Re: Anything Wrong Here?

[Guest guest]

I agree with you completely.

Ernie

At 02:49 AM 12/9/99=-0600, you wrote:

Perusing the Fort Wo=rth Star Telegram I came

across the following article in Section B, Page =2B. Anybody see any

problems?

BEDFORD MAN CUT ON F=ACE IN INCIDENT AT APARTMENT

Bedford -- Responding=to a report of a stabbing, police found a 23

year-old Bedford man lying =in blood early yesterday in an apartment

bathroom, authorities said. = The man, who suffered several cuts on his face, was=taken by helicopter ambulance to Hospital in Fort Worth=where he was treated. The man was released a few hours later. =br>

No other injuries were reported in the incident wh=ich

occurred about 4:00 AM in the 1400 block of Sierra Springs Drive.

Five other men were in the apartment when paramedics=and police arrived, but investigators had few details abouit the

stabb=ing, police said.

A butcher knife, which police s=aid they believe was

used in the stabbing, was found in the apartment, po=lice said.

Police and agents with the U.S. Immigr=ation and

Naturalization Service were investigating the case.

=-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o-o

Hold it..=..did he say helicopter? Gosh the traffic must have been

horrible=at 4:00 AM. Perhaps the wounds were so disfiguring that a

family p=ractice resident spent a whole hour sewing them before

discharge. I=s it really worth putting the aeromedical crew at risk

for this? Wh=en is this nonsense going to stop? I treated a

patient several year=s ago who came into the ED where I was working (JPS)

by helicopter with a= " fish hook in is eye. " The young man

had a treble hook f=rom a lure embedded in the superficial

conjunctiva. I anesthetized =the conjunctiva and removed the fish

hook while the patient was on the he=licopter stretcher. He got off

the stretcher and walked to triage.=nbsp; He was further examined, visual

acuity checked, prescription writte=n and the patient left the hospital

before the flight crew.

=Wow...it is really exciting to set up a landing zone and direct in the= " bird. " Adrenalin levels are cranked up to the next

le=vel.

In ACLS I will occassionally push megacodes beyond the s=tandard

stuff. Such as, your patient now has pulmonary edema. =What

are you going to do? Answer by paramedic, " Give em lasix=and

morphine, " Good. The patient is still having sympto=ms of

heart failure with hypotension. What are you going to do?&nbs=p;

Answer by paramedic, " Start Dopamine or Dobutamine. " O=K

you start dopamine and the patient does a little better, but his spO2 i=s

falling and the breath sounds are more wet. What are you going to=do now. Both paramedics sheepishly look at each other and saw,

=quot;We'll call the helicopter! So, if you don't know the

physiolog=y, pharmacology, and treatment, you " call the

helicopter. "  =; This is nuts. This is NOT what EMS is

about. Australian hel=icopter services are few and far between and

concentrate on interfacility=transfers. The scientific literature

is just not there to support =the use of aeromedical helicopters for every

complaint. In addition=, aeromedical helicopters are falling from

the skies with increasing freq=uency killing all aboard. We have

loss some bretheren here in Texas=this year. Instead, look at the

NAEMSP position paper on this issu=e. Patients who really will gain

an advantage by the speed of tra=nsport that a helicopter provides are

quite few. It is silly for a =ground ALS crew to sit on ther ground

with a multiple trauma patient and =wait 15 minutes for a

helicopter. This is followed by time lose whi=le the helicopter crew

assesses and treats the patient. Finally, th=e patient is tranported

to the helicopter. In many cases, the origi=nal ambulance could have

transported to patient to the trauma center, cle=aned up the ambulance,

got a Coca Cola, and are enroute back to the stati=on before the

helicopter patient actually makes it to the ED from the roo=f. This

is, of course, assuming the weather is marvelous. I=n the Bedford

case, the patient will be billed 3-4 thousand dollars just =from the

helicopter which he will not pay as he is going back to Mexico.=nbsp; The

helicopter crew were rousted from their beds. The only go=od thing

is that the ground ambulance crew had a " no transport " =and got

to go back to the station and get some sleep before morning.

We really need to look at this hard and fast. Helicopter o=perators

have provided criteria that encourages early and frequent use of=the

helicopter for rather minor things (surprise). They are =often

marketing to the First Responders and Police who will " call th=e

bird " before medical folks get to the scene. The road is

c=losed down with th helicopter running. The paramedics would look

ba=d not using the helicopter now that it is here. What a

racket! =; Nothing wraps up a call like sitting around the station

talking about h=ow they " called in the bird " and stopped traffic

for 30 minutes=. Wow...each member of the rescue was given a metal

helicopter ambu=lance pin to place on their uniform showing the shiney

helicopter. =Call again....call soon. I have visited a

volunteer service where t=hey mark on the first response vehicle each time

they called in the helic=opter. This is something to be proud of

Am I the only=one who feels this way (you know where I stand on

backboards). Be =honest. The new paramedics will flame me, the

experienced paramedic=s will laud me, and the flight crews will pray that

I go back to Australi=a and mess with them for several years.....maybe I

will.

Ti=rade off.

E. Bledsoe, D.O., Ph.D., EMT-P, FACEP., FAAEM=., FAEP, DABFP.

Hog wash.....

Click h=ere!

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