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Mon Apr 10 01:33:27 BST 2006

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PHTLS, does not teach you to load and go and NOT do any other  
treatment. It DOES teach you to get on the road asap and treat enroute.  
I have always questioned if this continued "interpretation" of load and  
go is somehow connected to one's lack of confidence in skills being  
performed in the back of moving ambulances...i.e..IVs, airway  
management, etc?

Regardless, the point is, treat enroute to  definitive care (Trauma 
Center I or II in Iowa). And as per the topic of  this thread as it 
began, never have know a medic to place a chest tube, in  my state, and 
certainly have not ever seen it taught in PHTLS, oh these  many, many 
years.

Jules

What I do not understand is the tremendous variations among EMS systems  
despite the PHTLS.    For example, the only, ONLY advantage of  air EMS over 
ground EMS is that it flys to remote, wilderness, and high rise  locations.   AIR 
ems is still EMS, and should be under the same  scrutiny as ground EMS.   Yet 
there is some urban legend that air ems  is a higher level of care than ground 
EMS.   The opposite is probably  more correct.     

In my continuing view NEITHER air or ground EMS should be putting in chest  
tubes or putting needles into the chest.  

k

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