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Wed Oct 29 21:44:44 GMT 2003

Tim, what I said is that patients are being flown because they have a 
dispatch to trauma center time (since most of the dispatched calls are for 
TRAUMA) of <30 minutes. Ground transport time is >45 minutes - FROM THE 
SCENE! This means that from the scene, the patient's flight time is <15 
minutes. In very rare situations, patients are flown from within an  urban 
area.

I should also point out that the closest hospital from a simultaneous 
dispatch area scene (not a trauma center) is ~20 minutes away. The helo can 
fly patients to the trauma center at least as fast as a ground ambulance 
could deliver the patient to a non-trauma hospital. Which would you choose 
if you had a trauma on your hands in the field and both air and ground 
units available on scene?

Jeremy Hawk, Paramedic

At 05:48 PM 10/28/2003 -0500, you wrote:

>On Fri, 24 Oct 2003 02:16:31 -0400, JenW133 at aol.com said:
> > I have to agree with Nick, in that a number of air transports in the
> > bay area are necessary, while others are not. Many remote areas in the
> > East Bay such as Bethel Island, Knightsen or even populated areas like
> > Antioch are between 25-60 minutes drive time, to the nearest trauma
> > facility.(depending on time of day of course) Not all areas that have
> > flight teams need them, but the ones that do should be justification
> > enough to keep them around.
>
>I agree that SOME flights are appropriate.
>
>I think that the 45 minute drive time should be the drive/fly decision
>point, but only when the patient truly meets trauma triage criteria.
>
>Except for mechanism criteria. Let's be serious, how many patients who
>meet mechanism criteria are not sitting in the hall an hour after arrival
>at the trauma center?.
>
>
> >
> > You have to ask yourself, if one of your loved ones were seriously
> > injured, would you want to risk a ground transport time that may delay
> > procedures that can only be done in the ER, versus the field? I know I
> > wouldn't!
>
>You have to ask yourself, what is the transport time?
>
>Nick Nudell and Jeremy Hawk both gave estimates of time from dispatch to
>trauma room as over 30 minutes. Patients are being flown because the
>transport time by ground is above 15 minutes, yet the helicopter
>transport time is more than 30 minutes. The question should be, why are
>you delaying necessary treatment AND putting your loved one at greater
>risk just for the opportunity to pay a bigger bill.
>
>If the ground transport time is more than 45 minutes AND they have truly
>life threatening injuries that does not apply. How many patients really
>meet those criteria. Patients are frequently flown because of one, or
>more, of the following: the ground crew gets to brag that their patient
>went by helicopter; the ambulance does not wish to be outside of their
>territory for that much time (this is just bad patient care, yet is often
>policy); it is near the end of shift; the crew chief does not have
>confidence in his/her ability to care for the patient (even though
>patient care can be delivered more safely and more easily in the back of
>an ambulance than in the even-more-cramped quarters of a helicopter; the
>helicopter crew hands out little helicopter pins that can be worn on the
>uniform to show that you have flown a patient; medical command flies
>anything; there is an attractive medic/nurse on the helicopter and the
>ground crew wants to flirt; and many others.
>
>I used to work in a trauma center taking the patients off the helicopter
>and down to the trauma area. It was routine that the patients transported
>by ground would be in the trauma center BEFORE the helicopter had landed.
>
>I fly about one patient a year. The trauma center is 20 minutes to 50
>minutes away.
>
>I do not call for a helicopter for RSI (it is not in my scope of
>practice). Waiting for a helicopter to come fix my airway, while my
>patient explores the bottom left of the oxyhemoglobin dissociation curve
>is homicide.
>
>Helicopters are not panaceas. They do many things well. They do not speed
>up short transports (less than 45 minutes). An ambulance is a more
>convenient place to deliver care (more room, less noise, less vibration,
>and usually faster). Helicopters should be staffed with more experienced
>providers, but politics plays just as much of a role in employment
>decisions with flight crews as with ground crews (as with emergency
>departments, too - some do it very well, some do not).
>
>Helicopters are appropriate for many things, but are abused and often
>unavailable for patients who will truly benefit from flight crew care and
>helicopter transport.
>
>Tim Noonan.
>
>
> >
> > Thanks for hearing me out!
> >
> > J. Warden Paramedic Fire/EMS Instructional Coordinator
> >
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