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Mon Apr 30 20:38:53 BST 2007

Since that scenerio is almost non-existent in most areas I say my mom is a load and go.  Her chances of survival are better.

Steve 

-----Original Message-----
From: farcpr at gmail.com
To: trauma-list at trauma.org
Sent: Mon, 30 Apr 2007 3:26 PM
Subject: Re: Trauma in the air Victims wait for help

If I am 30 minutes by ground from the local trauma center and I know that 
the helo can get there in five and the helo is 10 minutes away I will try to 
get the helicopter. What would you want me to do for your mom. 

Forrest 

On 4/30/07, rescsteve at aol.com <rescsteve at aol.com> wrote: 
> 
> Show me the data that the use of the copter makes a difference in patient 
> outcomes. 
> 
> Steve 
> 
> -----Original Message----- 
> From: farcpr at gmail.com 
> To: trauma-list at trauma.org 
> Sent: Mon, 30 Apr 2007 1:41 PM 
> Subject: Re: Trauma in the air Victims wait for help 
> 
> 
> I replied from my phone earlier, but your call that the 28 minutes was 
> outrageous has me stumped. If you were the EMS crew on the ground and you 
> thought that it would take you 20 minutes to get to the local trauma 
> center 
> and the helo would take 8 minutes would you package the patient and leave 
> after 8 minutes? Would you give up after 12 minutes? If you were expecting 
> the helo in 8 minutes when would you leave without them? If the helo took 
> 15 minutes to arrive and you left after 14 how could you justify that? If 
> you have to wait you are delaying transport? I guess I will never wait for 
> a helo again. 
> 
> On 4/29/07, Anthony caruso <medic541 at hotmail.com> wrote: 
> > 
> > Prêt, please tell me that crews did not wait on scene for the amount of 
> > time 
> > that they stated? 28 minutes? That's outrageous! Shame on them if they 
> > delayed transport with an ETA like that. I'm not sure how close they 
> were 
> > to a level 1 trauma center (or level 2 for that matter) but if you 
> figure 
> > that, add 28 minutes of flight time, plus the time it takes the crew to 
> > land 
> > assess the patient, package and become airborne from the scene with that 
> > patient. Looking at a time of possibly 36 minutes give or take? Way too 
> > long for me anyway. I do recall a statement in the protocols stating "do 
> > not delay transport". What's your take? 
> > Anthony Caruso NREMT-P. 
> > 
> > >From: "Pret Bjorn" <p.bjorn at netzero.net> 
> > >Reply-To: "Trauma & Critical Care mailing list" 
> > ><trauma-list at trauma.org> 
> > >To: "'Trauma & Critical Care mailing list'" <trauma-list at trauma.org> 
> > >Subject: RE: Trauma in the air Victims wait for help 
> > >Date: Sun, 29 Apr 2007 08:46:16 -0400 
> > > 
> > >Well done, Forrest. Good to be reminded that there're two sides to 
> every 
> > >story. 
> > > 
> > >As I was scanning Steve's original post, it was easy to imagine the 
> true 
> > >motives behind a competitive private air ambulance. I think many states 
> > >have experienced similar rogue providers with varying results. 
> > > 
> > >A visit to www.monoc.org is instructive: their web site an electronic 
> > >monument to the Paramedical Industrial Complex. Note the prominent 
> > >conservative icons: the Terror Threat barometer and the 9/11 memorial 
> > >(urging punishment for the terrorists and those who harbor them). 
> > > 
> > >Drilling further, it doesn't take long to find the "Save NJ Paramedics" 
> > >organization, whose mission it seems to declare New Jersey prehospital 
> > care 
> > >on the brink of a disaster, which only unrestricted private billing can 
> > >resolve. Even an amateur Google detective will soon discover that their 
> > >ostensibly grass-roots coalition is represented by Winning Strategies, 
> > one 
> > >of the leading public relations firms in the northeast. 
