Chopper cuts: medico backs controversial review

A LEADING intensive care specialist has backed a proposal to reduce the number of helicopters allowed to winch sick and injured patients in NSW to safety.

An independent review into the future of the state’s medical helicopter fleet, released yesterday, recommended reducing from six to four the number of chopper bases allowed to conduct winching operations.

Chopper crews use winches to extract the critically ill and injured from inaccessible locations like mountain ranges and coastal cliffs. The review urged the NSW government to cease winching operations by choppers in Wollongong and Tamworth as a matter of high priority. That would leave Canberra as the only inland city home to a medical chopper with a winch. The others would be based in Sydney, Newcastle and Lismore.

Current helicopter bases

But Dr John Lambert, an intensive care specialist from the NSW central west and vocal supporter of improved aeromedical coverage for regional communities, said he was “comfortable” with the recommendation.

“I understand the reasons why four bases have been recommended… I’m quite comfortable with the rationale behind it,” he told Fairfax Media.

He also is not concerned the Ernst & Young review had not endorsed long-running calls for a winch to be fitted to the Orange rescue helicopter, which services central and western NSW.

Dr Lambert said having every helicopter fitted with a winch was desirable but was not practical or realistic.

The 70 kilogram weight of an average winch limits the size of a patient the chopper can transport and equipment it carries. The additional weight also slows down the chopper and reduces the distance it can travel.

Highly-skilled, super-fit crews also are required. The review noted there were significant “costs and risks” associated with winching.

“Having this spread across many bases increases the risk as competency is more difficult to maintain, and increases the cost,” the review found. “This affects the safety of the service for the person being retrieved and the paramedics, doctors and crewmen performing the winch.”

The only known incident where a crew member has been injured or killed during a winching operation was Christmas Day in 2011, when experienced paramedic Michael Wilson died conducting a rescue near Wollongong. The cause of that incident is still under investigation.

The review’s authors, Ernst & Young, claimed restricting winching to four locations would only increase average mission response times in NSW by a maximum eight minutes.

About 160 winching operations are performed each year. It is not known how many were conducted by the Wollongong and Tamworth choppers.

The absence of a winch-equipped helicopter in western NSW was highlighted in 2009 when a chopper without one was sent to rescue a young man suffering from extreme dehydration on a mountain west of Orange.

A second helicopter – fitted with a winch - had to be dispatched from Sydney, arriving an hour later.

The man later died in hospital.

Doctors did not blame the death on the delay but the federal MP for the region, John Cobb, said the man’s family would never know.

“This man may have died anyway, but sending a helicopter without a winch took away any chance he had," Mr Cobb said at the time.

In 2011, the NSW chopper fleet spent about 5000 hours in the air carrying out 1500 so-called ‘primary’ missions – where a patient is picked up from an accident scene or remote location and flown to hospital. They spent about the same number of hours flying patients from one hospital to another.

The review called for bases at Newcastle, Tamworth and Orange to eventually become 24-hour, seven days a week operations.

Dr Lambert embraced that recommendation and said the central west had been without 24-hour coverage for too long.

The review also suggested Wollongong’s sole rescue helicopter be relocated to a new mega-base planned for Sydney, again claiming response times will not be affected.

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