Specialised
Trauma Air Response - STAR
They give so that
they may live; for to withhold is to perish" KAHLIL GIBRAN
Specialised Trauma Air Response is a
specialist Helicopter Emergency Medical Service (HEMS), utilizing a helicopter
platform to provide life saving and critical interventions to the critically ill
and injured patient. The STAR HEMS program is world renowned, and has received
international accreditation for the quality and nature of the service.
The STAR vision is to provide a safe and sustainable HEMS service to all citizens
of South Africa.
As a Section 21 Non Profit Organization, audited by Independent Auditors KPMG
on a totally transparent manner, STAR is heavily dependant on sponsorships and
donations to fulfill this vision.
Working closely within the health systems, the STAR system adds significant value
from a patient outcome, cost saving and system support perspective.
STAR was born in 1999 when the provincial government withdrew all subsidy from
the original "Flight for Life" Service, based in Johannesburg, which was then
downgraded from a 24 hour operation to a 12 hour, daylight only operation.
STAR took over the Flight for Life service in October 1999, working closely with
Flight For Life, and through partnerships and enhancing service delivery, quickly
saw the Johannesburg operation returned to a 24 hour operation, still working
closely with the Provincial Government. In line with the original Vision, STAR
progressed to introducing and operating more bases throughout the Country, providing
the 24 hour operation in Gauteng, supported by a daylight Service operating out
of Tshwane, a limited 24 hour operation in the Northern Province based in Polokwane,
along with daylight operations in Kwa- Zulu Natal and the Western Cape.
These operations are achieved with extremely limited state subsidy, who reimburse
STAR only for missions undertaken on their behalf, and therefore STAR relies heavily
on corporate sponsorships, such as the limited sponsorship generously provided
by a local Cellular Company - Cell C. A tightly monitored medical and financial
structure within the company ensures that we are able to continue our services
to all South Africans.
STAR operates according to strict dispatch guidelines extrapolated from numerous
international studies which show which type of illness or injury benefits most
from Helicopter Evacuation. These guidelines ensure that STAR's role within the
governmental health systems is maximized.
STAR Helicopters are crewed by a Paramedic and Emergency Doctor at all times,
this level of care is only found on 18 other services internationally, and STAR
is the only Helicopter Emergency Medical Service (HEMS) in Africa that offers
a 24 hour service.
The medical crew, operations centre personnel and most of the pilots are principally
volunteers, who offer their time freely, crew entry criteria is exceptionally
strict, and they are selected through numerous criteria, which have to be met
before they are allowed to apply to fly as Flight crew.
STAR maintains a neutral and independent position in the emergency setting, thus
allowing both Private and Government services, the ability to have access to the
system. This allows all South Africans, access to state of the art Aeromedical
care, and the time saving resource which we provide.
Again, in line with the Vision, in excess of 76 % of patients flown and impacted
are from disadvantaged communities, the vast majority if which are from rural
and semi rural communities who would normally never have had access to this type
of system.
On average the STAR system services between 150 - 200 calls per month, which consist
of a mixture of Inter-facility transfers and Primary medical responses.
Working closely with the health systems in which it operates, STAR has shown the
following benefits, not only to the critically ill patient, but to the entire
system as well:
System utilization
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- A HEMS program can support
not only the pre hospital resources, but the entire health system. With
a heavy focus on HIV / AIDS, the ambulance services spend significant
time moving these patients. Trauma is an equally costly and crippling
epidemic on the economy of the country. A HEMS program provides a better
quality of patient to a better quality of receiving facility, thereby
improving outcomes, reducing the burden on the Government.
- Studies have shown that
the quicker a survivable patient has access to tertiary care, the better
the outcome, the less time spent in hospital, and the lower the long
term burden on the Health System.
- If seen in isolation, a
HEMS program may seem costly, but seen in the bigger picture, this cost
becomes very small compared to the consequences of delays to hospital
or tertiary care.
- Many studies, as well as
key figures locally and abroad support this view.