> > > 
> > >In its proper context, the Astbury Park Press article is cynical and 
> > >sickening. One can only hope that the good people of New Jersey wise up 
> > to 
> > >the manipulation. 
> > > 
> > > 
> > >Pret Bjorn, RN 
> > >Bangor, ME USA 
> > > 
> > > 
> > >-----Original Message----- 
> > >From: trauma-list-bounces at trauma.org 
> > >[mailto:trauma-list-bounces at trauma.org] 
> > >On Behalf Of Forrest Robleto 
> > >Sent: Sunday, April 29, 2007 7:12 AM 
> > >To: Trauma &amp, Critical Care mailing list 
> > >Subject: Re: Trauma in the air Victims wait for help 
> > > 
> > >But there is more to the story.... 
> > > 
> > > 
> > 
> http://www.app.com/apps/pbcs.dll/article?AID=/20070427/OPINION/704270390/103 
> > >0/POLITICS 
> > > 
> > > 
> > >On 4/29/07, S Schecter <schecters at gmail.com> wrote: 
> > > > 
> > > > Posted by the Asbury Park 
> > > > Press< 
> > > > 
> > > 
> > 
> http://www.app.com/apps/pbcs.dll/misc?URL=/misc/register_zago.pbs&Category=z 
> > >ago&Destination=http%3A//www.app.com/ 
> > > > >on 
> > > > 04/22/07 
> > > > 
> > > > BY JAMES W. PRADO ROBERTS <JWR at APP.COM> 
> > > > STAFF WRITER 
> > > > 
> > > > If your house is burning, the closest firefighters douse the flames. 
> > > > 
> > > > If a burglar is prowling, the closest police officer gives chase. 
> > > > 
> > > > If you are critically injured in an automobile accident and need to 
> be 
> > > > airlifted to a trauma center, you'd think you would always get the 
> > >closest 
> > > > available medevac helicopter crew. 
> > > > 
> > > > Not in New Jersey. 
> > > > 
> > > > Across the state, victims of horrific auto accidents and other major 
> > > > trauma 
> > > > injuries have waited up to a half-hour longer than necessary for 
> > >state-run 
> > > > air rescue crews to reach them. Private medevac helicopters that are 
> > >much 
> > > > closer to some accident scenes are often deliberately not called by 
> > >state 
> > > > medevac dispatchers, the Asbury Park Press has found. 
> > > > 
> > > > At least 24 times since July, state medevac dispatchers sent a State 
> > > > Police 
> > > > helicopter to pick up seriously injured victims in Ocean and 
> > Burlington 
> > > > counties, even though a closer medevac operated by MONOC could have 
> > > > arrived 
> > > > to fly the patients to a trauma center faster, according to MONOC 
> and 
> > a 
> > > > review of state medevac dispatch recordings. 
> > > > 
> > > > Patients in those cases faced delays of three to 28 minutes, 
> according 
> > >to 
> > > > MONOC, a nonprofit regional emergency response organization, and 
> > records 
> > > > reviewed by the Press. 
> > > > 
> > > > "I think it's a turf battle, and they are playing it with people's 
> > >lives," 
> > > > said Assemblyman Peter J. Biondi, R-Somerset, sponsor of a bill that 
> > >would 
> > > > require the closest-available medevac to be dispatched to a trauma 
> > >scene. 
> > > > 
> > > > On at least two occasions, ground-based rescue crews canceled the 
> > >medevac 
> > > > and drove to a hospital rather than wait for a state helicopter, 
> > >according 
> > > > to Jeff Behm, MONOC's vice president of operations. 
> > > > 
> > > > In February, Miguel A. Flores of Toms River waited an estimated 17 
> > >minutes 
> > > > longer than needed for an air transport. A State Police helicopter 
> was 
> > > > called first, even though a MONOC medevac craft was much closer. 
