STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY GRAY DAVIS. Govemcr

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EMERGENCY MEDICAL SERVICES AUTHORITY

December 30, 2002

JAN 21 2003

ADMINISTRATIONSAN FRANCISCO GENERAL HOSPITAL

Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hosp-ital -Ofc #2AS1001 Potrero Aven.ue .

San Francisco. CA 94110

Dear Ms. O'Connell:

I am writing this letter to support the need for air medical access to SanFrancisco's level I trauma center, San Francisco General Hospita~. As Directorof the Emergency Medical Services Authority (EM SA) I am responsible foroversight and' coordination of emergency medical services statewide, including

trauma.

I feel that it is extremely important for San Fr.ancisco to establish helicopteraccess for emergency services. Tra"uma systems are designed to.get patiehtstothe most appropriate facility with the necessary resources in a short amount oftime. In an event with multiple injuries, such as vehicle crashes or earthquakes,or even a single case with specialized needs, it may be necessary to quicklytransport patients from and/or to neighboring jurisdictions for care. Because ofSan Francisco's size, location, and its bridge access issues, a heHcopter mayoften be the only viable access to and from the city.

EM SA definitely supports establishment of helicopter access in San Franciscoand has previously provided grant funding to help facilitate its establishment. Inadditi9n, its November 5, 2001 approval of San Francisco's trauma plan statedthat, " San Francisco may also wish to expedite its designation of a helipad so

that patients may be expeditiously transported to an appropriate facility." Icertainly feel that it would be a much needed addition to the city/county's trauma

system.

Please let me know if can help in any way. can be reached at (916) 322-4336.

[. u~Si.ncerely I

( i' CJ

~'--\:I~ichard E. ". ~Interim Director

.9TH STREET~ENTO. CALIFORNIA 95814.7043

0)-322-4336 FAX: (916) 324.2875

January 3, 2003

JAN 08 2003

.ADMINISTRA TIO~~

SAN FRANCISCO GENERAL HOSPITAL

Gene-Marie O'Connell-Executive AdministratorSan Francisco General Hospital-Ofc # 2A51001 Potrero AvenueSan Francisco, CA 94110

Dear Gene:

I am writing to support the development of air medical access at San Francisco Ge~!?ralHospital, which is essential to the future of this level I Trauma Center. .

I serve as President of Bishop + Associates, a national trauma care consulting firm, as ~ell asPresident of the National Foundation for Trauma Care. Our role is to help assure the ongoingviability of the nation's Trauma Centers, and we have conducted strategic planning for SFGH as

part of this role.

San Francisco General Hospital operates the nation's only Level I Trauma Center of staturewithout a helipad. As the sole trauma care provider for a 1 million+ population that is isolatedgeographically from other trauma centers, a!r medical access should be co~sidered a criti~alresource (it is required for American College of Surgeons veiifi~tion as a Levell TraumaCenter). Multi-casualty events, of increased probability due to the threat of terror, also requirethe ability to move seriously injured patients quickly to or from SFGH's Levell Trauma Center.

Also compelling are the economic benefits of air medical access. As SFGH resources havebeen are increasingly focused on primary care, essential tertiary care inpatient resources suchas neurosurgery and orthopedics have dissipated, undermining the necessa.ry infrastructurecritical to a Lever, Tr-auma Center. Surgi_cal resources in

Like other major Trauma Centers in the U.S., San Francisco General has the opportunity toprovide tertiary trauma care-to the seriously injured in the greater region surrounding SanFrancisco City/County. Expanding trauma care to a well insured population increases economicsupport for the trauma program and the hospital, and also help assure strong clinical support.An excellent example is this impact of San Francisco General Hospital's arrangement to providetrauma care for San Mateo County. 00 .

An SFGH helipad would minimize transport times for the seriously injured from throughout thegreater region as well as outlying areas of San Francisco City/County. The citizens of SanFrancisco City/County would benefit when they require immediate air medical transport to the

trauma center, and a helipad would also help assure the ongoing viability of the critical public

service of the SFGH Levell Trauma Center.

