Re: Questionable IV & RUDE flight crew

[Guest guest]

Based on your description, one was probably enough. I have seen two

large bore IV's started in the same arm, usually the AC and bicep or

back of the forearm. This was done in a major trauma center and at that

time acceptable practice. Care must be used so that a proximal site from

the same vein is not infiltrated, causing both to become useless.

Questionable IV & RUDE flight crew

A couple of weeks ago I was working a motorcycle race at a dirt track,

in whcih we had two riders hit each other. On arrival to the first

person, who was unresponsive and had snoring respirations, I asked that

an air medical serivce be called. The second person was also

unresponsive, but no snoring respirations. The first one was out for at

least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit.

The local EMS arrived and took care of the second person. I ask the

local EMS to call an air medical provider, and ask for either provider X

or Y, and thought that was who they called.

The air medical provider arrived and it was provider F, seems they have

a base close to this area, so they were called. The crew comes to my

unit and I give report to " kojack & Mr. Clean " . After this, they were

trying to decide if they wanted to start a line there or in the air. By

this time the pt was alert and talking. His family member was in the

unit talking with him also. They kick him out, and start barking orders

(the flight crew) they were almost tossed out on their ears they were so

rude. Finally Mr. Clean decides to start a line in the unit before

carrying the pt across the track. He starts one IV in the left hand,

and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that,

BI-LATERAL, meaning that one goes in one hand or arm and the other one

goes in the other.

It was suggested that we drive around to the other side of the track to

the awaiting helicopter. By EMT goes to drive around to the bird, and

the family member is still talking to the pt, and wanting to know where

he was being taken, as they were from out of town. The " flight medic "

yells again, and tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough,

but I think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Based on your description, one was probably enough. I have seen two

large bore IV's started in the same arm, usually the AC and bicep or

back of the forearm. This was done in a major trauma center and at that

time acceptable practice. Care must be used so that a proximal site from

the same vein is not infiltrated, causing both to become useless.

Questionable IV & RUDE flight crew

A couple of weeks ago I was working a motorcycle race at a dirt track,

in whcih we had two riders hit each other. On arrival to the first

person, who was unresponsive and had snoring respirations, I asked that

an air medical serivce be called. The second person was also

unresponsive, but no snoring respirations. The first one was out for at

least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit.

The local EMS arrived and took care of the second person. I ask the

local EMS to call an air medical provider, and ask for either provider X

or Y, and thought that was who they called.

The air medical provider arrived and it was provider F, seems they have

a base close to this area, so they were called. The crew comes to my

unit and I give report to " kojack & Mr. Clean " . After this, they were

trying to decide if they wanted to start a line there or in the air. By

this time the pt was alert and talking. His family member was in the

unit talking with him also. They kick him out, and start barking orders

(the flight crew) they were almost tossed out on their ears they were so

rude. Finally Mr. Clean decides to start a line in the unit before

carrying the pt across the track. He starts one IV in the left hand,

and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that,

BI-LATERAL, meaning that one goes in one hand or arm and the other one

goes in the other.

It was suggested that we drive around to the other side of the track to

the awaiting helicopter. By EMT goes to drive around to the bird, and

the family member is still talking to the pt, and wanting to know where

he was being taken, as they were from out of town. The " flight medic "

yells again, and tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough,

but I think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Based on your description, one was probably enough. I have seen two

large bore IV's started in the same arm, usually the AC and bicep or

back of the forearm. This was done in a major trauma center and at that

time acceptable practice. Care must be used so that a proximal site from

the same vein is not infiltrated, causing both to become useless.

Questionable IV & RUDE flight crew

A couple of weeks ago I was working a motorcycle race at a dirt track,

in whcih we had two riders hit each other. On arrival to the first

person, who was unresponsive and had snoring respirations, I asked that

an air medical serivce be called. The second person was also

unresponsive, but no snoring respirations. The first one was out for at

least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit.

The local EMS arrived and took care of the second person. I ask the

local EMS to call an air medical provider, and ask for either provider X

or Y, and thought that was who they called.

The air medical provider arrived and it was provider F, seems they have

a base close to this area, so they were called. The crew comes to my

unit and I give report to " kojack & Mr. Clean " . After this, they were

trying to decide if they wanted to start a line there or in the air. By

this time the pt was alert and talking. His family member was in the

unit talking with him also. They kick him out, and start barking orders

(the flight crew) they were almost tossed out on their ears they were so

rude. Finally Mr. Clean decides to start a line in the unit before

carrying the pt across the track. He starts one IV in the left hand,

and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that,

BI-LATERAL, meaning that one goes in one hand or arm and the other one

goes in the other.

