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TN Considers Requiring A/C on Air Ambulances after Death of Heat Stroke Patient

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According to a recent article by Tom Wilemon from The Tennessean, it’s a common procedure in Tennessee for medical helicopters without air conditioning systems to fly critically-ill patients to their destinations, despite all ground ambulances in the state being required to have functional air conditioning systems installed.

Chris Yoder, a 24-year old mechanical engineer from North Carolina, suffered an apparent heat stroke during the Bonnaroo indie music festival in Manchester, Tennessee. He was transported to a Chattanooga-area hospital by air ambulance, where he passed away hours later. Evidence shows that the helicopter that transported him to the hospital was, possibly, not equipped with air conditioning.

His passing has opened up a debate on whether or not air ambulances in Tennessee should be mandated to have climate control systems installed. If the proposed new mandate passes, any existing air ambulances without A/C could be required to upgrade in order to continue operations in the state.

According to records from the hospital that admitted him, the air ambulance company that transported Yoder was Missouri-based Air Evac Lifeteam. Most of that company’s medical transport helicopters are not equipped with air conditioning, according to The Tennessean.

Two days following the incident, Air Evac’s representative on a Tennessee Board of Health committee was reportedly battling the efforts by the state to require all air ambulances to have air conditioning systems. At the same time another operator, Vanderbilt LifeFlight, was encouraging the rule. LifeFlight, like most of the other air ambulance services licensed in Tennessee, does have air conditioning on its fleets even though it’s not a state requirement – yet.

Air Evac representative Robert Byrd says the A/C requirement would cause the Missouri-based air ambulance company to discontinue their operations in Tennessee. Out of his company’s 16 licensed air ambulances, he says that “a handful” have air conditioners, but that most of them do not. The company claims that installing air conditioners on its helicopters could cost anywhere from $25,000 up to $400,000, depending on the model.

Citing patient privacy concerns, Air Evac did not confirm or deny questions about the incident, whether Chris Yoder was transported by one of their helicopters, or whether the air ambulance that provides coverage for that area and would have responded to Yoder’s heat stroke is equipped with air conditioning. However, Erlanger Hospital’s logs show that the only helicopter that landed at the hospital when Yoder was admitted was registered to Air Evac.

CEO of Air Evac Seth Myers released a written statement that the company is working with the FAA to get the necessary approval to add air conditioning to its refitted Bell 206 helicopters, but that the process has been slow-going.

It may seem surprising to some that air conditioning is not required on all medical aircraft in every state, but it is often left up to individual services to decide whether to install the systems or not. This year, the state of Alabama implemented new rules that specifically do not require its air ambulances to have A/C systems. Alabama followed guidelines set last September by the Commission on Accreditation of Medical Transport Systems. The new guidelines state that the cabin temperatures have to be recorded once every 15 minutes. If the temperature in the cabin climbs above 95 degrees (or dips below 50 degrees), the air ambulance crew then needs to find ways to mitigate any possible health risks to the patient – and show that they did so.

Nevertheless, Dr. Martin Croce, chief of trauma and critical care for the University of Tennessee Health Science Center in Memphis, believes the state of Tennessee should require air conditioning on its air ambulances just as it does on its ground ambulances. He noted that patients suffering from cardiac arrest or traumatic brain injuries may do better if their body temperatures are kept lower than normal.

Dr. Croce also said that since pilots can’t fly helicopters high enough to effect truly substantial drops in temperatures in the cabin, he would err on the side of being in favor of air-conditioned air ambulances.

“The ground ambulances are air conditioned and that’s mandated, I believe,” he said, speaking of the current policies in Tennessee. “I really don’t see why the air ambulances should be any different.”

Vanderbilt Lifeflight’s Jeanne Yeatman had a motion on the table for the state to set temperature requirements, but withdrew it at the request of Air Evac’s Robert Byrd and other committee members.

Lifestar’s Jeff Gregory, who admits Air Evac has occasionally been “a thorn in [his] side,” feels that it would be unfavorable for the patients in Air Evac’s rural service areas if Tennessee were to put the Missouri company’s medical choppers out of service, even temporarily. “I cannot in my heart think that it is in the best interest of patient care to ground Air Evac where it would damage those patients in rural areas, true rural areas,” he said.

The Board of Health committee may agree with this sentiment. They are considering using language that will allow Air Evac to continue operating in the state until it can upgrade its helicopters with A/C systems or abide by the CAMTS cabin temperate guidelines.

A representative from LifeForce suggested that if the state does not mandate A/C on its air ambulances, it should set specific cabin temperature restrictions.

What do you think about the potential mandate? Should all medical helicopters be required to have air conditioners before they pick up ailing patients? Please leave your comments below.

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