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Mon Apr 30 21:38:41 BST 2007

Pret,

You are erring on your comparisons.

I said if there was no ALS, you ask me to compare nurse/medic to 2 BLS
EMT's...no comparison there and I agree.

But where there is good ALS ground then air EMS loses some of its advantage.

I agree that I do not live where you do and curvy, snow covered mountain
roads help little for the ground pounders. But take that same scenario and
it is snowing, then air EMS may be sitting in the hangar and staying warm
because most are VFR and cannot fly if too cloudy, or foggy or raining or
snowing, etc..

We can argue all day/night about this exact situation and that exact
situation  and if this and if that but in the overall scheme of EMS in the
US, air EMS is an overplayed card that is influenced more by marketing than
by actual science.

Andrew

----- Original Message ----- 
From: "Bjorn, Pret" <pbjorn at emh.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Monday, April 30, 2007 4:31 PM
Subject: RE: Trauma in the air Victims wait for help

Don't abandon objective reality in the obstreperous defense of your
paradigms.  Pretty soon you'll have your fingers in your ears,
hollering, "LAALAALAALAA-I-AM-NOT-LISTENING!"  Cripes, it's like arguing
with a guy who thinks his seatbelt will cause him to burn alive.

Time is time, whether the delays are geographic, meteorologic, or
military.  Every major trauma system innovation since the 1960's has
resulted from trimming time to definitive care.

Come with me to Darkness Falls, Maine, and we'll get drunk and crash a
car into a tree.  I'll take the twin-jet helicopter with the
nurse-paramedic crew from the trauma center, you can have the diesel
truck with the two EMT's from the local ambulance service.

Bet you reconsider when it's you, and it's real.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Andrew J Bowman
Sent: Monday, April 30, 2007 4:01 PM
To: Trauma &amp; Critical Care mailing list
Subject: Re: Trauma in the air Victims wait for help

Of course the data looks good from Korea, Vietnam and Iraq. Those places
have/had unsafe or non-existent ground transport capability. Air was the
only way to go. The US is not the same thing when it comes to ground vs.
air
EMS transport. You cannot defend US air EMS by quoting situations in
third
world war zones.

Andrew

----- Original Message ----- 
From: "Bjorn, Pret" <pbjorn at emh.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Monday, April 30, 2007 3:44 PM
Subject: RE: Trauma in the air Victims wait for help

The data is actually rather compelling and durable; it just doesn't come
out of most parts of New Jersey.  Instead, think Korea, Viet Nam, and
Iraq.

For that matter, I could (if HIPAA permitted) give you the names and eye
colors of at least a couple of our patients each year who would be
decidedly more dead or disabled if not for Maine's LifeFlight program.
To be fair, I admit our trauma center mortality is going UP at the same
time -- owing to patients who would have otherwise died at the community
hospital, or during the truck ride (from thirty minutes to four hours)
to a Maine trauma center.

Just because you live ten minutes' drive from a trauma surgeon, doesn't
mean everyone does.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of rescsteve at aol.com
Sent: Monday, April 30, 2007 3:03 PM
To: trauma-list at trauma.org
Subject: Re: Trauma in the air Victims wait for help

Show me the data that the use of the copter makes a difference in
patient outcomes.

Steve

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