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December 31. 2002

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Gene Marie 0' ConnellExecutive AdministratorSan Francisco General Hospital- Ofc #2AS1001 Potrero AvenueSan Francisco, CA 94110 ':-

-AD~J1INISTRATIONSAN FRANCISCO GE~lERAL HOSPITAL

Dear Ms. O'Connell:

!. ..4'. ~ ~" f " " ...1.: .2: -~ 1 ~:_:-4 -~ ~ T;~ ,fC' A ~ ;-1: ~~_.~~ ~...~ C' , ~ 1"+~'"' PT\ If~ ~ rr~."..' , , ,'~...~ 1.11 L:.J.V " J.~ ",Ul\.,Cd.1 J.J11"""LVl <1A1U J.j1..L..' \1.11..lU~.1 ,",4 4 U~4 :.. , ..'::._.4-.; , .-

are writing this letter in support of the need for consistently available air medical accessat San Francisco General Hospital (SFGH). Since 1998, 15-25 tratima patients from SanMateo County have been transported each month to SFGH for definitive trauma care..This arrangem.ent has been very beneficial to both your hospital and our County .

-

We believe that the existence of a functional helipad at SFGH would benefit the citizensof our county as well as increase the stature and expertise of your hospital. There arelarge parts of San Mateo County that are remote and inaccessible. We commonly use airtransport for severely injured patients in our county but none are sent to SFGH because ofthe lack ofan on-campus helicopter landing facility. We think that our citizens would be

better served with this increased option for air transport. This would also be extremelyuseful in the event ofa multi casualty incident or disaster.

We also believe that an on-campus helicopter landing facility will help to support themission of the hospital as a Level I Trauma Center. This will allow your hospital to havean adequate"n!1mber of patients to maintain its clinical skills and expertise. Both ourcitizens and your hospital would benefit from maintaining and improving its stature as apreeminent trauma center .

\\'.e strongly encourage the need for an on-campus htlicopter landing faciiity Cit SFGHbecause ofits implications in improving trauma care in the Bay Area.

Sincerely,.'

~.

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Barbara Pletz

EMS Administrator

II/!.,~ I'J.. f".(7 -i')~~ Karl K Sporer, MD

EMS Medical Director

Margaret Taylor, Director Health ServicesCc:

E)JERGE:\"C'. :\IEDIC.-\L SER\lCES

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vCITY AND COUNTY OF SAN FRANCISCOSAN FRANCISCO FiRE DEPARTMENT

698 SECOND STREET

SAN FRANCISCO CA 94107-2015

.dario H. T~o, Chief of Department

..yJi1ond R. Balzarini, Deputy Chief of Operations

Telepbone: (415) 558-3400Joseph C. Asaro, Deputy Chief of Administration

January 6, 2003

Ms. Gene Marie O'ConnellExecutive AdministratorSan Francisco General HospitalOffice #2A5100 I Potrero AvenueSan Francisco, CA 94110

Dear Ms. O'Connell.

I am writing ill Support of a study to assess the feasibility of access for air medical transports intoSan Francisco. I believe there is a need for air medical access, particularly to the Trauma Center.This would also address the potential for Mass Casualty Incidents, that may require Aeromedicaltransport for effective mitigation. .

The current responsibilities of the San Francisco Fire Department include the establishment ofpolicies and standards for fIre protection, rescue, and Emergency Medical Services. We \\rorkcooperatively with the Department of Public Health, which oversees the application of EMS,while the Fire Department has the primary responsibility for the provision of EmergencyMedical Services throughout the City and County of San Francisco.

Prior to my appomtment here in the. San Francisco Fire Department, I had experience in twoother fIfe departments in major cities. In Las Vegas, where I served as Fire Chief for five years,and in Seattle, where I served as Deputy Fire Chief, Aeromedical transports were facilitated inthe Level-One Trauma Centers serving the metropolitan areas. I have experienced at first handthe value of immediate air ambulance evacuation, and I fInd it surprising that helicopter access tothe Trauma Center does not exist here in San Francisco. As you know, Aeromedical access toLevel-One Trauma Centers is considered a standard in urban trauma care, and public safety

.operatIons.

At a minimum, a feasibility study will fully assess the needs of the commwllty , and will help

chart a course for the continued provision of ~e best possible patient care. Please feel free tocontact me at any time, should you have any questions regarding this topic.

