RE: Pt. Scenario

[Robert Cole <EMCOLERS@adaweb.net>]

good discussion all, I would mention one thing in regards to "cost" to the
small hospitals .  Trauma is by far one of the most money losing patient
populations when compared to other agencies.  When you look at the resources
required for a trauma patient, the cost of personnel, OT, time away from
other patients, etc...now look at the typical trauma patient is the
uninsured
and a major health care expense will cause them to declare bankruptcy...is
make the expenses near unrecoverable.  I would think that if cost were the
issue, small hospitals would love to send them on.  The reality (IMHO) is
that Ego's play a far larger role.  What doc (or other health care
professional) likes to admit they are over their head? I know that as a
medic I have trouble admitting it.  It goes contrary to what I am.  Docs are
no different, often worse.  Its been that way since the early days of shock
trauma.

Robert S. "Steve" Cole
Paramedic, CCEMTP
Education Department
Ada County Paramedics 
208-375-7079
emcolers@adaweb.net

"...A mind stretched with new ideas never regains its former shape"


-----Original Message-----
From: James.J.Misuraca@Hitchcock.ORG
[mailto:James.J.Misuraca@Hitchcock.ORG]
Sent: Wednesday, January 02, 2002 12:00 PM
To: flightmed@flightweb.com
Subject: RE: Pt. Scenario


OK lets take this one out of the realm of the flight crew. Lets pretend we
are
Dr.Joe Elemdee at the Center Barnboard Health Center. The local ambulance
has
had several of these calls this year. To his estimation, none of them have
been
as severe as they sound when they are dispatched or when they patch in with
scene info. 
"Do I take a chance and bring them here first or do I send them 30 miles
away
to Trauma Center without ever seeing them?"
As one responent recalled her observation of the Kansas region we struggle
with
these issues in the Vermont/ New Hampshire region. Politics, goverment,
weather, etc....
have conspired to limit our scene response and cause us to struggle with
this
senario on nearly a daily basis.
How can we make this sort of descion making less painful/ costly for the
small
providers? At what level of education or goverment protocol do we draw the
line
on excessive evaluation by centers that are not equiped to provide care? How
do
we do this and appear to be the "adjuncts to improved patient care" that we
know we are versus "the money hungry trauma scavangers in thier expensive
toy"
Excuse me, devils advocate

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