Safety in helicopter medevac

Back to talking about safety in helicopter medevac. Certainly this needs to be the largest looming concern in an industry that must solve the problem. Years ago, it was speculated that 250 strategically placed helicopter services could meet the needs of the United States. Essentially, helicopters were to reach out to rural areas where trauma services is not available to save a life. Today, in the U.S. there are over 800 helicopter medevac providers located in urban areas. Granted helicopters are expensive to launch and operate 24/7 days a week.   Trauma treatment is also expensive. Having stated this —- it is apparent that competition for revenue is a driving force with many pressures to perform. Helicopter medevac is a for profit business in a limited market with significant competition. So the big question is how to reconcile issues of profit and sustainability and avoid the catastrophic escalating number of accidents.

How many flights must a hospital have per month to maintain service? What kind of pressures play into this scenario?  You’re out there —- you know. Think on this.


The recent terrorist events in Paris blow my mind. We are definitely living or dying in a world gone mad with violence. How do you change this? What future is there for any of us continuing in a mindless engagement of destructive activity? Do guns and killing really solve any of this? The result of such actions stimulate ideas of retaliation. How can we create a more peaceful world respecting all as human with the same needs? (Food, shelter, water, family, freedom to be without threat and intimidation and respectful of all life.) We are deeply troubled and in trouble as we create a fear based world where no one feels safe. We individually and collectively must find ways to STOP IT. Our very planet depends on it. Our life and that of our children and their children for generations to come is in jeopardy. Find a way to do your part. Seek the guidance of a higher power. #Paris #violence #guns


Helicopter accident prevention

In the first blog on this site, I posed the notion that those in helicopter medevac had daily experience and knowledge in this arena that could be collectively accessed to prevent accidents that are costing people’s lives. The proliferation of accidents is alarming and there needs to change. I asked if those in the industry could talk about this. Clearly, no one stepped up to the plate most likely because of fear of reprisal, or fear of looking bad.

Today, I am going to make a different suggestion based on something I have discovered — Kaizen.    I discovered this in a program by Nightingale Connant. This is a system that evolved out of Asian philosophy which seeks to look for small steps to make improvements that will ultimately make great improvements or avoid terrible disasters. Several examples are sited in industry. Firestone ignored the seemingly small problem with their tires until they resulted in multiple accidents costing many lives that resulted in lawsuits and bad press. The Columbia space disaster that killed seven astronauts resulted because NASA tended to ignore small amounts of foam ripping away the craft’s structure until a massive amount ripped away on re-entry resulting in disaster.

We can all think of incidents in our own life where there were small signals of the possibility of an evolving problem, but we turned a blind eye or ear only to discover a greater costly problem later. It certainly is advisable to reflect on this notion which might be reflected in personal relationships that went sour or business decisions that were not sound. The idea of asking small questions to make small improvements that ultimately can result improved performance and cost savings, or catastrophe has been proven by research. We tend to think it is only big changes that will result in big results.

Organizations demanding high reliability must find ways not to fail. Helicopter medevac and hospitals are certainly qualify as high stakes environments. Survival of institutions and people make it so.   A culture of openness where employees are encouraged to discuss small or large problems without fear of reprisal needs to be encouraged.  Some institutions have even found ways to reward employees for bringing attention to problems. Group think is a phenomenon that has been researched and been proven to exist and contribute to costly mistakes. I don’t expect people or organizations to display their dirty laundry in a public forum. However, I do believe there are things that exist that people and institutions are turning a blind eye or deaf ear to.   Here are some things that one might consider. The key to success will be to create a culture of openness and a willingness to take action.

