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Medical Helicopters: Worth the Cost, Risk?

Gross, Ronald Ronald.Gross at baystatehealth.org
Wed Apr 18 14:50:05 BST 2012

I rarely disagree with Dr. Mattox, but in this case I think he has misrepresented the ACCS COT's position on Level I vs. Level III or IV trauma centers.  I would refer you to the current edition of the "Optimal Resources" document, aka "the Green Book", to see how the COT differentiates these centers , and see how the COT feels distribution of patients should be handled.  The major issue that was not referenced in Dr. Mattox's comment was case load/patient volume which translates into experience, capacity and capability.  I will stop there. 

Ronald I. Gross, MD, FACS
Associate Professor of Surgery, Tufts University School of Medicine
Chief of Trauma & Emergency Surgery Services
Baystate Medical Center
759 Chestnut Street
Springfield, MA  01199
ronald.gross at baystatehealth.org
From: trauma-list-bounces at trauma.org [trauma-list-bounces at trauma.org] On Behalf Of Ian Seppelt [seppelt at med.usyd.edu.au]
Sent: Wednesday, April 18, 2012 12:47 AM
To: Trauma-List [TRAUMA.ORG]
Cc: Trauma-List [TRAUMA.ORG]
Subject: Re: Medical Helicopters: Worth the Cost, Risk?

Can I please clarify, if there is no medical difference between level 1 and level 3 (aside from neuro and CPB) does that mean the ambulance services distribute the work purely on geography and not perceived 'level', so no ambulance would drive past a level 3 to get to the level 1 20 minutes further down the road?

Thanks, Ian

Sent from my iPad

On 18/04/2012, at 12:07 PM, K Mattox <kmattox at aol.com> wrote:

> The greater Houston area has 5 level 1 Trauma Centers all appropriately verified by ACS and the State of Texas.
> UTMB in Galveston
> Memorial Hermann Hospital
> Texas Children's Hospital
> Memorial Children's Hospital
> In addition there are More Than 15 level 2 or level 3 Trauma centers
> According to the ACS there is no quality difference between a Level 1 and a level 3 except for neuro trauma and cardiopulmonary bypass.
> These quality and approved trauma and acute care centers ( almost 20 in number) cover over 500 square miles and are scattered throughout the community.
> Real time motion data and meta analysis has demonstrated in the greater Houston metropolitan area the time from injury and notification until time of arrival at a trauma center is shorter in Houston than for helicopter transport
> The only pre/ post availability study I know of is a years analysis at UTMB (Galveston) using helicopters vs the first year after helicopter transport was discontinued.    For same service area and severity the mortality andorbidity was identical.    From many different methods of analysis the various Houston metropolitan area for air ambulance can be used to underscore an overuse and negative outcome clinical and cost data analysis.
> k
> Sent from my iPhone
> On Apr 17, 2012, at 7:35 PM, Stephen Richey <stephen.richey at gmail.com> wrote:
>> I'd like to know Dr. Mattox's thoughts on Dr. McCarthy's quote in that
>> article:  "The greater Houston area is served by just two level 1
>> trauma centers for over 5 million people," says Dr. James J. McCarthy,
>> medical director of the emergency center at Memorial Hermann Hospital
>> in Houston.
>> I hope  that was taken out of context making it sound like the urban
>> area of Houston is the ideal environment for HEMS.....
>> On Tue, Apr 17, 2012 at 8:26 PM, James Richardson <jimmnn at comcast.net> wrote:
>>>> From ABC News:
>>> http://tinyurl.com/cgf54cq
>>> Jim<
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