EXECUTIVE SUMMARY... ES-1

Transcription

1 EXECUTIVE SUMMARY... ES-1 CHAPTER 1 HISTORY AND BACKGROUND ORIGINS OF TRAUMA CARE SYSTEMS AND EMERGENCY MEDICAL TRANSPORTATION CARE OF THE INJURED AND AIR MEDICAL TRANSPORT THE U.S. EXPERIENCE INTEGRATED TRAUMA AND HELICOPTER EMERGENCY SYSTEMS IN THE U.S Trauma Centers vs. Trauma Systems National Priorities and Development of Trauma/HEMS Systems Professional Associations and Trauma/HEMS Advancements HELICOPTER AIR MEDICAL TRANSPORT TODAY SAN FRANCISCO BAY AREA AIR MEDICAL TRANSPORTATION CONCLUSIONS CHAPTER 2 PURPOSE AND NEED BASIS FOR THE STUDY BAY AREA AND SAN FRANCISCO TRAUMA CARE Bay Area Trauma Centers and Air Medical Access San Francisco Trauma Care System Evolution of Trauma Care in San Francisco and the Role of San Francisco General Hospital Trauma Center THE SAN FRANCISCO TRAUMA CARE SYSTEM ENVIRONMENT Geography and Demographics Trauma Care System Design CURRENT AIR MEDICAL ACCESS SYSTEM STRENGTHS AND VULNERABILITIES OF THE TRAUMA CARE SYSTEM Single Designated Trauma Center Capacity Saturation Environmental, Geographical and Medical Transport Constraints Multiple Casualty Incident Risk Natural and Geopolitical Pediatric Trauma San Francisco Off-shore Rescues and the Neighboring Region TRAUMA SYSTEM NEEDS RELATED TO AIR MEDICAL ACCESS Consistently Available Trauma Resources Comprehensive Pediatric Trauma Care Timely Access to Advanced Trauma Care and Improved Patient Transport PREVIOUS AIR MEDICAL ACCESS STUDIES IN SAN FRANCISCO Medical Use vs. Commercial Use The Vertiport Study The McKesson Report Findings and Conclusions CHAPTER 3 BENEFITS OF AIR MEDICAL ACCESS INTRODUCTION i

2 GENERAL BENEFITS OF HEMS Trauma Transport Scene Transport Studies Interfacility Transfer Studies Transfers from a Referring Hospital to Trauma Center Transfer from Scene Accident to Trauma Center Non-Trauma Transport PRIMARY BENEFIT: MITIGATION OF TRAUMA SYSTEM VULNERABILITIES The Care of Injured Children Standard Trauma Care Consistently Multiple Casualty Incidents Primary Benefit Summary SECONDARY ENEFIT FINANCIAL SUPPORT AND MAINTAINING QUALITY AT THE TRAUMA CENTER Economic Benefit of Air Medical Access Patient Volume and Trauma Center Performance Medical Staff Recruitment and Retention TERTIARY BENEFITS SAN FRANCISCANS INJURED IN SAN FRANCISCO AND NORTHERN CALIFORNIA ADDITIONAL BENEFIT TO THE BAY AREA REGION CONCLUSIONS CHAPTER 4 HELIPAD SITE STUDY INTRODUCTION HELIPAD DESIGN CRITERIA OBJECTIVES DESIGN CRITERIA Heliport, Helistop or Helipad? POTENTIAL HELIPAD SITES Rooftop Helipad CONCLUSIONS STRUCTURAL CAPABILITIES Code Requirements Building Description Assumptions Conclusions ELEVATOR REQUIREMENTS PRELIMINARY COST ESTIMATES AND SCHEDULE Timeline HELIPAD PERMITTING PROCESS Federal Government State Government City and County of San Francisco ii

3 Table of Contents CHAPTER 5 SAFETY ANALYSIS SAFETY ASSESSMENT AND ANALYSIS CRITERIA Types of Compatibility Concerns SAFETY Measurement Basis for Criteria HEMS Accident Data Base When Do HEMS Accidents Occur SFGH Accident Potential HEMS Accident Rate Comparison Risk Assessment Factors Deaths and Injuries in the Community AIRSPACE PROTECTION Compatibility Objectives Measurement Compatibility Strategies Basis for Criteria OVERFLIGHT Compatibility Objectives Measurement Compatibility Strategies Basis for Criteria CONCLUSIONS CHAPTER 6 NOISE ANALYSIS INTRODUCTION NOISE IMPACT CRITERIA Noise Measurement Methods Impact Criteria EXISTING SOUND LEVELS PROPOSED FLIGHT PATHS HELICOPTER MODELS HELIPAD NOISE PREDICTION Helipad Noise Analysis Noise Impact Assessment Helicopter Noise Abatement Options On Approach On Departure Conclusion CHAPTER 7 COMMUNITY OUTREACH GOALS OF OUTREACH EFFORT PUBLIC MEETINGS iii

4 Neighborhood Groups Healthcare Provider Community Groups Civic Organizations Description of Community Meetings: Neighborhood Groups Description of Community Meetings: Healthcare Provider Organizations Description of Community Meetings: Civic Organizations Expert Opinions and Letters of Support Helipad Hotline COMMUNITY OUTREACH MATERIALS SUMMARY OF COMMUNITY CONCERNS CONCLUSION APPENDICES A Glossary of Terms Used in Study...A-1 B Trauma Scene and Interfacility Transports...B-1 C Profile of injury In San Francisco...C-1 D Community Noise Measurements...D-1 E Handouts from the Community...E-1 F Expert Opinions and Letters of Support... F-1 G Community Outreach Materials... G-1 H Structural Engineer s Report...H-1 I Elevator Engineer s Report... I-1 FIGURES 2-1 Trauma Air Medical Catchment Areas (Without Proposed SFGH Helipad) Trauma Air Medical Catchment Areas (With Proposed SFGH Helipad) Primary Flight Path: North Departure Primary Flight Path: South Departure SFGH Helipad Site Options Alternative 1 (Wing C) Site Location Alternative 2 (Wing A) Site Location Alternative 1 Site plan Alternative 2 Site Plan SFGH Helipad Building Permit process Noise monitoring Locations Muni Routes Proposed Flight Paths Average Day DNL Contours Busy Day DNL Contours iv

5 Table of Contents TABLES 1-1 Bay Area Air Ambulance Providers Bay Area Air Rescue Ambulances Designated Trauma Centers in the Greater San Francisco Bay Region Hospital Helipad Final Approach and Takeoff Area (FATO) and Safety Area Size Requirements SFGH Helipad Site Study Summary Land Use Compatibility Chart Noise Monitoring Around SFGH Helicopter Usage Community Concerns v