  • Deficient administrative knowledge that may negatively impact how a program operates.
  • Problems of performance of equipment such as the rotor blades sited in an earlier post that resulted in an accident killing the pilot.
  • High level of competition and how this might affect performance.
  • Long hours on the job with nothing to do, but wait for a call.
  • Pressures on pilots to fly.
  • Standards of conduct or performance.
  • Action or inaction by FAA
  • NTSB findings after an accident: what might have been noticed, and discussed to determine if there were small things that ultimately led to an accident.
  • The use of night goggles and terrain sensing equipment has been left to self-policing and voluntary compliance. Developing standards and evaluating compliance by an organization charged with this responsibility is slow to non-existent.
  • Understaffing

More thoughts on trauma

What say we all go out and buy a handgun?   Crazy huh? We live in an unsafe world?   Our minds are constantly fed violence as entertainment.   Our kids have plenty of TV viewing of killing by those thought to be heroes! Think about it we are creating a judgmental world of fear, scarcity, and lack of opportunity because we keep the warring mentality going.  Traumatic injury is the number one social and health problem.  Families and government are in economic chaos. We can do better than this!

About 500 American children and teenagers die in hospitals every year from a gunshot wounds. That number is growing.  Mass killing shocks Americans, while they fail to see how they are part of the problem. An abstract titled “United States Gunshot Violence — Disturbing Trends” presented by researchers at the American Academy of Pediatrics (AAP) found that states with higher numbers of firearm ownership had higher proportions of childhood gunshot wounds. Incarceration in this country has escalated as prisons have become privatized big business lining the pockets of corporations at taxpayer expense. Juvenile incarcerations are up with on-size fits-all sentencing. Laws are destroying lives and wasting taxpayer dollars. New York paid $167,731 to feed, house and guard an inmate for a year. Prisons are grossly overcrowded.  The American prison system is massive. We need to change our mind about violence. There’s nothing heroic about it! Yes, guns do at times save lives. What can be done to create a new mind set and a different way of being in the world? Maybe it is related to thinking about how each of us thinks and taking the time to consider how we can make a difference.    Homelessness is now a blight on this country. There is an epidemic of mental illness without adequate services available to address any of it. Alternatives to incarceration might include rehabilitation programs, addiction treatment, problems o

Food For Thought

In 1995 there was a call for entries for an anthology of American voices — “Whispers in the Wind.” Out of 11,000 entries, 200 were selected. Food for Thought by Opal Cavitt was one of them. Copyright 1995 All rights reserved. I wrote this while having a cup of coffee thinking deeply of how someone was treating me. I believe ego gets in our way when what is really needed is respect, humility. Food For Thought  by Opal Cavitt

              I’m not sure when it happened. EQUAL, I mean. One day, I just realized I had become acutely obsessed, possessed, or regressed about this elusive substance — EQUAL.

I wanted it. I thought about it all the time. I would find myself racing like a crazed maniac to the nearest Seven Eleven or McDonalds for hot coffee, hot tea, iced tea or any beverage. Then, I would quickly make my way to the other counter where I’d shove my hand into a bin scarping up those wonderful little blue packets – EQUAL. I don’t know why. Would they equalize my brain? Would they magically make me equal on some man made plane? Would they eliminate my pain?   Would they, by some slight of hand, make the nickel in the seam of my pocket more equal to the quarter? Or the dollar that eluded me more equal to the ten or the $100 bill found in the pockets ahead of me or down the street?

The EQUAL in these wonderful little blue packets were the only sweetness I savored in life. They were free. I craved it. In hot tea, it became the elixir of my life. It would calm the palpitation of the fears that plagued me. It had power too. It didn’t take much of this white stuff to sweeten even a tall glass of tea.

Not long ago, I rushed to the Seven Eleven to find only a limited few packets in the bin. I trembled with fear. What if an Executive Decision had been made in the oval office? “Be careful how you dispense this commodity. Once the trailer trash or the people on the streets realize its value, we won’t be able to control it. Things will get out of hand.” They would hold it back; make me have to develop more cunning — plan ahead.

So much in life is so bitter — like getting up at 4 a.m. to get ready to catch a bus at 5 a.m. It’s Labor Ready, Add A Man or standin’ up for Standby in a line hoping to get a job before the hoards arrive at 6 a.m.   All of this for a job that might start at 7 a.m., 8 a.m., or even 9 a.m. for the smashing sum of four dollars and twenty five cents an hour.

