List Archives

Wed Jun 13 13:22:25 BST 2007

Who assumes medical control for the air program in this case?  

In many systems, the nearest EM clinician is in charge of treatment and
destination decisions; but in at least one state I'm familiar with, air
medical supervision is centralized and largely separate.  This fosters
some consistency and efficiency, but predictably at some cost to
communication and local logistics.  I'd like to know more about the Iowa
system.

And Jules, I admit that I'm late to the table and something of a
skimmer, but I think that much of the escalation here is from
sensitivity, not persecution.  "EMS is a(t) fault?"  "EMS screwed up?"
Those are your characterizations, aren't they?  Consider the possibility
that the "lynch mob" is in your head.

Just me, just now.
Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Jules K. Scadden
Sent: Tuesday, June 12, 2007 8:03 PM
To: trauma-list at trauma.org
Subject: Re: EMS management/crush injury

Roy says:
>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
theircolleagues.
>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.

 I agree....talk about communications between the field and the
hospital/EDs..that should be done 
continuously anyway. And ALL trauma's, especially ones such as this
should be reviewed and CQI'd..
?EMS people agree with discussing these things, that would be why they
have CQI policies.

I think the benefit of this thread has rapidly escalated into an "EMS is
as fault" instead of what
I "thought" the intent was, a frank, beneficial discussion.

Yes, EMS people will come to the defense of their colleagues, especially
those of us that work in Iowa 
and understand how our system works and why they probably made the
decision they did. But then I've seen 
doctors, nurses, & plumbers all come to the defense of their colleagues
also, especially when
?NO evidence has been presented they did anything WRONG and as far as
we've been told, 
detrimental to the patient.

?If this is a 'what can we do better" discussion, lets lose the "EMS
screwed up" piece in it
?and perhaps ask THEM why they called for a helicopter, before passing
judgment without all
the facts or reasons.

We have very little actual first hand information OR patient outcome
information. Could we try to
lose the lynch mob mentality?

I do believe you feel there needs to be a strong partnership between
EMS, ED and physicians, 
unfortunately, this discussion is no longer promoting that..if feels
alot like trying to point
a finger at a "perceived" wrong...unsubstantiated as that!

I'm sorry Dr. Caropreso, I do understand what your intent was with this
thread.

Julie 

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EMS management/crush injury