Standard of Care or Not?

[Guest guest]

OK, I know that I've ask this once before with no real answers given, so maybe

the air medical folks can help out here also.

 

Acme EMS receives a call for a MVC that is 25 miles from a level 4 ER.  It takes

them about 25 minutes to make the scene.  On arrival, they determine that one of

the pts is critical enough for air medical transport.  They call their normal

service, Ace Air, but they are told that they are not available.  They call Red

Barron Air which is further away from the scene..  Star of Life Air has a

location in the next county, which is about 10-15 minutes flight time to the

scene, but Acme flat out refuses to call them, meaning the pt has to wait.  RBA

flight time is about 30 minutes, so they request them and Acme waits on scene

for RBA to arrive.  What is the Standard of Care for this call?

 

Now, lets turn the tables here and say this is either a medical call or even the

same MVC that is 15 minutes from the same level 4 ER.  Acme gets on scene and

determines this is a possible CVA, cardiac or another call where air medical

could be used.  They decide to call Ace Air to transport.  This time they are

available and have a 25 min ETA.  Acme EMS transports the pt to the hospitals

helipad that is just across the street from in the parking lot for the ER.  They

sit there waiting for Ace to land.  Again, where does the Standard of Care and

liability lay? 

 

It makes no sense to me for them to sit and wait across from the ER for air

medical.  I know that once they enter the ER they have to be evaluated, treated,

and if transfer in required, that you have get a receiving doctor and hospital,

which takes time, sometimes too long.  Been there, done that.

 

We all have our own air medical group that we like to use, just as in the

funeral business, we have the embalming services that we like to use more than

another.  But in EMS why do we want to put a pt at risk to wait for our favorite

provider?  Why wait 30 minutes when you could call one that is 15 min away? 

Again, what is the standard of care and liability?  Is it worth sitting on scene

waiting for that additional 15 minutes or more?  Same goes for sitting at the

hospital helipad. 

 

We all know that if it is something that a level 4 is not able to treat, they

will make the pt stable and transport out either by ground or air.  But, don;t

the pt deserve proper care?

 

One thing about Acme EMS, is that at least once, if not more per day you hear

them say, call Ace Air.  Has ground EMS become that dependent on air medical as

back up?  I understand when they are needed, but for calls that you just don't

think you can handle?  If they can't handle certain calls, then maybe it's time

for them to leave EMS or transport to an ER where they can.

 

Just wondering.

 

Wayne