure in which ‘hood he resides). But please don’t speak for me. I have not been convinced that the helipad must be built at SFGH - for a multitude of reasons, including noise.

Balanced and reasoned? Telling people to move is silly, but OK, I’ll play… Stanford has a helipad. One would have to recommend Scott and his loved ones move very close to Stanford and not stray too far.

http://ap.google.com/article/ALeqM5hHSFSELZsHrhlQmdgmDAB47mVH-gD90VCTK80

I appreciate Dave’s unique view from both the pilots seat and the gurney of the helicopter. I’m also pleased he elaborated on his earlier comments.

In no particular order…

I think Dave misses the point of my “social services” question. We don’t live on fantasy island where money grows on trees. So ideally you have to pick and choose how you allocate assets (tax monies) to get the most impact. My question then, would you save more infants (to use Dave’s example) with $4million spent on social services (better health care, prenatal care etc.) or would you save more lives with a helipad? My guess is that social services is the better value. But I’m not sure, which is why I was asking. I know Dave is just joking (you are joking, right?), but celebrities are not the problem. And stereotyping them all does nothing for his argument - there are plenty famous folks who donate time and money to good causes - and plenty who don’t - just like all segments of society. I’m not sure I understand Dave’s comment on saving “1000 or so people”. Is that the number of people you transport annually? Please elaborate if possible.

Ship vs SFGH
Again, I’d like to see an analysis of the costs to maintain a trauma unit on a ship docked at Mission Bay. Such a ship would likely be immune from an earthquakes effects. If it makes no difference where one lands, I’d prefer they land there. Maybe it’s too expensive. But I’d like to know.

Dave states that “SFGH has one of the finest trauma centers in the country.” What is that statement based on? Poll numbers. Lives saved? Just wondering what the criteria are to be considered “finest…in the country”? (You’d think Oakland would be good too - at least at treating gun shots).

And remember, there are helipads. There just isn’t one in SF at the moment. How many more do we need? I’m just asking. Is this really a metropolitan issue? Should Marin have one? Two? Should SF have at least 4? Should there be one at every hospital with a trauma team? Does Oakland have a helipad?

No doubt, with your loved one’s life in the balance, you’d like them to be heliported promptly. That will still happen with or without a helipad at SFGH. Taking Dave’s recommendation for googling “golden hour”, there is this from Wikipedia (granted it’s not the Harvard Medical review but…) –>
While most medical professionals agree that delays in definitive care are undesirable, recent peer reviewed literature casts doubt on the validity of the ‘golden hour’ as it appears to lack a scientific basis. Dr. Bryan Bledsoe, an outspoken critic of the golden hour and other EMS “myths” like Critical Incident Stress Management, has indicated that the peer reviewed medical literature does not demonstrate any “magical time” for saving critical patients.[Bledsoe, Bryan E (2002). "The Golden Hour: Fact or Fiction". Emergency Medical Services 6 (31): 105.]

This has always been a neighborhood of friendly, caring people. Now, it seems that some people are more concerned about saving children in faraway countries than those in our own midst. How can we close our minds to what happens right around us? SFGH has one of the finest trauma centers in the country. That’s why it is the location best suited for the helipad.

Many changes have been made to this neighborhood and the city during my 25 years here, and I certainly haven’t liked many of them. But this is a living and growing municipality. Change happens. Nothing stays the same forever.

I join Dave in his challenge to those of you who oppose the helipad to put yourselves in the shoes of those whose lives hang in the balance or those of their loved ones who have only minutes to live if they don’t receive care.

Who pays for the flight?

In most cases, the HEMS providers are private companies (not government programs). This means that the patient’s health insurance provider pays for the flight- not the taxpayer. Some HEMS providers do not pursue collections against those who cannot pay (my company just takes it as a loss), and just accept it as part of the cost of providing a service to the community.

Is abiliy to pay a factor?

No. Trauma patients are not screened prior to transport. If the determination is made that a patient needs to be flown, then that patient will be flown. There is no discussion regarding insurance coverage until the conclusion of treatment. However, if a patient is conscious, they have the same right to refuse a flight as they do to refuse a ground EMS unit’s services.

Where are patients flown from?

Wherever the accident/illness occurred- roadway, beach, residence, hospital (transfers), etc…

Why are patients flown?

I am a pilot, not a medical crew member- therefore, I do not make that determination. That being said, you need to Google the following term: “The Golden Hour”.

Time, or more accurately, a lack of time, is the reason that patients are flown. The pick-up point might be not so far from a hospital, but due to rush hour traffic, it might take far too long to transport by ground. it’s about saving a life, brain, tissue, heart muscle.

How often are patients flown?

There are too many variables to be able to provide an honest answer to that question. If Fire / EMS does not call for a helicopter at an accident scene, or if there are no patient transfers to/from other hospitals, then the helicopter sits quietly on the pad. That being said, I would say that most patient transfers that are done by helicopter are the following: neonatal transfers to a neonatal facility, high risk OB to a women’s hospital, cardiac patients to a cardiac facility. Patients are always transferred by ground if they are stable and can tolerate a ground transfer.

Which hospital should have a helipad?