Very truly your.s,

~~Mario H. Treviiio

Chief of DeDartment

CITY AND COUNTY OF SAN FRANCISCO

SAN FRANCISCO FIRE DEPARTMENT

698 SECOND STREETMario R TreviDo, Chief of Depal1ment

SAN FRANCISCO. CA 94107-2015Raymond R. Balzarini, Deputy Chief of Operations"

Telephone: (415) 558-3400Joseph C. Asaro, Deputy Chief of Admiuistratiou

January 9,2003

Ms. Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital Medical Center1001 Potrero AvenueSan Francisco, CA 94110

~e.Dear Ms. ~nne11:

I appreciate the opportunity to comment on the proposal to build an aeromedical~landingsite on the grounds of San Francisco General Hospital Medical Center, As the EMSMedical Director for the San Francisco Fire Department" I emphatically believe that thispropos,al could have a dramatic impact in decreasing the morbidity and mortality ofcritically ill and injured patients, both from San Francisco and throughout the State ofCalifornia.

San Francisco Fire Department paramedics and emergency medical technicians (EMT's)are sometimes called upon to assist in the ground transport of critically ill patients whoare transported by medical helicopter to San Francisco. Because there is currently noapproved hospital-landing zone in San Franci"sco, aeromedical helicopters must now landat an outlying region of San Francisco. This then requires that a critically ill or injuredpatient must be unloaded from the helicopter, loaded onto an ambulance and transportedover San Francisco surface roads to then be unloaded again for transfer into theemergency department. This delay and continuous loading and unloading can have asignificant detrimental impact on critically ill or injured patients and may literally ~eanthe difference between life and death for some patients.

As you may know, prior to joining the Fire Department and the UCSF faculty, I served asthe lead flight physician for the Stanford Life Plight areomedical helicopter. During 1991and 1992, I was responsible for the aeromedical transport of more than 200 patients in theBay Area. Despite my high regard for the expertise at SFGH and other San Franciscohospitals, because of the lack of a hospital aeromedical landing zone, San Francisco wasNEVER the destination for critically ill or injured patients. This was true even if thatpatient was picked up on the outskirts of San Francisco and was a San Francisco resident.Instead, the decision was always made that it was in the patient's best interests toundertake a slightly longer flight time to transport the patient to Stanford Hospital or JohnMuir Medical Center because these facilities had helicopter landing zones that wouldallow for the rapid delivery of the patient into the Trallm~ r~nt~T

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The lack of an aeromedical.landing site in San Francisco does not serve our citizens inthe manner they deserve. If a loved one of ours were critically ill or injured and had to beflown by helicopter, we would certainly not want his or her life to be jeopardized byhaving to fly to San Francisco only to have to endure a 25-minute ambulance transportfrom the landing zone to the hospital. Instead, our loved one would be transported faraway from home when they could have been expertly cared for by the doctors, nurses andstaff at San Francisco General Hospital. This says nothing about patients from outside ofSan Francisco who today are not able to benefit from aeromedical transport to SanFrancisco General Hospital or any of the other expert medical centers within SanFrancisco.

It is a fact that every other mid-size and large urban center within the United States hasbeen successful in addressing the complex engineering, clinical, and neighborhoodissues that arise when implementing a hospital aeromedical landing zone. The fact thatSan Francisco has not yet been able to do this is lamentable, because the medicalexpertise certainly exists to benefit not only our own residents, but also many othercritically ill and injured patients throughout the Bay Area region.

It is for these reasons that I offer my unequivocal and emphatic support for the proposalto install an aeromedical-landing zone on the grounds of San Francisco General HospitalMedical Center. Please do not hesitate to contact me at (415) 561-5907 ifI may answerany questions regarding this matter.

jerelYo,.~M,,--",,'s. Marshal Isaacs~ MD~ FACEPEMS Medical DirectorSan Francisco Fire Department

Clinical Professor of MedicineUCSF

Attending Emergency PhysicianEmergency ServicesSan Francisco General Hospital

v"

The American Boardof Surgery, '00./ncoroorat8d 1937

OFFICERS:

MARK A. MALANGON!. ~.4.l

Chairman

RONAlD V MAIEfl. M.D

Vlce.Chairman

FRANK R. LEWIS, JA., M.O.

Sac"tsIY- Treasurer

Jj~..~J 08 £OOjJanuarv 3.2003

Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital -#2A51001 Potrero AveSan Francisco, CA 94110

Dear Ms. O'Connell:

I write to express my support for the efforts currently underway to provide airmedical access to SFGH for the transport of patients with emergencyconditions, particularly trauma. I have a particular appreciation for thesituation, since I served as a staff surgeon at SFGH for 20 years, from 1972-1992, and as Chief of the Surgery Department from 1986-1992. During thattenure the lack of air access to SFGH hampered the development of thetrauma center functions, and totally eliminated the possibility of having thehospital serve as an effective regional trauma center for the Bay area.

