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Outside cover and inside cover |
Table of Contents |
Executive Summary |
Chapter 1: History and Background |
Origins of Trauma Care Systems and Emergency
Medical Transportation |
1-1 |
Care of the Injured and Air Medical
transport-the U.S. Experience |
1-2 |
Integrated Trauma and Helicopter Emergency
Systems in the U.S. |
1-3 |
Trauma Centers vs. Trauma
Systems |
1-4 |
National Priorities and
Development of Trauma/HEMS Systems |
1-5 |
Professional Associations
and Trauma/HEMS Advancements |
1-10 |
Helicopter Air Medical Transport Today |
1-11 |
San Francisco Bay Area Air Medical
Transportation |
1-12 |
Conclusions |
1-13 |
|
Chapter 2: Purpose and Need |
Basis for the Study |
2-1 |
Bay Area and San Francisco Trauma Care |
2-4 |
Bay Area Trauma Centers
and Air Medical Access |
2-4 |
San Francisco Trauma Care
System |
2-6 |
Evolution of Trauma Care
in San Francisco and the Role of San Francisco |
2-7 |
General Hospital Trauma
Center |
2-7 |
The San Francisco Trauma Care System
Environment |
2-9 |
Geography and
Demographics |
2-9 |
Trauma Care System Design |
2-10 |
Current Air Medical Access System |
2-11 |
Strengths and Vulnerabilities of the Trauma
Care System |
2-12 |
Single Designated Trauma
Center |
2-12 |
Capacity Saturation |
2-15 |
Environmental,
Geographical and Medical Transport Constraints |
2-16 |
Multiple Casualty
Incident Risk-Natural and Geopolitical |
2-17 |
Pediatric Trauma |
2-17 |
San Francisco Off-shore
Rescues and the Neighboring Region |
2-18 |
Trauma System Needs Related to Air medical
Access |
2-19 |
Consistently Available
Trauma Resources |
2-19 |
Comprehensive Pediatric
Trauma Care |
2-19 |
Timely Access to Advanced
Trauma Care and Improved Patient Transport |
2-19 |
Previous Air Medical Access Studies in San
Francisco |
2-20 |
Medical Use vs.
Commercial Use |
2-20 |
The Vertiport Study |
2-20 |
The McKesson Report |
2-21 |
Findings and Conclusions |
2-22 |
|
Chapter 3: Benefits of Air Medical Access |
Introduction |
3-1 |
General benefits of HEMS |
3-2 |
Trauma Transport |
3-4 |
Scene Transport Studies |
3-4 |
Interfacility Transfer
Studies |
3-6 |
Transfers from a
Referring Hospital to Trauma Center |
3-6 |
Transfer from Scene
Accident to Trauma Center |
3-7 |
Non-Trauma Transport |
3-8 |
Primary Benefit: Mitigation of Trauma System
Vulnerabilities |
3-9 |
The Care of Injured
Children |
3-10 |
Standard Trauma
Care-Consistently |
3-10 |
Multiple Casualty
Incidents |
3-11 |
Primary Benefit Summary |
3-12 |
Secondary enefit-Financial Support and
Maintaining Quality at the Trauma Center |
3-12 |
Economic Benefit of Air
Medical Access |
3-13 |
Patient Volume and Trauma
Center Performance |
3-14 |
Medical Staff Recruitment
and Retention |
3-15 |
Tertiary Benefits-San Franciscans Injured in
San Francisco and Northern California |
3-15 |
Additional Benefit to the Bay Area Region |
3-15 |
Conclusions |
3-16 |
|
Chapter 4: Helipad Site Study |
Introduction |
4-1 |
Helipad Design Criteria |
4-1 |
Objectives |
4-2 |
Design criteria |
4-2 |
Heliport, Helistop or
Helipad? |
4-2 |
Potential Helipad Sites |
4-8 |
Rooftop Helipad |
4-8 |
Conclusions |
4-17 |
Structural Capabilities |
4-18 |
Code Requirements |
4-21 |
Building Description |
4-21 |
Assumptions |
4-21 |
Conclusions |
4-22 |
Elevator Requirements |
4-22 |
Preliminary Cost Estimates and Schedule |
4-24 |
Timeline |
4-25 |
Helipad Permitting Process |
4-25 |
Federal Government |
4-25 |
State Government |
4-25 |
City and County of San
Francisco |
4-26 |
|
Chapter 5: Safety Analysis |
Safety Assessment and Analysis Criteria |
5-1 |
Types of Compatibility
Concerns |
5-1 |
Safety |
5-2 |
Measurement |
5-3 |
Basis for Criteria |
5-3 |
HEMS Accident Data Base |
5-5 |
When Do HEMS Accidents
Occur |
5-7 |
SFGH Accident Potential |
5-8 |
HEMS Accident Rate
Comparison |
5-9 |
Risk Assessment Factors |
5-10 |
Deaths and Injuries in
the Community |
5-10 |
Airspace Protection |
5-11 |
Compatibility Objectives |
5-11 |
Measurement |
5-12 |
Compatibility Strategies |
5-12 |
Basis for Criteria |
5-12 |
Overflight |
5-13 |
Compatibility Objectives |
5-13 |
Measurement |
5-13 |
Compatibility Strategies |
5-13 |
Basis for Criteria |
5-14 |
Conclusions |
5-14 |
|
Chapter 6: Noise Analysis |
Introduction |
6-1 |
Noise Impact Criteria |
6-2 |
Noise Measurement Methods |
6-2 |
Impact Criteria |
6-5 |
Existing Sound Levels |
6-5 |
Proposed Flight Paths |
6-7 |
Helicopter Models |
6-8 |
Helipad Noise Prediction |
6-8 |
Helipad Noise Analysis |
6-8 |
Noise Impact Assessment |
6-10 |
Helicopter Noise Abatement Options |
6-11 |
On Approach |
6-11 |
On Departure |
6-12 |
Conclusion |
6-13 |
|
Chapter 7: Community Outreach |
Goals of Outreach Effort |
7-1 |
Public Meetings |
7-2 |
Neighborhood Groups |
7-2 |
Healthcare Provider
Community Groups |
7-2 |
Civic Organizations |
7-2 |
Description of Community
Meetings: Neighborhood Groups |
7-2 |
Description of Community
Meetings: Healthcare Provider Organizations |
7-6 |
Description of Community
Meetings: Civic Organizations |
7-8 |
Expert Opinions and Letters of Support |
7-8 |
Helipad Hotline |
7-9 |
Community Outreach Materials |
7-9 |
Summary of Community Concerns |
7-9 |
Conclusion |
7-9 |
|
Appendices |
Appendix A: Glossary of Terms Used in Study |
Appendix B: Trauma Scene and Interfacility Transports |
Appendix C: Profile of
Injury In San Francisco |
Appendix D: Noise Report |
Appendix E: Handouts From
the Community |
Appendix F: Letters of Support
|
Appendix G: Community
Outreach Materials |
Appendix H: Structural
Engineer's Report |
Appendix I: Elevator
Engineer's Report |