It was suggested that we drive around to the other side of the track to

the awaiting helicopter. By EMT goes to drive around to the bird, and

the family member is still talking to the pt, and wanting to know where

he was being taken, as they were from out of town. The " flight medic "

yells again, and tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough,

but I think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Wayne - I might not be able to offer much here except - as we all have opinions

- here's mine. In my experience it is unusual to start 2 lines in one hand,

especially as the initial lines. Not exactly what most are taught. Was there a

reason the other arm was not used? And, if it's for trauma needs, why not a

larger vein than the hand offers? And, if it appears that fluid rescuscitation

will not be needed immediately - then one line should be adequate for the time

being (possibly debatable). Flight crews do want to get everything possibly

needed done prior to lift-off.

But a flight crew rude? - NO WAY!! Question: Who's " Kojak " and " Mr. Clean " ?

Don't offend all of the bald headed medics out there!!!

Don Elbert, Tyler (an unoffended bald medic)

>>> rxmd911@... 10/18/05 12:35 PM >>>

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Wayne - I might not be able to offer much here except - as we all have opinions

- here's mine. In my experience it is unusual to start 2 lines in one hand,

especially as the initial lines. Not exactly what most are taught. Was there a

reason the other arm was not used? And, if it's for trauma needs, why not a

larger vein than the hand offers? And, if it appears that fluid rescuscitation

will not be needed immediately - then one line should be adequate for the time

being (possibly debatable). Flight crews do want to get everything possibly

needed done prior to lift-off.

But a flight crew rude? - NO WAY!! Question: Who's " Kojak " and " Mr. Clean " ?

Don't offend all of the bald headed medics out there!!!

Don Elbert, Tyler (an unoffended bald medic)

>>> rxmd911@... 10/18/05 12:35 PM >>>

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Most flight crews are staffed with a RN and a paramedic. Both are usually

certified FP-C and/or CCEMTP. Here is my thought on their treatment...if an IV

is needed start it. If two IV's are needed, then start them. As far as site

location goes, so long as the second IV site is above the initial, what is the

harm. As far as a flight crew being rude...you should ask yourself several

things: Was there any time constraints on the pt needing to be at an appropriate

facility (i.e.... did the pt need surgery, blood, etc.), Was there weather

issues outside that could possibly prevent the air staff from transporting the

pt to the facility desired, Was there something on scene that provided stress to

the crews? I do not know about the service you used or perhaps I do, in our

area we have a close relationship to the air medical teams, and I can tell you

that if I had a problem like you state you had, I would pick up the phone and

call the crew and ask their thoughts of the scene. This is the

best way to QA and QI a scene, thus allowing for improvements to be made in all

areas. Always remember a stressful environment leads to stress on the medic.

, NREMT-P, EMT-P, CCEMTP

Don Elbert wrote:

Wayne - I might not be able to offer much here except - as we all have opinions

- here's mine. In my experience it is unusual to start 2 lines in one hand,

especially as the initial lines. Not exactly what most are taught. Was there a

reason the other arm was not used? And, if it's for trauma needs, why not a

larger vein than the hand offers? And, if it appears that fluid rescuscitation

will not be needed immediately - then one line should be adequate for the time

being (possibly debatable). Flight crews do want to get everything possibly

needed done prior to lift-off.

But a flight crew rude? - NO WAY!! Question: Who's " Kojak " and " Mr. Clean " ?

Don't offend all of the bald headed medics out there!!!

Don Elbert, Tyler (an unoffended bald medic)

>>> rxmd911@... 10/18/05 12:35 PM >>>

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

I'd like to know more about this, but my questions are not necessarily related

to the rudeness of the flight crew or of the appropriateness of their IV

placement.

How far was it to the closest trauma facility? How far to a Level II or Level

I? Why was a helo called? How long was the helo response? How long were they

on the ground? What Level was the facility they took the patient to? Was the

patient admitted? What for? Etc, etc, etc……

If you want to respond privately, that is fine.

Just wondering,

Tater

Wayne D wrote:

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

I believe in distal to proximal whenever possible, but not two in the same

circulation feeder. Opposite limbs, not the same IF the second line is REALLY

necessary. I wonder how the air crew would react if someone stuck two angios in

the back of their hand?

There is no call for rudeness. The airmed business is becoming more competitive

and arriving like a paragod is NOT good for business. More people are going to

see this behaviour and make them vote with their feet. Contact the district

manager, or someone higher than the local level manager, and complain.

Life can be simple: Fly (drive) safe, give good care, and be nice. Can't get

simpler than that.

