Re: Tragic Crash Kills 3 of our Best.

[Guest guest]

OK, then, explain to me why there is EMS in the first place? Why did you

bother to write textbooks for something that apparently has no clinical

signifigance? Obviously the patient in the accident in Arkansas didn't need

an ambulance since she survived a CVA and a multi-fatality accident only to

be driven to the hospital by her family. What is it exactly that we all

doing hanging out at your house every year talking about something that

every study you just posted just said was useless? I guess drinking and

eating chilli is as of much use as anything else we do. It looks to me like

I could just drive around and pick people up in my car and do just as much

good for them as I could in my ambulance.

If this is all just one giant waste of time and money, why are we doing it?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR. We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options. For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

OK, then, explain to me why there is EMS in the first place? Why did you

bother to write textbooks for something that apparently has no clinical

signifigance? Obviously the patient in the accident in Arkansas didn't need

an ambulance since she survived a CVA and a multi-fatality accident only to

be driven to the hospital by her family. What is it exactly that we all

doing hanging out at your house every year talking about something that

every study you just posted just said was useless? I guess drinking and

eating chilli is as of much use as anything else we do. It looks to me like

I could just drive around and pick people up in my car and do just as much

good for them as I could in my ambulance.

If this is all just one giant waste of time and money, why are we doing it?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR. We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options. For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Where did I say that EMS does not make a difference? I am saying that SPEED

makes very little difference. EMS has a very positive impact on respiratory

disease, cardiac disease, trauma (in terms of providing limited fluids and

an airway), allergic reactions, seizures, stroke (if the patient is an

interventional candidate) and so on.

There are things that are important that can't be measured in mortality

rates. These include pain control, psychological assistance, compassion,

not making a problem worse, and so on.

Some people just need horizontal transportation.

You can look at helicopter crashes and make a point that the patient did not

need helicopter transport because they had minor injuries and the point is

valid (in that helicopters primarily offer the advantage of speed). But you

cannot say the same thing about ground ambulances. Some people need

horizontal transportation and care en route.

The discussion is SPEED.....your electromagnetic field is sensitive today.

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

OK, then, explain to me why there is EMS in the first place? Why did you

bother to write textbooks for something that apparently has no clinical

signifigance? Obviously the patient in the accident in Arkansas didn't need

an ambulance since she survived a CVA and a multi-fatality accident only to

be driven to the hospital by her family. What is it exactly that we all

doing hanging out at your house every year talking about something that

every study you just posted just said was useless? I guess drinking and

eating chilli is as of much use as anything else we do. It looks to me like

I could just drive around and pick people up in my car and do just as much

good for them as I could in my ambulance.

If this is all just one giant waste of time and money, why are we doing it?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR. We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options. For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Where did I say that EMS does not make a difference? I am saying that SPEED

makes very little difference. EMS has a very positive impact on respiratory

disease, cardiac disease, trauma (in terms of providing limited fluids and

an airway), allergic reactions, seizures, stroke (if the patient is an

interventional candidate) and so on.

There are things that are important that can't be measured in mortality

rates. These include pain control, psychological assistance, compassion,

not making a problem worse, and so on.

Some people just need horizontal transportation.

You can look at helicopter crashes and make a point that the patient did not

need helicopter transport because they had minor injuries and the point is

valid (in that helicopters primarily offer the advantage of speed). But you

cannot say the same thing about ground ambulances. Some people need

horizontal transportation and care en route.

The discussion is SPEED.....your electromagnetic field is sensitive today.

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

OK, then, explain to me why there is EMS in the first place? Why did you

bother to write textbooks for something that apparently has no clinical

signifigance? Obviously the patient in the accident in Arkansas didn't need

an ambulance since she survived a CVA and a multi-fatality accident only to

be driven to the hospital by her family. What is it exactly that we all

doing hanging out at your house every year talking about something that

every study you just posted just said was useless? I guess drinking and

eating chilli is as of much use as anything else we do. It looks to me like

I could just drive around and pick people up in my car and do just as much

good for them as I could in my ambulance.

