The reality around life-threatening medical assistance at BITD

dan200

#BSF200
Joined
Aug 28, 2007
Posts
16,155
RDC Crypto
8,640
Location
Tempe, AZ USSA
We can all learn a lot here about what is, has been, could and will be happening as far as the rescue stuff goes. I am blown away every time when I learn how stupidly complicated things that would seem like basic no brainers have become forbidden because of liability reasons. I know in the grand scheme of things it makes sense (much of it anyway) but 25 years ago when I was getting my EMT certification there seemed to be way less to worry about legally.

If we could change the tone in here a little and continue this dialog without having a "who is more right" dong measuring contest I think we could all benefit a little. (I include myself in that request.)

Also, maybe a few of you could spell out some of the acronyms you all are using? I think it would help me/us understand this better. I want to know more about how/why things are the way they are. Besides the mitigated risks I take myself, I have hundreds of friends who are on the course and in the pits and I would like to be as educated as can be. You never know when this knowledge can come in handy.

d200
 

Bro_Gill

Well-Known Member
Joined
Dec 5, 2007
Posts
15,147
RDC Crypto
10,599
Location
Big Bear, CA
Dan, fwiw- anyone can take an advanced first aid and CPR class and be almost to the level of EMT and it doesn't require the licensing that EMT does. In California, they are called First Responder basic for the most part and you cover everything manipulative that an EMT does without the advanced life support (ALS) support skills like IV monitoring, etc... This level of training does not require the federal background check and thumb print scan that a state license like EMT does, so it eliminates a lot of the hassle that some folks can't get around. Anything beyond the Basic Life Support care (BLS) requires a supervisory agency to be responsible for several things for the provider- Report keeping, training, update material, forwarding protocol changes, Quality Control, etc... I know people who have lost jobs when they practiced ALS intervention when they were off duty and not operating under someones license. It happens.

And Deano- There is a huge difference between someone reacting and doing what they can to save a life when the emergency happens and something entirely different when people are shopping a service they cannot legally provide- Like airship transport of sick and injured. And there is a MONSTER and I mean MONSTER liability when someone moves a patient and bypasses better medical intervention in the process. If you are flying someone in a helicopter and do not take them to the closest higher level care facility without a doctor's orders, there is a lawyer out there who will burn you down in court and own your chit. The law and what's right are not the same.
 

FirePig

Member
Joined
Aug 24, 2017
Posts
18
RDC Crypto
32
Location
Santa Rosa, CA
EMT is a certification not a license. Not that it probably means didily as far as what we do in the dez. About six years ago California required new EMT's and recertifying EMT's to undergo a one time background check. I know some EMT's who lost their certification due to bad life choices years ago. Once you pay the almost $200.00 background check fee you don't need to do it again. Unless you let your certification lapse and then you gotta go through the whole thing again.

I am under the impression this is a state regulation and not a federal reg. Does Nevada require the same thing?

Not every state recognizes First Responder. Though it is usually a prerequisite class to taking EMT. And, at least in California, it does not have to be renewed every two years through ones local EMS agency.
 

tapeworm

Well-Known Member
Joined
Nov 20, 2010
Posts
596
RDC Crypto
581
Location
Big Bear, CA
If the Honda Civic is all that was available while your good friend is dying on the Baja desert floor, it doesn't matter what the F the transport vehicle is. Time and any mode of transportation are the top priorities at that point - Sure, a nice plush Medi-vac helo or an a/c cooled ambulance would be the top choice .. Go re-read my post again and comprehend that I was applauding Jim and his R-44 at that particular rescue, not every rescue ...

Have a good day. An argument with you will not produce anything of value to this conversation but thank you for taking time out of your day for that great comment. It was about as pointless and meaningless as this post I just wrote.


Sent from my iPhone using race-deZert mobile app
 

Mike321

Well-Known Member
Joined
Jun 5, 2013
Posts
399
RDC Crypto
267
Location
San Francisco, CA
When I went through swimming lessons from basic to life guard, I recall a class where we had to jump into the water with all our clothes on. We had to instruct others on how to use their cloths to stay afloat: basically utilize all available resources at your disposal, keep as many people alive as possible, and maintain your separation between others because you just became the director of the situation until help arrived.

To repeat that exercise now, it sounds like a lot of people would have drowned due to potentially liability issues. Instead of giving them possible tools to utilize, it better/safer just to say, “hang on, help is coming” while I’m giving them instruction from a 20ft boat in a very large body of water until the proper vessel arrives?

