By Dennis Wagner
The Arizona Republic
FLAGSTAFF, Ariz. — Despite the alarms raised by Sunday’s fatal helicopter collision over Flagstaff, federal safety officials acknowledge that none of the major reforms outlined in a 2006 report would likely have prevented the crash.
The incident was a rarity — it marked only the second time in 23 years that two emergency medical service aircraft had collided in midair, officials said Tuesday.
The crash was the 10th nationwide involving an emergency medical service craft this year and raised to “disturbing levels” longstanding concerns about safety of air transports of patients who need medical attention right away, according to Mark Rosenker, the chairman of the National Transportation Safety Board.
But Rosenker said Tuesday that the recommendations issued in a 2006 NTSB report don’t appear to apply to Sunday’s collision.
Six of the seven people aboard the two medical-transport helicopters, including two patients, were killed. The seventh was in critical condition Tuesday at Flagstaff Medical Center.
The report, which came after 55 air-ambulance crashes in three years, called for setting standards to weigh risks of each transport, to critically assess weather conditions, to better train dispatch communication and to install a warning system aboard that would help pilots negotiate hills, mountains and other steep terrain.
In Sunday’s case, the conditions were ideal for flying: Visibility was good, temperatures were in the 80s, and the winds were negligible.
There were no known obstructions and no indications from the pilots there were any anomalies prior to the two copters striking one another just outside the hospital, Rosenker said.
Fewer than 48 hours earlier, an Air Evac helicopter responding to an injured motorcyclist crash-landed about 30 miles outside of Prescott for unknown reasons, injuring its crew of three.
The two accidents resurrected an ongoing debate within the emergency-medical community over whether air-evac choppers are being overused.
Dr. Bryan Bledsoe, an author on paramedic care and a teacher at the University of Nevada, said the public has been duped into believing that speed is essential for emergencies when, in most cases, it is not. He said the result is a huge expense for unnecessary medical flights that pose a greater risk to patients and health-care specialists.
“It’s kind of a misconception perpetrated by Hollywood and the media that speed makes a big difference,” Bledsoe said. “It (helicopter response) is an important service, but vastly overused.”
The former flight paramedic and medical director for helicopter service questioned whether helicopter transport was necessary for Michael MacDonald, a wildfire hotshot crew member who was flown to Flagstaff from the Grand Canyon after a spider bite became infected. MacDonald, who reportedly was being flown to the hospital after going into anaphylactic shock, died in the midair collision.
Bledsoe conceded that air response can be critical for victims who have suffered strokes, head wounds, heart attacks and some other conditions.
However, he said his study of 37,350 medical flights revealed that two-thirds of the patients had minor injuries, and a quarter were released within hours after being treated in emergency rooms.
Another study found that only 22 percent of the patients picked up by helicopters “possibly benefited” from the rapid response.
Thomas Judge, a paramedic with LifeFlight of Maine and ex-president of the Association of Air Medical Services, said Bledsoe is correct that helicopters should be used judiciously, but carries the point to extremes.
“The trauma literature is unequivocal . . . The greatest number of experts is going to say this is important, but we have to do it right,” he added. “
Judge questioned Bledsoe’s study data and argued that helicopters are valuable not just in getting victims to a hospital quickly, but in bringing critical expertise to them in the field. He said aircraft are especially important for isolated areas such as northern Arizona, or in big cities where traffic gets clogged.
Trauma workers must make a snap decision, based on hectic field reports, whether to send an ambulance or a helicopter.
“The risk of getting it wrong is so high,” Judge said. “The best circumstance is he’s going to end up in a rehab hospital. The worse is that he’s going to die.”
According to Bledsoe, the number of medical helicopters in service nationwide has more than doubled during the past decade and now totals somewhere between 750 and 1,000.
Reporters Jim Walsh and JJ Hensley contributed to this article.