Re: Physician-Staffed Helicopters

[Helodoc@aol.com]

As a physician who has been involved in air medicine for a few years, I would 
like to comment on the Cleveland controversy:

No American study has shown a benefit to flying physicians as compared to 
nurse-medic crews.  Studies done in other countries have to take into account 
the varied training of medical personnel.  How a physician, nurse, or 
paramedic is trained in the US and Canada is greatly different from the 
training received in other countries.  So the first problem with using an 
Australian study is that we need to know the background of the various 
specialties.

The other reality of helicopter transport is that it is performed in a very 
small space with a very limited drug and equipment list, and generally over a 
short duration.  Because of these limitations the number of treatment options 
is quite small.  Mainly what is required is stabilization, which is well 
within the training of most paramedics.  Most community hospital ICU nurses 
are used to dealing with very ill patients without direct physician 
supervision.  This is not at all unlike the model we are describing for the 
helicopter, with the only difference being that the nurse is bringing the 
patient to the physician, rather than the physician coming to the hospital to 
see the patient and the nurse.

So, why fly a physician on a helicopter?  Only a couple of reasons:  1) We 
need to have medical directors who have the experience of caring for patients 
in flight.  2) When the physician is doing research to see what can work in 
the air medical environment.

Dave Thomson


David P. Thomson, MS, MD, FACEP
Associate Professor
Emergency Medicine
Upstate Medical University
Syracuse, NY 13210
315.464.6219 voice
315.464.6229 fax

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