skyward medevac

gongshow · Post by **gongshow** » Wed Mar 03, 2004 10:49 am

Skyward's ontario plane is very busy, since it's based in Island Lake it's closer to the action than most other carriers.

I have asked ATC about the medevac status and they said only when you request priority will you be handled differently, a regular medevac flight that doesn't require priority but still has medevac in the call sign will not be handled any differently than the sched coming out of Shamattawa.

But I know that you do not have to be a code 4 to request priority, ATC guys have said that becoming priority comes at the discretion of the nurse/pilots, anytime that there are concerns about the patients health you become a priority. Say a kid has a badly broken leg and the pressure changes have made things worse, he's screaming and you're at 3000 thousand in the turbulence which is thrashing the kid around, even though this patient is stable and will be ok you probably should have priority over most other flights. The only time this might be a problem is if you arriving/departing at the same time as another medevac who has a code 4 which should only be Voyageur 795 or the lifeflight jets in MB.

Winnipeg ATC knows that lifeflight jets usually have seriously ill patients on board and always give them priority over the basic air ambulance carriers (skyward perimeter, etc.) so that shouldn't be an issue but i'm not sure if they know about Voyageur 795 and that it also handles code 4's

bandaid · Post by **bandaid** » Wed Mar 03, 2004 11:38 am

Very few medevacs come without potential for complications. If they were really stable they would be kept in the hospital where ever. We transfer patients for angiograms and plasty, bypass, anuerisms, GI, multible Fractures, gyn/obs, CVA, ect.... Things have changed drastically in terms of the level of care that these folks recieve enroute in the medevac. Given that, I'm sure that any Paramedic/flight nurse or Doctor will tell you that they would sooner have these patients on the ground at a critical care facility rather than circling the airport waiting for an okay to land.
Another issue that is often forgotten is that an important ground unit that may be needed for a serious call in whatever town they work in is tied up waiting for the Airevac to arrive. I have sat many a time at the airport in Kelowna waiting for an aircraft and hearing the city cars running their asses off. After 11pm their are only 2 cars on to cover this city. A medical team is waiting at the Hospital, xray, lab ect. All these people are impacted by a late flight and other patients at the hospital may suffer because of it. The airevac is just one small part of a very big picture.

Northern Flyer · Post by **Northern Flyer** » Wed Mar 03, 2004 12:07 pm

Come on now over half the medivacs in MB are the drunk guy fell and hit his head and needs a x-ray, or the little blue-berry blond took to many tylenol, or there's a monster BINGO in Thompson so lets complain of abdominal pain. Little Jimmy Jackpine has an infection in his toe because he hasen't had a bath in a month, so lets medivac him, his mom, and his dad to The Pas so they can spend Jimmys colledge fund at the casino.

I'm not being sour, just that after I shoot the second circling NDB approach down to minimums at three in the morning to pick up Sally Soreleg who twisted an ankle in a drunken stuper, I don't feel to much compasion, expecially when I see her walking down the street like nothing happened the next day.

End Of Rant,
Saving Lives

bandaid · Post by **bandaid** » Wed Mar 03, 2004 12:28 pm

You've been up north too long if that is your attitude. Sure when I worked in Prince Rupert that happened all the time. It's really easy to lose sight of the fact that the little blonde with the belly full of tylenol could die from liver failure if not treated or that she could use the phchiatrist afterwards, or that young Billy could loose a digit through no fault of his own other than environmental retardedness. The drunk that fell and hit is head is no longer a person because he has an illness call alcoholism. I too have been disgusted by some of the people that I have been forced to treat over the years and I am the last person in a glass house that should be tossing the stones, but I get paid to do this job and should I do it any differently because the patient is clean and sober? What difference should it make to you?

Kosiw · Post by **Kosiw** » Wed Mar 03, 2004 12:51 pm

I think it's the thought of having to risk your neck (even though its your job and you're getting paid to do it), for someone else's stupidity.

1st timer · Post by **1st timer** » Wed Mar 03, 2004 12:57 pm

Northern Flyer:

It is time to stop doing medivacs when you get as sour as you are. I have been there done that. Ask your CP for a change or start looking for another job if there is nothing else to do. You may not know it but your attitude will reflect in the work you do, and your job will suffer and those around you (FO, capt, EMT, nurse, doc ect...) will too.
Good luck do yourself a favor and get out while you still have some sanity.

bandaid · Post by **bandaid** » Wed Mar 03, 2004 1:08 pm

Kosiw,
Well I know that I have never done anything stupid and been lucky enough to walk away from it. Your right, it's frustrating. I have shaken my head in disgust more time than I can remember. I have been shot at, punched in the mouth, had knifes pulled on me, family threatened ect... And all this because I came to help someone. You make it sound like all your patients are screw ups. Whatever? Just be careful from here on in. I would hate for someone to think of you the same way as you feel about some of the patients you transport.

