Re: Aircraft - Inflight intubations - Scene flights

["David Steele" <DSTEELE1@mn.rr.com>]

Mr. Phillips.  First of all welcome to one of the best and most exciting careers you will ever encounter and I hope you enjoy it as I have for !%+ years ;-) ..

 

Now......  Your last statement...  Snip....On interfacility transports the
> answer is different. When ever possible do it prior......SNIP

 

Why  is it different if you believe that you can't take 5 minutes on scene to stabilize the airway if speed is that important why isn't it that important to get patients going in the hospital.  Aren't they calling us to get the patient to another hospital quickly?  The patients that frequently get tubes inhospital are they not as critical as scene patients that they need to be evaluated at a tertiary care facility in that "golden hour" also even despite the fact that they may have sat there for days"

 

We frequently get called to a scene and then diverted to a hospital so why would you have a different approach to airway management because they are in the hospital?  Is it because they are in a more secure environment?  Isn't the back of a stationary rig   more secure than an aircraft flying at 145 knots?

 

Some more food for thought.

 

David RN flight nurse..

 

PS.  I am remaining anonymous as this decision I feel is being made politically rather than medically.  I have fought long and hard on this topic and have been burning bridges.  Yesterday I ran into our medical director and he said it is the standard of the industry.  I said you know I don't think so.  I think that it happens as it happens in our program but I don't think it is standard.  I think it the local ambulances standard that they want.  They don't know our job, but they are very critical of our job (extremely long story).

 

any way I am happy to discuss this issue and break some of my anonymity privately as you can probably tell I am passionate about this issue and patient care.  I do want to be open and do what is in the best interest of the patient.  I just can't be sold that you can't stabilize the airway on scene.  Every one talks about the Golden hour which I support but in the reality of it all how many patients that hit your ER go to the OR for a surgical procedure within that hour or ever.  Statistics are Lo.. 5-7% of all trauma patients I think.  That is what the Golden hour refers to.  Yet When trauma patients die or more specifically head trauma patients die what do they die from.  Usually secondary head injury resultant from anoxia.  Airway Airway Airway is not the most important thing it is the only thing in many situations.

 

David