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HomeMy WebLinkAboutSOG 203.02 NEW 5-2013_Helispot Ops203.02 — Medical Helispot Operations Effective. 5/5/2013 Revised: Replaces. I. Guiding Philosophy With specially trained staff, equipment, and transport capability, medical helicopters offer a dimension of emergency medical care that is unequaled in the field. In contrast, statistics have indicated that more than 50% of line -of -duty fatalities for EMS workers occur during air ambulance accidents. We recognize the unique capabilities of air ambulances, along with the need to safely manage and coordinate their use, so that they are successfully integrated into our emergency response system. II. Purpose The purpose of this policy is to establish the performance expectations relative to the request for deployment, and safe and effective utilization of medical helicopters. III. Goal The goals of this policy are to: A. Communicate the criteria for requesting and responsibilities related to deployment of a medical helicopter. B. Set the performance standards relative to helispot preparation and operation. C. Establish procedures for safe response to medical helicopter crashes. IV. Definitions A. Danger Zone — Areas up-slope of helicopter and the tail boom and tail rotor area where blade contact is most probable. B. Helis pot — NIMS/ICS term for landing zone. C. Landing Zone (LZ) — 100' x 100' area designated for the landing of the helicopter that is free from obstructions and restricted from entry of bystanders. D. Helispot Manager — Officer assigned by Command to establish the helispot (landing zone) and manage helispot operations. V. General Policv & Criteria for Deolovment A. All fire department personnel shall recognize the criteria for placing a medical helicopter on standby and/or requesting a medical helicopter to the emergency scene. Since fire department personnel are often first on scene, members shall be capable of applying the criteria without the assistance of EMS personnel. B. Upon arrival and assessment of the patient(s), Beaumont EMS may cancel or upgrade a standby or deployment request made by a fire department member. C. General criteria for requesting a medical helicopter: 1. Any Priority 1 calls outside the City. 2. Any calls with moderate to severe burns. 3. At the request of the BEMS or private paramedic crew. D. Operational criteria to be considered: 1. Mechanism of injury a. Motor vehicle accidents have occurred at 20 mph or more and the occupants are not wearing seatbelts b. Vehicle rollover with unbelted passengers c. The passenger area of the motor vehicle is compressed to 18 inches d. Vehicle striking pedestrian at >10 miles per hour e. Falls from > 15 feet f. Motorcycle victim ejected at > 20 miles per hour g. MCI (Mass Casualty Incident) 2. Difficult access situations a. Remote rescue b. Ambulance egress or access impeded at the scene by road conditions, weather or traffic SOG 203.02 — Medical Helispot Operations Page 2 of 6 Time/distance factors a. Transportation time to the trauma/medical center greater than fifteen (15) minutes by ground ambulance b. Transport time to local hospital by ground greater than transport time to trauma center by helicopter c. Patient extrication time > 20 minutes d. Utilization of local ground ambulance leaves local community without ground ambulance coverage E. Clinical criteria to be considered: Patients with critical injuries resulting in unstable vital signs require the fastest, most direct route of transport to a trauma center, with a team capable of providing critical care services while enroute. Often this is the case in the following situations: a. Trauma Score < 12 b. Glasgow Coma Scale Score < 10 c. Penetrating trauma to the abdomen, pelvis, chest, neck, or head d. Any spinal cord injury; or any injury producing paralysis of any extremity e. Partial or total amputation of an extremity (excluding digits) f Two of more long bone fractures or a major pelvic fracture g. Crushing injuries to the abdomen, chest or head h. Major burns of the body surface area, or burns involving the face, hands, feet or perineum, or burns with significant respiratory involvement or major electrical or chemical burns i. Patients involved in a serious traumatic event who are less than 12 or more than 55 years of age j. Patients with near drowning injuries, with or without existing hypo- thermia k. Adult patients with any of the following vital sign abnormalities: 1) Systolic Blood Pressure <90 mmHg 2) Respiratory Rate <10 or />35 per minute 3) Heart Rate <60 or />120 per minute 4) Unresponsive to verbal stimuli 2. Stable patients who are accessible to ground vehicles probably are best transported by ground. VI. Helispot Preparation & Operations A. When the request for a medical helicopter has been made, Command will: 1. Assign an Officer (preferably a Chief Officer) as Helispot Manager with sufficient resources to achieve this function. 