DIRECTORS:

Barbara L. Bass, M.D.Richard H, Bell, Jr., M.D.William G. Clofll, rl1.DG. Patrick Clagett, r.1D.George E. Crult, M.U.Timothy J. Eberlein. M.DDavid V. Feliciano, M.OJames W. Fleshman, Jr., M.OTimothy C. Flynn, MD.Julie A. frelschlag, M.U.Richard l. Gamelll, MDKeith E. Georgcson, M.D.James C Hebert, M.D. .

DavId N. Herndon, M.D.Irvlno L. Kron, M.D.Thomas M. Krumnlel, M.D.frank R. Lewis, J(., MO.Keith D. Lill~ml)a, MO.Frank w. loGerfo, M.D.Ronald V. Maler, M.li.Mark A. Malangol1i. M.DMichael S, Nussbaum, M.(j.ThaodOre N. Pappas, M.D.Jeffrey l. ponsky, MDRussell G. Pastier, M.CJ.Bradley M Radgers. M.D.Michael G. Sarr, M.D.Bruce E. Stabile, M.D.Steven C. Stain. M.D.Jon S Thompson, M.D.Counney M. Townsel1d, Jr.. MMarshall M. Urist, M.D.Luis 0. Vasconez, M.O.

The essence of treatment of life-threatening medical conditions is often thespeed with which definitive medical care can be administered. Despite theadvances of prehospital treatment, and the value of such treatment inimproving outcomes, there is little that can be done in prehospital care for thepatient who has an exsanguinating injury, a severe head injury, or severerespiratory compromise. Such patients survive only for periods measured inminutes, and must reach definitive care quickly, where nursing, surgical, andanesthetic expertise are immediately available, if they are to survive.

EXECUTIVE STAFF:

Frank R. Lewis. Jr, t".[JEX8cutive Director

Robert S. Rhodes, M.li.Director of Evaluation

George E. Crult, rA.D.Dlrsctor of SpSC/aJ ProJ8CIS

Jane V BunceDirector of Operations

Thomas W BillStCfAssistant Director of Evaluatlol

Much the same is true of emergent cardiac conditions and occasionally ofnewborn emergencies. For all of these conditions, rapid transport to definitivecare is the essential condition underlying effective treatment.

In the central and northern Bay area, San Francisco General is the only facilitywhich has the needed size, personnel, and expertise to fW1ction in the mannerdescribed. It should be utilized as a regional facility for smaller hospitals inthe area, as well as for primary transport of defined trauma conditions, inorder to provide the most effective care not only to San Francisco residents,

MEMBER BOARD OFTHE AMERiCAN BOARO

OF MEDICAL SPECIALTIES

1617 John F. Kennedy Boulevard, Suite 860, Philadelphia, Pennsylvania 19103-1847(215) 568-4000 FAX: (215) 563-5718 Internet; http:llwww.absurgery.org

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but also to those of adjacent counties. A heliport at the hospital, not basedsome miles away, is the only effective way to make this a reality. There arenumerous examples today around the country in which this model has beenadopted, and has been shown to be extremely effective in improving thetrauma care for a region.

The development of air access to SFGH is a project which has been attemptedin the past by a succession of surgeons and administrators over a 30 yearperiod at the Trauma Center, and it has always succumbed to political oreconomic considerations. I don't think the medical value or need has everbeen questioned. I am enthusiastically supportive of your current effort andwish you every success.

Sincerely,

) A .3.- ~ 6" \.-v "')

Frank R. Lewis, Jr., M.D.

cc: Robert C. Mackersie, M.D.

OREGON HEALSCIENCES UNIVERSI

DIVISION OF GENERAL SURGE

3181 S.W. SAM JACKSON PARK RMAIL CODE L22

PORTLAND, OR 97201.30

TEL 503-494.13

FAX 503.494.88)~tl:1JFebruary 20, 2003

FEB 25 2003

ADMIMISTRATIONSAN FRANaSCQ GENERAL HOSPITAL

Gene Marie O'ConnellExecutive AdministratorTrauma Center- SFGH1001 Potrero AvenueSan Francisco, California 94110

Re: Aeromedical Access

Dear Ms. O'Connell:

This letter will serve to give my very strong support for Aeromedical Access toSan Francisco General Hospital (SFGH). When I was Chief of Surgery at SFGH, Ifought desperately to have such a resource. The politics were simply overwhelming, andit never came to pass. It is long overdue for multiple reasons.

