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Tue May 1 13:18:13 BST 2007

Tim, 
I have to agree with your observations.  Ken does make some good points, but forgets that the cluster of ground transportation in heavily congested areas can be alleviated in selected circumstances with a rotor winged aircraft.  Key words:  selected circumstances!
Ron

>>> "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za> 5/1/2007 1:20 AM >>>
Ken

While in principle I agree with you, I would say this with the proviso that the urban transport system must then have un-impeded access and egress: In morning/evening "rush hour" traffic it is much easier on our highways to land a heli ahead of the incident and upload a pre-packaged patient (usually by fire-first response) than to try and get an Ambo in and out to hospital through the busy streets (Often the chopper is there first anyhow, given the blockage). Transport times in our environment at those times of the day (0600 till 0900 and 1630 till 1900) are prolonged to say the least. Our highways in the bigger cities (Cape Town / Johannesburg / Pretoria / Durban) are designed to allow easy identification and institution of an LZ.

As to the other uses and other times of the day (and inner-city use / downtown use) I completely agree

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
M.Med (Emergency Medicine) Executive Committee member
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Division of Surgery (General) Room 4064
Department of Surgical Sciences
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za 
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302

-----Original Message-----
From: trauma-list-bounces at trauma.org 
[mailto:trauma-list-bounces at trauma.org]On Behalf Of KMATTOX at aol.com 
Sent: Tuesday, May 01, 2007 3:05 AM
To: trauma-list at trauma.org 
Subject: Re: Trauma in the air Victims wait for help

I have been watching this discussion point.    I have not  comment on purpose 
as I wanted to see just how this would unfold.    Air Ambulance use for off 
shore, high rise, and wilderness RESCUE is  essential.   Air ambulance for most 
urban and suburban areas of the  WORLD are overused, over expensed, and 
complications, death rates, and safety  records under reported.     

>From a strictly scientific standpoint, air ambulance use in urban and  
suburban areas cannot be supported.   From an economic standpoint,  including public 
relations and filling unfilled hospital beds, air ambulance use  are 
excellent vehicles if the case mix is such that sufficient number of the  passengers 
have some form of payment.    From a cost effective  analysis risk adjusted and 
time adjusted standpoint one can never defend air  ambulance use.    

But like CEO salaries, NFL 1s round draft choices, and politics, our  
discussions have very little chance in changing the  overexpenses.    

k

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Trauma in the air Victims wait for help