AAMS Public Service Award Remarks
AAMS Public Service Award
Remarks by Louis V. Lombardo
March 22, 2007
Acknowledgements and Thanks to:
- Dawn Mancuso, Airmed: ACN 1998, URGENCY for a Safer America 1999, and support in developing four editions of ADAMS.
- AAMS Board & Members, for Support of ADAMS
- Dr. Guenter Lob for Inspiration of ADAMS (with the example of ADAC in Germany)
- Alan Blatt, Dr. Marie Flanigan, and CenTIR staff, ADAMS 2003 – 2006, for doing the lion’s share of the work designing, building, and maintaining ADAMS
- Dr. John Wish for his sustained encouragement
- Drs. Champion, Augenstein, Cushing, Digges, Hunt, Malliaris, and Siegel, for their many years of work in developing and publishing of scientific papers on Automatic Crash Notification and URGENCY
- Colleagues at NHTSA.
- Most of all, my wife and life partner, Rita, for her support and encouragement.
Why the Atlas and Database of Air Medical Services (ADAMS) was created:
Today ADAMS is a research tool being used increasingly by government and industry to improve emergency care nationwide. For a safer future, ADAMS also carries the DNA for a more intelligent Rescue System for the Nation.
NEED is Great for Improved Rescue of Crash Victims:
- Historically in the U.S., motor vehicle crashes have killed nearly 3.5 million people and injured more than 300 million. That is more than 3 times the number of Americans killed and 200 times the number wounded in all wars since 1776.
- Currently, in crashes each year more than 43,000 people are killed (119/day on average.) and about 150,000 seriously injured (~410/day on average)
- The costs of crash injuries incurred in the U.S., each year, are estimated by NHTSA to amount to more than $100 Billion in economic costs (economic costs include zero value for pain and suffering) and $300 Billion in comprehensive costs (includes some estimated dollar values for pain and suffering).
What is happening? While many factors are involved, one major factor is that currently when rescuers arrive at the crash scene; the rescue resources are too little, too late, too often.
- Currently each year about 24,000 people killed in crashes were not taken to any medical treatment facility. The “not taken” are now 56% of the people killed each year. Many of the remaining 44% who were taken received less than optimal care and died of their injuries.
- Currently, the 150,000 people seriously injured in crashes each year suffer disabilities from brain injuries, from spinal cord injuries (including quadriplegia and paraplegia), and from crippling orthopedic trauma. Many of these injuries have catastrophic long term consequences for individuals, families, and society due to lack of timely, optimal quality care.
Today We Can Do Better – Much Better!
- Today technology, products and telematics services (such as OnStar, Mercedes Tele Aid, and BMW Assist supported by ATX) are on the market with the potential to reduce deaths and disabilities by an estimated 20%.
- Today we have the ability to instantly and automatically eliminate the Search from Search and Rescue with vehicles equipped with GPS based Automatic Crash Notification (ACN). Today, a basic ACN system is installed in about 5 million vehicles (of the 240 million vehicles on the roads). Within minutes of a car crash involving such vehicles, even before leaving their stations, rescue teams could have maps to the crash site with estimated travel times, recent satellite images of the crash site, and even current local traffic and weather information.
- Today we have the ability to eliminate the Sequentiality of Rescue Operations with Intelligent Automatic Crash Notification (IACN) that instantly and automatically communicates Crash Severity and URGENCY information on the likelihood of serious injuries from the crashed vehicle.
- Today we have the ability to intelligently and selectively use Early Activation and Auto Launch protocols to reduce delays in delivery of optimal care.
- Imagine a tomorrow that could be today with IACN. Imagine that when a crash occurs, within a minute, 9-1-1, Police, Fire, EMS, Air Medical Services, Hospitals and Trauma Centers are simultaneously alerted with actionable information on the location and the severity of the crash, the number of occupants, and much more. The instantaneous crash severity information can be used to make informed dispatch decisions such as Early Activation/Auto Launch – based on tangible, objective, data on crash force measurements and estimated probability of serious injury. Crash severity data can help dispatchers make decisions that are better and faster for crash victims needing lifesaving care – and that are justifiable to insurers and other interested parties.
Today while all this is possible, it is not in practice. The tragic result is that too often, when serious crashes occur, steps are taken sequentially:
- someone must observe the crash, then
- someone must call 9-1-1, then
- police travel over land to find the crash and check it out, then
- police call for EMS, then
- EMS travels over land to the site, then
- EMS calls for heavy rescue extrication equipment to be sent, overland, then
- EMS, may, call for Air Medical Services, then there is a warm up period and fly time to the scene
The result of this sequential approach is too much time, and too many lives and livelihoods are lost.
We can take the sequentiality out of present practices and put all rescue parties including Air Medical Services, Hospitals and Trauma Centers as team members into the information loop at the first step. We can stop waiting in the dark while victims die. Today we can, and must, operate more intelligently to increase the effectiveness and consequentiality of the Rescue System in saving lives and reducing disabilities.
What We Can Do Easily Now
- We can adopt a Vision Zero for Preventable Deaths and Disabilities. We can work on win/win business models to establish Communications Links between Telematics Services and Air Medical Services (270) and Hospitals and Trauma Centers (400) including 9-1-1 Public Safety Answering Points (PSAPs)
- We can start transmitting crash data to Air Medical Services, to Hospitals and Trauma Centers so that we can begin the process of developing protocols and relationships that result in greater life savings.
- We can use the power of ADAMS to perform research to establish an evidence based body of knowledge to accelerate the market adoption of the new technologies and systems of improved emergency care.
- We can continue developing ADAMS as a dispatch aid using ACN and ADAMS data to enable data driven rescue decision-making for timelier rescue and optimal treatment of seriously injured crash victims
I have focused on crash injuries because a major safety opportunity is at hand to improve care of crash victims. But your air medical industry also will be able to improve care for people suffering from other time-critical injuries as well. The National Safety Council currently estimates that unintentional injuries in 2005 resulted in more than $3.6 Trillion in economic and lost quality of life costs.
Note: These costs do not include costs resulting from homicides, suicides, and terrorist attacks which also result in time-critical injuries.
Add to this the potential benefits from timelier quality treatment of time-critical illnesses such as heart attacks and strokes and one can begin to sense the great need and growing value of your work. While the value of these losses is estimated in trillions of dollars each year for the nation; to individuals, families, and loved ones, the value of your work is priceless.
Let me end by saying that for crash victims, I often think of the people in the air medical industry as Angels, i.e. A-N-G-E-L-S Airmed Notified Gets Emergency Lifesavers Sooner.
Thank you for giving me the honor of the AAMS Public Service Award.