If this is all just one giant waste of time and money, why are we doing it?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR. We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options. For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Where did I say that EMS does not make a difference? I am saying that SPEED

makes very little difference. EMS has a very positive impact on respiratory

disease, cardiac disease, trauma (in terms of providing limited fluids and

an airway), allergic reactions, seizures, stroke (if the patient is an

interventional candidate) and so on.

There are things that are important that can't be measured in mortality

rates. These include pain control, psychological assistance, compassion,

not making a problem worse, and so on.

Some people just need horizontal transportation.

You can look at helicopter crashes and make a point that the patient did not

need helicopter transport because they had minor injuries and the point is

valid (in that helicopters primarily offer the advantage of speed). But you

cannot say the same thing about ground ambulances. Some people need

horizontal transportation and care en route.

The discussion is SPEED.....your electromagnetic field is sensitive today.

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

OK, then, explain to me why there is EMS in the first place? Why did you

bother to write textbooks for something that apparently has no clinical

signifigance? Obviously the patient in the accident in Arkansas didn't need

an ambulance since she survived a CVA and a multi-fatality accident only to

be driven to the hospital by her family. What is it exactly that we all

doing hanging out at your house every year talking about something that

every study you just posted just said was useless? I guess drinking and

eating chilli is as of much use as anything else we do. It looks to me like

I could just drive around and pick people up in my car and do just as much

good for them as I could in my ambulance.

If this is all just one giant waste of time and money, why are we doing it?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR. We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options. For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

" Bledsoe " <bbledsoe@e...> wrote:

> What emergencies are you responding to where 2 minutes makes a

difference?

> As a rule, you can't get the sudden death cases in less than 8 minutes.

You are skipping over a significant part of the picture. How much

time passed before 911 was even called? How much time did it take to

process the 911 call and dispatch the unit? How long did it take for

the unit to be enroute? Now, add that to your contractually mandated

8 minute response.

Two minutes DOES make a difference, but only if you haven't already

blown 8 of them.

Rob

[Guest guest]

" Bledsoe " <bbledsoe@e...> wrote:

> What emergencies are you responding to where 2 minutes makes a

difference?

> As a rule, you can't get the sudden death cases in less than 8 minutes.

You are skipping over a significant part of the picture. How much

time passed before 911 was even called? How much time did it take to

process the 911 call and dispatch the unit? How long did it take for

the unit to be enroute? Now, add that to your contractually mandated

8 minute response.

Two minutes DOES make a difference, but only if you haven't already

blown 8 of them.

Rob

[Guest guest]

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR. We

>>>> are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>>> reversable causes and the patient is as dead after our treatment as

>>>> they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient in

>>>> ROSC consistantly...those are the ones we are evaluating to see what

>>>> we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can start

>>>> minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR. We

>>>> are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>>> reversable causes and the patient is as dead after our treatment as

>>>> they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient in

>>>> ROSC consistantly...those are the ones we are evaluating to see what

>>>> we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can start

>>>> minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

Believe it or not:

Ross E, et al. " The impact of mode of arrival to the hospital on time

interval from symptom onset to treatment for patients with acute coronary

syndrome. " Prehosp Emerg Care. 2005;9(1):121

They found that patients who called 911 arrived significantly faster than

those transported by others, or who drove themselves. But overall survival

rates:

Arrived by ambulance 94%

Drove self 96%

Transported by others 98%

Obviously the differences are not statistically different. But, EMS gave

patients a better shot at definitive therapy and there is more than

mortality. Then you get into a cost benefit ratio.

Your question is the question of the century. We know EMS makes a

difference. But, what parts? That is what we are finding. EMS decreases

mortality in asthma and anaphylaxis. There is more than mortality, as I said

before, such as pain control and not worsening a problem. If I had the

answer, me and 100 EMS researchers would be on a beach somewhere.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

Believe it or not:

Ross E, et al. " The impact of mode of arrival to the hospital on time

interval from symptom onset to treatment for patients with acute coronary

syndrome. " Prehosp Emerg Care. 2005;9(1):121

They found that patients who called 911 arrived significantly faster than

those transported by others, or who drove themselves. But overall survival

rates:

Arrived by ambulance 94%

Drove self 96%

Transported by others 98%

Obviously the differences are not statistically different. But, EMS gave

patients a better shot at definitive therapy and there is more than

mortality. Then you get into a cost benefit ratio.

