Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 From: [mailto: ] On >>I can't seem to use the word " not " today (Freudian?) No comment..... >>Should have read, " Also, if your patient is in pain, you are not treating >>them properly. " Amen Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 From: [mailto: ] On >>I can't seem to use the word " not " today (Freudian?) No comment..... >>Should have read, " Also, if your patient is in pain, you are not treating >>them properly. " Amen Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 You have to first get on the scene and call the helicopter and then wait. Leaving Cleburne, you would be halfway up 67 to Dallas before the helicopter arrived at the scene. Besides, the case that was mentioned (leg burns on a 10-year-old) may not have met burn center criteria. Re: Re: Closest vs. Most Appropriate Facility > > He also did not tell you that it saves and hour and the pt receives care from a burn center not an er md who may or may not be up on the latest treatment for burns. > > > ---------------------------------------------------------------------------- ---- > > Closest vs. Most Appropriate Facility > > > > > > Does any one have any research on Closest vs. Most appropriate > facility? > > Should patients be transported to the facility more capable of > > addressing their illness \ injury even though there is a much closer > > facility that will only begin treatment, many times available on the > > ambulance, then transfer out to the other facility hours later? If so > > what criteria should they meet to justify the bypass? I have my own > > opinion but have not seen any studies, thanks in advance. > > > > Drew Bohn NREMT-P > > Operations Training Officer > > Orange County Ambulance Service inc. > > Orange, Texas > > <mailto:drewbohn@o...> drewbohn@o... > > <mailto:dbohn@g...> dbohn@g... > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 You have to first get on the scene and call the helicopter and then wait. Leaving Cleburne, you would be halfway up 67 to Dallas before the helicopter arrived at the scene. Besides, the case that was mentioned (leg burns on a 10-year-old) may not have met burn center criteria. Re: Re: Closest vs. Most Appropriate Facility > > He also did not tell you that it saves and hour and the pt receives care from a burn center not an er md who may or may not be up on the latest treatment for burns. > > > ---------------------------------------------------------------------------- ---- > > Closest vs. Most Appropriate Facility > > > > > > Does any one have any research on Closest vs. Most appropriate > facility? > > Should patients be transported to the facility more capable of > > addressing their illness \ injury even though there is a much closer > > facility that will only begin treatment, many times available on the > > ambulance, then transfer out to the other facility hours later? If so > > what criteria should they meet to justify the bypass? I have my own > > opinion but have not seen any studies, thanks in advance. > > > > Drew Bohn NREMT-P > > Operations Training Officer > > Orange County Ambulance Service inc. > > Orange, Texas > > <mailto:drewbohn@o...> drewbohn@o... > > <mailto:dbohn@g...> dbohn@g... > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 You have to first get on the scene and call the helicopter and then wait. Leaving Cleburne, you would be halfway up 67 to Dallas before the helicopter arrived at the scene. Besides, the case that was mentioned (leg burns on a 10-year-old) may not have met burn center criteria. Re: Re: Closest vs. Most Appropriate Facility > > He also did not tell you that it saves and hour and the pt receives care from a burn center not an er md who may or may not be up on the latest treatment for burns. > > > ---------------------------------------------------------------------------- ---- > > Closest vs. Most Appropriate Facility > > > > > > Does any one have any research on Closest vs. Most appropriate > facility? > > Should patients be transported to the facility more capable of > > addressing their illness \ injury even though there is a much closer > > facility that will only begin treatment, many times available on the > > ambulance, then transfer out to the other facility hours later? If so > > what criteria should they meet to justify the bypass? I have my own > > opinion but have not seen any studies, thanks in advance. > > > > Drew Bohn NREMT-P > > Operations Training Officer > > Orange County Ambulance Service inc. > > Orange, Texas > > <mailto:drewbohn@o...> drewbohn@o... > > <mailto:dbohn@g...> dbohn@g... > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 If I am in Cleburne Texas and I am burned, Parkland is about 1 hr 10 min without traffic by ground and about a 25-30 min by air, I believe that the answer is obvious, regardless of the cost / risk involved the benifit of the higher level of care would be a benifit to the patient.>>> KN: Flymedic1 (if that IS your real name,) I believe that critical and even serious burns should be treated long-term at burn centers and Parkland is an excellent one. If you would save 40 minutes by flying a patient from where you are as opposed to driving them, my question would be, " Does that 40-minute time savings influence the morbidity and mortality of the burn patient? " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? >>> So, If I was not transported to the Burn center by ground initally.... then If I am lucky, I am admitted to the burn ward 4-6 hours after my injury ??? Ehat is the best for the patient.