San Francisco General Hospital is arguably the most prestigious trauma center innorthern California. As such, it is a resource for the entire region and not just for thecitizens that live in San Francisco. It should be pointed out, however, that manyofthepeople who work in San Francisco live outside of the county and would benefitimmensely to have access to SFGH at night and on weekends. These.times are preciselywhen most motor vehicle accidents occur.

In order for the clinical activities in trauma to grow at SFGR, they will needaccess to severely injured patients from around the region. Most of these patients willhave e.ither personal injury protection or other insurance, which is not only important forthe clinical program, but can also be beneficial in increasing the type of patients thatwould lend themselves to clinical research. Evidence-based practice guidelines will only~ome when we are doing randomized studies on such patients. An increased occupancy

-"ev .ely injured patients will also improve the ability 'to recruit researchers, which are,6ral I.IJ all levell facilities.

Finally, I cannot help but mention the positive impact it would have on the cityand the county. The prestige of the center is something that all citizens withfu SanFrancisco can be proud of. It is unusual for a city-owned hospital to serve as a tertiarycenter for difficult patients; nevertheless, that is exactly what could happen if you wereable to achieve air medical access. Do not think it would be a negative to the local

1

community surrounding the hospital. Modem helicopters have noise abatement systems,and in the final analysis, it is a service that can really only be delivered by SFGH.

Sincerely,

~ ...;--' r~~

Donald D. iunkel ~

Professor of Surgery

Oregon Health & Science University

DDT: crew

?

UNIVERSITY OF CALIFORNIA. DA VIS

BERKELEY. DAVIS .IRVINE .LOS ANGELES. RIVERSIDE. SAN DIEGO. SAN FRANCISCO SANTA BARBARA .SANTA CRUZ

SCHOOL OF MEDICINEDEPARTMENT OF SURGERYF .WILLIAM BLAISDELL, MDPROFESSOR AND CHAIRMAN EMERITUS

UC DA VIS MEDICAL CENTER2221 STOCKTON BOULEVARDCYPRESS BUILDING, ROOM 3! 18

SACRAMENTO, CALIFORNIA 95817(9!6) 734-2207 (916) 734-395! faxn. ill iam.bJaisdell@ucdmc. ucdavis.edu

January 7, 2003

R

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Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital, #2A51001 Potrero AvenueSan Francisco, CA 94110

Dear Ms. O'Connell:

I understand that the issue of helicopter service for San Francisco General Hospital is nowbeing debated once again. I am extremely pleased to hear this and hope the plans come tofruition.

As you know, I was Chief of Surgery at SFGH from 1966 to 1978 and was the organizer of theTrauma Service. I also served for six months as the Acting Director of the Ambulance Serviceat the time we were introducing our paramedic program.

We pointed out that on many occasions particularly related to commuter time and sportingevents, there were far too many unnecessary delays in transporting critically ill patients. Ivividly recall one instance where an eight-year old was critically stabbed at school.Ambulance transport was delayed by over an hour and the child died en route to the hospital

Above and beyond the benefits to San Francisco, our fully-organized trauma program wouldbe in a position to seriously contract San Mateo County which does not have an organizedprogram of its own. SFGH would be in a position to act as a regional resource.

Best wishes on your effort. hope it is successful

Sincerely,

-'7

/-' ~~ i~/U-~ ~?::-z-?F. William Blaisdell, MD

Professor and Chairman Emeritus

Department of Surgery

FWB:mac

Forwarded by Kate GaraylDPHISFGOV on 02/28/200310:13 AM

"Kenneth A. Williams"

<vrdr@vrdr.com>

02/27/2003 07:44 PM

To: ..'Kate Garay'.. <Kate.Garay@sfdph.org>, <john.brown@sfdph.org>

cc: ..Selim Suner" <SSuner@Lifespan.org>, <hsibold@mema.net>

Subject: RE: San Francisco Trauma System and Air Medical Access

Kate and John,

I can certainly reply about the benefits of a good helipad at a Level 1

Trauma Center, and will try to be brief...should SF General have a helipad?

Certainly. Probably the best comparison situation I know of is Boston.Until a set of hospital helipads were completed some years ago, therewas no convenient helipad in Boston. The time it took to land at a

general purpose helipad, load the patient into an ambulance and drive tothe ED was often longer than the flying time to the next closest

tertiary facility. In situations were time is critical, either becauseof patient condition or system overload conditions, the ability torapidly access helipad resources is essential.

