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Mon Sep 28 15:58:37 BST 2009

Prêt,

While I agree with your premise as stated initially, the fact remains that the ALS crew was canceled, the patient went to an institution that took the time to do a CT scan the results of which they had no ability/capability to act upon, and with the symptoms initially expressed she might have fared better if she had been taken directly to a center with advanced capabilities.
As was stated earlier - looks like a good opportunity for teaching........

Ron

PS - pardon my ignorance, but what is "CCT"?  Critical care transport, perhaps?

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Bjorn, Pret
Sent: Monday, September 28, 2009 10:51 AM
To: Trauma-List [TRAUMA.ORG]
Subject: RE: Question

Consider that for many small hospitals, "just load(ing) and send(ing)"
is not as simple or automatic as it may seem from Houston or
Springfield.  In much of rural America, assembling any respectable CCT
at the local hospital takes a long time, and may rob a community of
valuable resources for even longer.

In this scenario, if I read correctly, the nearest ready ground team was
thirty minutes away from the sending hospital.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of kmattox at aol.com
Sent: Monday, September 28, 2009 9:34 AM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: Question

By my calculations, as is often the case, if the first hospital had just
loaded and sent and not wAited for helicopter etc, the ground time is
SHORTER.   
Sent via BlackBerry by AT&T

-----Original Message-----
From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>

Date: Mon, 28 Sep 2009 09:18:52 
To: 'Trauma-List [TRAUMA.ORG]'<trauma-list at trauma.org>
Subject: RE: Question

Since the times are the same, make it 30 minutes by ground and go
directly to the neuro institute.

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of cadeth66 at aol.com
Sent: Monday, September 28, 2009 7:46 AM
To: Trauma-List [TRAUMA.ORG]
Subject: Question

In light of the recent EMS Helicopter crash I extend my condolences to
their families. 

 But I want to pose a question to the list if you would have or would
have not airlifted this patient?

 17 y/o caucasian female calls 9-1-1 with "severe headache and left
sided numbness" local BLS arrives begins assesment, ALS arrives but is
cxl'd by BLS "services not needed" pt is brought into ED unresponsive
and decorticate posturing. Pt intubated w/in 5 min of arrival in ED. Pt
sent to CT head which shows intracranial bleed 8mm, midline shift w/
mass effect ( forgive me if this is wrong) pt begins to become unstable
bp tanks etc etc..... Neuro consult wants immed transfer.  Ground or
Air?   Ground will take 30 min to get to hosp and another 30 to
transferr to neuro institute. Helo takes 15 eta to hosp, hot load, 15
min to neuro institute....

 Weather clear and its roughly 2 AM

What would y'all do?
------Original Message------
From: Doc Holiday
Sender: trauma-list-bounces at trauma.org
To: .Trauma List
ReplyTo: Trauma-List [TRAUMA.ORG]
Subject: RE: Condolences and Concerns
Sent: Sep 28, 2009 07:36

From: Ronald.Gross at baystatehealth.org
>...this industry is now all about the money, and it is getting people
killed.

--> Saddened as we all are by the loss of friends/colleagues, I believe
we should always look ahead immediately for the opportunity to prevent
further such loss of life. Although we have helicopters buzzing about
our ED on a daily basis (we recieve 500 flights annually), I am not at
all an expert on the subject. Especially not how it goes in the USA. So
I have a question...

And I am only asking out of ignorance and a search for clarification - I
am not expressing an opinoin...

Is it a case of profit being the number one objective that is standing
in the way of safety here? Or is it lack of data? Or is it the public's
expectation that we use helicopters? Or what? I guess this List is the
place to find answers.

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