Your question is the question of the century. We know EMS makes a

difference. But, what parts? That is what we are finding. EMS decreases

mortality in asthma and anaphylaxis. There is more than mortality, as I said

before, such as pain control and not worsening a problem. If I had the

answer, me and 100 EMS researchers would be on a beach somewhere.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

Believe it or not:

Ross E, et al. " The impact of mode of arrival to the hospital on time

interval from symptom onset to treatment for patients with acute coronary

syndrome. " Prehosp Emerg Care. 2005;9(1):121

They found that patients who called 911 arrived significantly faster than

those transported by others, or who drove themselves. But overall survival

rates:

Arrived by ambulance 94%

Drove self 96%

Transported by others 98%

Obviously the differences are not statistically different. But, EMS gave

patients a better shot at definitive therapy and there is more than

mortality. Then you get into a cost benefit ratio.

Your question is the question of the century. We know EMS makes a

difference. But, what parts? That is what we are finding. EMS decreases

mortality in asthma and anaphylaxis. There is more than mortality, as I said

before, such as pain control and not worsening a problem. If I had the

answer, me and 100 EMS researchers would be on a beach somewhere.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

The interesting thing is:

While we are starting to find that some parts of EMS are not cost-effective

or make little difference, the medical helicopter fleet in the United States

has virtually doubled in 2-3 years. Now, we are taking the same subset of

patients, those transported ny EMS, and transporting even more by the most

expensive means available. And we wonder why Medicare reimbursement for EMS

sucks.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

The interesting thing is:

While we are starting to find that some parts of EMS are not cost-effective

or make little difference, the medical helicopter fleet in the United States

has virtually doubled in 2-3 years. Now, we are taking the same subset of

patients, those transported ny EMS, and transporting even more by the most

expensive means available. And we wonder why Medicare reimbursement for EMS

sucks.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

The interesting thing is:

While we are starting to find that some parts of EMS are not cost-effective

or make little difference, the medical helicopter fleet in the United States

has virtually doubled in 2-3 years. Now, we are taking the same subset of

patients, those transported ny EMS, and transporting even more by the most

expensive means available. And we wonder why Medicare reimbursement for EMS

sucks.

BEB

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

Well, no, actually having looked at the studies you posted, they say that

ACLS does not affect survival rates, rapid transport makes no clinical

difference. What is the literal essence of EMS? ACLS and rapid trauma

transport. What else are we in business for? I'm not being sensitive, I'm

being completely serious. Literally, what these studies prove is that I

could carry a defibrillator around with me in my car and hope that I found

somebody who just dropped dead, since I can't make the 8 minute mark anyway,

zap 'em a few times and drive them into the ER with traffic and have the

same results as the entire EMS industry.

Again, if speed isn't a factor, would it not be just as effective to have

patients drive to the ER themselves, take a bus or have a friend come get

them? It seems to me that we are wasting a whole lot of time, money and

effort for little gain looking at these studies you provided, as well as

risking lives needlessly for little gain.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>

>>>

>>>>

>>>> I appreciate your thoughts...but one of the things our Medical

>>>> Director is looking as is the need to transport while doing CPR.

>>>> We are analyzing and evaluating every patient we transport to the

>>>> hospital with CPR in progress to see if we had other options. For

>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>> no reversable causes and the patient is as dead after our treatment

>>>> as they were before we arrived...what magic pill is the ED going to

>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>

>>>> Now, if we are having results and we just cannot keep the patient

>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>> what we can supplement our care with so that the need to " rush like

>>>> mad-men " to the ED can be even further minimalized...we are making

>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>> patients emergency to the hospital...now we are doing less than 10%....

>>>>

>>>> Now, if we can just get our dispatch issues corrected and we can

>>>> start minimilizing the number of times we respond emergency as well....

>>>>

>>>> Keep safe,

>>>>

>>>> Dudley

>>>>

>>>>

>>>>

>>>>

>>>>

[Guest guest]

So, I pack some Benedryl, epi and Albuterol in my go bag, load the heart

start in my truck and I'm off to save lives huh?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>

>>>>

>>>>>

>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>> Director is looking as is the need to transport while doing CPR.

