I've long been a believer in the Bryan Bledsoe School ofHelicopter EMS (HEMS) Usage. Essentially, they have a place in EMS, but they should be like abortion – safe, legal, and rare.
Back home in Pennsylvania, I've been outspoken over the asinine use of HEMS. When you're within a mile of an open and functional trauma center, there is no good reason that you need to land a helicopter to transport your patient... yet I've seen and heard that happen.
Don't get me wrong, HEMS has its place in EMS. The providers often have more advanced tools and drugs, especially for securing airways in traumatically injured patients.
One of my most common places to use HEMS back home is actually at a prison that we cover. We often have some time delays in accessing, packaging, and removing the inmate to the ambulance, and the facility also has a true helipad. If I call for the helicopter when I'm in the facility, it's on the ground or landing by the time I can load the patient and move to the LZ (Landing Zone). Depending on the time of day and road conditions, my drive time from the facility to a Level II trauma center can be as little as 30 minutes, or as much as 45 minutes or more. That meets criteria, in most cases, to allow HEMS usage. And HEMS is actually faster if they are on the ground at the same time that I could start driving.
Now out here, I’ve got extended drive times from much of my territory to trauma centers, and in some places, even a hospital. My two closest hospitals for much of my territory are community hospitals, one of which is technically a "critical access hospital." Additionally, when my patient is down a trail, or on a boat, I’m rarely sitting waiting for a helicopter to land to take my patient away. The crews I’ve worked with are great at minimizing scene time, and usually are in the air within 5-6 minutes of climbing into my ambulance.
Now here’s the fun part. Often, when I send patients by helicopter, they go to the hospital Dr. Bryan Bledsoe works at. That’s just ironic, isn’t it?