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Tue May 1 17:00:46 BST 2007

In a message dated 5/1/2007 9:52:43 A.M. Central Daylight Time,  
brombwi1 at memorialhealth.com writes:

Show me  a paper that has data that air transport improves outcome in
the US. Every  one that I've seen shows no outcome difference. It's
amazing how fast  people ignore data when it goes against their biases.  

You have seen the same papers that I have seen.   I have really  really 
looked hard for the kind of paper that you are requesting.  The ONLY  papers I can 
find (more than 700 in my files on air ambulances) are those from  the 
military.   

One MAJOR (false) assumption is that TIME is an independent variable in  
trauma outcomes for patients that have survivable injuries.   In the  majority of 
population based studies that I can find, time was not such an  independent 
variable.    For the few kinds of injuries where time  might be a variable, 
ground ambulance use for urban transport is BETTER than  air.   So, a major 
question to the group, relates to the need to  speed, to fly, to have red lights and 
sirens, to spend $10,000 + per ambulance  ride, for the patient with 
survivable injuries, even though they are hypotensive  (which we now know to be a GOOD 
thing).    

 I continue to support helicopter use for rural, wilderness, high  rise, and 
off shore RESCUE (Maine might qualify for rural rescue), but that is  totally 
different from ALS Air Helicopter use, which is totally out of  control.   

k

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