Re: Corpus Christi newspaper reports on EMS response to Cheney incident

[Guest guest]

Sal,

Your patient's injury was complete the minute it happened. So helo

transport would have made NO difference in his outcome.

All you had to do was ventilate him, and he would have been the same if

transport time had been two hours.

How would helo transport have helped him? Not at all.

Respectfully,

Gene

> Good answer Henry.  I agree.  I would have flown him

> out as well considering that Armstrong is at least 1

> hour away from any hospital north or south.  This is a

> trauma patient and as per RAC protocol the mechanism

> is significant enough to warrant a bird.  Some medics

> from a particular service have been trained and taught

> that they can handle any call no matter how bad it is

> and that if you call a bird you are a wimp.  That in

> my opinion is very wrong.  Some of these guys have

> gone to work for a rural service and learned the hard

> way that you simply cannot think that way when you are

> in the middle of nowhere.  When I used to work for

> that service a supervisor refused to allow me to fly

> out a teenager from a motorcycle accident at a dirt

> bike track.  The kid had paralysis from the neck down

> after the bike landed on his back.  Apparently the kid

> was thrown off the bike in the air.  The location was

> at least 15-20 minutes from the nearest level III

> trauma center. 

> Salvador Capuchino Jr

> EMT-P

>

[Guest guest]

Sal,

I understand what you're saying, but I still don't see how helo transport

would have made any difference whatsoever in this patient's outcome. What's

the

neurosurgeon going to do? Not much. Perhaps the physicians will correct

me if I'm wrong, but I don't know of anything much that a neurosurgeon can do

in a case like this other than confirm the injury. In any event, 30-60

minutes won't make a bit of difference. Spinal cord injuries are not time

sensitive at all. That's why in triage, they are the last to go.

Respectfully, all I can see that was accomplished by this helo transport was

saddling the patient and his family with a huge bill for a service that wasn't

needed.

Don't we have an obligation not to do things that are useless? Don't we

need to think about the cost of services we " volunteer " our patients for when

they are vulnerable and can't make rational decisions?

If I were the family, I'd refuse to pay this bill and if pressed by the helo

company, would demand that your service pay it, since you're the one who

ordered it.

Let's think critically about this.

Best,

Gene

> In this case the nearest level III did not have a

> neurosurgeon on call where as the level III 30 miles

> away did.  the medics from the helicopter service know

> that when we call it is a patient that needs the care

> from the level III in Harlingen.

> Salvador Capuchino Jr

> EMT-P

>

> --- " Bledsoe, DO "

> wrote:

>

> > Salavdor, how would helicopter transport helped your

> > motorcycle accident

> > patient?  Would it have healed his spinal cord?  Was

> > there any treatment

> > necessary that required transport where a few

> > minutes makes a difference.

> > There is a risk in everything, from typing on this

> > computer to skydiving.

> > You always have to measure the risk against any

> > benefit. The risk of ground

> > ambulance transport while real, is better that the

> > risk of air ambulance

> > transport. Even transport by donkey cart has

> > risk-you have to measure them.

> >

> > 

> >

> >   _____ 

> >

> > From:

> > [mailto: ] On

> > Behalf Of salvador capuchino

> > Sent: Friday, February 17, 2006 9:17 AM

> > To:

> > Subject: Re: Corpus Christi newspaper

> > reports on EMS response

> > to Cheney incident

> >

> > 

> >

> > Good answer Henry.  I agree.  I would have flown him

> > out as well considering that Armstrong is at least 1

> > hour away from any hospital north or south.  This is

> > a

> > trauma patient and as per RAC protocol the mechanism

> > is significant enough to warrant a bird.  Some

> > medics

> > from a particular service have been trained and

> > taught

> > that they can handle any call no matter how bad it

> > is

> > and that if you call a bird you are a wimp.  That in

> > my opinion is very wrong.  Some of these guys have

> > gone to work for a rural service and learned the

> > hard

> > way that you simply cannot think that way when you

> > are

> > in the middle of nowhere.  When I used to work for

> > that service a supervisor refused to allow me to fly

> > out a teenager from a motorcycle accident at a dirt

> > bike track.  The kid had paralysis from the neck

> > down

> > after the bike landed on his back.  Apparently the

> > kid

> > was thrown off the bike in the air.  The location

> > was

> > at least 15-20 minutes from the nearest level III

> > trauma center. 