>>> KN: I would suggest that perhaps the advantages of being at a burn center do not come in the first few hours. Burn centers shine in their long term care of the patient. Any reasonably intelligent physician in a reasonably equipped emergency room can (in my opinion) manage the burn patient as well as the ER at Parkland. (I actually believe any reasonably intelligent paramedic should be able to do it as well.) >>> I would suggest that being a Paramedic in the field, on every patient that you see you ask your self this question. " What would I ant if this were me, my wife,child,mother,father,grandmother or grandfather? " >>> KN: My step-father suffered second and third degree burns over 60% of his body near Cleburne and was driven to Parkland. I sustained second and third degree burns over 37% of my body in a small town south of Dallas. I was driven by ambulance to Parkland. If I had it to do over I wouldn't change a thing, (except for the getting burned part.) What I want for my family is for medical care providers to provide care based on science, not on myths. Kenny Navarro UT Southwestern Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 If I am in Cleburne Texas and I am burned, Parkland is about 1 hr 10 min without traffic by ground and about a 25-30 min by air, I believe that the answer is obvious, regardless of the cost / risk involved the benifit of the higher level of care would be a benifit to the patient.>>> KN: Flymedic1 (if that IS your real name,) I believe that critical and even serious burns should be treated long-term at burn centers and Parkland is an excellent one. If you would save 40 minutes by flying a patient from where you are as opposed to driving them, my question would be, " Does that 40-minute time savings influence the morbidity and mortality of the burn patient? " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? >>> So, If I was not transported to the Burn center by ground initally.... then If I am lucky, I am admitted to the burn ward 4-6 hours after my injury ??? Ehat is the best for the patient.>>> KN: I would suggest that perhaps the advantages of being at a burn center do not come in the first few hours. Burn centers shine in their long term care of the patient. Any reasonably intelligent physician in a reasonably equipped emergency room can (in my opinion) manage the burn patient as well as the ER at Parkland. (I actually believe any reasonably intelligent paramedic should be able to do it as well.) >>> I would suggest that being a Paramedic in the field, on every patient that you see you ask your self this question. " What would I ant if this were me, my wife,child,mother,father,grandmother or grandfather? " >>> KN: My step-father suffered second and third degree burns over 60% of his body near Cleburne and was driven to Parkland. I sustained second and third degree burns over 37% of my body in a small town south of Dallas. I was driven by ambulance to Parkland. If I had it to do over I wouldn't change a thing, (except for the getting burned part.) What I want for my family is for medical care providers to provide care based on science, not on myths. Kenny Navarro UT Southwestern Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 If I am in Cleburne Texas and I am burned, Parkland is about 1 hr 10 min without traffic by ground and about a 25-30 min by air, I believe that the answer is obvious, regardless of the cost / risk involved the benifit of the higher level of care would be a benifit to the patient.>>> KN: Flymedic1 (if that IS your real name,) I believe that critical and even serious burns should be treated long-term at burn centers and Parkland is an excellent one. If you would save 40 minutes by flying a patient from where you are as opposed to driving them, my question would be, " Does that 40-minute time savings influence the morbidity and mortality of the burn patient? " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? >>> So, If I was not transported to the Burn center by ground initally.... then If I am lucky, I am admitted to the burn ward 4-6 hours after my injury ??? Ehat is the best for the patient.>>> KN: I would suggest that perhaps the advantages of being at a burn center do not come in the first few hours. Burn centers shine in their long term care of the patient. Any reasonably intelligent physician in a reasonably equipped emergency room can (in my opinion) manage the burn patient as well as the ER at Parkland. (I actually believe any reasonably intelligent paramedic should be able to do it as well.) >>> I would suggest that being a Paramedic in the field, on every patient that you see you ask your self this question. " What would I ant if this were me, my wife,child,mother,father,grandmother or grandfather? " >>> KN: My step-father suffered second and third degree burns over 60% of his body near Cleburne and was driven to Parkland. I sustained second and third degree burns over 37% of my body in a small town south of Dallas. I was driven by ambulance to Parkland. If I had it to do over I wouldn't change a thing, (except for the getting burned part.) What I want for my family is for medical care providers to provide care based on science, not on myths. Kenny Navarro UT Southwestern Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 -- " Kenny Navarro " wrote: " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? " When your transport is from a REAL rural area (Chinle AZ, Navajo Nation)and it is 1.5 - 2 hours by fixed wing turbo-prop to PHX or 2-2.5 hours to either SLC or ABQ (with a 15-20 ground