- By reducing both morbidity
and mortality, the system can reduce the so called "preventable death
or disability", by reducing a single disability alone, and the subsequent
disability grants, a HEMS program can quite easily justify its existence.
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Road resource backup
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- Roadside Emergency Medical
Services are already stretched to their limits. Should a road EMS service
need to move a critically ill patient from a rural location to a tertiary
center, it would leave the area severely depleted of resources.
- A HEMS program can rapidly
access the scene, and move the patient to hospital, allowing the road
resources to service other needy patients.
- A HEMS program can also
access very remote areas rapidly, sometimes even quicker that road crews
can get there.
- Studies show that a transport
time of more than 20 minutes can be potentially harmful to the survivable
patient.
- A comparison of a single
flight versus the cost of utilizing a ground unit to service the call,
and the resultant unavailability to service other calls, requiring additional
units, shows how cost effective a HEMS program can become.
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Inter facility transfer
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- Again, the studies have
shown that the quicker a survivable patient gets to definitive care,
the better the outcome.
- A HEMS program can also
significantly ease the burden on road EMS services. Some areas are supported
exclusively by one or two ambulances, should these resources need to
move critical patients over hundreds of kilometers, the area would be
left without resources.
- Local ambulance service
are also simply not trained or equipped to deal with the critically
ill patient.
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Refer to points prepared by Modernisation of Tertiary Services: Feedback of
the Trauma Surgery Focus Group as follows:
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- violent crime or road traffic
accidents over past 3 years.
- On scene deaths shown to
be due to overwhelming injury and lack of access
- Shortages of EMS services
- patient arrives on average 2-3 hours after injury, and 5 hours to
theatre (the golden hour is a rumour)
- Primary healthcare system
operates during working hours (trauma after hours) - and poorly trained
in managing minor injury
Management of Costs
- An estimated 35% of costs
in any service industry is due to poor quality. Effective strategies
of prevention (see secondary prevention) and establishing inclusive
trauma care systems have been proven to reduce costs
- Inclusive trauma care systems
shown to decrease mortality by 5 - 30%, with the biggest improvement
brought about by improving access to care and shortening time to definitive
care (USA, Australia, and Mexico).
- Delays to definitive care
induce sepsis, multiple organ failure and drive costs. The Systemic
Inflammatory Response occurring after any trauma is only terminated
by definitive care
- The consequences of the
above study and paper show that the longer the patient takes to get
to definitive care, the more that patient costs the Government and the
poorer the outcome for all.
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Why you should Support STAR:
- Reducing bleeding and the
need for blood products.
- Reduction in time spent
in an Intensive Care Unit.
- Reduction in time spent
in Surgery.
- Reduction in time spent
in Hospital.
- Reduction in the risk of
infection and other consequences.
- Reduction in rehabilitation
time
- Reduction in death and disability
payouts
- Reduction in costs to Government
and its funders
- Speed of time to scene and
time to hospital
- Accessibility into areas
where advanced care is not accessible
- Brings an entire Trauma
unit to the scene
- Where the "Golden Hour"
becomes the Platinum 15 minutes
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STAR in the community:
STAR has an active involvement within
the community, outside of the emergency setting. We at STAR have noticed the
significant impact, that the Helicopters have made on many peoples lives, and
as a result have selected days whereby we invite children, from 'Reach for a
Dream' and other organisations that help with providing better opportunities
for children from disadvantaged backgrounds.
STAR would like to continue offering the Life Saving Service which it does for
all South Africans, and has a vision of being able to place Helicopters in all
the Provinces, working with and supported by both the business community and
the local governments.
Financially it is not possible now,
however in the words of an unknown man who once said, "Patience is bitter
for those who are ambitious; however the rewards are far greater!" It is
a philosophy that we all live by. Please help us to achieve, and realize our
vision, as you will be helping to promote this Life saving organisation in a
most special way.
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any further information please feel free to have a look at our website or
contact either of the people mentioned below. |
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Thank You For Supporting
STAR
Specialised Trauma Air Response
Association incorporated under Section 21 - Reg No - 2000/010007/08
