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Mon Nov 24 22:56:04 GMT 2008

Well said Dr. Mattox!  We should also look at the objective data for  
modern times.  One example is Mechanism of Injury (MOI) which has not  
formally been revisited for a number of years.  If, for discussion  
purposes, the last formal review and evaluation of MOI was twenty  
years ago (1988?) specific to car crashes, the safety compartment of  
passenger vehicles has increased in both crashworthiness engineering  
and less injuries sustained for the properly restrained occupants,  
i.e. less life threatening injuries despite the external carnage of  
the vehicle appearing incompatible with life.  Additionally, in the  
70's when Flight for Life and subsequent rotocraft services started  
operations the specialty of Emergency Medicine was non-existent or at  
best new.  Surgeons were the best level of trauma care available at  
the time, there for patients needed to get to them.  Over the past 20,  
30, 40 years emergency medicine expertise and resources have changed  
as well as those of trauma surgery, yet we continue to strongly hold  
on to our dogmatic beliefs such as trauma patients must go to trauma  
centers; an erroneous philosophy as Dr. Mattox just pointed out.  We  
as an industry are equally fearful of change despite advancements in  
science occurring all around us with direct impact on how we care for  
our patient's.

My Great-Grandmother was born in a Conestoga wagon and lived long  
enough to see man walk in space.  Drs. Cooley and DeBakey participated  
in the first open heart surgeries and then pioneered the now main  
stream sub-speciality of cardiothorasic surgery.  Will Trauma and EMS  
ever reach such levels of maturity and advancement?  Or are we  
destined to tradition, even at the cost of our killing our colleagues  
and patients?

Take care,

Bob Waddell II
EMT-P (ret)
bobwaddell at bresnan.net
307 920 2020

On Nov 24, 2008, at 2:46 PM, KMATTOX at aol.com wrote:

> Yes, by some estimates up to 70% of the helicopter transport  
> patients have
> trivial to no medical conditions and are dismissed in just a few  
> hours after
> arrival at the hospital.    Even those programs with hospital   
> associated
> helicopter programs complain about this group of patients who could   
> have gone just
> as expeditiously to a doc in the box locally and been treated for   
> their
> minor condition.     IT IS THINGS LIKE THIS THAT THE  MARYLAND AND  
> OTHER PANELS
> NEED TO ADDRESS, BUT are reticent to discuss, for if  the  
> helicopters only flew
> for the indexable bad cases, the number of flights  would be too  
> few, so that
> they would not make enough money to stay in  flight.
>
> k mattox
>
>
> In a message dated 11/24/2008 2:34:40 P.M. Central Standard Time,
> sahajs at gmail.com writes:
>
> Are they  truly dispatching helos for pt's with NO APPARENT  
> INJURIES?!?!  As
> someone who works in EMS and trains providers, I find that stunning.  
> I also
> think that if the system is that flawed (my opinion) they need to  
> look at all
> aspects of it, starting with their education, and not make nationwide
> judgements based on that system.
>
>
>
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