transport from the airport to the receiving hospital in any case), compared to ground transports of anywhere from 6-10 hours, then yes, air evacuation makes sense. (Fixed wing is safer than rotary) Under those circumstances, the patient arrives in better condition than by ground, but the long term survival, when compared, is unknown. " Money can buy you a fine dog, but only love can make him wag his tail. " - Kinky Friedman Larry RN LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 -- " Kenny Navarro " wrote: " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? " When your transport is from a REAL rural area (Chinle AZ, Navajo Nation)and it is 1.5 - 2 hours by fixed wing turbo-prop to PHX or 2-2.5 hours to either SLC or ABQ (with a 15-20 ground transport from the airport to the receiving hospital in any case), compared to ground transports of anywhere from 6-10 hours, then yes, air evacuation makes sense. (Fixed wing is safer than rotary) Under those circumstances, the patient arrives in better condition than by ground, but the long term survival, when compared, is unknown. " Money can buy you a fine dog, but only love can make him wag his tail. " - Kinky Friedman Larry RN LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 -- " Kenny Navarro " wrote: " The evidence seems to suggest that the patient would do as well if the transport was provided by a ground ambulance rather than by helicopter. If there are no survival benefits to air transport, then why do it? " When your transport is from a REAL rural area (Chinle AZ, Navajo Nation)and it is 1.5 - 2 hours by fixed wing turbo-prop to PHX or 2-2.5 hours to either SLC or ABQ (with a 15-20 ground transport from the airport to the receiving hospital in any case), compared to ground transports of anywhere from 6-10 hours, then yes, air evacuation makes sense. (Fixed wing is safer than rotary) Under those circumstances, the patient arrives in better condition than by ground, but the long term survival, when compared, is unknown. " Money can buy you a fine dog, but only love can make him wag his tail. " - Kinky Friedman Larry RN LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2005 Report Share Posted May 2, 2005 " It delays definitive care by at least an hour or more, which places these patients in grave jeopardy (time is muscle) and unduly stresses them with another ambulance ride " Unless you are a cardiologist who refers your patients to facilities with diagnostic capability only. A " routine " or " it's not your heart " or " just to be sure, we won't find anything " precedure results in a Code 3 or helicopter response to transfer the patient to a TRUE cardiac capable hospital. It brings up one of my favorite sayings " Lack of planning on your part does not constitute an emergency on mine. " I bypass those hospitals not because of protocol, but because of common sense. Eddie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I thought well versed should be " well-versed " so it does not look like well lorazepam. This e-mail is confidential and intended solely for the use of the individual (s) to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent those of Baylor Grapevine EMS Medical control or Baylor Health Care System or its policies. If you have received this e-mail message in error, please phone (817)329-4015. Please also destroy and delete the message from your computer. B. , AAS, LP Baylor Regional Medical Center at Grapevine EMS Educator Baylor EMS Medical Control 1601 Lancaster Drive Suite #10 Grapevine, Tx 76051-3300 Office Direct Line Fax Cell Pager Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I thought well versed should be " well-versed " so it does not look like well lorazepam. This e-mail is confidential and intended solely for the use of the individual (s) to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent those of Baylor Grapevine EMS Medical control or Baylor Health Care System or its policies. If you have received this e-mail message in error, please phone (817)329-4015. Please also destroy and delete the message from your computer. B. , AAS, LP Baylor Regional Medical Center at Grapevine EMS Educator Baylor EMS Medical Control 1601 Lancaster Drive Suite #10 Grapevine, Tx 76051-3300 Office Direct Line Fax Cell Pager Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I thought well versed should be " well-versed " so it does not look like well lorazepam. This e-mail is confidential and intended solely for the use of the individual (s) to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent those of Baylor Grapevine EMS Medical control or Baylor Health Care System or its policies. If you have received this e-mail message in error, please phone (817)329-4015. Please also destroy and delete the message from your computer. B. , AAS, LP Baylor Regional Medical Center at Grapevine EMS Educator Baylor EMS Medical Control 1601 Lancaster Drive Suite #10 Grapevine, Tx 76051-3300 Office Direct Line Fax Cell Pager Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 You mean midazolam? E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 You mean midazolam? E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 You mean midazolam? E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 Whoops. At least I got the class of drug correct. This e-mail is confidential and intended solely for the use of the individual (s) to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent those of Baylor Grapevine EMS Medical control or Baylor Health Care System or its policies. If you have received this