1. Policy

A helicopter may be utilized for patients in critical condition, when air transport will be advantageous because of the distance between the patient and the hospital, where access to the patient is excessively delayed, or when special equipment or personnel provided by a helicopter ambulance will improve the care of the patient.

Ground transport will not be delayed if a helicopter is not available, or has not arrived, and the patient is ready for transport to the nearest appropriate hospital, in accordance with the existing transport protocol.

2. Procedure for Activating Helicopter Transport

A. When it has been decided by caregivers at the scene that a helicopter is needed, Central Dispatch shall be notified to make the initial call to put helicopter on standby. Central Dispatch shall notify Medical Control of the request and Medical Control shall confirm the helicopter order.

B. Central Dispatch shall be responsible to coordinate police, fire, EMS on the scene, and update Medical Control as needed.

C. As soon as the helicopter provider is ready for lift off, a recheck via phone will be made to Medical Control to confirm need.

D. The confirmation for lift off will be given by either Medical Control or the ALS provider enroute or on the scene.

E. If insufficient information is available to Medical Control or the EMT-P to confirm the need, the helicopter will be continued enroute until a determination is made.

F. The helicopter shall be directed to contact the fire department on the scene on Fire 2 frequency for direct air to ground contact .Communication shall remain open until the helicopter is on the ground safely.

G. It is the fire department's responsibility to set up and maintain the landing zone for the helicopter.

3. Guidelines for Requesting Helicopter Transport

The following guidelines are recommended in determining when helicopter transport is likely to be needed.

A. Transport to the closest hospital will be prolonged, i.e.: patient evaluation, time at scene and transport to the closest appropriate hospital will exceed 30 minutes AND life threatening critical injuries exist that require rapid transport using one of more of the following criteria:

1. Special management procedures are necessary, e.g., chest tube and cricothyroidotomy.

2. When direct transport to a tertiary care hospital is appropriate, i.e., intracranial injuries or multi-system trauma.

B. When help is needed to locate the victim from the air.

C. When access to the patient(s) cannot be made by ground vehicle or will be excessively delayed.

4. Medical Control

A. When a request for helicopter has been made, EMS personnel must still follow guidelines and protocols, established by Monroe County Medical Control, and contact the appropriate medical control physician.

B. If there is mutual agreement, the medical control physician will relinquish medical control to the helicopter team physician upon his/her arrival at the scene. (SEE Helicopter Physician-On-Scene)

C. Run reports will be completed by the ground unit and for review of all runs within the medical control region.

5. Responsibility of Helicopter Responding in Monroe County

A. Notification of Mercy Memorial Hospital of any request for services within Monroe County.

B. Coordination with fire services by communication on Fire 2 frequency (154.355) regarding scene landing.

C. All helicopters responding within Monroe County shall follow Monroe Medical Control policies and procedures.

D. If the helicopter service has a physician on board, he may request medical control upon arrival during phone notification.

E. A monthly log of all transports and scene runs will be sent to Medical Control at Mercy Memorial Hospital.

6. Landing Site

A. A minimum of 60 x 60 feet unobstructed landing area near the patient should be prepared and marked at night with road flares on all four corners.

B. The landing site preparation should be performed by public safety personnel (police or fire).

C. Public Safety agencies should leave emergency lights on to assist identification of accident site from the air.

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