Reduction in Med-Evac service may cost lives, doctor says Third of early-day victims are "at death's door."

October 04, 1991|By Mark Bomster | Mark Bomster,Evening Sun Staff

More than a third of the patients flown to trauma centers by Maryland's Med-Evac helicopter service between 3 and 7 a.m. last year were "hypercritical" and "at death's door," according to the state's emergency medical service director.

Gov. William Donald Schaefer halted the early-hour helicopter service this week as a budget-cutting move.

The early-morning flights accounted for 254 of the 4,300 patients flown by the Med-Evac system.

But of those, "probably 35 percent were already, by the time of their helicopter transport, beginning to show signs of deterioration," Dr. Ameen I. Ramzy, state director of Emergency Medical Services, said yesterday.

Those signs could include severe bleeding, shock or significant head injury, he said.

"For these patients, the time factor was extraordinarily critical," said Ramzy. Though the other patients also had serious injuries, "for the 35 percent, they were at death's door."

Ramzy said he is worried about the prospects of critically injured patients, now that the state has halted early-morning rescue flights.

"What's going to happen is some severely injured patients are not going to have as good a chance of survival," said Ramzy, who is also a surgeon at the Shock-Trauma Unit in Baltimore. "Some people are going to die."

The Med-Evac helicopter system was one of the high-profile state programs hit by the $450 million in budget cuts Schaefer imposed this week.

The system, which until this week had eight helicopter centers around the state, is considered a national model for quick-response emergency services that can get critically injured patients to trauma centers during the so-called "golden hour" before injuries become irreversible.

As of this week, however, the state no longer provides 3 to 7 a.m. rescue services from the four helicopter centers that once provided the service.

Also, as of Monday, Med-Evac helicopter centers at Centreville and in Montgomery County were closed, a move expected to increase the response time from the six remaining centers by a still-unknown amount.

Twenty-two Med-Evac program employees will lose their jobs because of the budget cuts, which are not officially due to go into effect until November.

But officials curtailed operations before the firings took effect because, they said, they were worried about the safety of flight crews due to lose their jobs.

"We can't, in good conscience, take these people and put them out in the environment they fly in with the knowledge that they've lost their jobs," said Maj. Charles R. Hutchins, commander of the Maryland State Police Aviation Division, which operates the Med-Evac system.

Hutchins said that in the days since the system was scaled back, "we don't have any cases that . . . helicopter response affected the outcome."

But eventually, he added, "there will be calls that we will handle that will take longer to handle."

Ramzy put it more bluntly:

"My personal reaction is a gut feeling of dread, that the technology exists to save lives, and those lives might be lost now."

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