e-mail message in error, please phone (817)329-4015. Please also destroy and delete the message from your computer. B. , AAS, LP Baylor Regional Medical Center at Grapevine EMS Educator Baylor EMS Medical Control 1601 Lancaster Drive Suite #10 Grapevine, Tx 76051-3300 Office Direct Line Fax Cell Pager Re: Re: Closest vs. Most Appropriate Facility sir you are not living in the real world it takes an hour for a or more to get the pt to the local hospital then he has a wait time if he is breathing of an indefinite time then he is evaluated and the transfer process begins that takes from 2 two 24 hours and he ends up in the burn center any way. Yes hours that we have no control over unless we transport by air and this removes the pt from some not so well versed dr who insist on treating things as they were done 50 years ago also not under our control. No matter how much pain treatment is given it does not remove the hours of mental anguish the pt and his/her family goes through. ------------------------------------------------------------------------ ---- ---- Re: Closest vs. Most Appropriate Facility > The burn center here is more than 100 miles away that is why we fly burn pts from here. I allows them to receive definitive burn care hours faster.... >>> What " definitive " burn care are you talking about? Kenny Navarro UT Southwestern Medical Center at Dallas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 Not all helicopters have 30-40 min response times. We have four helicopters 10 min or less from anywhere in our district Where as we are 45 min to the nearest burn center and over an hour from the second burn center...I agree with what was stated earlier the decision to fly or ground transport should be left up to the incharge and the patient > > > Why would you fly a burn patient? Will it make their burn better? > > > > > > > > > E. Bledsoe, DO, FACEP > > > Midlothian, TX > > > > > > Don't miss EMStock 2005 (http://www.EMStock.com) > > > > > > Re: Closest vs. Most Appropriate Facility > > > > > > What does the law say about this? I got into an argument with my LP > > partner > > > about this subject.He said he would take an adult code to children's > > medical > > > center if it was the closest facility. (in the scenario, I said that > > > children's and parkland weren't next door, that children's was the > > closest > > > facility but a regular adult ER was another 5mins down the road). > > > > > > He also said that if we had a burn pt, I said if they had second > degree > > > burns to 36% (both legs) if he would go to medical center at > > Lancaster (our > > > closest facility), or Parkland. I said that the weather was bad or > > > something, no bird available so we would trans. by ground, and he > > said that > > > he would go to MCAL. > > > > > > We run an MICU, I am a basic and my partner is an LP. > > > > > > I think he is in the wrong, but what does the LAW say? > > > > > > Red > > > Closest vs. Most Appropriate Facility > > > > > > > > > Does any one have any research on Closest vs. Most appropriate > > facility? > > > Should patients be transported to the facility more capable of > > > addressing their illness \ injury even though there is a much closer > > > facility that will only begin treatment, many times available on the > > > ambulance, then transfer out to the other facility hours later? If > so > > > what criteria should they meet to justify the bypass? I have my own > > > opinion but have not seen any studies, thanks in advance. > > > > > > Drew Bohn NREMT-P > > > Operations Training Officer > > > Orange County Ambulance Service inc. > > > Orange, Texas > > > <mailto:drewbohn@o...> drewbohn@o... > > > <mailto:dbohn@g...> dbohn@g... > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 Not all helicopters have 30-40 min response times. We have four helicopters 10 min or less from anywhere in our district Where as we are 45 min to the nearest burn center and over an hour from the second burn center...I agree with what was stated earlier the decision to fly or ground transport should be left up to the incharge and the patient > > > Why would you fly a burn patient? Will it make their burn better? > > > > > > > > > E. Bledsoe, DO, FACEP > > > Midlothian, TX > > > > > > Don't miss EMStock 2005 (http://www.EMStock.com) > > > > > > Re: Closest vs. Most Appropriate Facility > > > > > > What does the law say about this? I got into an argument with my LP > > partner > > > about this subject.He said he would take an adult code to children's > > medical > > > center if it was the closest facility. (in the scenario, I said that > > > children's and parkland weren't next door, that children's was the > > closest > > > facility but a regular adult ER was another 5mins down the road). > > > > > > He also said that if we had a burn pt, I said if they had second > degree > > > burns to 36% (both legs) if he would go to medical center at > > Lancaster (our > > > closest facility), or Parkland. I said that the weather was bad or > > > something, no bird available so we would trans. by ground, and he > > said that > > > he would go to MCAL. > > > > > > We run an MICU, I am a basic and my partner is an LP. > > > > > > I think he is in the wrong, but what does the LAW say? > > > > > > Red > > > Closest vs. Most Appropriate Facility > > > > > > > > > Does any one have any research on Closest vs. Most appropriate > > facility? > > > Should patients be transported to the facility more capable of > > > addressing their illness \ injury even though there is a much closer > > > facility that will only begin treatment, many times available on the > > > ambulance, then transfer out to the other facility hours later? If > so > > > what criteria should they meet to justify the bypass? I have my own > > > opinion but have not seen any studies, thanks in advance. > > > > > > Drew Bohn NREMT-P > > > Operations Training Officer > > > Orange County Ambulance Service inc. > > > Orange, Texas > > > <mailto:drewbohn@o...