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Tue Nov 25 21:42:52 GMT 2008

Thanks Bryan!!

Take care,

Bob

Robert K. Waddell II, EMT-P (ret)
The Sacco Triage Method (STM)

Wyoming office
1302 East 5th Avenue
Cheyenne, Wyoming 82001

307 920 2020

bwaddell at sharpthinkers.com
www.sharpthinkers.com

On Nov 25, 2008, at 11:48 AM, Bryan Bledsoe wrote:

> A couple of thoughts after reading these posts and having spent  
> hours in
> meetings over these issues.
>
> 1. Dr. Bass and staff want to fix any problems in Maryland. I am  
> convinced
> of that.  They are in political positions, but they are physicians  
> and good
> people. The panel was not paid and MIEMSS staff was not a part of the
> process nor did they try and influence the process.
> 2. The panel was well-balanced although the time was short. The  
> members of
> the panel worked collegially and diligently and we were surprisingly  
> on the
> same page.
> 3. This panel was to look at Maryland issues.  We would be naïve to  
> think
> that other states were not watching. However, we were here for the  
> people of
> Maryland.
> 4. The panel's recommendations are only recommendations and will go  
> to the
> Maryland EMS Board. The report is incomplete and may change.
> 5. There were numerous recommendations and these were by no means a
> "whitewash" as some have implied.
> 6. Recommendations included making a transition from a response time
> oriented system to a critical care provision system.  Also, MSP should
> become CAMTS accredited and obtain their own Part 135 and fly under  
> FAR Part
> 135 at all times (for EMS missions). These recommendations will  
> mandate
> fundamental changes in the system and culture including two medical  
> crew
> members. The number of helicopters appears to be excessive in this  
> area (MD,
> VA, DC, PA). It is up to the people of Maryland to decide how many  
> they want
> and how many they are willing to pay for. There is a point of  
> diminished
> return after a critical number of helicopters have been placed. A  
> task force
> with experts in asset placement should look at that. There is a  
> difference
> between helicopter triages and trauma center triage. These are often
> confused. The C&D category patients are currently being screened by a
> physician and this seems to be working as flights are now decreased.  
> Flights
> are already being reduced and will be reduced further making a large  
> number
> of helicopters unnecessary. The HEMS system needs to look at non- 
> traumatic
> time-sensitive conditions as well (e.g., STEMI, stroke, neurosurgical
> vascular lesions). The ghost of Cowley haunts Maryland in that  
> everything is
> trauma, trauma, trauma.
>
> The trauma surgeons (John and Bob) and Steve, Tom, Bill and Ellen each
> brought something unique to the table.  What resulted is a good  
> review for
> Maryland and I commend the MIEMSS people, Dr. Bass, Dr. Flocare and  
> others.
> I am sure that this was painful for them but I am sure their  
> intentions and
> dedication are genuine.
>
>> From a "helicopter critic"....
>
> Bryan
>
> Bryan Bledsoe, DO, FACEP
> Clinical Professor of Emergency Medicine
> University of Nevada School of Medicine
> University Medical Center
>
> 	
>
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