List Archives

Wed Jul 22 13:48:56 BST 2009

Odd: I didn't receive the original message from the List.

I think you're asking the right questions of the wrong people.  You seem
to have a pretty good grasp of the fundamental issues, at least to the
extent that the Trauma-List is left to debate details from a blurry
distance.  Few if any of us are familiar enough with your underlying EMS
system to give solid advice.  And frankly, your description leaves room
to wonder whether there's much of a system to begin with.

The attachment (an NAEMSP white paper, now five or six years old) does a
decent job of distilling the global principles of HEMS integration; but
all the advice in the world is nonetheless subject to local context.
Context, in this case, means a fairly detailed inventory of Indiana's
various hospital resources, existing rescue and transport capabilities,
geographic and meteorological influences, cross-border partnerships,
medical direction and practices, clinical and political
affiliations/cabals, ongoing performance improvement, pandisciplinary
education, and probably at least a half dozen other crucial factors I've
overlooked in haste.  It's the kind of stuff your state EMS system is
ultimately responsible for.  Have you talked to them?

In short, this is probably a MUCH bigger job than you want it to be.
But if you expect a product that's both functional and durable, there
ain't no shortcuts. 

Sorry.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Bill Mastrianni
Sent: Tuesday, July 21, 2009 7:02 PM
To: Trauma-List [TRAUMA.ORG]
Subject: RE: Helicopter EMS

Andrew, 
I know of no evidence that would support a true transport time
differential of ~30 min. (30 vs 60 min) for any of the patient
presentations you describe.   

Maj. Bill Mastrianni, EMT-P
Charleston County (SC) EMS 

-----Original Message-----
From: Andrew J Bowman <andrewj.bowman at gmail.com>
Sent: 21 July, 2009 18:52
To: Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>;
CCML <ccm-l at ccm-l.org>; EMED-L -- a list for Emergency Medicine
practitioners. <EMED-L at ITSSRV1.UCSF.EDU>; EMED-L -- a list for Emergency
Medicine practitioners. <EMED-L at LISTSRV.UCSF.EDU>
Subject: Helicopter EMS

Rural Indiana ground EMS service trying to develop a protocol for  
calling Helicopter EMS. Ground service is advanced life suppor

Usually 20 minutes by ground to closest ER (at best an unofficial  
level 4 trauma center) or up to 45-60 minutes by ground to an  
undesignated but likely level 2 center x 2. These two facilities also  
have top notch interventional cath labs and open heart.

Helicopter is 20 minutes minimum to arrive to either scene, designated  
LZ, or to the little hospital.

I have suggested severe trauma and true STEMI are POTENTIAL candidates  
for helicopter. Others have stated that should call for things like  
bad COPD, eclampsia, other "sick" medical.

I feel no benefit except for what I have described. Any help? Any  
evidence?

I
Typed by my index finger and sent from my iPhone.

Andrew J Bowman
Acute Care Nurse Practitioner
Trauma Nurse Specialist
Paramedic

Witham Health Services
Emergency Department
Lebanon, Indiana
765-485-8500 Work
765-426-4189 Cell
765-485-8509 Fax
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