> > Members 
> > > > of 
> > > > his family assumed that everything possible was done to help Flores, 
> > who 
> > > > later died from his injuries. 
> > > > 
> > > > "I want to know what the heck happened," said his sister, Maritza 
> > >Flores. 
> > > > "We have been in the dark." 
> > > > 
> > > > The New Jersey State Police say their two medevac units have saved 
> > > > thousands 
> > > > of patients - including Gov. Corzine, who was seriously injured in a 
> > >motor 
> > > > vehicle accident April 12 on the Garden State Parkway. They also say 
> > > > private 
> > > > medevac operators aren't as safe, while MONOC said its program is as 
> > >safe 
> > > > or 
> > > > safer than any in the industry. 
> > > > 
> > > > "Our record speaks for itself. In every case we've delivered our 
> > >patients 
> > > > safely," said State Police spokesman Capt. Al Della Fave. 
> > > > 
> > > > Because traumas by their nature are life-threatening, no one has 
> said 
> > >for 
> > > > sure if transportation delays led to permanent disability or death 
> for 
> > > > patients in these cases. 
> > > > 
> > > > But at least two victims, Flores in Toms River, and another in 
> Sparta, 
> > > > Sussex County, later died of their injuries in hospitals. 
> > > > 
> > > > Flores, 31, was critically injured shortly before 2 a.m. Feb. 22 
> when 
> > >his 
> > > > Toyota severed a utility pole adjacent to Hooper Avenue in Toms 
> River. 
> > > > Flores was thrown through his driver-side window and landed 42 feet 
> > >away. 
> > > > 
> > > > At the time, MONOC's air ambulance was available seven miles away at 
> > the 
> > > > Robert J. Miller Airpark in Berkeley, MONOC said. 
> > > > 
> > > > But the state's medevac dispatchers sent a New Jersey State Police 
> > > > helicopter dubbed SouthSTAR (Southern Shock Trauma Air Rescue). It 
> was 
> > >42 
> > > > miles away in Voorhees. 
> > > > 
> > > > It took SouthSTAR 27 minutes to arrive, according to recordings of 
> > State 
> > > > Police radio transmissions. 
> > > > 
> > > > MONOC says it could have been on the scene within 10 minutes. 
> > > > 
> > > > After SouthSTAR arrived, Flores' heart rate dropped, and he 
> eventually 
> > > > needed CPR, according to the dispatch recordings. As a result, he 
> > >couldn't 
> > > > be airlifted to the region's trauma center, Jersey Shore University 
> > > > Medical 
> > > > Center in Neptune. Instead, an ambulance drove Flores to Community 
> > >Medical 
> > > > Center in Toms River, where he died at 3:21 a.m. 
> > > > 
> > > > Flores was in bad shape - and he may have died even if MONOC's 
> > >helicopter 
> > > > was dispatched, said Behm of MONOC. But because he was not flown to 
> a 
> > > > trauma 
> > > > center by the closest medevac, there is no way of knowing, Behm 
> said. 
> > > > 
> > > > In another accident, just after 10 a.m. on Sept. 17 in Sparta, Gary 
> J. 
> > > > Wasilewski's motorcycle collided with a Honda CR-V. Paramedics at 
> the 
> > > > scene 
> > > > asked that a nearby private medevac be dispatched, according to 
> > > > Assemblyman 
> > > > Biondi and dispatch recordings. It could have arrived in 12 minutes, 
> > he 
> > > > said. 
> > > > 
> > > > The request was rebuffed by the dispatcher, who said, "You know what 
> > the 
> > > > rules are, and I'm not gonna, with the atmosphere here, I'm not 
> gonna 
> > > > change 
> > > > anything." 
> > > > 
> > > > The State Police's helicopter NorthSTAR, which had been in Mercer 
> > >County, 
> > > > didn't arrive until 27 minutes after it was dispatched, radio 
> > recordings 
> > > > show. 
