It's déjà vu all over again

Editor’s Note:

Editor's note: This story is in response to the recent news piece, "Air medical industry 'resisting upgrades'". Amid the recent spate of deaths, NTSB says the voluntary approach to improvements is not working. Tell us what you think in the member comments.

Is the EMS helicopter industry stuck in the 1980s? Like a famous baseball figure once remarked, "It's déjà vu all over again." It was back in that decade that the ground ambulance industry finally began to transition from something that seemed like a mortuary business to the more uniform, professional appearance we see in current day EMS.

I can remember how agencies back then ran fast and loose with regulations, staffing and equipment levels. While I can laugh now, it wasn't so funny then driving vehicles that didn't have equipment onboard or enough tread left in the tires while breathing carbon monoxide fumes in the passenger compartment.

Voluntary adoption of more stringent regulations didn't work then. Not enough money, operators said. But when regulators came calling, resources were suddenly there.

I also can recall how dinosaur medics and EMTs — me included — grumbled about the loss of our "freedom" as we headed into the 1990s. More regulations! More restrictions! But in hindsight, I think it's been more helpful than hurtful in helping us to professionalize the industry.

Unfortunately, this quaint homily does not quite apply to HEMS. If an ambulance suffers a flat tire, at least the person driving it can quickly try to pull over to the side of the road. If something goes wrong midflight in a helicopter, more often than not the end result is a crash.

Yes, changes will increase costs. But what will be the cost to crew and patients if the industry continues to follow its current path?

And as we discovered in the past, voluntary adoption means changes can never happen across the board, which can create unfair competition between services. It's time for the FAA to act now to protect those whose mission is to help others.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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