Cranes near the Royal Melbourne Hospital are causing problems. Photo: Eddie Jim
Critically ill Victorians could face longer and riskier ambulance journeys in coming months after the Royal Melbourne Hospital decided to shut down its helipad for more than 15 hours every day.
The hospital - one of Melbourne's two major trauma centres for adults - has temporarily closed its helipad from 3.30pm to 7am on weekdays and for 40.5 hours over weekends due to unmanned cranes on building sites nearby.
Fairfax Media understands the partial closure could last more than 18 months while cranes work on the new Peter Doherty Institute and Victorian Comprehensive Cancer Centre, due to be complete by mid 2014 and 2016 respectively.
Royal Melbourne Hospital executive director Di Gill said that while the helipad was closed, air ambulances could drop patients at the Royal Children's Hospital helipad nearby to be driven to the Royal Melbourne by ambulance.
While the diversion would add at least 10 minutes of travel time, Air Ambulance Victoria manager Paul Holman said the plan would have no impact on patient care.
But some Royal Melbourne Hospital doctors fear it will blow out transfer times for critically ill patients destined for the hospital. They are also worried it will result in more patients being sent to The Alfred, undermining the Royal Melbourne's profile as a major trauma centre.
One doctor who did not want to be named said staff wanted one crane manned 24 hours a day so helicopters could continue to land at the helipad.
Head of the Victorian State Trauma Registry and professor of emergency medicine Peter Cameron said there was no doubt paramedics would choose to go to The Alfred over the Royal Melbourne Hospital while the diversions were in place to avoid complications. He said the longer the transfer, the more risks there were for patients.
''The reality is most of the time we're transferring patients because they need some sort of intervention or sophisticated monitoring or treatment … so the longer the time in transit, the greater the risk because you have them in an environment that is sub-optimal,'' he said. ''Every time you transfer from a land vehicle to a helicopter to a land vehicle, something might fall out or be disconnected or whatever.''
The helipad closure comes as a new state government report showed that while Victoria's trauma system was improving outcomes for patients, transfer times to hospital were increasing.
The Victorian State Trauma Registry report for 2011-12 showed 2894 patients were hospitalised for major trauma, a 7.2 per cent increase from 2699 in 2010−11.
It said while the first hour immediately after sustaining major trauma is ''critical to patient survival and commonly referred to as the 'golden hour''' the number of patients taking longer than an hour to reach a specialist trauma centre had blown out.
In 2005-06, 42 per cent of non-entrapped patients waited longer than an hour to get to hospital, rising to 64 per cent in 2011-12.
Professor Cameron said although transfer times should be as short as possible, a focus on getting patients directly to a trauma centre rather than detouring via other hospitals could be increasing transit times. He said although it might take longer, it was considered better for most patients.
General manager of regional services at Ambulance Victoria Tony Walker said more sophisticated paramedic care at the scene of trauma cases may also be increasing pre-hospital transit times.