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Tue Nov 25 15:14:22 GMT 2008

Jeff,

Duly noted, I did state that incorrectly.  YES the value of trauma  
centers and trauma care is well established for patients with life  
threatening trauma.  Dr. Mattox referred to the group of flown  
patients that could have just as appropriately been treated at  a  
local "Doc in the Box."  Thank you for correcting my statement and the  
intent of my statement.

Take care,

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

On Nov 25, 2008, at 6:33 AM, Jeffrey Hammond wrote:

> Correction. Dr Mattox did NOT say trauma patients shouldn't go to  
> trauma centers. He was commenting about inappropriate triage for use  
> of air ambulances. The value of trauma centers and trauma syustems  
> is well established and not "an erroneous philospohy."
>
> Jeff Hammond
>
> ----- Original Message -----
> From: Robert Waddell II <bobwaddell at bresnan.net>
> Date: Monday, November 24, 2008 5:56 pm
> Subject: Re: Maryland Air Ambulance Review Panel
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
>
>> 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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