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Wed Jul 14 21:22:45 BST 2004

Dear Dr Frykberg,

Without belaboring the points

1, the families of the deceased want to know that their loved ones died in a noble enterprise. Thus suggesting otherwise adds unnecessary distress. we simply do not know.

2. the suspicions in your post must be resolved and one might hope that FAA and local coroners as well as whatever other institutional review is available will do so. If not addressed how can anything ever be improved. If these resourses are not currently operating appropriately in your neck of the woods it is incumbent on trauma leaders to react to make them available.

3. as to the final point about my opinion, I would base it on current evidence recently published in the JACS treating outcomes related to distance, severity, and time. in practical terms a critical injury that would take longer than 1 hour away from an appropriate trauma center by road could be considered for air if all other local factors are in order including the weather.

If the patient was not critically unwell  no matter what the distance, we would be forced to conclude that people lost their lives in a needless endeavor.

BUT as I said at the outset , that remains to be seen

Tom Horan

> ----------
> From: 	DocRickFry at aol.com[SMTP:DocRickFry at aol.com]
> Reply To: 	Trauma & Critical Care mailing list
> Sent: 	quarta-feira, 14 de julho de 2004 16:52
> To: 	Trauma & Critical Care mailing list
> Subject: 	RE: Chopper crash
> 
> In a message dated 7/14/2004 2:56:16 PM Eastern Daylight Time, "Thomas Anthony Horan" <thoran at sarah.br> writes:
> 
> >Dear Dr. Frykberg,
> >
> >of course you may be correct but your statements can not be made on the basis of
> >news reporting which can be terribly inaccurate, and frequently sensationalist.
> >Thus, you speak based on your personal biases,  and presumptions .
> >Careful assessment of all factors is needed. To do less is to dishonor those who lost their lives.
> >Such evaluation will not be useful if the case is pre-judged by opinion leaders
> >prior to the facts being gathered.
> >
> >Tom Horan
> >No tom--
> I speak on the basis of the information we have--certainly that info may be wrong, and I would be glad to modify my views should it be--but in the context of that information, there is no bias except my concession that I do tend to have a bias to err on the side of patient and crew safety, and the need for accountability in medical decisions. The lack of accountability of prehospital systms around the country in this regard is also a fact, not bias. Maybe you don't agree?  If so, we could discuss that, but in this context, I am sure you agree on the above principles.  Also, my views in no way dishonor those who lost their lives--nothing I said indicated they were at fault in any of this--their mission is to go when help is called for.  Those who did the calling deserve the dishonor.
> Please clarify for us your views on the necessity of this call (without the classic dodge of not knowing the info, let's pretend the account is accurate)--you seem to be very good at sniping those who give their views, without ever climbing out on that limb yourself--we are all waiting.
> ERF
> >
> >>  I wonder how much accountability those EMT's who made this ridiculously flawed decision will be held to--in my experience, that question never even comes up--medical errors seem to only get pinned on physicians and nurses.  I wonder how often the helicopter would be called if the person who makes the call has to pay for the trip ($1000/hour). It's awfully easy to spend someone else's money. But the decision was wrong...and without review, the mistake will never be acknowledged, meaning it will continue to happen
> >> ERF
> >>
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