Why does the public accept the EMS helicopter industry’s horrible safety record? Because the industry has sold the idea that it’s critical to deliver trauma victims to a hospital within the first “golden hour” after an injury. While the industry acknowledges that the EMS helicopter accident rate is high, it argues that many more lives are saved by EMS helicopters than are lost.
The logic is appealing. But it doesn’t wash. Here’s why.
- The Need for Speed. Though helicopters are fast, when it comes to getting the patient to a hospital, a ground ambulance is often faster. At least in urban areas, ground ambulances are more widely distributed than EMS helicopters. That means a ground ambulance is more likely to be stationed closer to the trauma victim. A well-positioned ground ambulance can often get to the trauma victim and deliver him to a nearby hospital quicker than a helicopter can. By and large, a helicopter’s speed advantage is limited to rural environments, where ground ambulances are fewer and farther between. The helicopter’s speed advantage is overrated.
- The Myth of the Golden Hour. There is nothing “golden” about the first hour after the accident. At least not for the patient. That’s because survival rates do not drop off precipitously 60 minutes after an injury. In fact, the peer reviewed studies have been unable to establish that there is any “magical time” for saving trauma victims. Sure, getting the patient to the hospital quickly is generally better. But the “golden hour” argument is marketing hype.
- “Life Flights” That Aren’t. At 12 year-old was airlifted from summer camp to a hospital in Austin, Texas after she hit her head in the shower. The bill for the flight was $16,000. Upon arrival at the emergency room, she was treated, and then sent back to her summer camp. Such stories aren’t unusual. In fact, some studies show a third of all patients delivered to emergency room by helicopter are released without ever being admitted to the hospital.
- Pricey Shuttles. Many EMS helicopter flights are inter-hospital transfers merely shuttling patients between hospitals. Operators love these profitable gigs. One calls the transfer patients “golden trout,” and encourages pilots to “hook” every one they can, regardless of how bad the weather conditions. No matter that, since the patient is already at a hospital, these transfers seldom classify as “emergencies.”
This is not to say that EMS helicopters never make a difference for trauma victims. But much less often then the industry would have us believe. One study showed that, at most, only 22% of those transported by EMS helicopter to Silicon Valley hospitals could be considered to have "possibly" benefited from the air ambulance. Other studies suggest that, even in cases involving serious trauma, helicopter transport improves the patient’s outcome less than 5% of the time. That means that 95% of the time the helicopter exposes the critically injured patient to an unnecessary risk.
The industry has oversold the need for EMS helicopters. The benefits simply do not outweigh the risks.