Maui air ambulance crash

[Miulang]

Re: Maui air ambulance crash

Looks like the doctors of Maui will officially have at least two alternatives to getting patients from Maui to Honolulu when they need special care. That should make everybody feel a little better about not having the same services as Honolulu, but it would be much much better for each island to have its own tertiary care center so patients don't have to go off-island to be treated.

Miulang

[Miulang]

Re: Maui air ambulance crash

There actually is backup already in place -- Army, National Guard and even Coast Guard helicopters and planes have filled the void since that last crash.

But that "backup" will only run through July...and the "backup" that was present previously from the Army is sending its troops and choppers off to Iraq soon. These were the nice folks who used to ferry people injured in crashes on H1 and H2 from the accident scene to the hospital. In a time of "peaceful" war like we are in now, I don't think you can count on continued support from the military.

Here's a SIXTH competitior entering the market: Pacific Wings

Miulang

[LikaNui]

Re: Maui air ambulance crash

If I was in the Legislature, I'd choose at least 2 carriers to provide the services so that if there were issues with one service, there would still be adequate backup to transport seriously ill patients

There actually is backup already in place -- Army, National Guard and even Coast Guard helicopters and planes have filled the void since that last crash.

[Miulang]

Re: Maui air ambulance crash

Competition in the air ambulance market for Hawai'i is really heating up now. Besides Hawai'i Air Ambulance, there are now 4 other companies filing certificates of need with the State. At the very least, this competition will be good for the residents of the neighbor islands who up until now had to rely solely on Hawai'i Air Ambulance to transport special care patients to Honolulu.

If I was in the Legislature, I'd choose at least 2 carriers to provide the services so that if there were issues with one service, there would still be adequate backup to transport seriously ill patients, as long as the Neighbor Islands don't have the same level of tertiary care services that Honolulu can provide.

Miulang

[lurkah]

Re: Maui air ambulance crash

"Paramedic (Marlena Yomes) brought joy and calm"

Marlena Yomes had been scheduled to fly on a Hawaii Air Ambulance plane that crashed in 2004 on the Big Island, killing the pilot and two paramedics.

But her shift had ended before the flight departed, and she did not go, Yomes' brother, Keith Moniz, said yesterday.

Hawaii Air Ambulance pilot Koichiro Kono recalled seeing Yomes crying at the office the morning after the crash.


Kono, who spoke with a Japanese accent, evoked laughter when he imitated Yomes, who made him the butt of all her jokes after he asked her weight before boarding a flight. "'You say one more time, I going kick your ass,'" he said. "Ever since, I was scared of her."

But Kono said she was different with others. Her voice was sweet when she spoke to her husband on the phone, and she "communicated with patients from the heart."

Kono broke down, sobbing, as he related how he had promised to keep her safe.

"I couldn't keep my promise," he sobbed. "Every time I think about this, I go crazy."

[cezanne]

Re: Maui air ambulance crash

Aloha oe Peter. Thanks for being a role model for our younger generation. Gonna miss you.

[AbsolutChaos]

Re: Fallout from Maui Air Ambulance Crash

However, Maui doesn't have any adolescent psychiatric lockdown treatment unit any more, and there are some specialties that COULD make a go of it, like cardiology and neurosurgery.
Miulang

In order to have a safe cardiology program, you should have an surgical open heart team also available. There are many instances of a patient becoming unstable and crashing, especially during the placement of a stent in the cath lab, which then necessitates immediate surgical intervention. Even during a routine cath procedure where you are only shooting dye into the heart without performing an intervention, patients can crash because the extent of their illness was previously unknown. There are very few cardiologists these days, especially with the advent of drug-eluding stents available to them, who would choose only to perform procedures where an open heart team would not be highly advised to be on stand-by. Right now there ARE cardiologists on the outer islands--however, they are limited in what they can do because they don't have surgical support. In these days of malpractice suits, they won't dare risk most interventions (and rightfully so) when they don't have a full array of options available should the patient not tolerate the minimally invasive procedure. With people living longer, heart patients nowadays have many more co-risk factors and are more fragile than heart patients in the past.