Now we have doctors available via mobile interfaces:

There is at least one app that can connect you to a US licensed doctor on your phone. Can an app-based doctor serve as the “medical director” for the situation? If you have a helicopter I’m assuming there is satellite data available as a backup, but I could be wrong.

Is the R-44 the optimal medical airlift? No, but it is an option that has worked several times.
Is a Class 11 the optimal vehicle to race off-road? No, but everyone cheers for them.

It sounds like BITD has a good plan coming online, what about SCORE?
 

Bro_Gill

Well-Known Member
Joined
Dec 5, 2007
Posts
15,147
RDC Crypto
10,599
Location
Big Bear, CA
So much ignorance. For Fire Pig- No, you have a background done every 2 years, you may not know it because your agency might do it for you, but the STATE of CALIFORNIA required a DOJ pull of you criminal history every 2 years for your STATE EMT LICENSE. While you may have a county issued card, it is still a STATE controlled license. And it can go ever further than that if you want National Registry. For Mike321- How many rescuers are flying in that R44 with the pilot and injured party?
 

FirePig

Member
Joined
Aug 24, 2017
Posts
18
RDC Crypto
32
Location
Santa Rosa, CA

Mike321

Well-Known Member
Joined
Jun 5, 2013
Posts
399
RDC Crypto
267
Location
San Francisco, CA
For Mike321- How many rescuers are flying in that R44 with the pilot and injured party?

Likely, none.

I’m not advocating the R-44 be “the” airlift platform of choice. That said, it is irresponsible to overlook how the R-44 can be useful – it’s a tool. It is the most common tool over head on race days, and not used very often for emergencies.

There are case studies proving it has been useful in our sport. Can you point to an incident in our sport where it would have been better to wait for a licensed medical helicopter make the round trip flight vs using the R-44 to assist?
 
Last edited:

green787

Well-Known Member
Joined
Jan 2, 2005
Posts
10,926
RDC Crypto
2,698
Location
Southern, CA.
Website
realsound.us
How do you equip the R-44 if you plan to chase with it, but you KNOW you are going to use it for med-evac??? If a moto goes down good chance there are spinal injuries.... Now does everyone just carry him to the copter and load him in??? Seems like a Jet Ranger or larger would be needed to transport a patient on a back board.....
 

Bro_Gill

Well-Known Member
Joined
Dec 5, 2007
Posts
15,147
RDC Crypto
10,599
Location
Big Bear, CA
I can point to actual cases where a Subaru was used to extract racers and take them to a hospital, but we aren't talking about Johnny on the spot, we are talking about teams saying they will provide medical transportation at races with their team helicopters, and THAT is illegal. The R44 should have transported a medically trained person to go and provide care of the injured person and get them stabilized for proper transport by a capable ship that would be dispatched to the scene. The minute a medical provider let the R44 lift off with the patient and didn't transport with them would be abandonment since they lost patient contact/care and the pilot is in no position to render aid while flying. Something as simple as repositioning the head to reopen the airway can not be done in this situation, and a simple, basic life assist skill that WOULD save a patients life is not done and they die. See where this becomes a real world problem and why they have rules about how and why transportation is done the way it is? If an R44 could get that third person in there to monitor the patient, I would have no problem. I do know that in the case at B2V, the helicopter flew past Pit 10 where ALS care was waiting for them.
 

calstyl2

Well-Known Member
Joined
May 9, 2013
Posts
654
RDC Crypto
1,112
Location
Cherry Valley, CA
Too many rooster swinging experts in here...............
Heli Jim does a bad ass job, would I put a critical airway in his Helo, no but if we had no option, get it done.
We loaded Heli Jim with a E Force cutter, sawzall and a go bag and he popped up all over the desert at the San Felipe.
 

dan200

#BSF200
Joined
Aug 28, 2007
Posts
16,155
RDC Crypto
8,640
Location
Tempe, AZ USSA
we are talking about teams saying they will provide medical transportation at races with their team helicopters, and THAT is illegal.
If you would provide some clarity here I would appreciate it.

If without saying publicly they were up there to help everyone and then on the fly they accidentally come upon a downed bike guy and they do help that guy, what happens?