" Service is love made visible. Friendship is love made personal. Kindness is

love made tangible. Giving is love made believable " - Anonymous

Larry RN, (former) CFRN, LP

Houston Texas

[Guest guest]

I believe in distal to proximal whenever possible, but not two in the same

circulation feeder. Opposite limbs, not the same IF the second line is REALLY

necessary. I wonder how the air crew would react if someone stuck two angios in

the back of their hand?

There is no call for rudeness. The airmed business is becoming more competitive

and arriving like a paragod is NOT good for business. More people are going to

see this behaviour and make them vote with their feet. Contact the district

manager, or someone higher than the local level manager, and complain.

Life can be simple: Fly (drive) safe, give good care, and be nice. Can't get

simpler than that.

" Service is love made visible. Friendship is love made personal. Kindness is

love made tangible. Giving is love made believable " - Anonymous

Larry RN, (former) CFRN, LP

Houston Texas

[Guest guest]

I believe in distal to proximal whenever possible, but not two in the same

circulation feeder. Opposite limbs, not the same IF the second line is REALLY

necessary. I wonder how the air crew would react if someone stuck two angios in

the back of their hand?

There is no call for rudeness. The airmed business is becoming more competitive

and arriving like a paragod is NOT good for business. More people are going to

see this behaviour and make them vote with their feet. Contact the district

manager, or someone higher than the local level manager, and complain.

Life can be simple: Fly (drive) safe, give good care, and be nice. Can't get

simpler than that.

" Service is love made visible. Friendship is love made personal. Kindness is

love made tangible. Giving is love made believable " - Anonymous

Larry RN, (former) CFRN, LP

Houston Texas

[Guest guest]

I see no reason, no matter how stressful the situation that a flight crew

should or would be rude. I have seen the same type of interaction between

private EMS and City Fire crews. It all comes down to respecting each others

jobs and have some understanding. I realize there are many constraints that

a flight crew must endure, critical patients, bad weather just to name a few

but using that as an excuse to be rude to the ground crew and/or family will

not, excuse my pun, fly.

I bet everyone would agree that a cardiac arrest, adult or child is

stressful on any ground crew. No matter how chaotic those scenes became, I

always took a few seconds to tell the family members the gravity of the

situation and that I would answer any questions at the hospital.

I have met and taught a number of flight crews over the years and I think

the company sets the tone of their staff. I have met a few crews that have

the paragods from the sky attitude and much more great folks who come in for

one thing the patient. We all must remember we are there for the patient's

benefit and that must be our focus.

The IV issue, I have never started two lines in one extremity. I don't think

that it would be a problem, but would like to see if that is an accepted

practice by sanctioned by their medical director.

Bernie Stafford EMTP

[Guest guest]

I see no reason, no matter how stressful the situation that a flight crew

should or would be rude. I have seen the same type of interaction between

private EMS and City Fire crews. It all comes down to respecting each others

jobs and have some understanding. I realize there are many constraints that

a flight crew must endure, critical patients, bad weather just to name a few

but using that as an excuse to be rude to the ground crew and/or family will

not, excuse my pun, fly.

I bet everyone would agree that a cardiac arrest, adult or child is

stressful on any ground crew. No matter how chaotic those scenes became, I

always took a few seconds to tell the family members the gravity of the

situation and that I would answer any questions at the hospital.

I have met and taught a number of flight crews over the years and I think

the company sets the tone of their staff. I have met a few crews that have

the paragods from the sky attitude and much more great folks who come in for

one thing the patient. We all must remember we are there for the patient's

benefit and that must be our focus.

The IV issue, I have never started two lines in one extremity. I don't think

that it would be a problem, but would like to see if that is an accepted

practice by sanctioned by their medical director.

Bernie Stafford EMTP

[Guest guest]

Wayne,

As a member of an Air Medical team, I apologize that they were rude. I have done

many flights with you guys at the tracks and you do a fantastic job! You see

some of the worst trauma out there!!

That being said, you don't have to have 2 lines established prior to transport.

In all REALITY, you don't have to have one. However, it is wise to have at least

one depending on the circumstances.

There are so many ways to obtain fast IV access out there that there is little

need to delay transport for an initial IV, much less a second one.

The placement of IV's on each side is a good idea but not mandated. The

protocols usually state that a patient should have 2 IV's, but don't

specifically state where (i.e. bilaterally).

The argument that I see surfacing states that it might be inapporopriate to do

both in one arm. This is not optimal, but actually has few complications.

just my piece,

Brent Dalley CCEMT-P

Wayne D wrote:

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Wayne,

As a member of an Air Medical team, I apologize that they were rude. I have done

many flights with you guys at the tracks and you do a fantastic job! You see

some of the worst trauma out there!!