Kosiw · Post by **Kosiw** » Wed Mar 03, 2004 1:26 pm

When I used to fly medivacs, providing good customer service was one thing, but I never felt as though I had to sympathize with who I was transporting....guess I am not a humanitarian at heart

bandaid · Post by **bandaid** » Wed Mar 03, 2004 1:31 pm

Let me tell you about the scariest medevac I ever did. I was working out of Prince Rupert when a call came in from a lighthouse nearly halfway to Vancouver Island for GI pain. I jumped into a Bell 206 and off we went. We had to stop at a fuel cashe along the way to top up the tanks in the 206 so we could make it back without stopping. It was an unusually clear day so the flight was very pleasant.
When we got to the Lighthouse, as often happens on nice days on the coast, their was a big bank of fog covering the island where the lighthouse was located. We managed to find the island by hovering from rock to rock and being guided by radio from someone in the lighthouse. He was telling us which way to go by sound.
We finally find the island and land on the helipad where their is a man standing at the pad with one big duffle bag over one shoulder and a big mail bag over the other. I asked where the patient was and he said that he was the patient. I said he looked quite healthy what with the heavy bags and all. He said that it was embarrassing what his problem was. I figured that for the money we paid for the aircraft and the fact that the pilot risked a lot to get to the island I would load this guy on the helicopter and get the story over the internal radio. He stated that he had been suffering from swollen hemorrhoids and losing sleep.
To make a long story short, this guy was not a priority and was none of the types of patient that some of you guys have discribed. Just a guy in pain that couldn't wait for the next scheduled coast guard visit to get to a clinic and have his condition treated.

confuzed · Post by **confuzed** » Wed Mar 03, 2004 5:28 pm

thanks for the clarification there gongshow. However, as long as you have an ACP(f) medic on board as well you can do a code 4. Obviously for certain issues you'll need a critical care paramedic which there are only so many companies that have them. It just depends on the case, as an individual with heart problems, stroke are pretty serious issues. I have also been bumped into a hold while hearing a medevac aircraft coming that weren't even asked if they were priority. After landing we find out that their patient was something minor where ours was having worse problems but just the fact that they announce medevac got us bumped. I do agree that things can change in flight, as it hasn't been unheard of to hear a medic ask for the closest hospital not caring what city or town it was enroute. They just needed to get on the ground with that patient ASAP. I've seen the really BAD calls, but like Kosiw (I think that's who said it) was saying there's also a lot of BS calls. I've had kids who said they weren't sick but mom said they were?!? However, like bandaid says you have to treat all patients as if there's a potential for it to get worse and treat them as though there is a problem with them. It is frustrating sometimes I admit pulling an aircraft 500 miles away to do this kind of trip, but it's not my call. We just go where MATC tells us to go. If there's issues as to whether or not it's a legit call, then it goes in the medics report from what i've been told. I've seen patients where a medic has tried to drop their arm on their face (they're apparently unconcious, and just a response test) and guess what the arm always manages to fall to the side of their head just before it hits them ?!? Oh well, what can you do, other then treat them as though there's something wrong.

Getting back to the main issue though, if you're not requesting priority that's cool but why bother calling yourself medevac in the first place? Who cares if you have a patient on board, it's just another charter right? Voyageur doesn't always fly around using the term medevac, only when it warrants it. Maybe it's a MB thing and that's fine whatever, now I know why they do and that's all I wanted to know. I just wasn't sure why we get tossed into a hold because there's a medevac aircraft inbound.....again after landing finding out the already stated. If the patient is really bad, then yah get them there as fast as you can with all the bells and whistles blowing away. If not, then why bother advertising that you're flying patients, who cares? ATC knows generally which aircraft do the medevacs around their area so they usually know what's going on. They know that Skyward 911 is a medevac machine, or voyageur 795 or the chopper even so it's not as though they're oblivious to what's going on. Just a thought.

Northern Flyer · Post by **Northern Flyer** » Wed Mar 03, 2004 5:43 pm

Sounds like I pi$$ed a few people off, I'll be honest, I do care about the young kids, and old people I fly. It's the people in between that I can't always feel sorry for.