Sent from my iPhone using Tapatalk
 

Bro_Gill

Well-Known Member
Joined
Dec 5, 2007
Posts
15,147
RDC Crypto
10,599
Location
Big Bear, CA
Depends on what they do. If they stop to render aid, and have someone trained in medical care and they provide care beyond the level allowed by the State they are operating in while not working as a professional, they can be held criminally and civilly liable, regardless of outcome. If they transport and there was higher medical care bypassed while they transport, same deal. I think it would be a real Chit Storm if someone trained and works in the EMS field and knows the ins and outs were to load a patient they treated into a copter that can't also transport the medical provider to continue care. Abandonment would only be the tip of that iceberg.
 

Honda48X

Well-Known Member
Joined
Jun 7, 2014
Posts
1,290
RDC Crypto
1,644
Location
San Felipe / Washington
It's all about RISK. You have four choices.
1. You can avoid the risk and wave and keep flying past the downed rider.
2. You can accept the risk and land and render aid along with a flight to a hospital.
3. You can transfer the risk and call for help and let the EMS system work as planned.
4. You can mitigate the risk, call for help, land, perform medical aid to your skill level and transport to the closest medical provider.

If I'm hurt I hope and pray they go with number 4.

Remember anyone can be sued but they have to win.
 

dan200

#BSF200
Joined
Aug 28, 2007
Posts
16,155
RDC Crypto
8,640
Location
Tempe, AZ USSA
if someone trained and works in.
What if you got rid of "and works in"

Would that be different?

There has to be some kind of loophole here. One that gets around the criminality part. Right?





Sent from my iPhone using Tapatalk
 

Bro_Gill

Well-Known Member
Joined
Dec 5, 2007
Posts
15,147
RDC Crypto
10,599
Location
Big Bear, CA
Mike- No, apples and potatoes. Dan- There is no loophole. Every time I recerted my EMT, it was always taught about level of care, abandonment, who you work under, etc... Required for every recert test that you understand the rules and regulations. When you cert for your level of medical provider, you register for the county you are in or are going to work in. At that point, you must follow the regulations and protocols of the county you have received your cert in, regardless of where you render aid in the state or U.S. The rules allow you to work up to the level your county cert is issued and reciprocity allows you to function under your county's protocols, even if you are in another county. There are times when this allows more care and times when it allows less. The basic level any of the EMTs are allowed to work up to when not in their professional position is EMT Basic/1 regardless of whether they are EMT1, 2, or P. Unless they can piggy back on another provider who is also there as a professional and has the higher level of certification, then they are allowed to operate up to their highest level of training under that professionals cert. So if you are a paramedic, off duty, and you arrive at an accident, you start by rendering basic care. When the fire department of ambulance arrives and there is a paramedic on it, then if they give permission to operate under their cert, the off duty paramedic can begin doing advanced life support skills as needed to help out. This is one of the reasons I suggest the First Responder Medical class. You are not certified under county EMS to operate as a professional and you can still provide 95% of what an EMT is allowed to do in the field, and 100% of the trauma type medical care we would see that can be treated with non-ALS interventions.
 

Redsand187

Active Member
Joined
May 21, 2016
Posts
38
RDC Crypto
21
Location
Central Washington
The reason Robinson helicopters have more crashes out there is because there are WAYYYY more of them in public then any other ship. On top of that its a training helicopter because is affordable to fly. They have their purpose. I've flown in them ALOT. with Jim as well.

Would I use it for medical. No probably not. Can it be used for medical? Yes. But you wont be landing on diablo dry lake bed when its 118 out side..

Robinsons are cheap. 600 ish a hour and cheaper Vs a Long Ranger or Astar that can be from 1200-2000 an hour
Not to start an argument, but there isn't significantly more Robinson's out there than Bell 206's, unless you combine every airship Robinson has built. I would also argue that the 206's have far more total flight hours than all of the Robinson's combined.

But that isn't to say a Robinson is some piece of junk toy. They are big for training, private ownership, and super light work.... which means the average Robinson pilot is WAY less experienced.

The helicopter you have, is the best one when it's needed, so in these cases where a Robinson has successfully extracted a victim, that is great! But if you have your choice, it's probably not what you are going to choose. They are like the class 11's of the sky. Sure they can do it, but it ain't going to be easy, and many minor things can end your race/send you falling out of the sky.

We've all used the end of a screwdriver as a hammer... but how many of use forgo purchasing a hammer because we have a screwdriver handle?
 
Last edited:
Top