Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 In a message dated 12/29/2005 11:37:12 A.M. Central Standard Time, bbledsoe@... writes: Don't give up so easy. I am wrong all the time--just ask my wife, He's not kidding! I've heard her tell him on several occasions he was wrong and she was right. He agreed in every case (smart man that he is) Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI LNMolino@... (Office) (Office Fax) " A Texan with a Jersey Attitude " The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 In a message dated 12/29/2005 11:37:12 A.M. Central Standard Time, bbledsoe@... writes: Don't give up so easy. I am wrong all the time--just ask my wife, He's not kidding! I've heard her tell him on several occasions he was wrong and she was right. He agreed in every case (smart man that he is) Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI LNMolino@... (Office) (Office Fax) " A Texan with a Jersey Attitude " The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Again, I'm not afraid to say this Dudley....EMS is a business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Again, I'm not afraid to say this Dudley....EMS is a business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Again, I'm not afraid to say this Dudley....EMS is a business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 One of the biggest reasons I hear that helicopters are used in Texas and similar rural states is that it allows the ambulance to return to service. That is akin to admitting everybody to surgery or the ICU so that the ED can stay open. I have ridden with fixed-wing aircraft (Super King Airs) throughout NSW and . The fleet is a part of the ambulance service. On any given day 6-8 aircraft leave Sydney with patients and return them home (where they are met at the rural airports by the local ambulance) and, at the same time, critical patients are picked up and returned to Sydney or other larger hospitals throughout the state. We picked up a merchant marine of the coast of the Tasman Sea that had horrible pancreatitis and electrolyte problems--he was low sick. The trip was not in range for a helicopter and besides there are only 10 or so medical helicopters in Australia and they are only used for rescue. The added room and the pressurized aircraft was a good environment to work in. In Kansas Wyoming, South Dakota and similar rural states fixed-wing ambulances are the norm. People forget that much of West Texas is not within range for helicopters without refueling. So, you have to figure in the slower speed of the helicopter (versus a fixed-wing ambulance), the time to refuel, the noise and vibration, the increased cost and danger and weigh that against any perceived benefits. Literature from Pennsylvania and North Carolina show that interhospital transport of patients by helicopter DO NOT improve survival. More than 10 studies now show that scene transport by helicopter improves survival in a very small fraction of the patients. The criteria being used for helicopter use was developed by the medical helicopter industry. That is like Krispy Kreme setting nutrition standards. The whole thing is a house of cards that will soon fall--especially if the NTSB cuts out night flights and mandates IFR. BTW--I worked as a flight paramedic for year. E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 One of the biggest reasons I hear that helicopters are used in Texas and similar rural states is that it allows the ambulance to return to service. That is akin to admitting everybody to surgery or the ICU so that the ED can stay open. I have ridden with fixed-wing aircraft (Super King Airs) throughout NSW and . The fleet is a part of the ambulance service. On any given day 6-8 aircraft leave Sydney with patients and return them home (where they are met at the rural airports by the local ambulance) and, at the same time, critical patients are picked up and returned to Sydney or other larger hospitals throughout the state. We picked up a merchant marine of the coast of the Tasman Sea that had horrible pancreatitis and electrolyte problems--he was low sick. The trip was not in range for a helicopter and besides there are only 10 or so medical helicopters in Australia and they are only used for rescue. The added room and the pressurized aircraft was a good environment to work in. In Kansas Wyoming, South Dakota and similar rural states fixed-wing ambulances are the norm. People forget that much of West Texas is not within range for helicopters without refueling. So, you have to figure in the slower speed of the helicopter (versus a fixed-wing ambulance), the time to refuel, the noise and vibration, the increased cost and danger and weigh that against any perceived benefits. Literature from Pennsylvania and North Carolina show that interhospital transport of patients by helicopter DO NOT improve survival. More than 10 studies now show that scene transport by helicopter improves survival in a very small fraction of the patients. The criteria being used for helicopter use was developed by the medical helicopter industry. That is like Krispy Kreme setting nutrition standards. The whole thing is a house of cards that will soon