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Tue Jul 1 19:41:50 BST 2008

I will be happy at anytime anywhere to professionally and data driveN to discuss this subject.   It is fAr overtime it is honestly discussed.   

K
Sent via BlackBerry by AT&T

-----Original Message-----
From: "William Bromberg" <brombwi1 at memorialhealth.com>

Date: Tue, 01 Jul 2008 13:30:13 
To: <trauma-list at trauma.org>
Subject: RE: med copters collide

Every time something like this happens, someone points out that medical
flights are being overused and that there is poor data to support it's
efficacy in general. The next posting scolds the original questioner for
the question, usually pointing out that you should not  "hurt the
feelings" or trivialize the sacrifice of the victims and that it's "not
the right time" to have the discussion.  Then it's forgotten about until
 a few weeks later when the next aircraft goes down. The cycle continues
and the conversation is never held.

Fine — I want a date. If now isn't the right time I propose we set a
date to discuss the appropriate use of aeromedical transportation in the
civilian setting because frankly I'm sick of these stories and I'm sick
of my flight crew being called out in all kinds of weather for
uninjured, intoxicated patients. For times when the ground crew is about
to go off shift and don't want to drive the hour round trip. For a dog
bite to the foot. And it goes on and on and on.

Each death is a tragedy. The unending litany of deaths is a crime.

But that's just my opinion..
Bill Bromberg

>>> "Marc Matthews - MedPro MMC X" <Marc_Matthews at medprodoctors.com>
6/30/2008 12:42 AM >>>
Agreed. There was a government scolding about a year ago suggesting
that these companies do a better job at policing themselves or else the
government would step in. What ever became of that?

MRM

________________________________

From: trauma-list-bounces at trauma.org on behalf of Errington Thompson 
Sent: Sun 6/29/2008 8:53 PM
To: trauma-list at trauma.org; ccm-l at ccm-l.org 
Subject: med copters collide

Ken has been talking about this for years.  We have too many copters
flying
for non-emergencies.  This is a very bad tragedy.

>From CNN:

(CNN) -- At least six people were dead and one critically injured
Sunday
after a midair crash between two medical helicopters near a hospital
in
Arizona, authorities said.

The collision, at Flagstaff Medical Center in Flagstaff, Arizona, set
fire
to a 10-acre area, according to fire officials, and another two rescue
workers were injured by a secondary explosion after the crash.

The helicopters collided at roughly 3:45 p.m. local time, according to
the
Federal Aviation Administration.

"As you can imagine, we've got lots of heaps of metal to go through,"
said
Capt. Mark Johnson of the Flagstaff Fire Department. "It's just
difficult
right now."

He said a landing pad on the roof of the hospital is used by medical
helicopters.

Federal Aviation Authority officials originally had reported at least
seven
deaths and three critical injuries, but they revised those numbers
after
investigators spent more time on the scene.

Flagstaff Police Department Sgt. Tom Boughner said the two rescue
workers
were not immediately believed to be seriously injured. He said the
helicopters crashed into a wooded area near a neighborhood and that no
one
on the ground was believed to have been injured or killed in the
crash.

He said the fire had been contained by Sunday evening.

FAA spokesman Ian Gregor said at least one of those killed in the
collision
was a patient.

He said three of those killed, including the patient, were aboard a
Bell 407
helicopter operated by Air Methods Corporation, an air medical service
provider. The other helicopter, operated by Classic Helicopter Service
of
Utah, also was a Bell 407. The other four victims, including the one
critically injured, were on that helicopter.

Both helicopters were headed to the hospital at the time of the crash,
Gregor said.

FAA safety inspectors from Phoenix, Arizona, were en route to the
scene
Sunday, and additional inspectors from Washington were expected to
arrive
Monday morning. The National Transportation Safety Board will lead a
probe
into the crash, Gregor said.

Errington C. Thompson, MD, FACS, FCCM

Trauma/Surgical Critical Care

Author -  <http://www.whereistheoutrage.net> Letter to America

Asheville, NC

  _____ 

From: ccm-l-bounces at lists.ccm-l.org
[mailto:ccm-l-bounces at lists.ccm-l.org] 
On Behalf Of KMATTOX at aol.com 
Sent: Sunday, June 29, 2008 11:20 PM
To: trauma-list at trauma.org 
Cc: SURGINET at listserv.utoronto.ca; ccm-l at ccm-l.org 
Subject: [CCM-L] Monocled Cobra bite

For the endemic and usual kinds of poisonous snake bites in the United
States I have always proposed to be very sparingly in using antivenin.
Today we received a patient arriving less than 40 minutes after being
bitten
on the finger by a monocled cobra.    He breeds and raises these snakes
and
his business is known to the authorities and the game warden near his
house.

Shortly after arrival his respiration just stopped and he was
intubated.
He was sedated as if he had been given a muscle relaxant.   His
BP,clotting
studies were basically normal.   His TEG was normal.     He required
no
pressors.    He had basically NO swelling or discoloration at the site
of
the bite as we usually see in US poisonous snakes.     We called around
the
country and the consensus was that he should receive specific
antivenin.
The closest antivenin was 1/4 the way across Texas (None in Houston or
Galveston), so it was flown here and he has received 6 vials of Naja
specific antivenin.    He is in the ICU and being supported with the
usual
ICU care.  

The reason I am posting this is for several reasons: 

1.    Cobra bites are RARE in the United States

2.    I find that cobra breeders and sellers are fairly common in the
United
States

3.    I found that the NEUROLOGIC paralysis was rapid and sure, and
the
hematological and coagulopathies effects of the antivenin were not
seen.  

4.    Several of you on this web site have seen cobra bites.    

I am seeking wisdom and advice as well as long range outcomes and
effects.
I feel certain that we will receive a large variety of opinion and
advice.
We will receive and welcome any and all and will weigh all advice
against
his clinical course.  

Thanks in advance.    

  _____ 

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cars
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med copters collide