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...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Its not that Texas is the be all of EMS. I just thought that was a bit of a leap in an effort to prolong your discussion. I flew fixed wing out of rural Texas for many years. I often thought the same thing. When I would sit down and try to figure out the details of how it could work I would run into all kinds or problems that were just insurmountable. Just a few here there is no such thing as a 5 minute response time for fixed wing aircraft. No point to hospital travel. You have to land at the airport and transfer to a ground truck then to the hospital difficult on the patient as well. There is just a lot more logistics involved. I don't know why everyone keeps stating that there is so much noise and vibration in a helicopter. It is big time noisy outside, but inside its no worse than an ambulance running the siren. The helicopter is the smoothest thing I have ever rode in Including any ground truck. Fixed wing is inherently small aircraft that get bounced around unmercifully at times. There is patient care issues such as do you drive by a ER with a physician in house to go to the airport for a another 30-45 minute flight? What if that patient is in need of a critical intervention? There are many more deterrents and obstacles that are to detailed to go into. I could be proven wrong tomorrow but I don't think it will ever be an effective option here. I would love to see the states that pre-hospital fixed wing works in and how they do it. If they are able to effectively transport patients within a given window of time It's got to be a difficult thing to make work effectively and consistently. > > > > > > > > > > > > > > > > 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 The last thing that I would ever want to do is get in a statistics war with Byran Bledsoe. I give up now YOU WIN!! > > > > 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 The last thing that I would ever want to do is get in a statistics war with Byran Bledsoe. I give up now YOU WIN!! > > > > 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 The last thing that I would ever want to do is get in a statistics war with Byran Bledsoe. I give up now YOU WIN!! > > > > 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 Don't give up so easy. I am wrong all the time--just ask my wife, 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 11:30 AM To: Subject: Re: Closest Chopper The last thing that I would ever want to do is get in a statistics war with Byran Bledsoe. I give up now.YOU WIN!! > > > > 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 Don't give up so easy. I am wrong all the time--just ask my wife, 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 11:30 AM To: Subject: Re: Closest Chopper The last thing that I would ever want to do is get in a statistics war with Byran Bledsoe. I give up now.YOU WIN!! > > > > 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 That's not fair to you , if we ask your wife, you'll be wrong in everything, ALL the time . Just like the rest of us married guys! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 That's not fair to you , if we ask your wife, you'll be wrong in everything, ALL the time . Just like the rest of us married guys! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 29, 2005 Report Share Posted December 29, 2005 Maybe I'll have more energy tomorrow...Lots to do today. :-) > > > > > > 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 Maybe I'll have more energy tomorrow...Lots to do today. :-) > > > > > > 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 Maybe I'll have more energy tomorrow...Lots to do today. :-) > > > > > > 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 30, 2005 Report Share Posted December 30, 2005 I agree that in some areas fix wing is the way to go. But, unless you are going to start building airport runways at the hospital, you are talking about two ground units having to be used to accomplish getting the patient to the hospital. As a manager, this is a scheduling and billing nightmare. Usually the insurance companys, unless pre- approved will only pay the fix wing service. Most of the fix wing services are responsible for scheduling the ground units and paying for it. Tom Marek West EMS Operations Manager Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 30, 2005 Report Share Posted December 30, 2005 I agree that in some areas fix wing is the way to go. But, unless you are going to start building airport runways at the hospital, you are talking about two ground units having to be used to accomplish getting the patient to the hospital. As a manager, this is a scheduling and billing nightmare. Usually the insurance companys, unless pre- approved will only pay the fix wing service. Most of the fix wing services are responsible for scheduling the ground units and paying for it. Tom Marek West EMS Operations Manager Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 30, 2005 Report Share Posted December 30, 2005 I agree that in some areas fix wing is the way to go. But, unless you are going to start building airport runways at the hospital, you are talking about two ground units having to be used to accomplish getting the patient to the hospital. As a manager, this is a scheduling and billing nightmare. Usually the insurance companys, unless pre- approved will only pay the fix wing service. Most of the fix wing services are responsible for scheduling the ground units and paying for it. Tom Marek West EMS Operations Manager Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 30, 2005 Report Share Posted December 30, 2005 I agree that each service needs to look at their system on flights. But to say that air medical is really not needed on most patients is a false statement. If the patient care structure is built with the patient care in mind, air medical is a factor. For instance my service (West EMS), we have RSI built into our system and an active Medical Director that is active in the field with his medics. Our system uses the air medical as a structured level in our rural setting. We have built our patient care with air medical as a tool, not a routine, patients must meet specifics. We have AEL# 51 as a neighbor, and we use them probably less than most of the services around us. But, we rely on them and have a good working relationship with them. Their crews know up front, that when we call, the patient meets our requirements for flight. The only patients that might get flown that could have went by ground are do to heavy Interstate traffic (holiday, weather, etc.) that would hender us to get the patient to our nearest Trauma Center that is in some of our area, over 50 minutes away in normal traffic days. Wes comment about RSI and higher leveled skills to be used by ground crews sounds good. But, for instance, when our system put our RSI protocals into effect. Each of our Medics have to go through an RSI skills station as a pass fail every 6 months. This takes a lot of time and money to make sure the medics can perform quality skills. RSI and special skills are nice to say you have them, but to back it with how many times a month or year each individual gets to use them is a whole new Q & I problem. Just my two cents Tom Marek West EMS Operations Manager Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 30, 2005 Report Share Posted December 30, 2005 I agree that each service needs to look at their system on flights. But to say that air medical is really not needed on most patients is a false statement. If the patient care structure is built with the patient care in mind, air medical is a factor. For instance my service (West EMS), we have RSI built into our system and an active Medical Director that is active in the field with his medics. Our system uses the air medical as a structured level in our rural setting. We have built our patient care with air medical as a tool, not a routine, patients must meet specifics. We have AEL# 51 as a neighbor, and we use them probably less than most of the services around us. But, we rely on them and have a good working relationship with them. Their crews know up front, that when we call, the patient meets our requirements for flight. The only patients that might get flown that could have went by ground are do to heavy Interstate traffic (holiday, weather, etc.) that would hender us to get the patient to our nearest Trauma Center that is in some of our area, over 50 minutes away in normal traffic days. Wes comment about RSI and higher leveled skills to be used by ground crews sounds good. But, for instance, when our system put our RSI protocals into effect. Each of our Medics have to go through an RSI skills station as a pass fail every 6 months. This takes a lot of time and money to make sure the medics can perform quality skills. RSI and special skills are nice to say you have them, but to back it with how many times a month or year each individual gets to use them is a whole new Q & I problem. Just my two cents Tom Marek West EMS Operations Manager Quote Link to comment Share on other sites More sharing options...
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