That being said, you don't have to have 2 lines established prior to transport.

In all REALITY, you don't have to have one. However, it is wise to have at least

one depending on the circumstances.

There are so many ways to obtain fast IV access out there that there is little

need to delay transport for an initial IV, much less a second one.

The placement of IV's on each side is a good idea but not mandated. The

protocols usually state that a patient should have 2 IV's, but don't

specifically state where (i.e. bilaterally).

The argument that I see surfacing states that it might be inapporopriate to do

both in one arm. This is not optimal, but actually has few complications.

just my piece,

Brent Dalley CCEMT-P

Wayne D wrote:

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Perfectly stated Bernie!!!!

From one old guy to another

Brent Dalley

Bernie Stafford wrote:

I see no reason, no matter how stressful the situation that a flight crew

should or would be rude. I have seen the same type of interaction between

private EMS and City Fire crews. It all comes down to respecting each others

jobs and have some understanding. I realize there are many constraints that

a flight crew must endure, critical patients, bad weather just to name a few

but using that as an excuse to be rude to the ground crew and/or family will

not, excuse my pun, fly.

I bet everyone would agree that a cardiac arrest, adult or child is

stressful on any ground crew. No matter how chaotic those scenes became, I

always took a few seconds to tell the family members the gravity of the

situation and that I would answer any questions at the hospital.

I have met and taught a number of flight crews over the years and I think

the company sets the tone of their staff. I have met a few crews that have

the paragods from the sky attitude and much more great folks who come in for

one thing the patient. We all must remember we are there for the patient's

benefit and that must be our focus.

The IV issue, I have never started two lines in one extremity. I don't think

that it would be a problem, but would like to see if that is an accepted

practice by sanctioned by their medical director.

Bernie Stafford EMTP

[Guest guest]

,

I can't believe this...it scares me when we agree on something....DOH!!!!

Dudley

Re: Questionable IV & RUDE flight crew

I'd like to know more about this, but my questions are not necessarily related

to the rudeness of the flight crew or of the appropriateness of their IV

placement.

How far was it to the closest trauma facility? How far to a Level II or Level

I? Why was a helo called? How long was the helo response? How long were they

on the ground? What Level was the facility they took the patient to? Was the

patient admitted? What for? Etc, etc, etc??

If you want to respond privately, that is fine.

Just wondering,

Tater

Wayne D wrote:

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

,

I can't believe this...it scares me when we agree on something....DOH!!!!

Dudley

Re: Questionable IV & RUDE flight crew

I'd like to know more about this, but my questions are not necessarily related

to the rudeness of the flight crew or of the appropriateness of their IV

placement.

How far was it to the closest trauma facility? How far to a Level II or Level

I? Why was a helo called? How long was the helo response? How long were they

on the ground? What Level was the facility they took the patient to? Was the

patient admitted? What for? Etc, etc, etc??

If you want to respond privately, that is fine.

Just wondering,

Tater

Wayne D wrote:

A couple of weeks ago I was working a motorcycle race at a dirt track, in whcih

we had two riders hit each other. On arrival to the first person, who was

unresponsive and had snoring respirations, I asked that an air medical serivce

be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS to

call an air medical provider, and ask for either provider X or Y, and thought

that was who they called.

The air medical provider arrived and it was provider F, seems they have a base

close to this area, so they were called. The crew comes to my unit and I give

report to " kojack & Mr. Clean " . After this, they were trying to decide if they

wanted to start a line there or in the air. By this time the pt was alert and

talking. His family member was in the unit talking with him also. They kick

him out, and start barking orders (the flight crew) they were almost tossed out

on their ears they were so rude. Finally Mr. Clean decides to start a line in

the unit before carrying the pt across the track. He starts one IV in the left

hand, and then wants to start another one in the same location. Correct me if

I'm wrong, but in BTLS it states that a bi-lateral IV is just that, BI-LATERAL,

meaning that one goes in one hand or arm and the other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being taken,

as they were from out of town. The " flight medic " yells again, and tells him to

step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews are,

I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Guest guest]

Wayne and all,

Most of what I want to say has been said already by others on the list, but

I somehow feel the need to echo it anyway for this kind of thing is near and

dear to me.

From the ground crew stand point, was the helicopter needed? It sounds like

it was in the beginning providing that transporting by ground to an

appropriate trauma center would have taken more than 30-45 minutes. How long

did the

ground crew wait for the aircraft? Did the ground crew attempt an IV, but

was unsuccessful prior to the arrival of the air crew? Once the patient

became alert and stable, how far out was the helicopter? It is acceptable to

cancel a helicopter if it's no longer needed.

