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A man was standing next to his vehicle on the shoulder of the road on I-90 near exit 263 when another vehicle traveling on I-90 and struck the man. Witnesses say the man walked into the lanes of the freeway right before he was hit.

The accident happened Saturday morning, March 9, 2019, in the westbound lanes of I-90, and the man was airlifted to Sacred Heart Medical Center in critical condition. Washington State Patrol say that the accident is still under investigation.

Air Ambulances

Air ambulances—often called Life Flight which is a trademark—are fully operational ambulances that use helicopters to transport a patient directly to a waiting emergency room. As of 2016, there are over 1,000 air ambulance services that transported over 500,000 patients to hospitals around the country. In most cases, the flight either saves a life or prevents further serious injury for the patient.

When are Air Ambulances Used?

The decision to use a air ambulance is one of a fair amount of controversy. The air ambulance is supposed to be limited to cases where the injured would die or experience much greater injury if not taken to a hospital in minimum time.

However, many in the industry say that too often, the decision to use the service was made unnecessarily which then ties up resources for when it is needed. However, supporters of the system say that the decision is made in the heat of an emergency, and it must be made quickly if it is going to be helpful.

Who Makes the Decision?

In most cases, EMS staff on the ground at the scene will make the call with the decision falling to those trained to make the call or to the senior EMS person at the scene. Unfortunately, training for those to make the call is limited to the more populated cities and counties. When trained, those making the call will keep in mind a host of factors such as traffic, travel time, best receiving hospital, the condition of the patient and the likelihood that the patient will die or suffer greater injury if not taken by air.

Poor Decisions

However, often the call for the service comes from untrained EMS personnel typically working in smaller counties that do not have the resources to train the EMS workers. This creates poor decision which can pull resources from where they are needed, and in many cases, these poor decisions on the ground become costly for the patient.

In a study done by the National Center for Biotechnology Information, most of the decisions made for triage at the scene—which includes life flight services—comes from the “gut feeling” of the EMS personnel in charge. The study concluded that over 65 percent of the time, this gut feeling was the primary consideration for making the decision rather than explicit triage material.

Many say, no big deal, as long as the outcome was good. However, if a decision to use the service turns out not to be medically necessary, then the cost of the flight was unnecessarily incurred by the patient.  The average air ambulance cost around $50,000 in 2016, and most insurance policies pay either a caped amount or only 60 percent of the bill leaving thousands of dollars left for the family of the injured.

In one case in 2013, two children were transported by air ambulance to a trauma center for minor injuries over the objections of the parents who were then left with as $29,000 bill that their insurance won’t cover. This left the parent with a bill they couldn’t pay and a feeling of frustration and helplessness as their wishes regarding the medical treatment of their children were not heeded.

So What can be Done?

In many states, lawmakers are proposing legislation the will allow the patient to turn down the service–which would include a parent’s right to refuse for their child.  Many states are also trying to address the rising costs of air transport. In 2007, the average cost was only $13,000 which is one fourth of the cost today for the same service and laws are being proposed that will either cap what can be charged or require insurance carriers to cover more for the service.

Steve Whitehead, a firefighter/paramedic with the South Metro Fire Rescue Authority in Colorado suggest the acronym FALTER can help ems personnel make these decisions.

F is for Fear: If there is a genuine fear among medical personnel on the ground that they are unable to handle the situation and the patient might die or suffer greater serious injury, then it should be considered.

A is for Access: Is there proper access to accept the flight near the accident to make it worth it?

L is for Lazy: This is a gut-check for the EMS on the scene. Is the reason because it is just easier?

T is for Time: Does it really save time? Consider the time for the flight to arrive, fly and unload.

E is for Extraction: Is extraction necessary? Is the patient really “sick and stuck” and in need of transport?

R is for Real: One last check is to see if the need is real, and if the air flight would really save time. Account for the flight to the scene, time to get to the chopper, the flight given air traffic and regulations and then is the landing site at the hospital clear.

Do I Need an Attorney?

Air transport can be one of the hidden costs associated with a serious injury that resulted from someone else’s negligence. When this happens, consider consulting with an attorney who can help you work with the insurance company of the one who caused your injuries. The attorneys at  Crary, Clark, Domanico, & Chuang, P.S., have the experience and knowledge to go toe-to-toe with the insurance companies and their lawyers to get you fair compensation for your injuries. Call them at (509) 926 4900 or send them a message.

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