In order to entice a surgeon to come to an outer island, the surgeon have to be assured that there are sufficient cases for him/her to make a living, and I'm not sure that even "Mainland Maui" has that kind of a population yet. I hope the island does, but for the past three years, whenever I've heard the possibility of an open heart surgery center being opened, it is about one on the Big Island--not Maui. Even on Oahu the number of open heart surgeries are decreasing, despite receiving patients from the outer islands, simply because more interventions are being done in the cath labs--but at the same time the patients we DO see in the OR are much more unstable than previous years (because these are the patients the cath lab is afraid to touch). I suspect that many of these patients will end up requiring surgery later down the line, but that's all I'll say on that. Anywho, I hope it all changes...if population continues to boom, you're right, the demand for such services will finally be met because there's sufficient demand--and population on islands such as Maui.

[Miulang]

Re: Maui air ambulance crash

Along similar lines, the State Legislature is considering setting up a special fund to upgrade at least one hospital on each island to Level 1 Trauma Center status based on recommendations from the American College of Emergency Physicians, the American College of Surgeons and the Legislative Reference Bureau.

"...The 108-page College of Surgeons Committee on Trauma report points out that 50.7 percent of deaths in Hawaii for ages 1 to 44 are from injuries, primarily from motor vehicle crashes.

The rates of unintentional injury on the neighbor islands were more than double those for Honolulu, suggesting "an association between delayed access to organized, definitive trauma care and risk of death in areas outside Oahu," the College of Surgeons' report said.

"A concerted public health effort is needed to develop a trauma system serving needs of all residents and visitors in the state."

The Senate Ways and Means Committee report stressed the importance of a strong trauma system not only to deal with traumatic injury "as a public health problem," but to respond to disasters and emergencies...."

Miulang

[Miulang]

Re: Fallout from Maui Air Ambulance Crash

I sympathize with the need for more advanced care services on the outer islands, and as someone who is contracted to provide a specific service for certain critically ill patients with Hawaii Air Ambulance (as of now), I would love see more of such services based on the outer islands. Unfortunately, from the medical industry standpoint, there still aren't enough people on the outer islands, with the possible exception of maybe one city, to make such medical services profitable enough to justify their placement on the outer islands. It's gonna take more of that much-hated overdevelopment on the outer islands before we see more advanced medical care make it there as well.



It's an ugly double-edged sword. More population-->better healthcare opportunities-->detriment to the environment/beauty of the outer islands at the same time. And let's not forget about that even uglier reality--the nursing shortage that is also going to make bringing advanced medical care services to outer islands extremely difficult.

On Maui, they're focusing on access to nonspecialty care by obtaining CON permits to build 2 small hospitals...one in the Kihei area and one in the Lahaina area. Kula Sanitarium is now Kula General Hospital and can treat most types of acute medical emergencies. However, Maui doesn't have any adolescent psychiatric lockdown treatment unit any more, and there are some specialties that COULD make a go of it, like cardiology and neurosurgery. The plastic surgeons can stay in Honolulu because that expertise is not needed in life-threatening situations.

So AbsolutChaos you're right...the population of Maui has grown to the point where people are demanding better access to healthcare, and it's because Maui has become the "Mainland Island". But even healthcare in Honolulu is not what it is up here. It helps that we have one of the best medical schools in the country and a network of teaching hospitals where docs can practice bleeding edge techniques. If you have a heart attack up here and call 911, an aid car will reach you within 3 minutes usually. We pay for these services via property taxes, and it's one thing I happily vote for every time the levy comes up for renewal because I want to make sure that service is available to me in case I end up needing it someday.

Miulang

[AbsolutChaos]

Re: Fallout from Maui Air Ambulance Crash

I sympathize with the need for more advanced care services on the outer islands, and as someone who is contracted to provide a specific service for certain critically ill patients with Hawaii Air Ambulance (as of now), I would love see more of such services based on the outer islands. Unfortunately, from the medical industry standpoint, there still aren't enough people on the outer islands, with the possible exception of maybe one city, to make such medical services profitable enough to justify their placement on the outer islands. It's gonna take more of that much-hated overdevelopment on the outer islands before we see more advanced medical care make it there as well.



