Medical Flights Under Scrutiny After Fatalities

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It was a week ago today in the skies above Flagstaff, Arizona that two emergency flights designed to save lives ended in tragedy. A pair of medical helicopters collided in midair and seven people died. For the rescue workers who responded to the crash, it was an especially difficult scene. Many of the victims were their friends and colleagues.

Now, as Arizona Public Radio's Daniel Kraker reports, the collision has raised concerns about the dangers of emergency flights.

DANIEL KRAKER: In Flagstaff Medical Center's emergency department, this is a sound doctors and nurses hear quite a bit. It means a medical helicopter is on its way. On a typical day about three medical choppers touch down here bearing patients from far-flung rural communities. Over the past two decades, it's become a much more common sound. Emergency medical flight hours have doubled in that time nationwide and the Flagstaff hospital has seen a huge increase as well.

Mr. BILL ASHLAND (Manager, Flagstaff Medical Center Trauma Program): It is crucial and it does save lives.

KRAKER: That's Bill Ashland, a former flight nurse and now manager of Flagstaff Medical Center's trauma program. He says helicopters have become even more important as small rural hospitals close emergency rooms and cut expensive high tech treatments.

Mr. ASHLAND: That's why we have trauma centers and trauma systems. And in order to get those patients to their - in a rural area like we have in northern Arizona, it's just prohibitive to load them on an ambulance, on a backboard, you know, with possible neck fractures and internal bleeding.

KRAKER: But as the number of medical helicopters has increased, there are now over 800 nationwide, so have the number of accidents. With this latest crash in Flagstaff, there have been 10 crashes nationwide so far this year with 17 fatalities. That puts the industry on pace for its deadliest year ever.

Mr. MARK ROSENKER (Chairman, National Transportation Safety Board): We are extremely concerned with the high number this year particularly of EMS accidents that we are being required to investigate.

KRAKER: That's National Transportation Safety Board Chairman Mark Rosenker. At a press conference in Flagstaff after the crash, he said the numbers were disturbing, and called on the federal aviation administration to adopt new safety regulations for the fast growing industry.

For example, more training for dispatchers and mandating more high-tech equipment like night vision goggles. But critics of the industry say stricter safety measures may not go far enough. Bryan Bledsoe is an emergency physician outside Dallas.

Dr. BRYAN BLEDSOE (Emergency Physician): The medical evidence fails to show really any benefit whatsoever from helicopter transport. Granted there may be a very, very small subset of just extremely critically ill or injured patients who benefit. But the vast majority of literature shows that these patients do just as well when transported by ground.

KRAKER: Bledsoe published a study two years ago that found as many as a quarter of patients flown to hospitals have injuries so minor, they're not even admitted.

Dr. BLEDSOE: We've got to get the physicians and the paramedics on the scene to really use the helicopters only for those patients where the benefits exceed the risk.

Dr. JEFF DANIEL (Director of EMS Services, Flagstaff Medical Center): What we are doing in those cases is erring on the side of doing what's best for the patient.

KRAKER: Dr. Jeff Daniel is director of EMS Services at Flagstaff Medical Center.

Dr. DANIEL: You have to look at it on the front end of what is the suspicion that we may have a patient who's critically injured, regardless of what ultimately happens with that patient.

KRAKER: The cause of the crash above Flagstaff is still under investigation. What is known is that the Grand Canyon community lost two critical emergency workers. Mark Yeston is a back country ranger at the National Park who worked with the paramedic on board one of the helicopters.

Mr. MARK YESTON (Park Ranger): In 26 years that I've been in emergency medical services in multiple western states, I've lost a total of, well, now eight friends and professional colleagues in helicopter crashes and helicopter incidents. That's a lot.

KRAKER: Yeston says everyone in the industry knows there's risk involved. But the reward - the chance to save lives, he says, is worth it. Still, every time he goes in the air, he says a little prayer before takeoff and gives thanks when the helicopter touches down.

For NPR News, I'm Daniel Kraker in Flagstaff, Arizona.

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