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Tue Sep 30 22:52:28 BST 2008

The problem is lack of consistent triage criteria for helicopter
transportation and the lack of consideration of ground transport to
closer hospital for minor injuries. (or for mechanism of injury as an
indication). For example all of us know that using mechanism alone
produces an over-triage of >60%. Consideration for movement of this
indication to a closer hospital and then inter hospital transport to
the trauma center should be done.

That does not say helicopters are bad. Certainly they are good when
indicated. A comparison perhaps is the every GSW of the chest does not
need a thoracotomy. A major portion can be treated with a chest tube.
Likewise every trauma patient does not need helicopter transport to the
trauma center. Many can go be ground to a closer facility for assessment
and then to the trauma by the best vehicle as conditions dictate

Back to principles and preferences. The principle is good trauma care.
The preference is where, when and how based on conditions of the patient
and the situation of distance, time and weather

Norman

Norman McSwain Jr, MD FACS
Trauma Director Charity Hospital
Professor of Surgery
Tulane University School of Medicine
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Forrest Robleto
Sent: Tuesday, September 30, 2008 4:34 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: trauma-list Digest, Vol 63, Issue 39

I just worry that the arguments are not objective.  I know that there
are
places in New Jersey that are as much as two hours from a trauma center
in
heavy traffic.  (20 minutes otherwise).  I believe there are too many
helicopter flights but I do not believe that all of them are
unnecessary.

You seem to be  against helicopters and your arguments may be right in
some
places at some times.

I wouldn't want to second guess folks who were actually looking at the
weather when they made the decision to fly.

I know I saw different weather than the forecast you heard and much more
 traffic than the norm for Saturday evening.

On Tue, Sep 30, 2008 at 7:46 AM, Stephen Richey
<stephen.richey at gmail.com>wrote:

> Yes, but the traffic significantly decreases (most of the time) once
you
> get
> out away from 95 and 495 especially during non-peak hours.  The main
route
> from the Waldorf area to the hospital they were headed to originally
is
> not nearly as busy as the interstate, save for rush hour and on
holiday
> weekends.
>
> >From the weather reports I heard, the rain was described as "light to
> moderate" so that is what I based my comments upon.  However, I agree
with
> the assessment that the weather was far below what I would have flown
into,
> even with every imaginable electronic safety system known to man at my
> disposal.  Despite considering the pilot in question to be one of the
best
> I
> ever had the pleasure of flying with (and I've flown with a lot of
> helicopter pilots so that is saying something), I still question his
> judgment in accepting the mission given the weather conditions.  The
> "corporate culture" of aeromedical operations in general and
especially the
> MSP aviation division would be likely contributing factors in the
flawed
> decision making that cost a good pilot and his passengers their lives.
>
>
> On Tue, Sep 30, 2008 at 7:00 AM, <trauma-list-request at trauma.org>
wrote:
>
> > I was on the road ( I-95, I-695) that night, traffic was very heavy
> > and the rain (remnants of a passing hurricane) was also very heavy.
I
> >  don't know about the necessity of that particular flight but the
> > traffic and the weather were not good.  I was driving from NJ to
> > Baltimore.
>
>
> --
> 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
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
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>

-- 
V/R

Forrest Robleto
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

"In a completely rational society, the best of us would be teachers and
the
rest of us would have to settle for something less."
--Lee Iacocca
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trauma-list Digest, Vol 63, Issue 39