Re: transport time (school assignment)

["Joel Hochhalter" <JHochhalter@salud.unm.edu>]

This is an all to often falsely stated issue.  It is a matter of simple
math along with some physics thrown in.  It is impossible, with all
things equal (because that is what you imply) that a ground ambulance
can get to a trauma center, hospital, scene, or etc faster than an
aircraft leaving at the same time.  What is often overlooked is the
helicopter is often, not always, called until after EMS has arrived,
assessed the patient, placed them in the back of the ambulance.  The
clock does not stop ticking for this to happen.  So if you leave with
the ambulance at that time, or call for air support then the obvious
answer is yes the ground transport is faster (the 10 min difference you
reference is this issue exactly) and improper utilization of air support
has occurred IF the patient meets air criteria.  If you are looking at
this for comparison then you are looking at apples and oranges not equal
information and statistical values.  If you look at the helicopter on
scene and the ambulance on scene (provided a quick and timely decision
has been made) the transport time of the aircraft is impossible to beat
by ground.  We (EMS) need to review how aircraft are used, why aircraft
are used, when do we decide to launch one, who decides to launch, what
is the criteria for use. This does not mean that every MVC etc needs a
helicopter, I believe that proper utilization of resources is often
overlooked. The usual fact is the skill level is often equal; however, a
certification does not mean anything in the great scheme of life...it's
can you do anything with it.  So we are talking about blood transfusion
(trauma) etc, and speed.  On the other hand some air services provide a
plethora of extended skills, i.e. pericardiocentesis, chest tubes etc. 
A viable patient, a correctly identified/assessed patient far exceeds
the importance of the competition of who can get it done
faster,.......the "Golden Hour" well that's yet another subject. Keep
one thing in mind in your pursuit of being a flight nurse....don't get
caught up with the competition ideals (no value) GIVE YOUR PATIENT THE
BEST POSSIBLE CARE...MAKE THE RIGHT DECISIONS.....EVERYONE WINS. Trying
to win a race (ground vs. air) leads to fatalities, mistakes, and bad
decisions. God knows EMS does not need anymore absent crew members.
BE SAFE 
FLY SAFE
jdh  

>>> docmseeloff@hotmail.com 03/26/02 02:16PM >>>
TO: Flightmed group:
From: Mark Seeloff
Subject: Transport Time (School assignment)

I would like to introduce myself to the group. I am nursing student at
the 
University of Buffalo. I am also a career firefighter/paramedic with
the 
City of Lockport Fire Department, New York. I am also a hospital 
corpsmen(USNR) for the 3 /25 Marine company out of Buffalo, New York. I
have 
experience with Mercy flight (ground crew) and helicopter evacuation
with 
the marines.I am interested in becoming a flight nurse after college. I
have 
a question for the group that has to do with transport time.

My fire department runs the local ambulance service and there is a
local air 
ambulance. I researched the department records for transport time for 
traumas for the past 3 years. I compared the transport time from
leaving the 
scene to on scene at the local trauma center both by our ground
transport vs 
air transport. Our ground time for transport was 30 minutes to the
trauma 
center. The air transport time was 40 minutes. My department is
ACLS,PALS 
and BTLS certified. My question is Should we wait the 10 minutes for
the air 
transport or should we by pass the air transport for the faster time to
the 
trauma center ? Considering the golden hour but the local protocol
states 
that the air transport if available be used.
We are certified in ACLS,PALS, and BTLS but we do not have all the
fancy 
machines that is carried on the helicopter. I would appreciate your
inputs 
on this subject. Thanks




Mark Seeloff
Student Nurse
University of Buffalo
docmseeloff@hotmail.com 



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