Happy New Years everyone :) Just wanted to drop in my 2 cents re:the scenario.
This pt.obviously has significant potential for major trauma...including significant mechanism of injury,signs and symptoms of multiple organ system trauma, and a poor historian due to not only the ETOH but also the potential head injury...
from the info in the email...going by ground and going by air are equal in transport times...to two different facilities, and two different levels of care...i guess i would answer this question as a "No" due to two different reasons. 1. the community hospital having limited care (from the assumption i'm making) to where as you could get a full-blown trauma center w/not only acute care but also definative care after the fact to where the community center may have to ship out later increasing the cost to the pt. and possibly the pt.s family. 2. I being a medic myself have nothing against road medics or their abilities but if I were the pt.or the pt.'s family memeber i would want the extended care i may recieve from a flight crew trained in higher critical care procedures (most of the time) compared to a road medic that is limited to certain procedures...not only by training but also possibly by local protocol.
now these are just my opinions...thanks for the invite...
I would appreciate any feedback that you all might have to offer on this =
Pt. is a mid-thirties female, involved in MVC, unknown if restrained. Pt. =
is apparently the driver. Pt. vehicle hits utility pole at greater than =
55mph producing significant damage to vehicle. (You later find out that =
the vehicle has also rolled over.) Approximately 20 minutes of extrication =
are required to disentangle the patient. Ambient air temperature is =
approx. 20 to 25 degrees F.
Pt. does not remember the crash. ETOH on board. Pt. oriented to person =
only. Pt. has a one inch laceration to the left temporal region and active =
bleeding from both nares. Pt. also c/o pain on palpation to the chest. =
Chest wall is intact with bilateral breath sounds clear and equal. Pt. co =
genralized ABD pain with increase on palpation of all quadrants. Pt. also =
c/o lower back pain. Pt. is slightly tachycardic with evelvated B/P. Resps =
and Sats WNL.
Transport times as follows:
By ground to trauma center: 30-40 minutes
By air to trauma center: 10 minutes
By ground to local community hospital: 10 minutes
Does anybody feel that this particular patient recieves any benefit from =
going to the community hospital by ground?
Thanks a lot and have a happy and safe new year!
Adam Oplinger NREMT-P