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Fri Apr 25 20:10:11 BST 2008

Sir every thing is just not that cut and dry, and yes the state protocols do address it, but lets take a step back for a second, because you might as well just insult every medic that works their butt off every day to do everything they can for each and every patient we have , trauma and medical alike ! And for you to say it is a possibly a lack of education on our part, I am assuming sense you where not clear on if you are pointing that finger at Paramedics, but at this point I will take it as that, you can quote protocols , state and local all you want, it comes down to what the boss says ! We have to follow our local protocols and procedures that keep us from getting fired or sued for deveating from local protocol, by your attempt at dropping this failure in the laps of the front line people , the Paramedics and first responders is typical of someone that is not in educated and aware of what happens in prehospital care, I don't know your qualifications , you have not stated, but
 to blame the bullet for killing some one instead of the person who pulled the trigger is like blaming a pencil for a misspelled word sir ! It is so easy for doctors and emergency room staff and the like to stand back and talk about something they think they understand, yet not being directly involved , and even the medical directors have no clue  cause they are the ones that make our local protocol yet are never on the trucks, never have to make the choices we do on scene, all just set back and make uninformed or "perfect world declarations" and dump the blame where it does not belong ! Now how you think politics has nothing to do with where a patient goes, you can not possibly be involved in a EMS in any way, politics are every thing in a county run 911 service that has county commishners that want to get paid, and Insurance companies demand a patient not be taken past a medical facility or they will not pay ! There is all kind of politics that are involved, we are not talking of
 political causes, we are talking about political governing, we can not by protocol transport a patient out of the county by ground, if the patient can not go by air we must transport to the closest facility, which is the county ER ! And due to county commission not wanting trucks transporting to Nashville on every call they will not change this because of our high call volume, we as medics can request of a supervisor in significant cases if we can transport to Nashville, but will likely get turned down except in exceptional cases, which I have had and basicly had to beg for the patients sake to allow transport and still been turned down! We do not have the luxury of multiple hospitals and a trauma center in our direct area, we have one public hospital that has 250 beds, in a pinch we can transport to the military base , but they do not want trauma brought there, so the medics have no choice but to try and fly patients , if the aircraft is not available, we have little choice but t
o take to local level 2 ER. Now how that reflects on Paramedics and first responders is a uneducated statement on your behalf ! We have bosses and that is the law of the day, what needs to happen is for there to be a means , training of medical directors and law makers to make it so the "Pencils" ( the Paramedics and first Responders) are not blamed when  words gets misspelled ! You can stand on a soap box and spew all you want about state protocols, they mean nothing when countered by the local protocols that where written to protect the population of our county as a whole for the rest of the calls that are not trauma ! It does not make it right but you are pointing your finger in the wrong direction , plain and simple! Insult all you want , you are the uneducated here, you are the problem cause people like you look at the tree that fell as the problem, not the weak roots and the high wind that caused the tree to fall, the people making the rules need the education sir until then 
we MUST follow those rules !
LB
-------------- Original message from Anthony Caruso <medic541 at hotmail.com>: -------------- 


> 
> 
> 
> LB, I'm not quite sure how it's political. EMT's on scene make the 
> determination . If the patient(s) has been traumatized severely enough then 
> they go to the appropriate hospital. State wide protocols dictate that. No way 
> around it. Calling for a chopper is a tool that we have. What may be the 
> underlying cause here is the lack of education possibly. More is needed to be 
> able to identify the patients that have been severely traumatized and make the 
> appropriate transport decision. My decision to transport who where and when has 
> never been influenced by any political causes. 
> 
> Just my 2 cents. 
> 
> AMC. 
> > To: trauma-list at trauma.org> Date: Fri, 25 Apr 2008 16:46:56 +0000> Subject: 
> Re: (no subject)> > Sorry about that, I meant they are usually in the air once 
> we call in 4-8 mins which they can get to a scene anywhere in the county within 
> minutes, depending though on how we receive the call , we sometimes call while 
> responding to let them know what we are going on and put them on standby which 
> shortens there responce because they will go ahead to the aircraft, once we 
> determine need we let them know to launch or not, Air Evac does flying standbys 
> , they will launch and head your direction and we can cancel them dependant on 
> need for airlft or not.> LB> -------------- Original message from "Andrew J 
> Bowman" : -------------- > > > > How can you safely 
> get a helicopter to a scene within 4 minutes of calling > > them? > > > > You 
> call, they receive call, re-check weather, quick aircraft check, > > start-up, 
> lift off, fly to scene, land, get out. > > > > Andrew > > > > > > > is just not 
> acceptable! We have one of the four of Vanderbilt's BK's right > > > here at our 
> local hospital, and if they are on the pad we can usually > > > either get them 
> to a scene within 4-8 mins of calling for them, > > > > -- > > trauma-list : 
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