RE: transport time (school assignment)

["Breese, Robert P" <Bob.Breese@usa.xerox.com>]

Mark,
What are you using as the departure point in your reference?  You state that
you have a 30 minute ground transport time to the trauma center (ECMC, I
presume) and a 40 minute flight time.  Since the BK-117 (Mercy Flight of
Western NY) cruises at an average 120 mph, you must be transporting your
patients with an average ground speed of 160 mph.  If this is true, what
type of ambulance are you using...cuz I want one!
If you are trying to compare the time from extrication to the trauma center
and find that the dustoff takes 10 minutes more, why?  Are there delays in
dispatching the helicopter?  If so, why?  Having the bird on the ground,
waiting on the patient remove much of the delay.  As to your point of
considering the golden hour..
It is a marketing myth.  Plain and simple.  The closest study that alludes
to any specific time to treatment of trauma patients and survival is a US
Army study from WW1 that found if a soldier could be dragged from the
trenches to a Battalion Aid station and surgeon within 71 minutes, they had
a survival rate better than 50%. (sorry I don't have the specific citation
at my finger tips).
What kinds of things delay air medical crews at the LZ?  Let's look at a
few:
	Lack of proper assessment by ground crews prior to transport
	Lack of intravenous access in a patient who needs airway control
medication
	Lack of airway control in patients who require it
	Lack of recognition of life-threatening conditions that must be
remedied prior to placing in the aircraft (e.g., tension pneumothorax).
	Improper/inadequate packaging of patients for air medical transport.
	Remote patient hand-off points from aircraft
This is not to say that air medical personnel are any more proficient at
getting things done faster, but if a patient is presented to the air crew
having been well assessed, problems identified, and IV access in place (
much of which you do enroute, but we SHOULD do before loading), it would
greatly reduce the time from patient contact to lift-off.  Then it's just a
matter of which way the wind is blowing as to the ground speed to the trauma
center.
Bob Breese, MICP, FP-C
	


-----Original Message-----
From: Mark Seeloff [mailto:docmseeloff@hotmail.com]
Sent: Tuesday, March 26, 2002 4:17 PM
To: flightmed@flightweb.com
Cc: taw3@buffalo.edu
Subject: transport time (school assignment)


<liberally snipped>



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