It's an ugly double-edged sword. More population-->better healthcare opportunities-->detriment to the environment/beauty of the outer islands at the same time. And let's not forget about that even uglier reality--the nursing shortage that is also going to make bringing advanced medical care services to outer islands extremely difficult.

[Miulang]

Fallout from Maui Air Ambulance Crash

The grounding of the fleet of Hawaii Air Ambulance and the reluctance of many of the flying nurses and techs to return to the air after the latest tragedy underscores one really serious need for which residents of the Neighbor Islands should be sitting in their politicians' offices demanding some solutions: lack of accessibility to specialty medical services onisland, which is forcing medical personnel and families to make the agonizing decision to ship critically ill patients to Honolulu for treatment. This is costly and emotionally devastating both to patients and their families.

Flying critically ill patients to Honolulu may have worked well in years past, when the islands were less densely populated, but now all the major islands have enough population to support specialty services on each island and should be able to support a tertiary care hospital to treat most illnesses. As more and more people move to Hawai'i from the Mainland, where it's fairly easy to get specialized medical treatment, the expectations of those people about the health services they receive will also increase. The current health care system of Hawai'i is not keeping pace with the growth and aging of its residents and visitors.

Even Oahu residents' lives may be in peril if they are victims in a traffic accident on the freeway because the odds of your being taken to a hospital in a timely manner is exacerbated by two problems: 1. with the gridlock on the highways, it's virtually impossible for ambulances and aid cars to get to an accident scene quickly and 2. Medevac services, which are provided gratis by the National Guard now, will be sharply curtailed soon due to the need for staff and equipment to be used for training troops on their way to Iraq.

I don't blame the health care providers and workers for this deficiency: I blame the Legislature for being unwilling to step up to the plate and looking at alternatives to fixing one of the most basic needs of the people they represent.

Miulang

[LikaNui]

Re: Maui air ambulance crash

On Wednesday March 15th, services will be held at the Hope Chapel in Kaneohe

They forgot to give a time... it's at 6pm.

[oggboy]

Re: Maui air ambulance crash

Likanui, I'm not going to give the link to the Maui News story today with the reports from the eye witnesses on the ground because it's too painful for me to do that, suffice to say that it appears your friend's son did a heroic thing by trying to land the plane as far away from all the commercial buildings in that congested area of Kahului as he could before crashing. Please tell your friend that the eyewitnesses on Maui think his son was a hero because he saved a lot of lives.

Miulang

With all the lives that COULD HAVE BEEM LOST! This pilot is a (HERO).
Again with deepest sympathy to all the OHANA!
OGGBOY

[LikaNui]

Re: Maui air ambulance crash

This just came in from Aloha Airlines:

Subject: Peter Miller Services and Memorial Foundation

Aloha all,

The MEC has been notified of the planned services for Peter Miller,
son of Retired Aloha Captain Emmett Miller, who worked for Hawaii Air
Ambulance and died in the tragic plane crash on Maui. Starting at 3pm
Tuesday, March14th, friends and family will gather at the Kailua boat
launch to share thoughts and prayers for Peter, and at 4pm, his ashes
will be taken to sea on the procession of boats that will follow. There
will also be an aerobatic exhibition by a long time friend of Peter's in
his honor.
On Wednesday March 15th, services will be held at the Hope Chapel in
Kaneohe, located at 45-813 Pookela St. Kaneohe (directions below). The
Miller Family has asked that in lieu of flowers, donations can be made to
the Peter Miller Foundation, which is being established for the betterment of young aspiring surfers in Hawaii.
If you have any questions, please call the Aloha MEC office at
838-0022.

Fraternally,
Aloha MEC

[Miulang]

Re: Maui air ambulance crash

Likanui, I'm not going to give the link to the Maui News story today with the reports from the eye witnesses on the ground because it's too painful for me to do that, suffice to say that it appears your friend's son did a heroic thing by trying to land the plane as far away from all the commercial buildings in that congested area of Kahului as he could before crashing. Please tell your friend that the eyewitnesses on Maui think his son was a hero because he saved a lot of lives.

Miulang