Once the air crew was there, from what you have described, there would have

been no reason to start an IV on-scene. IV's can be initiated in the

aircraft and should be if there is not an emergent need such as medications to

facilitate intubation, immediate fluid resuscitation, etc.

Starting two IV's on the same side ... as long as there is two different

vein paths, I haven't heard of this being a problem. Starting it in the same

vein, maybe not a good idea. Sometimes the air crew has better access to one

arm over the other depending on how their aircraft is configured. But, again,

it sounds like they didn't need to start the IV on-scene.

The rudeness is completely unacceptable. There is NO excuse for that! Our

jobs, both ground and air come with stresses. The EMS crew, the patient, the

family and any other personnel on-scene (fire and police) should be treated

with kindness and respect by the air crew regardless of what kind of pressure

or stress they're under. You absolutely should call their

supervisor/director and report the bad behavior. And, as someone else has

mentioned, it would

be beneficial to QI the call with the air crew as well to try and understand

what their rational was for what they did clinically. It would surprise me

if their protocols and or Medical Director supports starting an IV or two

on-scene when they could have done it in the aircraft. After all, the

helicopter is supposed to save time, right?

If this particular provider displays this behavior on a regular basis and/or

makes bad decisions clinically, don't use them! How would that be

benefiting the patient? If you have more than one helicopter service in your

area,

call the one that does the best job and does it safely.

Good luck,

In a message dated 10/18/2005 1:14:27 PM Central Standard Time,

rxmd911@... writes:

A couple of weeks ago I was working a motorcycle race at a dirt track, in

whcih we had two riders hit each other. On arrival to the first person, who

was unresponsive and had snoring respirations, I asked that an air medical

serivce be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS

to call an air medical provider, and ask for either provider X or Y, and

thought that was who they called.

The air medical provider arrived and it was provider F, seems they have a

base close to this area, so they were called. The crew comes to my unit and I

give report to " kojack & Mr. Clean " . After this, they were trying to decide

if they wanted to start a line there or in the air. By this time the pt was

alert and talking. His family member was in the unit talking with him also.

They kick him out, and start barking orders (the flight crew) they were

almost tossed out on their ears they were so rude. Finally Mr. Clean decides

to

start a line in the unit before carrying the pt across the track. He starts

one IV in the left hand, and then wants to start another one in the same

location. Correct me if I'm wrong, but in BTLS it states that a bi-lateral IV

is just that, BI-LATERAL, meaning that one goes in one hand or arm and the

other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being

taken, as they were from out of town. The " flight medic " yells again, and

tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Non-text portions of this message have been removed]

[Guest guest]

Wayne and all,

Most of what I want to say has been said already by others on the list, but

I somehow feel the need to echo it anyway for this kind of thing is near and

dear to me.

From the ground crew stand point, was the helicopter needed? It sounds like

it was in the beginning providing that transporting by ground to an

appropriate trauma center would have taken more than 30-45 minutes. How long

did the

ground crew wait for the aircraft? Did the ground crew attempt an IV, but

was unsuccessful prior to the arrival of the air crew? Once the patient

became alert and stable, how far out was the helicopter? It is acceptable to

cancel a helicopter if it's no longer needed.

Once the air crew was there, from what you have described, there would have

been no reason to start an IV on-scene. IV's can be initiated in the

aircraft and should be if there is not an emergent need such as medications to

facilitate intubation, immediate fluid resuscitation, etc.

Starting two IV's on the same side ... as long as there is two different

vein paths, I haven't heard of this being a problem. Starting it in the same

vein, maybe not a good idea. Sometimes the air crew has better access to one

arm over the other depending on how their aircraft is configured. But, again,

it sounds like they didn't need to start the IV on-scene.

The rudeness is completely unacceptable. There is NO excuse for that! Our

jobs, both ground and air come with stresses. The EMS crew, the patient, the

family and any other personnel on-scene (fire and police) should be treated

with kindness and respect by the air crew regardless of what kind of pressure

or stress they're under. You absolutely should call their

supervisor/director and report the bad behavior. And, as someone else has

mentioned, it would

be beneficial to QI the call with the air crew as well to try and understand

what their rational was for what they did clinically. It would surprise me

if their protocols and or Medical Director supports starting an IV or two

on-scene when they could have done it in the aircraft. After all, the

helicopter is supposed to save time, right?

If this particular provider displays this behavior on a regular basis and/or

makes bad decisions clinically, don't use them! How would that be

benefiting the patient? If you have more than one helicopter service in your

area,

call the one that does the best job and does it safely.

