[CCM-L] trauma-list Digest, Vol 63, Issue 38

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Without evidence of benifit, what criterea should trigger an air transport decision? Unless and until there is good evidence of benifit from air transport in civilian EMS systems, the substantially higher cost should be enough to cause us to stop using air transport, even before the risks of air transport are taken into account.

However if you are going to talk about risks, then in the case of primary transports (as opposed to secondary, interfacility transfers), one cannot compare the risks of trasporting the patient by air to not transporting him at all, rather the relative safety (or lack of safety) of ground transport would need to be taken into account. If there are, as recently discussed on this list, no reliable data on the safety of ground medical transportation to use as a comparison, then it seems to me that a claim that anyone is endangered by putting them on a helicopter instead of into a ground rig is on weak footing.

John Annen
Zürich, Switzerland

----- Original Message ----
From: Stephen Richey <stephen.richey at gmail.com>
To: Discussion of Critical Care Medicine <ccm-l at ccm-l.org>; trauma-list at trauma.org
Sent: Monday, September 29, 2008 2:54:58 PM
Subject: Re: [CCM-L] trauma-list Digest, Vol 63, Issue 38

On Mon, Sep 29, 2008 at 8:41 AM, Arthur Morgan <arthurmorgan2 at gmail.com>wrote:

> Stephen Richey wrote:
>
>>
>>
>>    s.
>>
>>  How about we stop beating our heads against a brick wall and cut the
>> throats of the air ambulance industry by partnering with the insurance
>> industry to do away with the funding for such services. I know the old adage
>> about getting up with fleas when you lay with dogs, but perhaps the cost of
>> associating with the insurance industry is worth it if we can truly nip this
>> problem in the bud.  Any comments or threats of burning me at the stake for
>> my heresy?
>>
>> I am told that this 'plane flew because of severe injuries and bad traffic
> patterns on the road ( possibly due to light rain ).
> It is possible that the reasons to fly were adequate.
>

Well, the definition of "severe" in Maryland does not mean much seeing as
how they tend to lose their damn minds over MOI.  That being said, having
driven the area in question multiple times, the traffic on the roads at that
time of night is relatively light.  Even in the face of light rain, the
option of ground transport would still have likely result in more
expeditious arrival at the hospital when one considers the time delays
associated with launch and landing of the helicopter.

Until you can show in individual flights that patients and staff were
> endangered unnecessarily, you will get nowhere.


I believe there is plenty of evidence to support this: the literature
showing no benefit, the NTSB reports stating the helicopters should not have
been flown in X circumstances, etc.




-- 
Stephen L. Richey, CRT
Aviation Injury Research Project Leader
Saginaw Valley State University
Work E-mail: slrichey at svsu.edu
Home Office Phone: 248-366-4452

"It is the characteristic excellence of the strong man that he can bring
momentous issues to the fore and make a decision about them. The weak are
always forced to decide between alternatives they have not chosen
themselves."- Dietrich Bonhoeffer
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