Re: Closest Chopper

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.

>

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

> > > > > >

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.

> >

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.

> >

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.

> >

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.

> >

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.

> >

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!

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!

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.

> > >

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.

> > >

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.

> > >

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

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

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

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

December 30, 2005