Good luck,

In a message dated 10/18/2005 1:14:27 PM Central Standard Time,

rxmd911@... writes:

A couple of weeks ago I was working a motorcycle race at a dirt track, in

whcih we had two riders hit each other. On arrival to the first person, who

was unresponsive and had snoring respirations, I asked that an air medical

serivce be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS

to call an air medical provider, and ask for either provider X or Y, and

thought that was who they called.

The air medical provider arrived and it was provider F, seems they have a

base close to this area, so they were called. The crew comes to my unit and I

give report to " kojack & Mr. Clean " . After this, they were trying to decide

if they wanted to start a line there or in the air. By this time the pt was

alert and talking. His family member was in the unit talking with him also.

They kick him out, and start barking orders (the flight crew) they were

almost tossed out on their ears they were so rude. Finally Mr. Clean decides

to

start a line in the unit before carrying the pt across the track. He starts

one IV in the left hand, and then wants to start another one in the same

location. Correct me if I'm wrong, but in BTLS it states that a bi-lateral IV

is just that, BI-LATERAL, meaning that one goes in one hand or arm and the

other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being

taken, as they were from out of town. The " flight medic " yells again, and

tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Non-text portions of this message have been removed]

[Guest guest]

Wayne and all,

Most of what I want to say has been said already by others on the list, but

I somehow feel the need to echo it anyway for this kind of thing is near and

dear to me.

From the ground crew stand point, was the helicopter needed? It sounds like

it was in the beginning providing that transporting by ground to an

appropriate trauma center would have taken more than 30-45 minutes. How long

did the

ground crew wait for the aircraft? Did the ground crew attempt an IV, but

was unsuccessful prior to the arrival of the air crew? Once the patient

became alert and stable, how far out was the helicopter? It is acceptable to

cancel a helicopter if it's no longer needed.

Once the air crew was there, from what you have described, there would have

been no reason to start an IV on-scene. IV's can be initiated in the

aircraft and should be if there is not an emergent need such as medications to

facilitate intubation, immediate fluid resuscitation, etc.

Starting two IV's on the same side ... as long as there is two different

vein paths, I haven't heard of this being a problem. Starting it in the same

vein, maybe not a good idea. Sometimes the air crew has better access to one

arm over the other depending on how their aircraft is configured. But, again,

it sounds like they didn't need to start the IV on-scene.

The rudeness is completely unacceptable. There is NO excuse for that! Our

jobs, both ground and air come with stresses. The EMS crew, the patient, the

family and any other personnel on-scene (fire and police) should be treated

with kindness and respect by the air crew regardless of what kind of pressure

or stress they're under. You absolutely should call their

supervisor/director and report the bad behavior. And, as someone else has

mentioned, it would

be beneficial to QI the call with the air crew as well to try and understand

what their rational was for what they did clinically. It would surprise me

if their protocols and or Medical Director supports starting an IV or two

on-scene when they could have done it in the aircraft. After all, the

helicopter is supposed to save time, right?

If this particular provider displays this behavior on a regular basis and/or

makes bad decisions clinically, don't use them! How would that be

benefiting the patient? If you have more than one helicopter service in your

area,

call the one that does the best job and does it safely.

Good luck,

In a message dated 10/18/2005 1:14:27 PM Central Standard Time,

rxmd911@... writes:

A couple of weeks ago I was working a motorcycle race at a dirt track, in

whcih we had two riders hit each other. On arrival to the first person, who

was unresponsive and had snoring respirations, I asked that an air medical

serivce be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit. The

local EMS arrived and took care of the second person. I ask the local EMS

to call an air medical provider, and ask for either provider X or Y, and

thought that was who they called.

The air medical provider arrived and it was provider F, seems they have a

base close to this area, so they were called. The crew comes to my unit and I

give report to " kojack & Mr. Clean " . After this, they were trying to decide

if they wanted to start a line there or in the air. By this time the pt was

alert and talking. His family member was in the unit talking with him also.

They kick him out, and start barking orders (the flight crew) they were

almost tossed out on their ears they were so rude. Finally Mr. Clean decides

to

start a line in the unit before carrying the pt across the track. He starts

one IV in the left hand, and then wants to start another one in the same

location. Correct me if I'm wrong, but in BTLS it states that a bi-lateral IV

is just that, BI-LATERAL, meaning that one goes in one hand or arm and the

other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the family

member is still talking to the pt, and wanting to know where he was being

taken, as they were from out of town. The " flight medic " yells again, and

tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough, but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Non-text portions of this message have been removed]

[Guest guest]

Wayne,

Thanks for answering my questions. Your responses lead me to a couple of

more, which I will have to get to later today or tomorrow. I will email you

off-list.