> drewbohn@o... > > > <mailto:dbohn@g...> dbohn@g... > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I still have many more letters to read on this subject but Mr. Hatfield does come up with a well thought out note. I just don't agree totally with his thoughts. I have always supported the Bledsoe Theory on helicopter's in prehospital settings. I watch a service locally that flies any and every non-qualified medical or injury patient daily because they also own the helicopter service. It's use of medical forethought is ridiculous. Keeps my medical insurance premiums at a high rate and totally distorts the reason we flew victims out of the rice patties in Viet Nam. In this area however, we have the UTMB burn center less than 35 minutes away by air and 2 hours by ground if the ferry has not just left the dock when you arrive. We do excellent triage in the field, secure the airways, give analgesics and get them there about the same time it takes to get to the local hospital by ground. Are helicopters overused? Yes!!!!! Do the local hospitals give good definitive care. Yes, if there is a life threatening reason to stop there. Is the Golden Hour overrated? Yes!!!!! in some cases and I feel that severe burns are not one of those. I try to make myself the patient in this case and I feel that I would rather be flown immediately to Galveston than stop at the local hospital and see my friends. Just color me crazy. Andy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I still have many more letters to read on this subject but Mr. Hatfield does come up with a well thought out note. I just don't agree totally with his thoughts. I have always supported the Bledsoe Theory on helicopter's in prehospital settings. I watch a service locally that flies any and every non-qualified medical or injury patient daily because they also own the helicopter service. It's use of medical forethought is ridiculous. Keeps my medical insurance premiums at a high rate and totally distorts the reason we flew victims out of the rice patties in Viet Nam. In this area however, we have the UTMB burn center less than 35 minutes away by air and 2 hours by ground if the ferry has not just left the dock when you arrive. We do excellent triage in the field, secure the airways, give analgesics and get them there about the same time it takes to get to the local hospital by ground. Are helicopters overused? Yes!!!!! Do the local hospitals give good definitive care. Yes, if there is a life threatening reason to stop there. Is the Golden Hour overrated? Yes!!!!! in some cases and I feel that severe burns are not one of those. I try to make myself the patient in this case and I feel that I would rather be flown immediately to Galveston than stop at the local hospital and see my friends. Just color me crazy. Andy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 I still have many more letters to read on this subject but Mr. Hatfield does come up with a well thought out note. I just don't agree totally with his thoughts. I have always supported the Bledsoe Theory on helicopter's in prehospital settings. I watch a service locally that flies any and every non-qualified medical or injury patient daily because they also own the helicopter service. It's use of medical forethought is ridiculous. Keeps my medical insurance premiums at a high rate and totally distorts the reason we flew victims out of the rice patties in Viet Nam. In this area however, we have the UTMB burn center less than 35 minutes away by air and 2 hours by ground if the ferry has not just left the dock when you arrive. We do excellent triage in the field, secure the airways, give analgesics and get them there about the same time it takes to get to the local hospital by ground. Are helicopters overused? Yes!!!!! Do the local hospitals give good definitive care. Yes, if there is a life threatening reason to stop there. Is the Golden Hour overrated? Yes!!!!! in some cases and I feel that severe burns are not one of those. I try to make myself the patient in this case and I feel that I would rather be flown immediately to Galveston than stop at the local hospital and see my friends. Just color me crazy. Andy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2005 Report Share Posted May 3, 2005 In a message dated 5/2/2005 5:19:37 P.M. Central Standard Time, bbledsoe@... writes: You have to first get on the scene and call the helicopter and then wait. Leaving Cleburne, you would be halfway up 67 to Dallas before the helicopter arrived at the scene. Besides, the case that was mentioned (leg burns on a 10-year-old) may not have met burn center criteria. Andy Replies: Then in your case it would not have been a good thing to fly, right? Gosh, it's a no-brainer and someone actually made the point. How bad the burn, how close the hospital by ground, and how close the helicopter to burn center. Get out of the all or nothing state of mind and start thinking about the patient, not how bad you hate the frigging helicopter services. Quote Link to comment Share on other sites More sharing options...
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