>>>>> We are analyzing and evaluating every patient we transport to the

>>>>> hospital with CPR in progress to see if we had other options. For

>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>> no reversable causes and the patient is as dead after our treatment

>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>

>>>>> Now, if we are having results and we just cannot keep the patient

>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>> what we can supplement our care with so that the need to " rush like

>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>> patients emergency to the hospital...now we are doing less than

>>>>> 10%....

>>>>>

>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>> start minimilizing the number of times we respond emergency as

>>>>> well....

>>>>>

>>>>> Keep safe,

>>>>>

>>>>> Dudley

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

[Guest guest]

So, I pack some Benedryl, epi and Albuterol in my go bag, load the heart

start in my truck and I'm off to save lives huh?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>

>>>>

>>>>>

>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>> Director is looking as is the need to transport while doing CPR.

>>>>> We are analyzing and evaluating every patient we transport to the

>>>>> hospital with CPR in progress to see if we had other options. For

>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>> no reversable causes and the patient is as dead after our treatment

>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>

>>>>> Now, if we are having results and we just cannot keep the patient

>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>> what we can supplement our care with so that the need to " rush like

>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>> patients emergency to the hospital...now we are doing less than

>>>>> 10%....

>>>>>

>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>> start minimilizing the number of times we respond emergency as

>>>>> well....

>>>>>

>>>>> Keep safe,

>>>>>

>>>>> Dudley

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

[Guest guest]

Let's look at Princess 's case, shall we? She was " stabilized " in the

ambulance and then driven slowly, ever so slowly, to the hospital. All the time

she was bleeding out into her chest cavity from a lac that probably could have

been fixed. OK. Now, so much for " stabilization " of trauma patients in the

field. We know it doesn't happen.

However, can't there be a happy medium? For her, dawdling around possibly

allowed her to die, and it can be argued reasonably that rapid but safe

transport to a trauma facility (there are none of them in Paris, I understand)

could have saved her.

On the other hand, rapid but safe grounding vs. helo txp across Paris would have

made great sense, and helo use no sense whatsoever. Hell, the thing probably

would have run into the Eiffel Tower just across the way anyway.

We all need a hard look at reality. We function upon so many myths and folk

notions that have grown up with our profession. We need to shuck the myths and

look at just what it is that we do that is genuinely important and helpful.

We know about defibrillation. But we also need to look at airway management.

Airway management, and related respiratory problem management is one place where

we can shine and we DO make a difference. Since I specialize in airway

management issues, this stands out to me as being a place where we can tout our

importance to the community.

I am grouping all conditions that involve airway, such as acute onset pulmonary

edema secondary to left heart failure, COPD crises, asthma crises, anaphalyxis,

drug overdoses, all cases of diminished LOC where a patent airway is not

assured, and those rare cases involving true airway obstruction where only a

surgical airway will work.

As we plan deployment of resources, it seems to me that we need to focus on

those areas that we know we make a difference in.

That said, change of topic:

Today I heard a new one. 911 gets a call to a rural area on a highway where the

caller simply says " I need help. " On arrival, he points out his flat tire and

asks EMS to fix it.

One of the people present said, " Y'all should have told him you'd fix it, but it

would cost him $2,000. "

Somebody else said they should have defibrillated his tire, called medical

control, and pronounced it.

Best,

GG

In a message dated 2/21/2005 1:09:14 PM Eastern Standard Time, " Brown "

writes:

>

>Bunches.....personally I have a few ROSCs that didn't have 2 minutes to

>give, and just because you've decided that trauma patients have more time

>than we once thought doesn't ever mean that taking our time to the ED is a

>good idea. While the actual, literal number of optimal minutes that a trauma

>patient has to recieve definitive surgery is speculative, I doubt that it

>can be proven that granting a GSW to the chest or a fractured liver patient

>an additional 15 minutes tooling along through town is the proper treatment.

