And I freely admit that my knowledge of advance trauma care is .....limited. Maybe nonexistent, really. And having posted this, I am likely going to get to find out what kind of gravy goes best with shoe leather.....
But I can't help but wonder about the actions and decisions of the EMT's as seen from the outside at a distance....Yeah, I am armchair quarterbacking here, and all that....
But:
Here's the thing: I live near an area that the EMT folks use to land the LifeFlight helicopters and to transfer patients.
So, today, about a mile from this area, there is a Motorcycle vs Truck accident, with predictable results.
Now, the ambulance picked up the motorcycle rider, and brought him to the transfer area. Where they sat for approximately 15 minutes waiting on the chopper.
The copter landed, and still, the victim was in the ambulance for another 40 minutes I assume they were trying to stabilize him or stop bleeding long enough to get him to better care.
However:
When you add in at least 15 minutes flying time to a trauma center in either Chicago or South Bend (likely Chicago is better, and closer by a minute or two and that was the direction the chopper flew off towards).....you are at, with the time spent in the ambulance on the ground while the chopper is waiting, at or beyond what it would take to drive to said hospital (Ferinstance, *I* can get to the trauma center in Chicago (Northwestern Memorial), in "normal" traffic, in 45 minutes, maybe 55 if traffic is heavy....and I don't have red lights and a siren.
Now, I don't know if the EMT's can do more sitting still than they can in a moving ambulance, but time from pickup to hospital had to be, including while the chopper waited on the ground, at least at least an hour and 10 minutes....which is actually MORE than what it would have taken to 'Scoop and Run" to the Trauma Center by road. Remember, road time is 45-55 minutes in my personal vehicle, no lights, no siren, etc. There is a "Normal" hospital with an emergency room less than 15 minutes away by car ...likely about 10 minutes by ambulance....maybe a minute or two less. One would think that they would have brought him to a nearby emergency room, stabilized him there, then, if need be, transported him via chopper from hospital to hospital. In the time the ambulance was waiting for the chopper to arrive, (not the time the chopper waited on the patient to be moved from the ambulance) he could have been in an emergency room....perhaps not a Trauma Center, but a much better equipped facility than the back of an ambulance.
Again, I don't know if sitting still allows the EMT folks to do more than what they could do moving...if so, then the ground hold maybe makes sense. If not, them there was no real reason for the Chopper that I can see. .
I just don't understand the concept of hurry up and then wait.....then Wait and Hurry up! If you need the chopper, then I would assume time is of the essence....And if it isn't, then why call the chopper to begin with?
Again, I may be doing the EMT's, professional that they are, a disservice by questioning their actions. If so, I will apologize in advance. Perhaps there were unforeseen circumstances that changed things as the situation unfolded.
But it really doesn't make sense from the outside.
5 comments:
I would 'guess' based on my past volunteer experience, they were trying to stabilize the patient. It's harder than hell to work on somebody in the back of a rocking ambulance, much less hear important things like breath sounds, etc. And helos are even noisier... Also, many helo crews now include a certified nurse, who can also give advanced care.
I think I saw an AD post on this a while back. Something about being too eager to use all the toys every time.
We have the same thing going on here. Mayo1 goes out every crash, 20 minutes out, 20 minutes back, and 15 of "stuff" getting loaded. I can drive to Mayo in about 50 minutes in my pickup without the benefits of lights or sirens. Local emergency room is less than 10 minutes out.
Once you have a helo, you need to pay for it.
I recall watching accidents in Iraq. nearby people would throw the injured into cars and speed off to the closest hospitals. The time they would have waited for an ambulance would have been more fatal than any harm or lack of stbility done in the car. And in an emergency, you can ignore a lot of traffic rules.
In most cases, you are much better off not waiting for an ambulance.
Being a Critical Care Flight Paramedic, I can tell you it is not always about the distance to the trauma center. Depending on the local responders, the level of provider varies; it could be a Paramedic Unit, or could be an EMT-Basic ambulance. Depending on the severity of injury, the patient may need advanced airway control, utilizing paralytic medications and the placement of an Endotracheal Tube, both of which are above the EMT-B level of providers. In addition, most of the HEMS (Helicopter EMS) providers also carry blood products (PRBC's) that can be instrumental in stabilizing a critically injured patient. These are not available on even local Paramedic - level ambulances.
In the end, every case is different. The decision to call a helicopter is usually made by the provider on the ground; and with all human decisions, not every time we are called may be the best choice. But they are making the best judgment they can with the limited resources they have.
Hopefully this is a little better rationale of the decision and reasoning behind calling a helicopter.
Thanks
BadgerMedic
Yes, actually, that does explain a lot.
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