Here's a scinario for you. Julie Jigglybush is eight and three quarter months pregnant, she is medivaced out of Timbuctoo on wednesday in labour. Turns out it was false labour so she checks out of hospital against doctors orders, and jumps on a train back to Timbuctoo thursday morning. Thursday night phone rings "Hay Northern, go pick up Jigglybush in Timbuctoo she's about to calf." You want to talk about a waist of tax payers dollars, because of a stupid person who couldn't put two and two together and figure out that hay, maby the docter is right I could have this baby any minute. That poor baby.

But in all honesty, that never happens. I'm just trying to stur the pot. Even if it did what would I care, its just more hours in the log book.

oldtimer · Post by **oldtimer** » Wed Mar 03, 2004 6:46 pm

I did a lot of Medivacs out of Edmonton and we always called ourselves a medivac, simply because it was policy, dictated mostly by the requirement to have a gate opened so the ambulance could get airside. It got to the point, and I think this was a feeling shared by all of our pilots, is that this is just another flight and I am not going to be a hero and take absurdly ridiculous chances just because you are a medivac. That is not to say we didn't care or anything like that, it's just that we did not want happenings in the back to influence our decisions as pilots. A wise old chief pilot once told me that it is better to let the patient die in the comfort of a hospital than in the back of an airplane so any medivacs we did, we made sure we could complete the trip. That was being a responsible pilot. After that, make the flight as smooth and quick as you safely could. Sometimes we got stuck with sudden changes but we adapted. I have found that ATC can at times get carried away with this medivac prioprity thing and some pilots seem to get their rocks off calling themselves a medivac. But for the most part, pilots are just following orders, either from the company or the medical provider.

ahramin · Post by **ahramin** » Wed Mar 03, 2004 7:13 pm

Not without some apprehension of getting flamed for being off topic, i am just posting this for everyone's information:

It's medevac,

As in med and evac.

Not medivac,

as in medi and vac.

Unless of course you are a travelling vacuum salesman who really needs to get there.

I know i know, who cares. Just thought i would point it out.

Respectfully

ahramin

Oh, and some of our captains file medevac for every flight, while some only file if they want some extra consideration. I have noticed that controllers are a little bit better about giving direct routings if you are medevac.

bandaid · Post by **bandaid** » Wed Mar 03, 2004 7:22 pm

Yah, well what can I say, some people are just born on the wrong side of the bell curve. To steal from another post, someone get her a sign.

AIR 3.11 · Post by **AIR 3.11** » Wed Mar 03, 2004 7:50 pm

Here's an example. Flew a MEDEVAC (Code 4) into somewhere ON the other day. Another MEDEVAC from MB was coming in at the same time. They got priority.....we were asked to extend 5 miles to accomodate them. We landed right after them and pulled up to the ramp a couple of minutes after them. When we got there, there was no room on the ramp so we had to park on the taxiway. The ambulance that was there and waiting wasn't sure which aircraft to go to. We hopped out and talked to them..... we figured it must be for the other a/c seeing as they got the priority. It turns out no patient was on board. Just 2 pilots coming in MEDEVAC status to save time. So it does happen.... mind you that's the first time i've seen something like that since i've been doing this type of flying........but still......shouldn't be used if not necessary and definitely not used if no patient on board.......that's just ignorant.

Cat Driver · Post by **Cat Driver** » Wed Mar 03, 2004 8:00 pm

It has always been thus...

A lot of Northern medevac's were nothing more than a scam to get us to fly in unsafe weather.....

During my time with Austin Airways we never did figure out how to handle these calls, usually we just went, sometimes we saved lives...sometimes we kept the sked in weather that was not really safe to fly in.

I guess saving even one life made up for a lot of non medical emergencies flights....

Cat

oldtimer · Post by **oldtimer** » Wed Mar 03, 2004 8:15 pm

ahramin is correct on the spelling. BC has the best system. The Air Ambulance Service decides who goes medevac status and who doesn't.
I beleive ATC or TC on complaint from Nav Canada, or even from users, can violate pilots for flagerant missuse.

ahramin · Post by **ahramin** » Wed Mar 03, 2004 9:03 pm

That sounds like a much better system but still ... where is the accountablity? The Air Ambulance Service is the one paying the fuel bills correct? So they have a conflict of interest too.

But at least it becomes real easy to check if it is being abused. Which does not mean that anyone checks.