An intermediate example is our current situation at Rhode IslandHospital. The helipad is at ground level, across 2 parking lots fromthe emergency department; about 1/4 mile away. The time required tooffload a helicopter patient, load into an ambulance, drive to the EDand move the patient into a treatment area averages 12 minutes. I'vetimed it on many occasions. The helicopter could fly 20-25 miles, land,and move the patient into the ED at UMASS in about the same time.

Therefore, critically ill or injured patients north of Providence aretypically flown to Boston or UMASS Worcester even when the geographicdistance to Providence is less because of the delay at our helipad. AtUMASS Medical Center, for example, a patient is typically in the ED 2minutes after the helicopter lands.

Those who say you don't need a hospital helipad because there are notmany flights into the area are forgetting that many flights don't occurbecause there currently isn't a hospital helipad.

In an MCI or disaster situation, particularly because of the geographyin your area, the need to move a number of patients in or out of SFGeneral by helicopter could make quite a difference in morbidity and

mortality.

I'd be happy to discuss this further, and certainly support your effortsto provide a helipad at SF General.

Kenneth A. Williams, MD, FACEPvrdr@vrdr.comClinical Associate Professor of Surgery, Brown UniversityAsso~iate Professor of Clinical Emergency Medicine, the Univ. of Mass.Physician Medical Consultant, Rhode Island Dept. of Health EMS DivisionImmediate Past President, Air Medical Physician AssociationSenior Medical Officer and USCG Liaison, RI-l DMAT

University Emergency Medicine FoundationPrincipal Investigator, The Rhode Island Disaster Initiative

www.RIDIProject.org

SAN

FRANCISCO

MEDICAL

SOCIETY

February 25,2003

Edward Chow, MD

President

San Francisco Health CommissionCity and County of San Francisco

I 0 I Grove Street, Room 311

San Francisco, CA 94102An ad~ocate foT

Physicians

and

thiir PatientS Dear Dr. Chow:

At the February meeting of the San Francisco Medical Society Executive Committee,we met with Christine Wachsmuth, RN, MS, and Robert Mackersie, MD, of SanFrancisco General Hospital and John Brown, MD, San Francisco Director of EMS todiscuss the need for and the desirability of locating a helipad at SFGH.

As a result of this discussion, I am writing to indicate that SFMS supports thecontinuation of the study exploring the feasibility of the helipad. It is clear that theSFGH Level I Trauma Center is an important community resource and may bejeopardized without the addition ofair medical access.

Sincerely,

41Ue'.t:..)---

Rita Melkonian, MDPresident

cc: Christine Wachsmuth, RN, MS

1409 Sutter Street

San Francisco

California

94109

415.561-0850

FAX 415.561-0833rron"'.!nnl""".R-._I

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March 2. 2003

San Francisco Public Health Commission101 Grove Street Room 31.1San Francisco, CA 94'102

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\""'1', Re: AIR MEDIC..\l ACCE:SS FEASIBIlITY SruDY

M"t..'I\'lilm"""'"",:"",1 (h.'r Dear Presjdent Cho.~' and members of the Commission.

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The San Francisco Plar.ning and Urban Research Association (SPUR) Urban Policies

Committee heard a presentation by David Prcw!er of rbe r\IR MEDICAl. ACCESS

FEASIBIL.m- STL"DY at our February meeting. The committee ~.hole-heartedlyendorses this study.

We were ,~truck by the fact that San Francisco is the only major city without air

medical access to its trauma center. The need is obvious, not only to increase thequality of care but to maintai11 the level of service of our superb trauma center .

The stud>' itself has addressed in great detail all of the pertinent is,~ue~, i..r1cludingnot only !he need, but such issues as a~ticipated frequenc", of flights, sound levelstudies, and possible locations for a helipad. We believe that the study providesampl.e information on which to base a decision about beginning the service, and weurge your Commission to accept the study and to initiate the s~rvice as soon as

possible.

Sincerely)

p~~ w !t'lij~

Peter \XJinkelstein, Co-Chair, SPUR's {Jrbatl Policies Committee

Cc: David Prowler

~! !(o~Cl;!',,',:..r.,,;n

.

