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EMS management/crush injury

Roy Danks roydanks at hotmail.com
Tue Jun 12 19:10:31 BST 2007

I'm not sure we can come to any conclusion as yet.  I don't think the EMS people communicated effectively.  The general notion that "bigger is better" (University v community setting) has little weight.  They (EMS) need to keep medical control informed in a situation such as this.  It doesn't sound as if it was  moving at break-neck speed and they had a good handle on what was going on at the scene. And, don't get me started on helicopters.  I love aircraft of all kinds, esp rotor wing.  Aeromed saves lives, but are, in general, over priced flying billboards for many hospitals and for their own private gain when not affiliated with a hospital.  Ever see a aeromed crew get to the scene and say "this pt doesn't need us...take him by ground"???  Nope.  Doesn't happen.
As for HIPPA.  B.S.!  Why even bother Googling anything?  I'm pretty net savvy and never even considered it.  I don't see any patient identifiers AND the patient never went to Phil's hospital.  That's crap.  You sound like one of "them" (Gov't folks).
But, since you went there (HIPPA).  Are you familiar with another gov't ape known as EMTALA?  Having a surgeon or EM doc stroll out to the helipad at the hospital  to "eyeball" the patient then send them on is, as far as I understand it, a violation of EMTALA.  We had a surgeon do that "Somewhere in Missouri where I trained"...meeting the ambulance in the bay and telling them "we can't handle that here"...and were fined a substantial penalty.  The presence of the helipad at the hospital and using it as a "meeting point" is of concern as well.  One might argue, convincingly: you pulled into the parking lot of a level III trauma center, with a surgeon inside....perhaps 100? or 50? yards away and didn't get the patient evaluated?  Ohhhhh....I don't know...sounds likes a nice bonus for some blood sucking attorney when the patient exsanguinates en route to the university.
Phil:  This is how I see it.  Sit down with EMS and talk communications.  EMS people on this thread are going to come to the defense of their colleagues.  I'm going to play the devil's advocate and tell you that they over-stepped their boundaries.  The reason you and your hospital are called "medical control" is because you are there to help them make decisions.  Not all the time...not for every patient.  This was hardly and "every patient" encounter and they would be wise to learn from this situation.
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