Re: Pt. Scenario

["Wesley Copeland Sr., MICT, NREMT-P, CCEMT-P" <wcemt@terraworld.net>]

Allan,

I agree with you completely, however the sad fact is, that your statement,
"In fact, I doubt that any EMS protocols exist anywhere that would not
require (or at least strongly suggest) that this patient be transported to
the trauma center." is not always the case.  It is sad to think that anyone
involved in emergency medicine in the year 2002 would not fully understand
and utilize air transport from the scene directly to an appropriate trauma /
medical center, but here in Kansas it is not that uncommon of a situation.
(Kansas has yet to enact a state wide trauma system)  Usually the field
providers are all for it, but the small town Dr's have the attitude "We've
done without a helicopter for years just fine!"  We also run into a lot of
Medical Directors whom have a poor understanding of the COBRA regulations in
regard to scene flights.  We do have services that utilize helicopters, but
we also have rural BLS and ALS services whose medical directors will not
allow them to call for a Helicopter on scene.  We have been working hard to
try to educate these individuals without stepping on toes but sadly, the old
saying "you can't teach an old dog new tricks" is holding true.  Kansas is
in the process of developing a state wide trauma plan but many small rural
hospitals and doctors are against it for financial reasons.  I have no doubt
that in time this situation will be resolved but until then we are forced to
accept these unfounded opinions and clean up the mess they create.   Don't
get me wrong, overall I have great respect for my colleges here in Kansas
and the appropriate "Powers" are working hard to solve these problems.  I
only post this message to stimulate thought and enforce the fact that we
should never get to comfortable in the "air medical industry".  A few bad
apples (or opinions) can ruin everything.  And in these day's of cost
comparisons and managed care, the benefits of air medical verses the costs,
are being looked at closely.  Much like the studies that claims air medical
transport has no significant difference in survival.  I doubt their is a
person on this mailing list that would agree with that, yet someone out
there believes this to be true, and the average citizen doesn't know the
difference and will take such studies as reliable and correct information
unless we continue to educate and defend our place in the medical system.





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