Comments for Medic 22

Comment on Boxed Doc by James

James — Tue, 13 Dec 2011 05:08:11 +0000

People are plain lazy. It definitely is tiring to answer every call, when there really aren’t any emergency.

Back where I’m from. We’ve would just give those guys a boot in their behind.

Comment on Post bird. by michael

michael — Sat, 26 Nov 2011 15:10:53 +0000

Ahhh, the joy of working the holidays! It sure ain’t like the TV shows I used to watch, when kind old neighbors brought cookies to the firehouse and they sang Silent Night. Silent Night? Ha!!!

Comment on Need the bird? by BH

BH — Mon, 21 Nov 2011 13:57:54 +0000

30 minutes for the bird to even arrive vs 40 minutes by ground is a no-brainer- I can’t even believe there’s a debate about this.

The fly boys will always try to justify themselves with the current over-saturation of flight services in many areas, but don’t let them talk you (speaking to the readership in general) into making stupid decisions based on zero evidence of benefit.

Comment on Need the bird? by BigWoodsMedic

BigWoodsMedic — Sun, 30 Oct 2011 22:12:00 +0000

I have to agree with this after reading articles and blogs about this subject. Lately I more often ride the 20-40 ground minutes to a L 1 trauma center, or in poor weather go by ground to a smaller hospital that can stabilize the pt and arrange transport if needed. I will always fly severe burns because the nearest center is 2 hours away. It’s very regional for everyone with distances to resources, and such things must be considered for each call that meets rapid transport criteria. But I try to instill it in my students to consider the time between the “helo can be here in X minutes.”

Comment on Need the bird? by David

David — Sun, 30 Oct 2011 17:12:02 +0000

“At no point in this discussion did anyone ask for any clinical information about the patient I presented, choosing only to armchair quarterback the call based on a transport decision.”

You stated in the article that “On the initial assessment it’s obvious that this 23 year old female patient has severe chest trauma and will most likely need to be intubated as soon as the extrication is performed.” That would be clinical information, yes?

This is a hot topic in the world of EMS, not only operationally but in the world of reimbursement (my primary domain currently). At the end of the day, ground and air crews should make the best (clinical) decision that will be in the patient’s best interest.

These discussions do need to occur. Unfortunately, many ground providers are not aware of what all is involved in getting an aircraft off the ground (weather clearance, aircraft start up, etc.). As such, these things are not taken into consideration.

Our overall focus needs to be the transport of a patient to the closest appropriate facility that can provide the definitive care the patient needs; a focus on that priority, paired with knowledge of the actual capabilities of air medical providers, will help ground providers make the appropriate decision.

Comment on Need the bird? by Medic22

Medic22 — Sun, 30 Oct 2011 11:07:07 +0000

Rather than offer anecdotal evidence, take a look at a summation of HEMS vs. Ground research. There is a nicely detailed annotated review of HEMS studies at http://cctcore.org/documents/HEMS%20Outcomes%20Literature%202004%20to%202006.pdf
As I mentioned several times previously, there are several instances when it is appropriate to fly a patient. Some of those include head injury, burns, an acute medical condition outside an acceptable ground transport window and multisystem trauma with prolonged extrication. In simple trauma calls, when attended by ALS, ground vs. HEMS has no appreciable increase in survival to discharge.
I specifically left the scenario I presented vague, with no patient information presented, aside from the initial impression, as to gauge the opinion of the readers. As I expected, there were opinions expressed by both sides, those that are proponents of scene to trauma center HEMS and those that feel as if HEMS is over utilized. At no point in this discussion did anyone ask for any clinical information about the patient I presented, choosing only to armchair quarterback the call based on a transport decision.

Comment on Need the bird? by Air 3/M38

Air 3/M38 — Sun, 30 Oct 2011 02:44:23 +0000

@ Kevin I still work over 1000 hours a year in the ground and teach my students never to forget where they come from. Make decisions based on patient care and what is in their best interest. I love being a Medic and I love working on the ground and in the Air.

Comment on Need the bird? by Air 3

Air 3 — Sun, 30 Oct 2011 02:36:29 +0000

Again many opinions about air transportation are based not on education but a misconception of air transport capabilities. Contrary to popular belief aircraft can fly in the rain as long as visibility is within FAA minimums. Which change based on day, night, local area, terrain, etc. let the professional make those decisions. As far as your Blog by all means you are correct it is yours, but in our profession wouldn’t you agree that to be an informative educational article we should all be providing data based on hard facts and not opinion? An if based on our personal perceptions or opinions shouldn’t that be mentioned as an opinion of the writer? It take experiance and maturity to acknowledge that you may have mispoke based on lack of experiance mr m22. But if you are going to blatantly tell someone they are “wrong” provide factual information so that we may all benefit from your research and experiance, instead of possibly misleading others with our opinions. I have been incorrect on more occasions than I can remember but didn’t learn a thing until recognized my own short comings on the particular subjects. Become a credible source and you will gain quality followers to your blog. Ie people following to learn from your experiance and not your opinions.

Comment on Need the bird? by Kevin

Kevin — Sun, 30 Oct 2011 01:25:02 +0000

I have just one thing to add, what if it was raining? Then there is no other option. It is fine for those of us transporting by ground to care for critical patients when the weather sucks, right. So would you agree that if it’s ok for ground EMS to transport critically ill/injured patients in less than optimal conditions, why can’t it be done when conditions are optimal. Also If I’m not mistaken, those of you that fly got your experience by working ground EMS, don’t forget where u came from. A wise man once asked the question, what’s the difference between a ground paramedic and a flight medic, about 50 pounds.

Comment on Need the bird? by medic22

medic22 — Sun, 30 Oct 2011 00:52:39 +0000

Again, let me cite some instances where it is highly appropriate to fly. Burns. Head trauma. Multi system trauma. Prolonged extrication with trauma. Medical patients that are within a tight window and not able to be grounded, such as a STEMI or new onset CVA symptoms.

However, in many cases, at least in the area where I work, it is in the patient’s best interest to transport them by ground.

YMMV. Thats why it’s my blog. It’s my opinion.