The hospitals that can offer the highest level of trauma care / burn care / cardiac care / OB & neonatal care. It is very common for a helicopter to fly right over several hospitals with a trauma patient onboard, while enroute to an appropriate trauma center. Why? Because the patient needs a nigh level of care, or they will no survive- all hospitals are NOT created equal.

Believe it or not, helicopters have landed at nearby hospitals with trauma patients, and have been told that they need to go elsewhere! Every hospital has an ER, but many cannot deal with trauma- they simply do not have the equipment or the qualified staff on duty or on call.

Stanford, etc… I used to live next door to UCSF Hospital. I don’t live in California right now. Distance / time= helicopter flies at about 2 miles per minute, as the crow flies. You will have to do the measuring.

That said, trauma patient flights need to go to the CLOSEST APPROPRIATE TRAUMA CENTER. When we leve an accident scene, that is where we will be headed, because a life is hanging in the balance.

Social services:

I have transported infants who have had been ejected from a motor vehicle during a major collision, children who have drowned or who have been run over by a car while riding their bicycles…. my experience during those flights was that a really good social services program was not going to help them survive their injuries.

Some people in this forum seem not to want to accept the reality that we are talking about the preservation of life here- that somebody’s mother might live because a helicopter is landing at the hospital. As is usually the case in a metropolis, people are more concerned with their own personal wealth and making sure that the world does not start knocking on their own little door….

SFGH or elsewhere:

As a person who has actually had be transported by helicopter after a horrible accident where 2 deer ran in front of my motorcycle and almost killed me, I will say this- until you or a loved one have to be transported by helicopter to the nearest appropriate trauma facility in order to survive your injuries, you cannot make the statement that, “it doesn’t matter if I’m on the gurney or someone else.”

What I am saying is that when it is your child who is bleeding to death in your arms, you will not think the way that you are thinking right now; you will think differently. To state otherwise is simply a callous statement designed to insulate you from your true feelings- that your property value is more important to you than the life of another.

I lived in San Francisco for most of my life- I was an artist, a vegan, a protester,
etc… it was not until I moved away and lived in other communities that I realized how conflicted and callous city people can be- they worry about the environment and they recycle and ride their bikes to work, but they will walk right over somebody bleeding to death in the street. They are selective with their love and concern, and they tend to choose to be concerned with things that are faceless, because dealing with a real face or a beating heart is much too personal for them- they avoid contact with most things that have the potential to disrupt the balance of their lives that they have struggled for so many years to achieve. They can only be passionate about things that they are able to hold at a distance.

Safer landing on a ship / piers?

It doesn’t matter to me where I land- but if the patient is going to have to be transported by ground after that, then what was the point of flying them?

If I had $4 mil to spend:

I would probably publish a newspaper that documents how much money celebrities make, and how little they really contribute to this world.

That said, the question (restated) is, “who do you save”? That is between me and my god. Who do you want to save?

1000 or so people:

While this is only my opinion, I believe that things would unfold this way:

1. Initially, perceived property values might go down ever so slightly, out of fear.

2. After residents experience the fact that the helipad will actually be used so infrequently, and experience first-hand that the ambient sounds of the city mask most of the helicopter noise that is generated during those infrequent operations, that property values will go right back up.

Compensation?

In a word, “no”. In regards to life, the needs of the few outweigh the needs of the many. You live in a city- accept the reality that you live there with thousands of other people…that you are not alone.

I do want to make one thing perfectly clear- Even though I fly a helicopter, I experience no pleasure when an aircraft flies over my house. If it is an EMS helicopter, then I understand that someone out there is probably dying and that their needs presently outweigh my own.

The people (or, rather, the well-to-do property owners) of San Francisco need to re-visit the meaning of life. The meaning of life is “to live”.

Great to have your perspective on this discussion.
Please add more. Perhaps you have some answers to some of the other questions you posed?

Why patients are flown?
Where they are flown from?
How often they are flown?
Who pays and who doesn’t? (any other info other than ability to pay? Who REALLY pays? HMO’s? Taxpayers? or…?)
How this might impact a neighborhood where a hospital helipad resides?

I’ll add some others…

Is SFGH the only option for a helipad in SF?

Are there other hospitals here that could accommodate a helipad?

What is the difference in time, if any, vs. flying to Stanford for most of your flights?

Out of all the flights you made in 2007, how many lives would have been saved by that time difference (if there is a time difference) between SF and Stanford?

Would you feel safer landing on a ship or on a helipad down by the piers?

For the 1000 or so people who live within a block of the helipad, would one expect the value of their home to be negatively impacted by the construction of a helipad and the subsequent arrival of regular air traffic? What about the impact to those within a 1/2 mile radius (or more) who will hear those aircraft as they approach and take-off from the helipad (admittedly quieter than older Huey’s)? Should they be compensated in some way if their home values take a hit as a result of a new helipad?

If your had $4 million to spend, would you save more lives by spending it on a helipad, or on other social services?

Yeah - I have a few more questions, but let’s start with those.
-
btw - I’m glad we have helicopter rescue teams. But I have yet to be convinced that they need to land at SFGH. Doesn’t matter if I’m on the gurney or someone else.