Guest guest Posted October 22, 2008 Report Share Posted October 22, 2008 I do not use the terms Golden Hour and Platinum 10 minutes in teaching anymore other than to point out how they developed and how the evidence does not support them. However, I still believe in efficient work at the scene, purposeful task accomplishment and getting underway as soon as possible. Having spent most of my career in places where the nearest hospital was at least 30 minutes away, I learned that most of the things we do after ABCs can easily be done in the comfort of your ambulance while you're making progress toward the hospital. That does NOT mean careening down the road with all sirens, whistles, and bells going and tossing you around like a popcorn kernal in the back. I am aware that studies are beginning to show that scene time does not make a difference in mortality, but it can make a difference in patient comfort, getting back in service, and so forth. I guess I'm talking about working efficiently to get under way more than " scooping and hauling. " Balance, friends, balance. GG > > No problem, Vernon. Ten minutes is a good average. The problem with > using specific terminology such as " platinum ten minute " is that is > gives the recipient the impression that the golden hour program is being > referred to. You may want to use different terminology or formulate your > own. > > From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On > Behalf Of vernon.wickliffe > Sent: Wednesday, October 22, 2008 11:11 AM > To: texasems-l@yahoogrotexasem > Subject: Re: I have a scenario for you guys > > Steve, I understand that the " golden hour " his serious flaws. It was > Dr. Cowley of shock trauma that supported this magical hour. But I > was talking scene time the " platinum ten minute " I believe even the > good Dr. Bledsoe would agree. Getting a patient off the scene in > less then ten minute is support by both BTLS and PHTLS. > > > > > > > > Respond to a call were someone has been hit in the head by a > > tire. Will he > > > is airing it up it explodes. You arrive and find a 20-25 year > old > > male > > > sitting with blood clotting in nose laceration to bridge of nose > > and > > > swelling to the forehead and nose and severe knee pain with > > laceration. > > > Patient is sitting in chair as we approach the foreman tells the > > patient to > > > put his head back, we stop that action and take manual c-spine > the > > patient > > > states " what happened to me? " Due to the local hospital being > > level IV and > > > the nearest level III is 45 miles away we decide to airlift. The > > foreman > > > immediately states no helicopter! We tell him that whatever this > > young man > > > has cannot be fixed in our local hospital and that it would be > > best to have > > > him at a higher level of care as quickly as possible he again > says > > no > > > helicopter and that we are wasting time we have the young man c- > > collared, > > > spiders, head blocks, backboard moved to unit monitors attached > IVs > > > attempted pt begging to be airlifted and foreman still refusing > > helicopter > > > screaming we been on scene 45 minutes (in reality 15 minutes). > He > > even > > > states that every time you come out here you have to airlift(we > > have been to > > > this plant 5 times airlifted one with all ribs separated from > > sternum due to > > > crushing injury from forklift). > > > > > > What would you do? > > > > > > Would you complain? > > > > > > And if yes to who? > > > > > > This is the highest man on the totem pole at this plant so where > > do you go > > > from here? Just forget it or is this something that can be taken > > up with > > > DSHS? > > > > > > Debbie > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2008 Report Share Posted October 22, 2008 No problem, Vernon. Ten minutes is a good average. The problem with using specific terminology such as " platinum ten minute " is that is gives the recipient the impression that the golden hour program is being referred to. You may want to use different terminology or formulate your own. From: texasems-l [mailto:texasems-l ] On Behalf Of vernon.wickliffe Sent: Wednesday, October 22, 2008 11:11 AM To: texasems-l Subject: Re: I have a scenario for you guys Steve, I understand that the " golden hour " his serious flaws. It was Dr. Cowley of shock trauma that supported this magical hour. But I was talking scene time the " platinum ten minute " I believe even the good Dr. Bledsoe would agree. Getting a patient off the scene in less then ten minute is support by both BTLS and PHTLS. > > > > Respond to a call were someone has been hit in the head by a > tire. Will he > > is airing it up it explodes. You arrive and find a 20-25 year old > male > > sitting with blood clotting in nose laceration to bridge of nose > and > > swelling to the forehead and nose and severe knee pain with > laceration. > > Patient is sitting in chair as we approach the foreman tells the > patient to > > put his head back, we stop that action and take manual c-spine the > patient > > states " what happened to me? " Due to the local hospital being > level IV and > > the nearest level III is 45 miles away we decide to airlift. The > foreman > > immediately states no helicopter! We tell him that whatever this > young man > > has cannot be fixed in our local hospital and that it would be > best to have > > him at a higher level of care as quickly as possible he again says > no > > helicopter and that we are wasting time we have the young man c- > collared, > > spiders, head blocks, backboard moved to unit monitors attached IVs > > attempted pt begging to be airlifted and foreman still refusing > helicopter > > screaming we been on scene 45 minutes (in reality 15 minutes). He > even > > states that every time you come out here you have to airlift(we > have been to > > this plant 5 times airlifted one with all ribs separated from > sternum due to > > crushing injury from forklift). > > > > What would you do? > > > > Would you complain? > > > > And if yes to who? > > > > This is the highest man on the totem pole at this plant so where > do you go > > from here? Just forget it or is this something that can be taken > up with > > DSHS? > > > > Debbie > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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