> > > > 
> > > > "The policy is State Police first; however, we expect dispatchers to 
> > get 
> > > > the 
> > > > most appropriate helicopter there," said David W. Gruber, a senior 
> > > > assistant 
> > > > commissioner in the state Department of Health and Senior Services. 
> > > > 
> > > > When NorthSTAR brought the 54-year-old Wasilewski to the roof of 
> > > > Morristown 
> > > > Memorial Hospital, his heart stopped, according to Biondi. 
> Wasilewski 
> > >fell 
> > > > into a coma and was taken off life support a week later, according 
> to 
> > >his 
> > > > fiancee, Denise Danzeisen. 
> > > > 
> > > > "Why? Why? They were sitting right there," she said of the private 
> > >medevac 
> > > > helicopter located in Netcong and operated by the Atlantic Health 
> > >hospital 
> > > > chain. "Why couldn't they do it? It makes no sense." 
> > > > 
> > > > The state health department is currently reviewing its medevac 
> > dispatch 
> > > > policy, and an independent consultant's report is due in June. It is 
> > >also 
> > > > reviewing whether the State Police should put a third medevac 
> > helicopter 
> > > > into service in central New Jersey. 
> > > > 
> > > > NorthSTAR has been dispatched since 1988 by University Hospital in 
> > >Newark. 
> > > > The hospital took over dispatch responsibilities for SouthSTAR last 
> > >fall. 
> > > > 
> > > > Anna Farneski, a spokeswoman for the University of Medicine and 
> > >Dentistry 
> > > > of 
> > > > New Jersey, which operates University Hospital, declined to comment 
> on 
> > > > specific dispatches, citing patient privacy laws. The Press asked 
> > > > specifically about dispatch decisions, not patients' conditions. 
> > > > 
> > > > "We are unable to address misinformation disseminated by those who 
> > would 
> > > > turn New Jersey's medevac service into a for-profit enterprise," 
> > >Farneski 
> > > > said. 
> > > > * 
> > > > First hour is critical* 
> > > > 
> > > > It's called the golden hour. 
> > > > 
> > > > Since the Vietnam War, emergency medical professionals have 
> maintained 
> > > > that 
> > > > 60 minutes can mean the difference between life and death for the 
> > > > critically 
> > > > injured. 
> > > > 
> > > > Beginning in 1988, the New Jersey State Police have safely flown 
> > >thousands 
> > > > of patients to trauma centers within that time. State health 
> > department 
> > > > policy gives the State Police a virtual monopoly over air rescues, 
> as 
> > >long 
> > > > as a helicopter is available. 
> > > > 
> > > > Private operators are called only if the state's medevac helicopters 
> > >can't 
> > > > respond, according to official dispatch rules and state policy 
> > letters. 
> > > > 
> > > > Most other states rely on private medevac operations to ferry the 
> > > > critically 
> > > > injured to trauma centers. But until two years ago, NorthSTAR and 
> > > > SouthSTAR 
> > > > - the State Police's two helicopter rescue units - had operated here 
> > > > virtually without competition. 
> > > > 
> > > > Last year, the agency's medevac helicopters responded to 1,261 
> > accident 
> > > > scenes, and transported another 314 patients from one medical 
> facility 
> > >to 
> > > > another. 
> > > > 
> > > > But to settle a lawsuit, in 2004 New Jersey decided to allow private 
> > > > medevac 
> > > > helicopters to be based in the state. There are now three private 
> air 
> > > > ambulances in the state, including MONOC's, which had its first 
> flight 
> > >in 
> > > > April 2006. 
> > > > 
> > > > By way of comparison, Maryland State Police, who pioneered 
> nonmilitary 
> > > > medevac operations in 1970, also relegate private medevac 
> helicopters 
> > to 
> > > > accident scenes only if the Maryland police can't respond. But 
> > Maryland 
> > > > State Police ferry five times the number of trauma victims that New 
> > >Jersey 
> > > > State Police do, with eight medevac helicopters on standby 
> throughout 
> > >the 
> > > > state. Maryland has only a third more land and fewer residents - 5 
> > > > million, 
> > > > compared to 8.7 million in New Jersey. 
