The Myths & Costs of Medical Helicopter Evacuaion Services

Less than six hours before a Jet Ranger medical evacuation helicopter valued at $1.5 million and its flight crew touched down at the scene of a car-truck crash south of Tamaroa Thursday, first responders had already met in Pinckneyville to explain the criteria and costs of activating the service.

Pinckneyville Ambulance Service Director Shane Malawy felt it was important to debunk the myths about medical helicopter use, and he brought to Pinckneyville Mike Kennedy of Arch Medical Services and George Hess of Air Evac Medical Services as his panelists. Malawy said there is on again, off again criticism as to how often the service is enlisted. That's the first myth.

Between January and mid-October of this year, Pinckneyville Ambulance Service has responded to 2,201 calls. Only 15 of those were emergencies requiring air transportation. Responses to vehicle crashes, ATV accidents and hunters falling out of deer stands are common.

For the Pinckneyville Community Hospital, it treated 3,376 patients yet requiring only 30 helicopter transfers. Those were for cardiac, stroke or trauma injury patients.

Kennedy, Hess and Malawy said the criteria are well-defined. Emergency Room physician Dr. Christie L. Foster of St. Mary's Good Samaritan Hospital in Mount Vernon makes sure those criteria are met.

"First of all, you're mixing aviation with healthcare," said Mike Kennedy with Arch Air Medical, "two of the highest regulated industries there are." The costs are hard to accept, between $15,000 and $25,000 for the 20 minute flight from a Southern Illinois accident scene or local hospital to St. Louis.

There are around the clock staffing and equipment costs. Unfunded government mandates increase the cost of flying. Malawy minced no words in saying hospitals and the ambulance service receive no revenue from the helicopter services. And, first responders can call off a flight in mid-air if it isn't warranted at no cost to the patient. Helicopter crews have also assisted at no charge even though a transfer was called off.

Malawy said although the costs are high, it pales by some of the cases he has seen. He cited a ground transfer from Marshall Browning Hospital to St. Louis which had to be diverted to Belleville Memorial Hospital when the patient went into distress. The family had the bill from Marshall Browning, from the ambulance service, from Belleville Memorial and the St. Louis hospital when a medical helicopter would have gotten the patient from here to there in 20 minutes.

"If their vital signs are not where they should be, that makes a determination," said Shane Malawy, administrator of Pinckneyville Ambulance. "If there's gross obvious traumatic injuries, fractures of multiple long bones." A conscious patient can make their own determination about the method of transport.

Arch Air Medical and AirEvac both offer memberships that can cut down on medical flight costs for about $100 a year per family and covers use of both services. That eliminates any costs left over after an insurance settlement. It's about money, but it's more about time when the minutes count.