fall--especially if the NTSB cuts out night flights and mandates IFR. BTW--I worked as a flight paramedic for year. E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 One of the biggest reasons I hear that helicopters are used in Texas and similar rural states is that it allows the ambulance to return to service. That is akin to admitting everybody to surgery or the ICU so that the ED can stay open. I have ridden with fixed-wing aircraft (Super King Airs) throughout NSW and . The fleet is a part of the ambulance service. On any given day 6-8 aircraft leave Sydney with patients and return them home (where they are met at the rural airports by the local ambulance) and, at the same time, critical patients are picked up and returned to Sydney or other larger hospitals throughout the state. We picked up a merchant marine of the coast of the Tasman Sea that had horrible pancreatitis and electrolyte problems--he was low sick. The trip was not in range for a helicopter and besides there are only 10 or so medical helicopters in Australia and they are only used for rescue. The added room and the pressurized aircraft was a good environment to work in. In Kansas Wyoming, South Dakota and similar rural states fixed-wing ambulances are the norm. People forget that much of West Texas is not within range for helicopters without refueling. So, you have to figure in the slower speed of the helicopter (versus a fixed-wing ambulance), the time to refuel, the noise and vibration, the increased cost and danger and weigh that against any perceived benefits. Literature from Pennsylvania and North Carolina show that interhospital transport of patients by helicopter DO NOT improve survival. More than 10 studies now show that scene transport by helicopter improves survival in a very small fraction of the patients. The criteria being used for helicopter use was developed by the medical helicopter industry. That is like Krispy Kreme setting nutrition standards. The whole thing is a house of cards that will soon fall--especially if the NTSB cuts out night flights and mandates IFR. BTW--I worked as a flight paramedic for year. E. Bledsoe, DO, FACEP Midlothian, Texas Don't miss the Western States EMS Cruise! http://proemseducators.com/index.html _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 8:52 AM To: Subject: Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 " E. Bledsoe, DO, FACEP " wrote: In Kansas Wyoming,South Dakota and similar rural states fixed-wing ambulances are the norm. Most of the interfacility stuff we did on the Navajo Nation was done by fixed wing for the reasons you mentioned, speed, comfort and safety. " The true soldier fights not because he hates what is in front of him, but because he loves what is behind him. " - GK Chesterton --------------------------------- Yahoo! DSL Something to write home about. Just $16.99/mo. or less Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 " E. Bledsoe, DO, FACEP " wrote: In Kansas Wyoming,South Dakota and similar rural states fixed-wing ambulances are the norm. Most of the interfacility stuff we did on the Navajo Nation was done by fixed wing for the reasons you mentioned, speed, comfort and safety. " The true soldier fights not because he hates what is in front of him, but because he loves what is behind him. " - GK Chesterton --------------------------------- Yahoo! DSL Something to write home about. Just $16.99/mo. or less Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Do you guys see the extremes you are going to prove your right? Sydney...Alaska...The Tasman Sea. Come on, we were talking about Texas. The studies take everything...all flights into account. This includes all those metropolitan based 10 minute flights which skewed the whole thing. Nobody is arguing that those flights are appropriate. Yes there is misuse. Yes there needs to be education. Yes they could transport more patients by ground effectively and yes there are bigger fish in this world to fry. In the end Air is still a very needed and beneficial thing. I seem to remember you telling me not to use the trauma center or CT analogy. Why can you now use the surgery/ICU analogy to make you your point? BTW, I think everyone knows that you can find literature and studies that will support almost any viewpoint. I've got things to do today...You guys have at it... > > One of the biggest reasons I hear that helicopters are used in Texas and > similar rural states is that it allows the ambulance to return to service. > That is akin to admitting everybody to surgery or the ICU so that the ED can > stay open. I have ridden with fixed-wing aircraft (Super King Airs) > throughout NSW and . The fleet is a part of the ambulance service. > On any given day 6-8 aircraft leave Sydney with patients and return them > home (where they are met at the rural airports by the local ambulance) and, > at the same time, critical patients are picked up and returned to Sydney or > other larger hospitals throughout the state. We picked up a merchant marine > of the coast of the Tasman Sea that had horrible pancreatitis and > electrolyte problems--he was low sick. The trip was not in range for a > helicopter and besides there are only 10 