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Wed Jul 2 18:14:20 BST 2008

What a unique idea. Put people in jobs that they are the best trained. 
Typed by the thumbs of
Norman on his BlackBerry 

Norman McSwain, MD
Tulane Univ Surgery
504 988-5111

----- Original Message -----
From: trauma-list-bounces at trauma.org <trauma-list-bounces at trauma.org>
To: 'Trauma &amp; Critical Care mailing list' <trauma-list at trauma.org>
Sent: Wed Jul 02 12:03:01 2008
Subject: RE: Helicopter crashes

Very true Jules!  Thanks.  All this was put into context in April while
sitting in on a meeting intended to discuss why Trauma Surgeons should be
responding to the scene of a disaster to triage patients a highly prominent
and one of the country's leading Trauma Surgeons told the group that besides
their idea being fecal matter, he and most of his colleagues are highly
educated and skilled and nearly worthless when the tools of their trade are
taken away from them, i.e. placing them in an environment they are not best
suited for.  He proposed that we better train EMS to do what's best for the
patients in the prehospital arena, including prompt and safe transport, and
bring them to the ED and Trauma Teams so they can do what they do best where
they do it best!  You would have thought the concept was provided in some
futuristic language.  The group ultimately decided to work as a Team for the
best outcomes for the patients versus an ego based feeding frenzy.

All levels of healthcare Providers from all vantage points must be part of
the solution.

Take care, 

Bob 

(307) 920 - 2020 cell

bobwaddell at bresnan.net 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Jules
Sent: Wednesday, July 02, 2008 10:40 AM
To: Trauma &amp, Critical Care mailing list
Subject: Re: Helicopter crashes

Good idea Bob....just make sure the street provider has a part in it..often
time management doesn't have a clue what is happening in the street or for
the patient. The person working with the situation everyday is a valuable
resource and has important input to give.

We often time forget to listen to those voices in our association (s).

Jules

On Wed, Jul 2, 2008 at 11:22 AM, Bob Waddell <bobwaddell at bresnan.net> wrote:

> It seems that we and the popular press jump on exactly the same bandwagon
> when a tragedy such as these occur, yet I would propose that we DETERMINE
> THE TIME IS RIGHT TO DISCUSS EMERGENCY MEDICAL TRANSPORTS versus the
ground
> vs air issue in isolation.  The recent death of a Paramedic in Delaware is
> no less devastating to EMS and EM than that of the loss of life in
Arizona,
> California, . . .  WE have developed a system were the patient, their
> family, the Physician, the Nurse, the Paramedic, the EMT, the cat can call
> 911 and SOMEBODY's going to the hospital in an emergency vehicle.
>
> Unsafe vehicles, vehicles NOT specifically designed for the objectives
> demanded, inadequate and inappropriate protocols, failure to decline
> services for a plethora of medically valid reasons, and lack a data are
> only
> the beginnings of why good healthcare providers and their operational Team
> members are dying unjustifiably.  Let's quit the political self
> congratulatory rhetoric and let's actually DO something to fix the
problem!
>
> With NNAEMSA, EMS EXPO, and NAEMSE conferences coming up in the next few
> months I propose we start an ACTION Force (not Task Force), and bring the
> issues forth.  I can look into finding meeting space if there is any
> interest.
>
> Take care,
>
> Bob
>
> (307) 920 - 2020 cell
>
> bobwaddell at bresnan.net
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org]
> On Behalf Of McSwain, Norman E Jr.
> Sent: Wednesday, July 02, 2008 9:10 AM
> To: Trauma & Critical Care mailing list
> Subject: RE: Richey and Helicopters
>
> How about just comparing the "need" of air vs ground, based on the
> patient's condition and the comparative difference in time. The time
> must be measured in time from the incident to arrival at the hospital
> not just the partial time of air vs ground drive/fly times from injury
> site to the hospital.
>
> Example - waiting for the launch and arrival vs just starting out to
> drive the distance is a variable that MUST be considered. Most folks
> don't include this when they measure transport times.
>
> Norman
>
> Norman McSwain MD
> Professor, Tulane School of Medicine
> Trauma Director, Charity Hospital Trauma Center
> norman.mcswain at tulane.edu
> 504 988 5111
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert F. Smith
> Sent: Wednesday, July 02, 2008 9:39 AM
> To: 'Trauma & Critical Care mailing list'
> Subject: RE: Richey and Helicopters
>
> Unfortunately there is no
> NTSB mandate to investigate ambulance crashes, and there is no uniform
> database for these crashes.  This makes it extremely difficult to
> compare the risk of air vs. ground.
>
> Dave,
>
> Do you think that is something that is "fixable" if pressure was applied
> by
> our various august governing bodies?
>
> Rob
>
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