>If I had your kid in my rig with serious internal injuries from an accident,

>and it took me 30 minutes pooting around stuck in traffic to deliver them to

>a trauma surgeon, I sincerely doubt that you'd be out in the ambulance dock

>congratulating me on a great job because I spent an additional 20 minutes

>getting to the ER because " We now know that trauma patients have more time

>than we once thought. "

>

>magnetass sends

> Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR.  We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options.  For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Let's look at Princess 's case, shall we? She was " stabilized " in the

ambulance and then driven slowly, ever so slowly, to the hospital. All the time

she was bleeding out into her chest cavity from a lac that probably could have

been fixed. OK. Now, so much for " stabilization " of trauma patients in the

field. We know it doesn't happen.

However, can't there be a happy medium? For her, dawdling around possibly

allowed her to die, and it can be argued reasonably that rapid but safe

transport to a trauma facility (there are none of them in Paris, I understand)

could have saved her.

On the other hand, rapid but safe grounding vs. helo txp across Paris would have

made great sense, and helo use no sense whatsoever. Hell, the thing probably

would have run into the Eiffel Tower just across the way anyway.

We all need a hard look at reality. We function upon so many myths and folk

notions that have grown up with our profession. We need to shuck the myths and

look at just what it is that we do that is genuinely important and helpful.

We know about defibrillation. But we also need to look at airway management.

Airway management, and related respiratory problem management is one place where

we can shine and we DO make a difference. Since I specialize in airway

management issues, this stands out to me as being a place where we can tout our

importance to the community.

I am grouping all conditions that involve airway, such as acute onset pulmonary

edema secondary to left heart failure, COPD crises, asthma crises, anaphalyxis,

drug overdoses, all cases of diminished LOC where a patent airway is not

assured, and those rare cases involving true airway obstruction where only a

surgical airway will work.

As we plan deployment of resources, it seems to me that we need to focus on

those areas that we know we make a difference in.

That said, change of topic:

Today I heard a new one. 911 gets a call to a rural area on a highway where the

caller simply says " I need help. " On arrival, he points out his flat tire and

asks EMS to fix it.

One of the people present said, " Y'all should have told him you'd fix it, but it

would cost him $2,000. "

Somebody else said they should have defibrillated his tire, called medical

control, and pronounced it.

Best,

GG

In a message dated 2/21/2005 1:09:14 PM Eastern Standard Time, " Brown "

writes:

>

>Bunches.....personally I have a few ROSCs that didn't have 2 minutes to

>give, and just because you've decided that trauma patients have more time

>than we once thought doesn't ever mean that taking our time to the ED is a

>good idea. While the actual, literal number of optimal minutes that a trauma

>patient has to recieve definitive surgery is speculative, I doubt that it

>can be proven that granting a GSW to the chest or a fractured liver patient

>an additional 15 minutes tooling along through town is the proper treatment.

>If I had your kid in my rig with serious internal injuries from an accident,

>and it took me 30 minutes pooting around stuck in traffic to deliver them to

>a trauma surgeon, I sincerely doubt that you'd be out in the ambulance dock

>congratulating me on a great job because I spent an additional 20 minutes

>getting to the ER because " We now know that trauma patients have more time

>than we once thought. "

>

>magnetass sends

> Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR.  We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options.  For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Let's look at Princess 's case, shall we? She was " stabilized " in the

ambulance and then driven slowly, ever so slowly, to the hospital. All the time

she was bleeding out into her chest cavity from a lac that probably could have

been fixed. OK. Now, so much for " stabilization " of trauma patients in the

field. We know it doesn't happen.

However, can't there be a happy medium? For her, dawdling around possibly

allowed her to die, and it can be argued reasonably that rapid but safe

transport to a trauma facility (there are none of them in Paris, I understand)

could have saved her.

On the other hand, rapid but safe grounding vs. helo txp across Paris would have

made great sense, and helo use no sense whatsoever. Hell, the thing probably

would have run into the Eiffel Tower just across the way anyway.

We all need a hard look at reality. We function upon so many myths and folk

notions that have grown up with our profession. We need to shuck the myths and

look at just what it is that we do that is genuinely important and helpful.

We know about defibrillation. But we also need to look at airway management.

Airway management, and related respiratory problem management is one place where

we can shine and we DO make a difference. Since I specialize in airway

management issues, this stands out to me as being a place where we can tout our

importance to the community.

