The development of Helicopter EMS (HEMS, or as the Federal Aviation Administration recently coined it: “Helicopter Air Ambulance” or “HAA”) services in the United States has taken a decidedly different path in recent years compared to those in other countries. The wide spread use of single engine, VFR only aircraft, owned and operated by for profit companies is a uniquely American phenomena; at odds with most other countries who have developed HEMS programs around the world. This has resulted in significant direct competition between HEMS programs, as well as highly questionable billing practices that have started to garner attention. The origins of this development, including the use of the US “Airline Deregulation Act” to prevent states from regulating HEMS programs will be examined. More recent efforts in the US to tie reimbursement and program accreditation to the levels of care provided and minimum standards of equipment are still nascent at this time. Efforts by the US National Transportation Safety Board (NTSB) to mandate improved safety equipment standards have been met with resistance by the industry and the FAA. This has resulted in wide variability in US HEMS programs and the adoption of IFR standards, mandating NVG use, twin-engine aircraft and risk assessment strategies. There is also increasing scrutiny being placed on appropriate utilization criteria in the face of skyrocketing bills and questionable billing practices by for-profit companies.
Standards in HEMS. What standards?
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Burnout: A crisis of faith
Ka, , 2016, The Talks smaccDUB 2016, physician health, psychological burnout, Resilience, 0
This talk covers why its normal to burnout (so let's talk honestly about it), and (most importantly) offers practical...
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PURE: Point-of-Care Ultrasound in Resource-limited Environments
Phoebe Adams, , 2016, The Talks smaccDUB 2016, 0
The World Health Organization notes that 80-90% of all diagnostic problems could potentially be solved by basic radiograph (x-ray)...
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DNR Should Be The Default: PRO – Alex Psirides, CON – Sara Gray
Phoebe Adams, , 2016, The Talks smaccDUB 2016, CPR, default, DNAR, DNR, Do Not Resuscitate, End of life, End Of Life Care, Ethics, Futility, Resuscitation, SMACCDub, 0
Alex Psirides – PRO The application of ‘CPR-for-all’ is the ultimate evidence drift. A treatment that is completely appropriate...
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Publishing and the future of critical care knowledge dissemination
Ka, , 2016, The Talks smaccDUB 2016, data sharing, future, journals, publication, science, 1
Journals have been the main way to publish science for 400 years, but the system is no longer fit...
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The ICU is no place for the Elderly – PRO: Francesca Rubulotta, CON: Karin Amrein
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Elderly, ICU, 0
Francesca Rubulotta and Karin Amrein both came out swinging in this debate that universally gets people going! The crowd...
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Geriatric EM: Our new USP?
Ka, , 2015, 2016, The Talks smaccChicago 2015, The Talks smaccDUB 2016, elderly emergency care, elderly falls, emergency care, frailty, Geriatrics, 0
This talk will outline the importance and significance for the specialty in getting to grips with managing elderly patients...
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Does the Early Bird Catch the Worm?: How to be truly “awake” during a shift
Phoebe Adams, , 2016, The Talks smaccDUB 2016, Fatigue, shift work, SMACCDub, warm up, 0
Is there a specific time during our shift when we are too fatigued to safety practice? That was the...
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How Medical Students Can Choreograph Their Own Education
Phoebe Adams, , 2016, The Talks smaccDUB 2016, continious medical education, Debriefing, deliberate practice, educational theory, FOAMed, making experts, medical education, Medical Simulation, Peer to Peer teaching, performance, SMACCDub, 0
More than a hundred years ago Osler moved medical education to the bedside. Somehow today, most medical education still...