2. Ensure the Law Enforcement Branch Director/Group Supervisor has requested sufficient officers to achieve site security and crowd control. B. The Helispot Manager will insure: 1. Selection of an appropriate heli spot (landing zone) location. a. Recommended area is 100 ft. x 100 ft. (At the discretion of the pilot, a smaller area may be acceptable.) b. Land slope should not exceed 5 degrees. SOG 203.02 — Medical Helispot Operations Page 3 of 6 c. The area should be free from obstructions (i.e. bystanders, cars, trees, wires, stumps, buildings, bushes, etc.) 2. Preparation of the helispot. a. Helispot Design and Marking 1) Square zones are most utilized and should conform to the figure below. 1>>��11" 101"It" Fil L! C O IV's F E R A P P RO A (", I�H n; a " I i ° ",A11 irsF 9 21 lJ' v . 2) Inverted Y zones may be utilized in mass casualty incidents if multiple helicopters will be landing, or if preferred by the pilot. 3) Do not use cones or tape, as these can become flying debris. b. Provide appropriate helispot lighting. 1) Helispot lighting bags are located on all District Chief cars. 2) Four amber lights should be placed in each of the four corners. 3) A darker shaded 5th light should be placed between the two amber lights on the upwind side of the zone (see figure above). 4) Do not use white lights, spot lights or white strobes. SOG 203.02 — Medical Helispot Operations Page 4 of 6 5) At night, turn off all non-essential lights and insure any spot, flood or hand lights near the touchdown area ARE NOT pointed toward the helicopter, as this will temporarily blind the pilot. c. Provide dust abatement, if required. 1) Normally not required on asphalt or other hardened surfaces. 2) On natural surfaces, misting the helispot area with water to control dust may be necessary. 3) Engine company providing dust abatement should be positioned upwind from the helispot. Communications are established and reports are provided to the pilot. a. Coordinate communications through Fire -EMS Communications per SOG 502.02 Deployment of Medical Helicopters. b. Prvide a briefing to the pilot concerning the following: 1) Location of helispot (landing zone) 2) All obstacles within 1/8 mile 3) Type of surface and condition 4) Wind direction Sample Report: "Airlift, this is Helispot Manager. The landing zone is a (roadway, school, parking lot, field), surrounded by LLLet trees, buildiWs,fences), approximately (dimensions, marked by (strobes, lights, flares, cones). Obstacles and hazards in the area are (wires, light standards, radio towers, efences) to the (note in each compass direction Surface winds are (calm, light, variable, strong, gusting) in (compass direction Clearest path of approach is from the (compass direction)." c. Immediately notify the pilot of any changes to the above information! 4. Assistance is provided to the medical helicopter crew. a. Never approach the helicopter until the crew communicates that it is safe to do so! b. Be prepared to provide security for the helicopter, to prevent non - crew members from approaching the aircraft. c. The crew will select two or three personnel to help load the patient into the helicopter. d. When approaching or departing the aircraft, remain aware of the tail rotor and follow the crew's directions. e. Secure any loose items such as sheets and do not wear loose clothing, hats, etc. SOG 203.02 — Medical Helispot Operations Page 5 of 6 Helispot and medical helicopter crew are cleared for departure. a. Clear all ground personnel away from helicopter prior to engine start. No one may approach after engine(s) is started. b. Re-establish two-way radio contact with pilot and confirm the helispot (landing zone) is secure. c. Notify the pilot immediately if an unsafe situation develops. C. Response to a Medical Helicopter Crash 1. Alert Command and Fire -EMS Communications. 2. Call for additional resources as needed. 3. Coordination with Command (of original incident) is imperative. 4. Consider establishing a Medical Branch/Group for patient triage, treatment and transport for both incidents. 5. 111vill piutpprii piutc t i� p ih h�i r nnnle untilid t'noi e 'lentin; the utnm�li� pti�i�pr bldnkliY 6. Size -up should include: 1. Extent of damage to aircraft 2. Aircraft position and stability 3. Fuel spill and/or fire 4. Search & rescue potential 7. Rescue & Firefighting Considerations 1. Insure proper PPE with SCBA. 2. Utilize foam for fire control and vapor suppression. 3. Maintain accountability. 4. Provide illumination of area. 5. Establish Decontamination Group, if required. 6. Appoint a Liaison Officer for coordination with external agencies. 7. Secure the scene/preserve evidence. SOG 203.02 — Medical Helispot Operations Page 6 of 6