In the United States today, most airborne medevac ambulance services are provided by private operators. Many hospitals will contract out their helicopter services to one of several major corporations that will provide the hospital with helicopter services for both on-scene and inter-hospital transports. The obvious advantage of airborne medical transport is speed, particularly in rural areas. In emergency medicine, doctors and nurses speak of the "golden hour" for a trauma victim. This golden hour: represents the first hour after an accident, when survival rates are significantly increased IF the patient reaches definitive medical care within the first hour of the accident. Clearly in many areas of the United States, the only possible way to transport a critical patient within the "golden hour" is by helicopter. Airborne medical transports are not confined to trauma patients. There are many specialized cases such as burns, pediatrics, neo-natal and cases requiring a hyperbaric chamber that all benefit from a rapid response to a specialized facility.
The Maryland State Police (MSP) was the very first non-military agency to medevac a victim in the United States when they transported a patient in a Bell JetRanger aircraft in 1970. Driven by the efforts of Dr. R. Adams Cowley, the state of Maryland established a largely successful trauma response system, of which the MSP Aviation Command was a cornerstone. Today, the Maryland State Police are regarded as one of the premier police/medevac operators in the world. Unfortunately, tragedy can strike the best, and they are currently recovering from a fatal medevac crash in September. To further compound this tragedy, the MSP Aviation Command has come under fire, fueled largely by politics and media misinformation. Recently, the MSP Aviation Section received worldwide positive media coverage as they rescued motorists from a flash flood caused by a water main break. The rescues were seen live on the national news networks.
Airborne Law Enforcement Medevacs
Although private operators do the bulk of the medevac transports, there are still many agencies that still perform this lifesaving mission full time. The Maryland State Police, the Nassau County (NY) Police Department, the Fairfax (VA) Police Department, the United States Park Police Aviation Unit, the Orange County (FL) Sheriff’s Office and the Los Angeles County Sheriff’s Office are just a few of the agencies performing these missions daily. Most airborne law enforcement units staff their aircraft with a tactical flight officer that is also certified as a paramedic. They perform "double duty" and assist with the specialized equipment such as FLIR, night sun etc. during a police mission and switch to the lifesaving role during a medevac mission.
The airborne aw enforcement aircraft performing law enforcement and medevac missions is assigned with personnel that have incredible talent. A highly trained pilot, teamed with a police officer/paramedic can literally respond from a high speed pursuit of an armed bank robber to a serious auto accident with injuries in a matter of seconds.
What are the rewards of the medevac assignment? Police officer Ralph Spinola, Chief Pilot for the Nassau County (NY) Police Aviation Unit explains, "It is a good feeling to help out during very serious medical emergencies and know that you really impacted someone's life and in many cases actually saved their life." The medevac mission does have its downside, the aircrews interact act with severely injured patients, and many times these patients are teens or children, and it can take an emotional toll. One police officer/paramedic from an east coast agency, who wishes to remain anonymous, tried to express his feelings. "I have a young son and naturally when we get a patient around his age my thoughts drift to my own son. In some ways, that is a help, as it gives me the incentive and strength to provide the very best medical care to the patient because I see the patient as my own son." The other downside is that medevac mission may take the airborne law enforcement asset away form the crime fighting mission and searches or pursuits will go without air support.
However, airborne law enforcement medevacs also allow for very positive publicity for a particular agency. As one senior trooper/paramedic stated, "I always hear of a story where someone has received a traffic citation from a trooper and it is usually someone insisting on their innocence or that the trooper was discourteous so it is very nice to hear when I am wearing my flight/paramedic uniform and a person walks up to me and says, you guys saved my brothers (etc.) life." When a police helicopter performs lifesaving rescue missions on live TV, as was the case recently with MSP or when the United States Police dramatically rescued several persons including a flight attendant from the icy throes of the Potomac River after the crash of an Air Florida 737 on January 13, 1982. No amount of power point presentations or reports can so vividly demonstrate the lifesaving work of these brave aviation units.
Unfortunately, many of the police/medevac operators are being threatened by the fiscal concerns of private operators. Since private operators are profit driven, they often cry foul that public agencies have a distinct advantage. These operators will often state that public operators, using taxpayer dollars, do not efficiently or as effectively deliver these emergency medical services. Somehow, what is best for the emergency medical patient gets lost in these fiscal battles.
In any case, there are literally thousands of persons alive today thanks to the skill, training and dedication of many airborne law enforcement units.