Take care,

In a message dated 10/19/2005 10:36:02 AM Central Standard Time,

rxmd911@... writes:

,

Ground transport to a level 2 facility would have taken about 45. The pt

was stable and talking when the air craft arrived, and it only took about 15

for them to get there from the time that they were called. No IV was attempted

by us, as we were still assessing the pt, who was again by now alert and

talking. At that point, I saw no need to attempt the IV. Now, had this pt

been

unstable and needed IV access for meds, then YES an IV would have been

started, if not to.

The medic think about starting one IV above the other one, and then decided

that he would start it right next to the first one.

Wayne

lisawhir@... wrote:

Wayne and all,

Most of what I want to say has been said already by others on the list, but

I somehow feel the need to echo it anyway for this kind of thing is near and

dear to me.

From the ground crew stand point, was the helicopter needed? It sounds

like

it was in the beginning providing that transporting by ground to an

appropriate trauma center would have taken more than 30-45 minutes. How

long did the

ground crew wait for the aircraft? Did the ground crew attempt an IV, but

was unsuccessful prior to the arrival of the air crew? Once the patient

became alert and stable, how far out was the helicopter? It is acceptable

to

cancel a helicopter if it's no longer needed.

Once the air crew was there, from what you have described, there would have

been no reason to start an IV on-scene. IV's can be initiated in the

aircraft and should be if there is not an emergent need such as medications

to

facilitate intubation, immediate fluid resuscitation, etc.

Starting two IV's on the same side ... as long as there is two different

vein paths, I haven't heard of this being a problem. Starting it in the

same

vein, maybe not a good idea. Sometimes the air crew has better access to

one

arm over the other depending on how their aircraft is configured. But,

again,

it sounds like they didn't need to start the IV on-scene.

The rudeness is completely unacceptable. There is NO excuse for that! Our

jobs, both ground and air come with stresses. The EMS crew, the patient,

the

family and any other personnel on-scene (fire and police) should be treated

with kindness and respect by the air crew regardless of what kind of

pressure

or stress they're under. You absolutely should call their

supervisor/director and report the bad behavior. And, as someone else has

mentioned, it would

be beneficial to QI the call with the air crew as well to try and

understand

what their rational was for what they did clinically. It would surprise me

if their protocols and or Medical Director supports starting an IV or two

on-scene when they could have done it in the aircraft. After all, the

helicopter is supposed to save time, right?

If this particular provider displays this behavior on a regular basis

and/or

makes bad decisions clinically, don't use them! How would that be

benefiting the patient? If you have more than one helicopter service in

your area,

call the one that does the best job and does it safely.

Good luck,

In a message dated 10/18/2005 1:14:27 PM Central Standard Time,

rxmd911@... writes:

A couple of weeks ago I was working a motorcycle race at a dirt track, in

whcih we had two riders hit each other. On arrival to the first person,

who

was unresponsive and had snoring respirations, I asked that an air medical

serivce be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit.

The

local EMS arrived and took care of the second person. I ask the local EMS

to call an air medical provider, and ask for either provider X or Y, and

thought that was who they called.

The air medical provider arrived and it was provider F, seems they have a

base close to this area, so they were called. The crew comes to my unit

and I

give report to " kojack & Mr. Clean " . After this, they were trying to

decide

if they wanted to start a line there or in the air. By this time the pt

was

alert and talking. His family member was in the unit talking with him

also.

They kick him out, and start barking orders (the flight crew) they were

almost tossed out on their ears they were so rude. Finally Mr. Clean

decides to

start a line in the unit before carrying the pt across the track. He

starts

one IV in the left hand, and then wants to start another one in the same

location. Correct me if I'm wrong, but in BTLS it states that a bi-lateral

IV

is just that, BI-LATERAL, meaning that one goes in one hand or arm and the

other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the

family

member is still talking to the pt, and wanting to know where he was being

taken, as they were from out of town. The " flight medic " yells again, and

tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough,

but I

think that this guy wanted to show off.

Thanks,

Wayne

---------------------------------

Yahoo! Music Unlimited - Access over 1 million songs. Try it free.

[Non-text portions of this message have been removed]

[Guest guest]

Wayne,

Thanks for answering my questions. Your responses lead me to a couple of

more, which I will have to get to later today or tomorrow. I will email you

off-list.

Take care,

In a message dated 10/19/2005 10:36:02 AM Central Standard Time,

rxmd911@... writes:

,

Ground transport to a level 2 facility would have taken about 45. The pt

was stable and talking when the air craft arrived, and it only took about 15

for them to get there from the time that they were called. No IV was attempted

by us, as we were still assessing the pt, who was again by now alert and

talking. At that point, I saw no need to attempt the IV. Now, had this pt

been

unstable and needed IV access for meds, then YES an IV would have been

started, if not to.

