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Mon Mar 2 02:08:26 GMT 2009

On Sun, Mar 1, 2009 at 8:18 PM, Forrest Robleto <farcpr at gmail.com> wrote:

> Ian,
>
> You're correct of course.  Given all the variability the EMT on the scene
> often has to make a tough decision.  But sometimes it's not all that tough,
> if you have a shocky teenager from an MVA and traffic has you two hours
> from
> the trauma center and it's a 12 minute flight, most of the variables go
> away.

Let's not forget that that "12 minute flight" is going to be more like an
hour given the dispatch time, the preflight, the response to the scene, the
on-scene assessment and treatment by the helicopter crew, the return to the
hospital and then unloading of the victim.   Perhaps the best option is to
transport them to the closest hospital and have the helicopter meet you
there (assuming you really think it is necessary to transfer them out)?

>
>
> I know that helo's are inherently dangerous but so are motor vehicles.  The
> ambulance is not the safest means of travel.

Actually, compared to the other alternative (helicopters), ground ambulances
are a relatively safe mode of transportation.

>
>
> There are some folks who are predisposed to downplay the usefulness of the
> medical helicopter out of hand.  There are times when it's right and times
> when it's not but I knew that Stephen would pickup on the family arriving
> first statement.
>

I don't dismiss their utility out of hand.  Remember, I flew aeromedical
transfers while in the Air Force.   They have their place, just like any
other tool.  The problem is that I see them being used as a very risky and
very expensive alternative to proper triage and treatment in many areas.
The one thing that (for lack of a better phrase) pisses me off about the 'we
need helicopters in our rural area because our EMTs are bad and we can't
afford medics" argument is that it is exactly that sort of sentiment that
holds EMS back.  If your EMTs are bad- retrain them and fire the ones who
can't or won't come up to an acceptable level of competency (even if they
are volunteers, you can still fire them).  The utility of medics is still
questionable in trauma and even in other settings, so the best thing that
can be done in a lot of situations is to push for top notch BLS care and
supplement that with a handful of medics (even if it is on an "intercept"
basis from a regional ALS service rather than "local" medics) based on the
call volume.

> He is to helo's what Lou Dobb's was to aliens.
>

Thank you?  I think.....not really sure what you are referring to.  If that
is referring to the fact that I take the stance that until I have credible
proof that an otherwise outlandish claim- be it that exposing a lot of
people to a greater risk for what appears to be no benefit to most, minimal
benefit to a handful and great benefit to one in several thousand or to the
existence of aliens, Sasquatch, etc- is defensible I will be skeptical, then
I agree and believe that you paid me a compliment.  If you are trying to peg
me as someone who is closeminded and unwilling to see alternative positions,
then you have taken my prior posts in completely the wrong manner.

-- 
Stephen L. Richey, CRT

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