What about stuff that is not controlled by the Air Ambulance Service? Like private medevacs or radioactive isotopes going from UBC to seattle? I would think that surely you can use the medevac callsign without having to get permission from the Air Ambulance Service?

ahramin

NO LINK* · Post by NO LINK* » Thu Mar 04, 2004 5:16 am

Yeah, and passing judgement will bite you in the ass too! I've happened to run across both pilot's and FSS who thought they were really doing the world alot of good. I was questioned on two different occasions after disembarking with no patient on-board-let alone flight crew, to be ridiculed by my fellow aviators. It was only after I was finished with my explanation of PATIENT CONFIDENTIALITY that I reached into the plane and grabbed the cooler that contained a vital organ ready for transplant. Oh, and just then the road ambulance showed up. I'll keep smiling at least that wasn't my organ in the box. I'll agree that there may be a little flagrant use of the term-but the good still outweighs the bad.

gongshow · Post by **gongshow** » Thu Mar 04, 2004 12:22 pm

Alberta seems to have a real good medevac system in place, many companies get a piece of the pie, all King Air 200's with the raisbeck mod, very nice.

BC i'm not so sure of, giving a medevac contract to one company who didn't even have the airplanes it needed at the time, seems a little sketchy

But you wanna talk about sketchy, head on over to Manitoba. Pistons doing medevacs, It's an absolute free for all, no one seems to care what goes on, if the taxpayer only knew. Double/triple billing, planes 600 miles away doing a medevac where another plane might only be 100 miles away, but hey the nurse is getting free doughnuts. If time is no issue a company will send the airplane that is furthest away to make more money and on and on it goes. No one seems to care, but hey the bills are getting paid.

Here is an example of what actually goes on. Company A does a patient transfer from YTH to YWG, in YWG they get a call to pick up 2 patients in YST, so they go to YST back to YWG, then they have to bring a new patient back up to YTH, so the routing was YTH-YWG-YST-YWG-YTH which equals 1389 miles which is about $11,112 dollars. But the billing will go like this YTH-YWG-YTH-YST-YWG-YTH-YWG-YTH and the YST trip will be double billed as well because there were two patients on board so now the miles are 2507 or $20,056 plus the double bill runs the tab to $24,752. Not a bad day for only flying 1389 miles in a piston twin.

But hey can't really blame them, the bills keep getting paid no questions asked

jimmyjazz · Post by **jimmyjazz** » Thu Mar 04, 2004 3:07 pm

Who uses a piston twin I only know of king air's, metro's , conquest's and of course citation

gongshow · Post by **gongshow** » Thu Mar 04, 2004 4:25 pm

Skyward uses a Cessna 421

clearmyside · Post by **clearmyside** » Fri Mar 05, 2004 5:13 pm

anyone should understand that an flight calling themselves a MEDEVAC is like an ambulance on the street with sirens and lights on meaning: get the hell out of my way...shit's going down in the back of this bus!!!
there's ambulances driving around all the time with no lights on, still transporting patients. so, why some pilots (and we like to believe we belong to the smarter group) are such numbnuts and don't see the true meaning and urgency of an aircraft calling themselves MEDEVAC is beyond me. in ontario as well as in bc MEDEVAC status is only allowed in critical cases. some controllers are actually on the ball and ask if someone's a priority medevac or not.
unfortunately, there's always those who abuse the system just to get ahead, but trust me when i say this: things are underway to stop the practice of unnecessary medevac calling. there has to be more accountability and hopefully there will be. we are after all not only responsible for some passenger's life, but for a passenger's life who in case of a true medevac needs to get from a to b in a hurry TO SAVE HIS LIFE. anyone, abusing the status, abuses the sytem and with so many companies flying medevac these days, it is bound to happen that a true medevac is delayed and the patient (worst case scenario) dies.

bandaid · Post by **bandaid** » Fri Mar 05, 2004 11:14 pm

I will say one thing about the BC system and that is that it has grown leaps and bound over the 24 years that I have been a paramedic here. Designated aircraft for transport. I have done trips back and forth from the Kootenays to Calgary in a 337, I have flown in Grummund Goose, in Husky Fairchild, in Beavers, single engine Otters and in Mallards. In BC now the aircraft are all duel pilot, twin turbo or jet. We still use a variety of Helicopters though I can not tell you which ones. I sometimes look back on my career and feel lucky to still be alive.

jackalope · Post by **jackalope** » Fri Mar 05, 2004 11:46 pm

Like that little boy and the wolf: if you are always screaming at the same volume, you will not be heard.

If you use the term "Medevac" like it is supposed to, you will get the service you require, and everyone will know it is the real thing. If we are dispatched on a Code 4 (only level which warrants the Medevac call sign here in Ontario) and happen to overhear the medics talking like "this wasn't as serious as we were told", etc. I will ask them if they want to drop the medevac label, so that we can save it for when we really need it.
This keeps us in the good books with ATC and the sched guys too, so that they know we don't take advantage of it. That way, when we are on a real Code 4 they clear the way without question, even if we were 4th in line for the approach, etc.

skyward medevac

Skyward Medivac