List Archives

Wed Jul 2 21:52:39 BST 2008

Well said!

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 William Bromberg
Sent: Wednesday, July 02, 2008 3:13 PM
To: trauma-list at trauma.org
Subject: Re: Flagstaff Tragedy

Pret, as demonstrated below, you are in fact NOT the chief scolder. Nor
am I proposing any legislation or regulation by the government about
when to use the helicopter because frankly I think the government would
screw it up. As Dr Hardcastle noted I think it is time for a serious
look at the indications for helicopter transfer from a medical (not
regulatory) framework. I'm not sure how you got from my comment to "You
seem quick to radically regulate medical helicopters in order to save a
dozen peers and patients per year -- this criminal litany."

I think we can all agree that an unstable, bleeding patient 120 miles
from the nearest hospital would likely benefit from helicopter transport
so no, I do not propose allow all the rural Mainers or Portlanders to
die without the benefit of medevac. 

I think we could also agree that if the patient would get to the
hospital faster by ground than by air  they should probably NOT be flown
— this happens all the time at my institution and I have no authority
demand or ammunition to convince them not to do so — that's why I want
to start the discussion.

There are a lot of in betweens and I for one am incredibly insulted
when someone accuses me of demeaning people whose lives may be at risk
unnecessarily. I cannot see how it is "callous" to try to save both
patient and provider's lives by coming up with guidelines to prevent
unnecessary flights and to appropriately provide them to  people who
need them.  

And what does " don't preach unless you've been there" mean anyway? I
am a trauma surgeon in a mixed rural/urban and suburban setting who
takes care of people from as close as the parking lot to as far away as
6 hours south (Jacksonville was on diversion). I am a private pilot and
have flown on the helicopter a number of times. I'm pretty sure that
most of the people on this list have "been there" in one way or another.
Do we have to die in an aircraft accident to be able to discuss
indications for aeromedical evacuation?

And Scott Crossfield died because ATC vectored him directly into a
thunderstorm — sort of like sending a helicopter up into bad weather
for unclear reasons. 

Bill Bromberg 

>>> "Connie Potter" <Connie at traumafoundation.org> 7/2/2008 11:56 AM
>>>
The critical comments re: Flagstaff's tragic crash appear to come
mostly
from those least familiar with the rural nature of emergency care and
distances, the diminishing numbers of "volunteer EMT's" able to leave
their primary catchment area to transport a patient, AND the lack of
access to even LIV trauma care in the great mass of this US, but who
wish to second guess those who are no longer alive to rebut statements
that they flew/died for nothing.  

Many trauma systems review every airmedical use. Portland OR's ATAB
forbids them within 40 miles of the scene because they delay care.  
The
rest of the rural American often does not have the luxury of even
calling for airmed resources because there are none.  Rural hospitals
are losing specialists at an alarming rate so patients are being
transported for "routine stuff"?   Sorry, but not to an FP.   

No problems with spiders?  Where do you live?  A Brown Recluse caused
one of my patients to lose her arm by the time it necrosed to the
bone.
This time the unlucky patient was a college student at U of M in
Missoula, a firefighter from my home town.  We at home will think of
him
as having died in service, thank you very much.  

Except for a few of this list, the callous comments any time one of
flights goes down becomes increasingly demeaning to those who get out
daily to place their life and safety on the line.  No, we don't try to
fly when it is unsafe and we do flight following because it is.  My
flight crew was in the air on the Columbia Gorge when Mt St. Helens
blew: Should we have factored that possibility into all of our flight
plans?  And if flying is so easy, why did Scott Crossfield die after
his
plane tore apart in a thunderstorm?  Even the best don't always make
it.
God Rest Them and Give Them Peace and pray for the survivor.  And,
don't
preach unless you've been there.  

Connie Potter

-----Original Message-----
From: trauma-list-bounces at trauma.org 
[mailto:trauma-list-bounces at trauma.org] On Behalf Of
trauma-list-request at trauma.org 
Sent: Wednesday, July 02, 2008 2:37 AM
To: trauma-list at trauma.org 
Subject: Spam:trauma-list Digest, Vol 61, Issue 4

Send trauma-list mailing list submissions to
	trauma-list at trauma.org 

To subscribe or unsubscribe via the World Wide Web, visit
	http://list.mistral.net/mailman/listinfo/trauma-list 
or, via email, send a message with subject or body 'help' to
	trauma-list-request at trauma.org 

You can reach the person managing the list at
	trauma-list-owner at trauma.org 

When replying, please edit your Subject line so it is more specific
than "Re: Contents of trauma-list digest..."
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/ 

--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

Flagstaff Tragedy