> > > > 
> > > > "We can have a helicopter anywhere in the state from 12 to 18 
> > minutes," 
> > > > said 
> > > > First Sgt. Richard Bruns, flight operations supervisor for the 
> > Maryland 
> > > > State Police. 
> > > > 
> > > > The Sikorsky helicopters used by the New Jersey State Police for 
> > medevac 
> > > > operations, originally built to fly CEOs, not patients, are larger 
> and 
> > > > faster than some private air ambulances: At a cruising speed of 150 
> > >knots, 
> > > > the State Police medevac could fly from the tip of Sandy Hook to the 
> > tip 
> > > > of 
> > > > Cape May in 41 minutes - 4 minutes and 30 seconds 
> > > > faster than MONOC's Eurocopter, which has a cruise speed of 135 
> knots. 
> > > > 
> > > > But MONOC - which is owned and operated by a consortium of 20 
> > hospitals 
> > > > from 
> > > > Hudson to Cape May counties, including Jersey Shore - says it is 
> wrong 
> > >for 
> > > > the state health department to force trauma patients to wait longer 
> > for 
> > > > the 
> > > > State Police when another helicopter is closer. 
> > > > 
> > > > "This is a no-brainer," Behm said. "This needs to be changed now." 
> > > > 
> > > > MONOC's medevac does respond when SouthSTAR is unavailable, and Behm 
> > >said 
> > > > MONOC's helicopter has seen an increase in accident scene calls 
> since 
> > > > Flores 
> > > > died on Feb. 22. 
> > > > * 
> > > > Assembly bill considered* 
> > > > 
> > > > In March, Assemblyman Herb Conaway Jr., a medical doctor, held a 
> > hearing 
> > > > on 
> > > > a bill similar to Biondi's that would require the state to dispatch 
> > the 
> > > > closest medevac helicopter to a trauma scene. 
> > > > 
> > > > Conaway, D-Burlington, asked Dr. Eric Munoz, a fellow member of the 
> > > > Assembly 
> > > > Health and Senior Services Committee, who teaches at UMDNJ and is a 
> > >trauma 
> > > > surgeon at University Hospital: "You are the trauma doc here. . . . 
> > Does 
> > > > 10 
> > > > minutes matter?" 
> > > > 
> > > > Munoz, R-Union, responded: "I don't think I've had once where I've 
> > said 
> > >if 
> > > > the helicopter got there earlier, this person would be alive. . . . 
> > I've 
> > > > been working in Newark 20 years, I can't remember an incident." 
> > > > 
> > > > Other agencies measure response times in seconds. 
> > > > 
> > > > In New York City last April, officials announced that a pilot 
> program 
> > to 
> > > > install global positioning satellite equipment in ambulances had 
> > reduced 
> > > > its 
> > > > emergency medical response times to the most serious calls by just 
> 33 
> > > > seconds. The city then spent nearly $50 million to install the 
> > equipment 
> > > > in 
> > > > 1,565 emergency response vehicles. 
> > > > 
> > > > "In an emergency," New York Mayor Michael Bloomberg said at the 
> time, 
> > > > "every 
> > > > second counts." 
> > > > * 
> > > > Financial incentives?* 
> > > > 
> > > > The question of which helicopter is asked to respond to trauma calls 
> > is 
> > > > not 
> > > > just a question of patient care, as MONOC maintains - it's also a 
> cash 
> > > > competition, some say. 
> > > > 
> > > > While the State Police itself does not charge patients for the 
> > flights, 
> > > > the 
> > > > hospitals that provide in-flight medical staff charge a flat fee of 
> > >$1,337 
> > > > for each patient. A typical private medevac fee for an auto accident 
> > > > victim 
> > > > is $8,000 or more, most of which is paid for by insurance. 