When my job is done, I pick up my daily reminder: “In Gold We Trust.” Then it’s back to the Seven Eleven to pour my coffee and pick up a handful of little blue packets. I tear a small corner on the side so I can watch these precious crystals flow into a gentle pool in my cup. On some days, I’m generous with myself — four packets, instead of the two my taste usually requires. Hey, I’m a good person. I deserve EQUAL. As I sip its sweetness, I wonder if it would make my gait in these cast-a-way sneakers fall in line equal to Etonics, Reeboks, or Adidas. Will it infuse my soul with some new spirit that will make me palatable to those well on their way to EQUAL?

Does acceptance of the mind wash that feeding off of, or plundering those perceived as less equal, make one equal ? EQUAL to what? What is the value of this forward/backward dance that threatens to destabilize and make everything UNEQUAL?

Even God’s birds are not safe.

Our Constitution says all men are created equal with the right to pursue life, liberty and happiness. But the Constitution was written by men who took more EQUAL. And what of women? Or children?   Imbibed with this magical potion, would I now be more EQUAL to the task of pursuing life and happiness, while I have no liberty? All I can really pursue is the notion of a JOB that is guaranteed to enslave me and make me less EQUAL.

Our democratic system claims to be government of the people, by the people, and for the people. Majority rules. But of course, in the final analysis, this is not so. This system entraps my body, but not my mind. I strive diligently to free my soul. How can I embrace a system perpetuated by myth? Even its masses have fallen away and no longer care to participate. This is a system straining against its own seams and a harsh reality: It is turned against itself. Under its philosophy, even learned people become confused, sell out, lose their WAY and their values to become victims of their own minds and UNEQUAL.

Out on the street, down and out, am I not created equal in the eyes of the Lord? And when it’s all said and done, and we make that final journey, who will be calling the plays? Will this commodity called money buy my passage? I think not. We’ll all leave the same way: alone and EQUAL.

EQUAL is really an adult thing. Kids don‘t understand it. They only know sugar is sweet. Better give this stuff to your kids — especially those with curly heads and darkened skins. Maybe it can help them grow up to EQUAL.

Only one last gulp in this cup. Hmm . . . I wonder if the little blue packets at McDonalds are equal to those at Burger King or those at Seven Eleven? Or for that matter, those at the supermarket for $3.50 a box?

All I know is: I need EQUAL. On my way out I’ll allow my nimble fingers to pluck another packet. Ah, hell, if no one’s watching I’ll shove fistfuls into my pockets. The intensity of my feeling about these little blue packets, and my feelings of scarcity, and my convictions or fear that somehow I might not really be EQUAL, is punctuated by the tenuousness of my plight — UNEQUAL.

Maybe in the right hands, in some surreptitious way, someone could start a national campaign for EQUAL. Maybe I should become a collector . . . get my hands on as many of these little blue packets as possible. I could become a profiteer of EQUAL. How many packets would it take to make me EQUAL? If I could really get my hand son this stuff, I might get high. It would be better than winning the lottery.

You really can’t talk enough about something like this. It’s not the kind of thing to keep under wraps. I cannot protest enough about a world without EQUAL.

Out on the street, it’s fuckin’ shit or mother fuckin’ shit. One needs something to equalize the bitterness.   Hmmm . . . I wonder if a packet of EQUAL savored under the viaduct is just as sweet as one savored at the Hilton Hotel.

Unlike sugar or the stuff in other packets, EQUAL IS DIFFERENT. Has my mind gone to seed? Have I lost touch with reality? I think not.

I strive desperately to keep one reality before me at all times: My JOB here is to find my way HOME to PEACE and EQUAL. Yes, I’m angry . . . but I try to sweeten my life with EQUAL. You ask, why my obsession with EQUAL. Maybe it’s all foolishness or maybe — just maybe . . . its food for thought