> > Salvador Capuchino Jr

> > EMT-P

> >

> > --- Henry wrote:

> >

> > > Ok I have read all the post and will reply to

> > Mike's

> > > because it was the

> > > last one I read. I will say up front that I would

> > > have flown this

> > > gentleman to the closest trauma center. Several

> > > questions first.

> > > 1. How many pellets in 7.5 or 8 bird shot?

> > > 2. Can bird shot kill?

> > > 3. Is a human hide tougher to penetrate than a

> > bird,

> > > rabbit ect...?

> > >

> > > Answer:

> > > 1. A bunch

> > > 2. Yea it can

> > > 3. No it is not

> > >

> > > Even though this guy was conscious and talking I

> > > would have assumed

> > > immediately that the shot penetrated the chest

> > > cavity. Which makes this

> > > man shot multiple times in the chest and neck. The

> > > only place this guy

> > > needs to be is in a trauma center immediately.

> > > Unless ground can get him

> > > there before the helicopter including any wait

> > time

> > > for the bird then he

> > > needs to go by helicopter.

> > >

> > > Multiple gunshot wounds to the chest and neck

> > should

> > > be reason enough

> > > for any arm chair medic, doctor or lawyer to fly

> > > this guy. I think if

> > > this gentleman walks out of the hospital without

> > any

> > > problems he is a

> > > very very lucky man. A littler closer or a few

> > more

> > > shot hitting vital

> > > organs and this would have been a different story.

> > > Everyone in

> > > government is trying to down play this incident in

> > > regards to the

> > > patients condition for obvious reasons. They can

> > > down play it all they

> > > want but it was very serious.

> > >

> > > Lets talk about hunting today. I have been a bird

> > > hunter since I was big

> > > enough to pick up a shot gun and pull the trigger.

> > > Safety has always

> > > been a big concern and I preach it to my son who

> > is

> > > a better bird hunter

> > > than I am. I have been hunting for at least 40

> > years

> > > and have seen minor

> > > lapses in safety for whatever reason or another.

> > > None of those have been

> > > because the other hunter did not have safety on

> > his

> > > mind while hunting.

> > > Hell that why they call them hunting accidents. If

> > > not they would be

> > > called hunting murder or hunting blow your ass up.

> > >

> > > I would bet that the Vice President (even though

> > he

> > > is a republican) had

> > > every intention of being a safe hunter that day.

> > >

> > > At the end of the day here is what you do:

> > >

> > > Fly the patient when necessary and practice safe

> > > hunting.

> > >

> > > Henry

> > >

> > > PS. What I would like to see occur on this list

> > > server is less dogging

> > > of the helicopter issue and more instruction and

> > or

> > > education on when it

> > > is appropriate to fly. Dr. B, Gene and others that

> > > people look up to, if

> > > we keep going down this path younger medics that

> > > read your post may

> > > interpret that helicopters have no place in EMS

> > and

> > > should not be used.

> > > I firmly believe that they have a place and

> > provide

> > > a service that we

> > > can take advantage of when it is necessary. Kinda

> > > like the baby and bath

> > > water thing.

> > >

> > >

> > > hatfield wrote:

> > >

> > > >  Because he is 78, he needs to be flown? Because

> > > he was hit with

> > > > birdshot, he

> > > > needs to be flown? What about his true medical

> > > condition? What of

> > > > that,

> > > > required flight? The fact that he has good

> > medical

> > > coverage? This is a

> > > >

> > > > factor when flying?

> > > >

> > > >

> > > >

> > > > Mike

> > > >

> > > >

> > > >

> > > > And I stand corrected, he was flown.

> > > >

> > > >

> > > >

> > > > Hatfield FF/EMT-P

> > > >

> > > >

> > > >

> > > > Re: Corpus Christi

> > newspaper

> >

> === message truncated ===

>

>

> __________________________________________________

>