III

Emergency Medical Services Section

January 6, 2003

1 O ZilO3JAN

Ms. Gene Marie O'Connell

Executive AdministratorSan Francisco General Hospital-Office #2A5

1001 Potrero AvenueSan Francisco CA 94110

ADMINISTRATION

SAN FRANCISCO GENER/01.L HOSPITAL

Dear Ms. O'Connell,

I am pleased to state in the strongest possible terms my support for developing a medicalhelicopter landing facility at San Francisco General Hospital. As the Emergency MedicalSystems Medical Director for the Department of Health I am responsible for givingtimely, comprehensive and high quality emergency medical care to patients in the Cityand County of San Francisco.

As cited in the 2001 Trauma Care System Plan, there is a lack of resources to ensure thatall residents and visitors in San Francisco and surrounding regions have time-criticalaccess to the most proximal Level I trauma services in the area. In light of thevulnerabilities of the existing trauma system-the isolating geography, increasing trafficcongestion and population density and the mounting potential for delayed transport; thevulnerabilities to earthquakes, mass casualty events and terrorism; the vulnerabilities totrauma center capacity disruption or saturation; the lack of definitive advanced pediatrictrauma care and limited access to expeditious pediatric trauma center transfers; and the .

lack of consistent expeditious access to the Level I center from remote areas-there is aneed for alternatives to ground transportation for critical trauma patients in San Franciscoand its neighboring regions. The lack of air medical access for emergency patients,including a medical helicopter-landing site, was also identified in our 1999 EMS Systemplan as an area where San Francisco did not meet State EMS Standards. While progresshas been made, we will not reach full compliance with State Standards until the issues ofappropriately sited air medical access are resolved.

San Francisco is at high risk for acts of terrorism that can produce large numbers ofcasualties rapidly. These patients are likely to need immediate trauma care. A SFGH-based medical helicopter landing facility will enable paramedics to rapidly transport suchinnocent victims to you for care, and for you to be able to transfer these patients ifoverwhelmed to other trauma centers. With this capability, our trauma system canbecome truly regional and we can utilize this area's tremendous trauma expertise withother Bay Area communities. This development will deliver a high standard of care toSan Francisco residents and visitors wherever they happen to be in our region whentragedy strikes.

68 -12th Street, Suite 220San Francisco, CA 94103-1242

(415) 355-2600. FAX (415) 552-0194..,..,.., dnh ~t "0 II~/ ~

Department of Public HealthPopulation Health and Prevention

I look forward to supporting this program at the upcoming Health Commission and otherforums for approval. Please contact me at 3552607 if you have any questions.

Sincerely,

~1-

-_."' £:, Brown MD MPA

Medical Director

vEMiRGiNCY Niiiii5""As:iO(iAiiON RE C E I V EDCALIFORNIA STATE COUNCIL FEB 9 2003

ADMINISTRATION

SAN FRANCISCO GENERAL HOSPITAL

Mark Wandro, RN, BSN, CENState ENA Secretary3512 Orinda Dr.San Mateo, CA 94403February 17, 2003

Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital1001 Potrero Ave. Suite #2ASSan Francisco, CA 94110

Dear Ms. O'Connell,

As a representative of emergency nurses in the San Francisco Bay Area, I know firsthand howlimited our trauma resources are. Critical Care ambulances are at a premium and transport timesare often delayed due to lack of access. Even when they are available, transport is often delayeddue to the traffic congestion present on city and area streets. San Mateo County, for example,does not have any trauma center and relies on sending patients via ground transport to either SanFrancisco General or Stanford. Traffic delays can lengthen transport to either facility.

That is why I support Air Medical Access to SFGH. It may make the difference between life anddeath for critically injured patients. No expense is too great if that injured patient happens to beyou or your loved one.

Sincerely,

(\It ~. l)J ~~~-

Mark Wandro, RN, BSN, CEN

San Francisco Bay Area ChapterPrp~inpnt ?00?

City and County of San Francisco Emergency Medical Services Section

December 30,2002

Ms. Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital-Office #2AS1001 Potrero AvenueSan Francisco, CA 94110

Dear Ms. O'Connell

I am pleased to state strongly my support for direct aeromedical access at San Francisco GeneralHospital. As the Administrator of the Department of Public Health's EMS Section, I shareresponsibility with the EMS Medical Director to assure that San Francisco has an integratedEmergency Medical Services System that provides timely, comprehensive, and high qualityemergency patient care.