or so medical helicopters in > Australia and they are only used for rescue. The added room and the > pressurized aircraft was a good environment to work in. In Kansas Wyoming, > South Dakota and similar rural states fixed-wing ambulances are the norm. > > People forget that much of West Texas is not within range for helicopters > without refueling. So, you have to figure in the slower speed of the > helicopter (versus a fixed-wing ambulance), the time to refuel, the noise > and vibration, the increased cost and danger and weigh that against any > perceived benefits. Literature from Pennsylvania and North Carolina show > that interhospital transport of patients by helicopter DO NOT improve > survival. More than 10 studies now show that scene transport by helicopter > improves survival in a very small fraction of the patients. The criteria > being used for helicopter use was developed by the medical helicopter > industry. That is like Krispy Kreme setting nutrition standards. The whole > thing is a house of cards that will soon fall--especially if the NTSB cuts > out night flights and mandates IFR. BTW--I worked as a flight paramedic for > year. > > E. Bledsoe, DO, FACEP > Midlothian, Texas > > Don't miss the Western States EMS Cruise! > http://proemseducators.com/index.html > > > _____ > > From: [mailto:texasems- l ] On > Behalf Of Jon > Sent: Thursday, December 29, 2005 8:52 AM > To: > Subject: Re: Closest Chopper > > > I thought we were talking about Texas here. You can twist and turn > to try to make your thought processes fit everyone else from here to > Alaska if you want to, but I really think it would benefit you to > walk a mile in another mans shoes as it appears your opinions are > derived from a single perspective. I wish you could come do the job > for a while so you could see first hand. You're obviously an > intelligent and thoughtful man so I am sure you would readily see > that there are many applications and needs out there. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Do you guys see the extremes you are going to prove your right? Sydney...Alaska...The Tasman Sea. Come on, we were talking about Texas. The studies take everything...all flights into account. This includes all those metropolitan based 10 minute flights which skewed the whole thing. Nobody is arguing that those flights are appropriate. Yes there is misuse. Yes there needs to be education. Yes they could transport more patients by ground effectively and yes there are bigger fish in this world to fry. In the end Air is still a very needed and beneficial thing. I seem to remember you telling me not to use the trauma center or CT analogy. Why can you now use the surgery/ICU analogy to make you your point? BTW, I think everyone knows that you can find literature and studies that will support almost any viewpoint. I've got things to do today...You guys have at it... > > One of the biggest reasons I hear that helicopters are used in Texas and > similar rural states is that it allows the ambulance to return to service. > That is akin to admitting everybody to surgery or the ICU so that the ED can > stay open. I have ridden with fixed-wing aircraft (Super King Airs) > throughout NSW and . The fleet is a part of the ambulance service. > On any given day 6-8 aircraft leave Sydney with patients and return them > home (where they are met at the rural airports by the local ambulance) and, > at the same time, critical patients are picked up and returned to Sydney or > other larger hospitals throughout the state. We picked up a merchant marine > of the coast of the Tasman Sea that had horrible pancreatitis and > electrolyte problems--he was low sick. The trip was not in range for a > helicopter and besides there are only 10 or so medical helicopters in > Australia and they are only used for rescue. The added room and the > pressurized aircraft was a good environment to work in. In Kansas Wyoming, > South Dakota and similar rural states fixed-wing ambulances are the norm. > > People forget that much of West Texas is not within range for helicopters > without refueling. So, you have to figure in the slower speed of the > helicopter (versus a fixed-wing ambulance), the time to refuel, the noise > and vibration, the increased cost and danger and weigh that against any > perceived benefits. Literature from Pennsylvania and North Carolina show > that interhospital transport of patients by helicopter DO NOT improve > survival. More than 10 studies now show that scene transport by helicopter > improves survival in a very small fraction of the patients. The criteria > being used for helicopter use was developed by the medical helicopter > industry. That is like Krispy Kreme setting nutrition standards. The whole > thing is a house of cards that will soon fall--especially if the NTSB cuts > out night flights and mandates IFR. BTW--I worked as a flight paramedic for > year. > > E. Bledsoe, DO, FACEP > Midlothian, Texas > > Don't miss the Western States EMS Cruise! > http://proemseducators.com/index.html > > > _____ > > From: [mailto:texasems- l ] On > Behalf Of Jon > Sent: Thursday, December 29, 2005 8:52 AM > To: > Subject: Re: Closest Chopper > > > I thought we were talking about Texas here. You can twist and turn > to try to make your thought processes fit everyone else from here to > Alaska if you want to, but I really think it would benefit you to > walk a mile in another mans shoes as it appears your opinions are > derived from a single perspective. I wish you could come do the job > for a while so you could see first hand. You're obviously an > intelligent and thoughtful man so I am sure you would readily see > that there are many applications and needs out there. