Re: Pt. Scenario

["Wesley Copeland" <wcemt@terraworld.net>]

Well my answers to these two new questions would be:  Yes and Yes!!

Wesley Copeland Sr., MICT, NREMT-P, CCEMT-P

-----Original Message-----
From: Adam Oplinger <ajoplinger@FlightMedicMail.com>
To: flightmed@flightweb.com <flightmed@flightweb.com>
Date: Thursday, January 03, 2002 2:56 PM
Subject: Re: Pt. Scenario


OK!

I'm glad to see that my pt. scenario has generated some interesting
discussion.

After having had the opportunity to read all of your comments back to back,
I would like to modify the original question that I asked at the end of my
original posting. First, however, I would like to comment on some of the
prevalent themes that I have gleaned from your responses.

The most frequently repeated topic from many of your replies has been the
community hospital vs. trauma center argument. Let me first of all state
that it was not my intention to go this direction with this posting, but you
raise some interesting points. I have had the opportunity to work with some
folks at small, rural community hospitals who, because of their geographic
location in relation to a trauma center or air-medical program, have become
VERY adept at recieving trauma patients and performing initial stabilization
because they have had no choice but to do so. There is no other hospital to
take these patients to initially! Conversely, I have seen the exact opposite
happen as well. I feel, however, that even though these facilities can do
well at initial stabilization of seriously injured trauma patients, this
type of patient is going to eat-up a lot of resources that many of these
facilities are already short on, and therefore they should go directly to a
trauma center, if that is at all possible.

Next, there seemed to be some discussion on the point of who is better
trained and equipped to manage this type of patient in the pre-hospital
setting, ground medics or air-medical providers. While I don't think that
anyone could argue that air-medical providers, as a general rule, have
larger armamentarium of skills and medications and more liberal protocols to
draw from, there are many extremely capable ground providers of all levels
of certification out there who, given the same tools that air-medical
providers have the priviledge of being able to use, would be able to manage
these patients as well if not better than many of us who fly for a living.
While I do not advocate allowing all ground providers to practice the same
skills that air-medical providers are allowed to perform for reasons of
training, quality improvement, and volume vs. risk, I think we all need to
remember that we started out in a ground ambulance or ICU as well.

So now, for the question. Based on the same scenario that I initially
posted, use this as the question:

Is it appropriate to transport this patient by medical helicopter directly
from the scene to a trauma center?

Bonus question:

Is it appropriate to transport a patient by medical helicopter directly from
a scene to a trauma center based on mechansm of injury?

Take care all and keep the responses coming
Adam Oplinger NREMT-P

--- RNCCT@aol.com wrote:
><FONT FACE=arial,helvetica><FONT  SIZE=2>No, we don't know what the
capabilities of any given facility are at any given time.&nbsp; But we do
know that to be a designated trauma center there are many components that
together make them a trauma center.&nbsp; Yes, the attending surgeon at the
community facility may be board certified and the trauma centers fellow last
year, but what good is he if the CT tech is 45 min away and the
anesthesiologist is an hour away?<BR>
>Those are the things that aren't<I> supposed</I> to happen with a reputable
trauma center</FONT>

_____________________________________________________________
Get yourname@FlightMedicMail.com:
Sign up at http://www.FlightMedicMail.com

_______________________________________________
Flightmed mailing list



_______________________________________________
Flightmed mailing list