> > > > 
> > > > The State Police medevac program is suppose to be funded by an 
> annual 
> > > > vehicle registration fee surcharge, which increased from $1 to $3 in 
> > >July. 
> > > > 
> > > > The medevac's revenue would have increased to $21.5 million, which 
> > could 
> > > > have been used to replace the State Police's aging Sikorsky S76-B 
> > > > helicopters. However, most of the money was diverted into the 
> general 
> > > > treasury for other purposes. This year, the medevac unit will 
> receive 
> > >the 
> > > > same amount of money as it did in 2006 - approximately $8.5 million. 
> > > > 
> > > > In addition to trauma rescue, the medevac helicopters perform 
> various 
> > > > police 
> > > > and security missions. The most junior State Police trooper pilot 
> will 
> > > > receive a $56,820 salary this year, according to Capt. Della Fave. 
> > There 
> > > > are 
> > > > 22 medevac pilots. 
> > > > 
> > > > Hospitals that supply medical personnel on the flights will receive 
> a 
> > > > total 
> > > > of $2.5 million billing this year from the state, on top of the 
> > $817,000 
> > > > they expect from patient flights. 
> > > > 
> > > > The hospitals involved in the program are University Hospital, 
> Virtua 
> > >West 
> > > > Jersey Hospital in Voorhees and Cooper University Hospital in 
> Camden. 
> > > > 
> > > > >From 2001 through 2006, University Hospital and Virtua received 
> $10.2 
> > > > million from the state, not including as much as $5 million more in 
> > > > patient 
> > > > billings. Last year, the hospitals won a three-year grant to 
> continue 
> > >the 
> > > > service. Income to the hospitals was expected to be $3.3 million 
> this 
> > > > year. 
> > > > 
> > > > The real reason private operators want to be called first, said Dr. 
> > >Steven 
> > > > Ross, chief of Cooper's trauma unit, is that auto accident victims 
> in 
> > >New 
> > > > Jersey have good insurance policies that will pay for medevac 
> > services. 
> > > > 
> > > > "You want my honest answer? It's a pure and simple profit motive. 
> > >There's 
> > > > money to be made," Ross said. 
> > > > 
> > > > Stephen D. Olsen, MONOC's chief flight paramedic, disagrees. 
> > > > 
> > > > "What we think this is is a patient care issue. If there was a fire, 
> > >you'd 
> > > > want the closest fire truck," he said. "This is the same thing." 
> > > > -- 
> > > > trauma-list : TRAUMA.ORG 
> > > > To change your settings or unsubscribe visit: 
> > > > http://www.trauma.org/index.php?/community/ 
> > > > 
> > > 
> > > 
> > > 
> > >-- 
> > >V/R 
> > > 
> > >Forrest Robleto 
> > >R House Health & Safety 
> > >www.RHouseTraining.com 
> > >FRobleto at RhouseTraining.com 
> > >609-792-9047 
> > >-- 
> > >trauma-list : TRAUMA.ORG 
> > >To change your settings or unsubscribe visit: 
> > >http://www.trauma.org/index.php?/community/ 
> > > 
> > > 
> > > 
> > >-- 
> > >trauma-list : TRAUMA.ORG 
> > >To change your settings or unsubscribe visit: 
> > >http://www.trauma.org/index.php?/community/ 
> > 
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> > 
> 
> 
> -- V/R 
> 
> Forrest Robleto 
> R House Health & Safety 
> www.RHouseTraining.com 
> FRobleto at RhouseTraining.com 
> 609-792-9047 
> -- 
> trauma-list : TRAUMA.ORG 
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> 

-- V/R 

Forrest Robleto 
R House Health & Safety 
www.RHouseTraining.com 
FRobleto at RhouseTraining.com 
609-792-9047 
-- 
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Trauma in the air Victims wait for help