Direct aeromedical access to San Francisco General Hospital is critical to the San FranciscoEMS System. San Francisco General Hospital is the only Trauma Center in San Francisco. Onmost days, for approximately 16 hours, traffic throughout the region is grid locked. For seriouslyinjured patients in distant areas of the City, rapid aeromedical transport to the Trauma Center isthe most appropriate life saving intervention. Additionally, a SFGH-based helipad will allow arapid transfer of critical pediatric patients to a Pediatric Trauma Center, which can provideoptimal care to a seriously injured child.

San Francisco, as a hallmark city, is at risk for terrorism, including conventional weapon attacks,designed to produce large numbers of casualties. These casualties typically present with war-likeinjuries that require rapid access to trauma care. A SFGH-based helipad will facilitate rapidtransport of these patients from throughout the city to the hospital, and from the hospital to othercritical care centers throughout the region.

Please contact me with any questions at 355-2609.

Sincerely,

~

Mich~~l PetrieAdministrator

H:\helicopters\ 12-30-02 SFGH Areomedical Program.doc68 -12th Street, Suite 220

.i San Francisco, CA 94103-1242

;' (415) 355-2600. FAX (415) 552-0194

www .dph.sf.ca.us/ems

Department of Public Health

Population Health and Prevention

January 13,2003

BOARD or DIRECTORS

Andrew McGuire,

E.~"cutiv" Dir"L.tor

Maggie Escobedo-Steele

Ray Ga[chalian

David Grubb

Gary Mason

PaulO'Rourke, MD

William Schecter, MD

Nancy Snyderman, MD

Radha Stern

Penny Tannlund

FO[;r-;DER

Donald D. Trunkev. MD

Gene Marie O'ConnellExecutive AdministratorSan Francisco General Hospital -Ofc #2AS1001 Potrero AvenueSan Francisco, CA 94110

fn~Dear M~nell:

I am extremely pleased to write in support of much-needed air medical access to SanFrancisco General Hospital.

As you know, the Trauma Foundation is a non-profit policy organization which has been part0! ill'.: 5i;il1 FJC!!-:;.:isco Genel-a: l{ospitaJ (SFGH) campus since 1975. Vlith Dr. DonaldTrunkey, Director ot. SFGH's Burn Center, I founded the Burn Council atSFGH in 1975 withthe mission of preventing burn injuries. Six years later, we expanded our mission to includethe "prevention of all injuries, improved trauma care, and improved rehabilitation," and theIJurn Council was renamed the Trauma Foundation. Since then, the Trauma Foundation hasworked to prevent. traumatic injuries caused by fire-related accidents, motorcycle and othervehicular accidents, and gun violence, to name just a few ofour policy issues. Each of theseinvolves major trauma tor infants, children, youth, and adults whose lives often depend onspeedy access to either a Level I Trauma Center or a Pediatric Trauma Center.

For nearly thirty years, I have been involved in efforts around the state to provide air medicalaccess to trauma centers. Starting in 1984, the Trauma Foundation helped launch CAL-ST AR, a medical air transport service which now provides coverage throughout northernCalifornia. The need for air medical access to SFGH, a Level I Trauma Center, isindisputable: injured San Franciscans currently have no medical air access available tothe only Level I Trauma Center in the area. A recent survey of the 25 largest cities in theUnited States found that only San Francisco fails to provide such access to any of itshospitals. Yet the increased population and resulting traffic density of San Francisco canspell the difference between life and death for trauma victims in need of immediate traumacare. Given the types of unintentional inj uries that occur in San Francisco's urbanenvironment on a daily basis, the less frequent, but very real dangers of earthquakes in theB~.:i Are.?, 3r!ti th~ jn~;reased potential for multi-casualty events and bioterrorism, Sanfr;;;i1ci~;(:v must b~ abl.i; to respond to the urgent need for speedy, efficient air medicaltransport for trauma victims. There can be no mistake: lives will continue to be lostunnecessarily as long as San Francisco sputters along without a medical helipad at SFGH andair medical access to SFGH. We are long overdue for this essential component ofa Level ITrauma Center.

J will continue to work with advocates and policy makers in California to improve air medical

:,_.-;.,:traIJsport..and ~holeheartedly support San Francisco General Hospital's efforts to improve its'~~ ~"1rauma caJ~:.ct:~tivery Please let me know ifI can be of further assistance..-, .., \ ..

: '.::0..:. ' ~Sincerely .',... ' ,

..,

San Franciico General Hospitaf

San Francisco. c~lirorma 94"1 to

415.821.8209

415.282.2563 Fax

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/ A ~~ McG .,..,t,-.llUreW t.ltre

Executive Director