From: rkaplan@netcom.com (Richard Kaplan)
Subject: Re: Air Lifeline experience
Date: Mon, 31 Aug 92 01:43:17 GMT
Organization: Netcom - Online Communication Services  (408 241-9760 guest) 

In article <7219@lib.tmc.edu> jmaynard@oac.hsc.uth.tmc.edu (Jay Maynard)
 writes:

>Not necessarily. There's nothing that says that private/part 91 operations
>can't be just as professional as part 135 operations, just as there's nothing
>that says that volunteer EMS services can't be just as professional as paid

Part 91 operations MAY be as professional (particularly with a high time
pilot).

Part 135 operations MAY be less professional (particularly with a
low time, recently certificated commercial pilot).

However, in general, the commercial pilot is trained to handle the
aircraft ^^^^^^^^^^ in a more precise manner and has demonstrated
these skills to an  objective examiner.  That's why the private/commercial
distinction is there.  It is unwise for AirLifeline and/or
the pilot himself to be the judge of whether a given private
rated pilot is competent to handle commercial-level risk
management.


>services. (Sorry if this sounds too strident; I'm a volunteer paramedic, and I
>just got back from a call where a bystander who was an RN commented to the
>mother of an 11-year-old patient about how long we were taking to get him
>ready for transport by saying, "That's the thing about these volunteer
>services. You get what you pay for." ARGH!)

Your analogy is not fair because even though you are not paid as
a paramedic, you are still trained, licensed, and equipped to
the same standards as a paid paramedic.  A better analogy would
be (independent of volunteer/paid status) between a BCLS
(Basic Cardiac Life Support) ambulance and an ACLS (Advanced
Cardiac Life Support) ambulance.  Sometimes the former can 
handle a situation just as well, but if a patient is in 
certain heart rhythms when the ambulance arrives on scence
(e.g. V. fib) the ACLS ambulance has a tremendously higher
chance of reviving the patient.


>There are cases where transport by air with Lifeguard handling would be
>appropriate in other than an air ambulance. I don't know if I'd take such a
>case, though; I'd probably spend too much time worrying about the patient's
>medical condition and not enough worrying about flying. Fortunately, it's not
>a problem yet, as I don't own an airplane...

IMHO AirLifeline is inappropriate for a 
critical patient or for any time-sensitive medical mission.
An air ambulance or a ground ambulance moving fast would
be more appropriate.  It's just not worth risking additional
injury or illness.  Moreover, an acutely ill patient is
much better off in an appropriately equipped ground ambulance
at 60+ MPH than in a non-medically equipped airplane at
150+ MPH.  

If the issue is a medically stable patient needing urgent
transport for transplant surgery, see my comments regarding
commercial/Part 135 operations above.  Moreover, the 
cost of air ambulance service pales in comparison to the
cost of transplant surgery.

If the issue is semi-urgent transport of medical cargo
(rarely is such a need an "emergency" except some organs
for transport, and then see the paragraph above), THEN
there may be a quite appropriate role for AirLifeline
and the private pilot.  However, this still does not 
justify the private pilot's lowering his weather
minimums.

-- 
Richard Kaplan M.D.           Medical Software Exchange BBS
806 2nd St. SW # 104          (507) 281-1989 14,400 HST
Rochester, MN  55902          (507) 281-1689 Voice
PP-ASEL-IA     N4VRB          rkaplan@mayo.edu|netcom.netcom.com  
Newsgroups: rec.aviation