I am grouping all conditions that involve airway, such as acute onset pulmonary

edema secondary to left heart failure, COPD crises, asthma crises, anaphalyxis,

drug overdoses, all cases of diminished LOC where a patent airway is not

assured, and those rare cases involving true airway obstruction where only a

surgical airway will work.

As we plan deployment of resources, it seems to me that we need to focus on

those areas that we know we make a difference in.

That said, change of topic:

Today I heard a new one. 911 gets a call to a rural area on a highway where the

caller simply says " I need help. " On arrival, he points out his flat tire and

asks EMS to fix it.

One of the people present said, " Y'all should have told him you'd fix it, but it

would cost him $2,000. "

Somebody else said they should have defibrillated his tire, called medical

control, and pronounced it.

Best,

GG

In a message dated 2/21/2005 1:09:14 PM Eastern Standard Time, " Brown "

writes:

>

>Bunches.....personally I have a few ROSCs that didn't have 2 minutes to

>give, and just because you've decided that trauma patients have more time

>than we once thought doesn't ever mean that taking our time to the ED is a

>good idea. While the actual, literal number of optimal minutes that a trauma

>patient has to recieve definitive surgery is speculative, I doubt that it

>can be proven that granting a GSW to the chest or a fractured liver patient

>an additional 15 minutes tooling along through town is the proper treatment.

>If I had your kid in my rig with serious internal injuries from an accident,

>and it took me 30 minutes pooting around stuck in traffic to deliver them to

>a trauma surgeon, I sincerely doubt that you'd be out in the ambulance dock

>congratulating me on a great job because I spent an additional 20 minutes

>getting to the ER because " We now know that trauma patients have more time

>than we once thought. "

>

>magnetass sends

> Re: Tragic Crash Kills 3 of our Best.

>>

>>

>>>

>>> I appreciate your thoughts...but one of the things our Medical

>>> Director is looking as is the need to transport while doing CPR.  We

>>> are analyzing and evaluating every patient we transport to the

>>> hospital with CPR in progress to see if we had other options.  For

>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with no

>>> reversable causes and the patient is as dead after our treatment as

>>> they were before we arrived...what magic pill is the ED going to

>>> deliver after another 15 to 20 minutes of getting them there???

>>>

>>> Now, if we are having results and we just cannot keep the patient in

>>> ROSC consistantly...those are the ones we are evaluating to see what

>>> we can supplement our care with so that the need to " rush like

>>> mad-men " to the ED can be even further minimalized...we are making

>>> great strides...when I got here 4 years ago we ran over 50% of our

>>> patients emergency to the hospital...now we are doing less than 10%....

>>>

>>> Now, if we can just get our dispatch issues corrected and we can start

>>> minimilizing the number of times we respond emergency as well....

>>>

>>> Keep safe,

>>>

>>> Dudley

>>>

>>>

>>>

>>>

>>>

[Guest guest]

I give up...... :~)

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

So, I pack some Benedryl, epi and Albuterol in my go bag, load the heart

start in my truck and I'm off to save lives huh?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>

>>>>

>>>>>

>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>> Director is looking as is the need to transport while doing CPR.

>>>>> We are analyzing and evaluating every patient we transport to the

>>>>> hospital with CPR in progress to see if we had other options. For

>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>> no reversable causes and the patient is as dead after our treatment

>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>

>>>>> Now, if we are having results and we just cannot keep the patient

>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>> what we can supplement our care with so that the need to " rush like

>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>> patients emergency to the hospital...now we are doing less than

>>>>> 10%....

>>>>>

>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>> start minimilizing the number of times we respond emergency as

>>>>> well....

>>>>>

>>>>> Keep safe,

>>>>>

>>>>> Dudley

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

[Guest guest]

I give up...... :~)

E. Bledsoe, DO, FACEP

Midlothian, TX

Don't miss EMStock 2005 (http://www.EMStock.com)

Re: Tragic Crash Kills 3 of our Best.

So, I pack some Benedryl, epi and Albuterol in my go bag, load the heart

start in my truck and I'm off to save lives huh?

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>

>>>>

>>>>>

>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>> Director is looking as is the need to transport while doing CPR.