The medic think about starting one IV above the other one, and then decided

that he would start it right next to the first one.

Wayne

lisawhir@... wrote:

Wayne and all,

Most of what I want to say has been said already by others on the list, but

I somehow feel the need to echo it anyway for this kind of thing is near and

dear to me.

From the ground crew stand point, was the helicopter needed? It sounds

like

it was in the beginning providing that transporting by ground to an

appropriate trauma center would have taken more than 30-45 minutes. How

long did the

ground crew wait for the aircraft? Did the ground crew attempt an IV, but

was unsuccessful prior to the arrival of the air crew? Once the patient

became alert and stable, how far out was the helicopter? It is acceptable

to

cancel a helicopter if it's no longer needed.

Once the air crew was there, from what you have described, there would have

been no reason to start an IV on-scene. IV's can be initiated in the

aircraft and should be if there is not an emergent need such as medications

to

facilitate intubation, immediate fluid resuscitation, etc.

Starting two IV's on the same side ... as long as there is two different

vein paths, I haven't heard of this being a problem. Starting it in the

same

vein, maybe not a good idea. Sometimes the air crew has better access to

one

arm over the other depending on how their aircraft is configured. But,

again,

it sounds like they didn't need to start the IV on-scene.

The rudeness is completely unacceptable. There is NO excuse for that! Our

jobs, both ground and air come with stresses. The EMS crew, the patient,

the

family and any other personnel on-scene (fire and police) should be treated

with kindness and respect by the air crew regardless of what kind of

pressure

or stress they're under. You absolutely should call their

supervisor/director and report the bad behavior. And, as someone else has

mentioned, it would

be beneficial to QI the call with the air crew as well to try and

understand

what their rational was for what they did clinically. It would surprise me

if their protocols and or Medical Director supports starting an IV or two

on-scene when they could have done it in the aircraft. After all, the

helicopter is supposed to save time, right?

If this particular provider displays this behavior on a regular basis

and/or

makes bad decisions clinically, don't use them! How would that be

benefiting the patient? If you have more than one helicopter service in

your area,

call the one that does the best job and does it safely.

Good luck,

In a message dated 10/18/2005 1:14:27 PM Central Standard Time,

rxmd911@... writes:

A couple of weeks ago I was working a motorcycle race at a dirt track, in

whcih we had two riders hit each other. On arrival to the first person,

who

was unresponsive and had snoring respirations, I asked that an air medical

serivce be called. The second person was also unresponsive, but no snoring

respirations. The first one was out for at least 2-3 minutes.

All the necessary precautions were taken and he was placed in the unit.

The

local EMS arrived and took care of the second person. I ask the local EMS

to call an air medical provider, and ask for either provider X or Y, and

thought that was who they called.

The air medical provider arrived and it was provider F, seems they have a

base close to this area, so they were called. The crew comes to my unit

and I

give report to " kojack & Mr. Clean " . After this, they were trying to

decide

if they wanted to start a line there or in the air. By this time the pt

was

alert and talking. His family member was in the unit talking with him

also.

They kick him out, and start barking orders (the flight crew) they were

almost tossed out on their ears they were so rude. Finally Mr. Clean

decides to

start a line in the unit before carrying the pt across the track. He

starts

one IV in the left hand, and then wants to start another one in the same

location. Correct me if I'm wrong, but in BTLS it states that a bi-lateral

IV

is just that, BI-LATERAL, meaning that one goes in one hand or arm and the

other one goes in the other.

It was suggested that we drive around to the other side of the track to the

awaiting helicopter. By EMT goes to drive around to the bird, and the

family

member is still talking to the pt, and wanting to know where he was being

taken, as they were from out of town. The " flight medic " yells again, and

tells him to step back out of the door so we can go.

I was never use this provider again, if this is the way that their crews

are, I'll call the provider that I want and ask for.

So, my question is, was the IV's placed in a strang position or is this

acceptable? The guy was stable, and only one IV would have been enough,

but I

think that this guy wanted to show off.

Thanks,

Wayne

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[Guest guest]

Get ion touch with the flight service program director and give him an

earful. All flight services I know of will certainly rectify the

situation ASAP, especially rudeness of crews.

-MH

[Guest guest]

Get ion touch with the flight service program director and give him an

earful. All flight services I know of will certainly rectify the

situation ASAP, especially rudeness of crews.

-MH

[Guest guest]

Get ion touch with the flight service program director and give him an

earful. All flight services I know of will certainly rectify the

situation ASAP, especially rudeness of crews.

-MH