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Do you guys see the extremes you are going to prove your right? Sydney...Alaska...The Tasman Sea. Come on, we were talking about Texas. The studies take everything...all flights into account. This includes all those metropolitan based 10 minute flights which skewed the whole thing. Nobody is arguing that those flights are appropriate. Yes there is misuse. Yes there needs to be education. Yes they could transport more patients by ground effectively and yes there are bigger fish in this world to fry. In the end Air is still a very needed and beneficial thing. I seem to remember you telling me not to use the trauma center or CT analogy. Why can you now use the surgery/ICU analogy to make you your point? BTW, I think everyone knows that you can find literature and studies that will support almost any viewpoint. I've got things to do today...You guys have at it... > > One of the biggest reasons I hear that helicopters are used in Texas and > similar rural states is that it allows the ambulance to return to service. > That is akin to admitting everybody to surgery or the ICU so that the ED can > stay open. I have ridden with fixed-wing aircraft (Super King Airs) > throughout NSW and . The fleet is a part of the ambulance service. > On any given day 6-8 aircraft leave Sydney with patients and return them > home (where they are met at the rural airports by the local ambulance) and, > at the same time, critical patients are picked up and returned to Sydney or > other larger hospitals throughout the state. We picked up a merchant marine > of the coast of the Tasman Sea that had horrible pancreatitis and > electrolyte problems--he was low sick. The trip was not in range for a > helicopter and besides there are only 10 or so medical helicopters in > Australia and they are only used for rescue. The added room and the > pressurized aircraft was a good environment to work in. In Kansas Wyoming, > South Dakota and similar rural states fixed-wing ambulances are the norm. > > People forget that much of West Texas is not within range for helicopters > without refueling. So, you have to figure in the slower speed of the > helicopter (versus a fixed-wing ambulance), the time to refuel, the noise > and vibration, the increased cost and danger and weigh that against any > perceived benefits. Literature from Pennsylvania and North Carolina show > that interhospital transport of patients by helicopter DO NOT improve > survival. More than 10 studies now show that scene transport by helicopter > improves survival in a very small fraction of the patients. The criteria > being used for helicopter use was developed by the medical helicopter > industry. That is like Krispy Kreme setting nutrition standards. The whole > thing is a house of cards that will soon fall--especially if the NTSB cuts > out night flights and mandates IFR. BTW--I worked as a flight paramedic for > year. > > E. Bledsoe, DO, FACEP > Midlothian, Texas > > Don't miss the Western States EMS Cruise! > http://proemseducators.com/index.html > > > _____ > > From: [mailto:texasems- l ] On > Behalf Of Jon > Sent: Thursday, December 29, 2005 8:52 AM > To: > Subject: Re: Closest Chopper > > > I thought we were talking about Texas here. You can twist and turn > to try to make your thought processes fit everyone else from here to > Alaska if you want to, but I really think it would benefit you to > walk a mile in another mans shoes as it appears your opinions are > derived from a single perspective. I wish you could come do the job > for a while so you could see first hand. You're obviously an > intelligent and thoughtful man so I am sure you would readily see > that there are many applications and needs out there. > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Sorry...I didn't realize that Texas is the be all, end all of EMS systems and operations. I truly do not feel my opinions are derived from a single perspective...I merely like to look outside my areas box once in a while to see how other folks do it...and then examine to see if new to me ideas could be beneficial to the operations I currently find myself in. I truly am not a fan of the " because we've always done it that way " arguements so prevalent in this profession...and public safety as a whole. Again, let me re=phrase...I don't believe that fixed wing is inappropriate for pre-hospital care in rural areas of Texas. It is faster than rotor, hugely safer, and, like you would see in many areas where it is used for pre-hospital care, there are places to land them all over the rural areas...and as long as rotor wing providers continue to compete against each other in helicopter