>>>>> We are analyzing and evaluating every patient we transport to the

>>>>> hospital with CPR in progress to see if we had other options. For

>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>> no reversable causes and the patient is as dead after our treatment

>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>

>>>>> Now, if we are having results and we just cannot keep the patient

>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>> what we can supplement our care with so that the need to " rush like

>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>> patients emergency to the hospital...now we are doing less than

>>>>> 10%....

>>>>>

>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>> start minimilizing the number of times we respond emergency as

>>>>> well....

>>>>>

>>>>> Keep safe,

>>>>>

>>>>> Dudley

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

[Guest guest]

OK, I'm just reading the studies YOU posted that basically prove that

everything we do in EMS with the exception of asthma and anaphylazis is of

little or no clinical value and makes no identifiable difference in patient

mortality. Don't become exasperated because I believe you.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>>

>>>>>

>>>>>>

>>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>>> Director is looking as is the need to transport while doing CPR.

>>>>>> We are analyzing and evaluating every patient we transport to the

>>>>>> hospital with CPR in progress to see if we had other options. For

>>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>>> no reversable causes and the patient is as dead after our treatment

>>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>>

>>>>>> Now, if we are having results and we just cannot keep the patient

>>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>>> what we can supplement our care with so that the need to " rush like

>>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>>> patients emergency to the hospital...now we are doing less than

>>>>>> 10%....

>>>>>>

>>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>>> start minimilizing the number of times we respond emergency as

>>>>>> well....

>>>>>>

>>>>>> Keep safe,

>>>>>>

>>>>>> Dudley

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

[Guest guest]

OK, I'm just reading the studies YOU posted that basically prove that

everything we do in EMS with the exception of asthma and anaphylazis is of

little or no clinical value and makes no identifiable difference in patient

mortality. Don't become exasperated because I believe you.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>>

>>>>>

>>>>>>

>>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>>> Director is looking as is the need to transport while doing CPR.

>>>>>> We are analyzing and evaluating every patient we transport to the

>>>>>> hospital with CPR in progress to see if we had other options. For

>>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>>> no reversable causes and the patient is as dead after our treatment

>>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>>

>>>>>> Now, if we are having results and we just cannot keep the patient

>>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>>> what we can supplement our care with so that the need to " rush like

>>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>>> patients emergency to the hospital...now we are doing less than

>>>>>> 10%....

>>>>>>

>>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>>> start minimilizing the number of times we respond emergency as

>>>>>> well....

>>>>>>

>>>>>> Keep safe,

>>>>>>

>>>>>> Dudley

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

[Guest guest]

OK, I'm just reading the studies YOU posted that basically prove that

everything we do in EMS with the exception of asthma and anaphylazis is of

little or no clinical value and makes no identifiable difference in patient

mortality. Don't become exasperated because I believe you.

magnetass sends

Re: Tragic Crash Kills 3 of our Best.

>>>>>

>>>>>

>>>>>>

>>>>>> I appreciate your thoughts...but one of the things our Medical

>>>>>> Director is looking as is the need to transport while doing CPR.

>>>>>> We are analyzing and evaluating every patient we transport to the

>>>>>> hospital with CPR in progress to see if we had other options. For

>>>>>> instance, if we sit on scene for 25 or 30 minutes doing ACLS with

>>>>>> no reversable causes and the patient is as dead after our treatment

>>>>>> as they were before we arrived...what magic pill is the ED going to

>>>>>> deliver after another 15 to 20 minutes of getting them there???

>>>>>>

>>>>>> Now, if we are having results and we just cannot keep the patient

>>>>>> in ROSC consistantly...those are the ones we are evaluating to see

>>>>>> what we can supplement our care with so that the need to " rush like

>>>>>> mad-men " to the ED can be even further minimalized...we are making

>>>>>> great strides...when I got here 4 years ago we ran over 50% of our

>>>>>> patients emergency to the hospital...now we are doing less than

>>>>>> 10%....

>>>>>>

>>>>>> Now, if we can just get our dispatch issues corrected and we can

>>>>>> start minimilizing the number of times we respond emergency as

>>>>>> well....

>>>>>>

>>>>>> Keep safe,

>>>>>>

>>>>>> Dudley

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>