By Rosalind S. Helderman
Washington Post Staff Writer
Tuesday, November 25, 2008
Maryland has seen a dramatic drop in the number of patients flown to hospitals since the September crash of a Maryland State Police helicopter killed three rescue workers and a patient.
According to statistics presented to a panel of national experts, emergency workers flew patients to hospitals 226 times in the seven weeks after the crash and decided against flying in 169 instances in which flights were initially requested. The panel is reviewing the state's use of helicopter transport.
If the trend holds, there will be fewer than 1,700 air transports in the 12 months following the September crash, compared with about 4,100 in fiscal 2008. The state's aeromedical director, Douglas J. Floccare, told the experts yesterday that he worries that a "skittishness" among ambulance crews might have led them to avoid necessary air transports.
"I'm concerned there are some patients now that should be getting flown to trauma centers who are not," Floccare told the seven-member panel.
The sole survivor of the Sept. 27 crash, Jordan Wells, 18, told reporters yesterday that she hopes the helicopter medevac system is improved. In a statement, her family said that Wells's right leg was amputated and that she has undergone multiple surgeries. Her parents said Wells is "totally alert and continues to improve every day."
In an interview, Jordan Wells's father, Scott, indicated that the crash in Prince George's County had taken a psychological toll on his daughter, as well as a physical one.
"It was very difficult and emotional finding out that her friend had died, that everyone else had died," Scott Wells said. "And every day it was just another battle with the pain and the operations."
When the helicopter crashed, Jordan Wells and another teen were being flown to Prince George's Hospital Center after a Waldorf car accident, and the incident prompted questions about whether Maryland's 11 state police helicopters were being used more than necessary.
The other patient, Ashley Younger, 17, was killed in the air crash, and her mother has questioned whether Younger's and Wells's injuries from the car accident were serious enough to require the airlift. Stephanie Younger, has noted, for instance, that her daughter was able to call her after the car accident.
The first emergency workers on the scene classified Younger's and Wells's conditions as category D, the least severe for trauma victims under Maryland's triage guidelines. Other rescue workers on the scene revised their conditions to category C because the car had been crushed in the accident.
Scott Wells said that in October, when his daughter was able to speak for the first time to her parents, she apologized for the car crash.
After the September helicopter crash, Robert R. Bass, executive director of the Maryland Institute for Emergency Medical Services, directed paramedics to consult with trauma center doctors when deciding whether to fly category C or D patients to hospitals. Rescue workers can still decide on their own whether to fly the most seriously injured patients, those rated category A or B.
Bass said yesterday that the reduction in medevac flights is attributable in part to the policy change. Since the crash, doctors have been consulted 122 times about whether patients should be flown and have approved flights in 38 percent of the cases. Bass said rescuers have also made fewer requests for medevac helicopters.
Wells said he and his wife do not want people to avoid helicopter transport. "The odds are really in your favor," he said. "Things like this don't happen a lot."
The expert panel, convened by Bass in response to the crash and chaired by Robert C. MacKersie, director of trauma services at San Francisco General Hospital, was briefed yesterday about Maryland's state-run air ambulance system. Members are scheduled to present recommendations for improving the system today.
State Sen. E.J. Pipkin (R-Queen Anne's), attending the hearing, said the system needs more-comprehensive change than the panel is likely to propose. He noted that the experts are not reviewing helicopter maintenance records or other safety issues.
"This is Thanksgiving come early," Pipkin said. "This is a pile of turkey we're getting served up."
Staff writer Jenna Johnson and the Associated Press contributed to this report.