rich environments...patients can be reached and treated and returned to higher levels of care much faster in a plane than a helicopter...since this works in other states, I don't see a reason why, with proper design, a similar concept could not work in Texas. Why is it you feel that fixed wing is inappropriate for the pre-hospital environment? Dudley Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Sorry...I didn't realize that Texas is the be all, end all of EMS systems and operations. I truly do not feel my opinions are derived from a single perspective...I merely like to look outside my areas box once in a while to see how other folks do it...and then examine to see if new to me ideas could be beneficial to the operations I currently find myself in. I truly am not a fan of the " because we've always done it that way " arguements so prevalent in this profession...and public safety as a whole. Again, let me re=phrase...I don't believe that fixed wing is inappropriate for pre-hospital care in rural areas of Texas. It is faster than rotor, hugely safer, and, like you would see in many areas where it is used for pre-hospital care, there are places to land them all over the rural areas...and as long as rotor wing providers continue to compete against each other in helicopter rich environments...patients can be reached and treated and returned to higher levels of care much faster in a plane than a helicopter...since this works in other states, I don't see a reason why, with proper design, a similar concept could not work in Texas. Why is it you feel that fixed wing is inappropriate for the pre-hospital environment? Dudley Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Speaking of looking outside of our immediate area, I know that AeroCare, the flight service for the South Plains (Lubbock) and Eastern New Mexico, has at least one fixed-wing transport. -Wes Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Speaking of looking outside of our immediate area, I know that AeroCare, the flight service for the South Plains (Lubbock) and Eastern New Mexico, has at least one fixed-wing transport. -Wes Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Speaking of looking outside of our immediate area, I know that AeroCare, the flight service for the South Plains (Lubbock) and Eastern New Mexico, has at least one fixed-wing transport. -Wes Re: Closest Chopper I thought we were talking about Texas here. You can twist and turn to try to make your thought processes fit everyone else from here to Alaska if you want to, but I really think it would benefit you to walk a mile in another mans shoes as it appears your opinions are derived from a single perspective. I wish you could come do the job for a while so you could see first hand. You're obviously an intelligent and thoughtful man so I am sure you would readily see that there are many applications and needs out there. > > > > > > > > > > > > > > This can happen when the patient stops being the primary > > > > concern > > > > > for > > > > > > those > > > > > > > on the call. > > > > > > > > > > > > According to the story, the patients weren't even > extricated > > > yet > > > > > when > > > > > > the chopper arrived. Obviously, ETA was not a primary > > concern > > > > in > > > > > this > > > > > > instance. I hear medics all the time saying they would > not > > > call > > > > > so- > > > > > > and-so flight service for a dead dog. This is a prevalent > > > > thing. > > > > > So > > > > > > if there was no threat to the patient, and there was no > > policy > > > > > > superceding the medic's actions, what exactly is the > problem > > > > here? > > > > > > > > > > > > I agree. I would like to hear the story from the medics > and > > > the > > > > > other > > > > > > service, not just whining from the losers. > > > > > > > > > > > > Rob > > > > > > > > > > > > > > > > > > > > > Perhaps your right about this case...but then again you > could > > > also > > > > > be very wrong. There are so many different dynamics > involved > > in > > > > > some of these decisions. The level of care offered by the > > > > personnel > > > > > on scene is variable depending on where you go. If there > was > > an > > > > > immanent patient care issue that was beyond their > capabilities > > > but > > > > > within the capabilities of the closest air service then that > > > > changes > > > > > things the other direction...toward them being wrong to wait. > > > > > > > > > > The problem here is not whether or not someone should catch > > some > > > > > grief from their boss based on being outside of some > > protocol. > > > > The > > > > > question is did they do the right thing. The patient > doesn't > > > have > > > > > to have been harmed for their actions to have been wrong. > You > > > can > > > > > have a good outcome despite poor care in lots of situations? > > most > > > > of > > > > > us have thanked god for that at one time or another. > > > > > > > > > > I believe personal preference often plays a roll in the > choice > > > of > > > > > the services utilized...despite what maybe ethically > correct. > > Is > > > > > this right? This isn't anymore right than dialing 911 in > one > > > city > > > > > and demanding the EMS from another city because you believe > > that > > > > > they are better for whatever reason. This is also no > > different > > > > than > > > > > choosing to go to a hospital that is farther away than a > > closer > > > > > appropriate one. We have a system based on ethical choices > > and > > > we > > > > > must stay within it. If you don't like the closest provider > > to > > > > you > > > > > then you should address the issues with that provider rather > > > than > > > > > circumventing the system. This would also apply to those > > > creating > > > > > protocols based upon personal preferences. A protocol from > > your > > > > > Medical Director doesn't make it any more legally or > ethically > > > > > defensible if it's not the most appropriate choice in a > given > > > > > situation. > > > > > > > > > > Jon > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Jon wrote, " BTW, I think everyone knows that you can find literature and studies that will support almost any viewpoint. " OK. Find it. The burden of proof is on you. You say it makes a difference, prove it. In terms of rural NSW and Texas, the geography is the same. The plants and animals are different-but the people and the travel times are the same. _____ From: [mailto: ] On Behalf Of Jon Sent: Thursday, December 29, 2005 9:47 AM To: Subject: Re: Closest Chopper Do you guys see the extremes you are going to prove your right? Sydney...Alaska...The Tasman Sea. Come on, we were talking about Texas. The studies take everything...all flights into account. This includes all those metropolitan based 10 minute flights which skewed the whole thing. Nobody is arguing that those flights are appropriate. Yes there is misuse. Yes there needs to be education. Yes they could transport more patients by ground effectively and yes there are bigger fish in this world to fry. In the end Air is still a very needed and beneficial thing. I seem to remember you telling me not to use the trauma center or CT analogy. Why can you now use the surgery/ICU analogy to make you your point? BTW, I think everyone knows that you can find literature and studies that will support almost any viewpoint. I've got things to do today...You guys have at it... > > One of the biggest reasons I hear that helicopters are used in Texas and > similar rural states is that it allows the ambulance to return to service. > That is akin to admitting everybody to surgery or the ICU so that the ED can > stay open. I have ridden with fixed-wing aircraft (Super King Airs) > throughout NSW and . The fleet is a part of the ambulance service. > On any given day 6-8 aircraft leave Sydney with patients and return them > home (where they are met at the rural airports by the local ambulance) and, > at the same time, critical patients are picked up and returned to Sydney or > other larger hospitals throughout the state. We picked up a merchant marine > of the coast of the Tasman Sea that had horrible pancreatitis and > electrolyte problems--he was low sick. The trip was not in range for a > helicopter and besides there are only 10 or so medical helicopters in > Australia and they are only used for rescue. The added room and the > pressurized aircraft was a good environment to work in. In Kansas Wyoming, > South Dakota and similar rural states fixed-wing ambulances are the norm. > > People forget that much of West Texas is not within range for helicopters > without refueling. So, you have to figure in the slower speed of the > helicopter (versus a fixed-wing ambulance), the time to refuel, the noise > and vibration, the increased cost and danger and weigh that against any > perceived benefits. Literature from Pennsylvania and North Carolina show > that interhospital transport of patients by helicopter DO NOT improve > survival. More than 10 studies now show that scene transport by helicopter > improves survival in a very small fraction of the patients. The criteria > being used for helicopter use was developed by the medical helicopter > industry. That is like Krispy Kreme setting nutrition standards. The whole > thing is a house of cards that will soon fall--especially if the NTSB cuts > out night flights and mandates IFR. BTW--I worked as a flight paramedic for > year. > > E. Bledsoe, DO, FACEP > Midlothian, Texas > > Don't miss the Western States EMS Cruise! > http://proemseducators.com/index.html > > > _____ > > From: [mailto:texasems- l ] On > Behalf Of Jon > Sent: Thursday, December 29, 2005 8:52 AM > To: > Subject: Re: Closest Chopper > > > I thought we were talking about Texas here. You can twist and turn > to try to make your thought processes fit everyone else from here to > Alaska if you want to, but I really think it would benefit you to > walk a mile in another mans shoes as it appears your opinions are > derived from a single perspective. I wish you could come do the job > for a while so you could see first hand. You're obviously an > intelligent and thoughtful man so I am sure you would readily see > that there are many applications and needs out there. > > > > > > Quote Link to comment Share on other sites More sharing options...
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