RE: transport time (school assignment)

["Gregory J. Rupert" <gregoryrupert@sprynet.com>]

Hello Mark

 

John makes very valid points about the standard of care issue. In studies related to neuro trauma Abbott et al (1998) and Baxt WG, Moody P. (1987) patient outcomes were looked at prospectively comparing ground ALS and Air Ambulance transports. There was a marked statistical difference in patient outcomes with similar GCS = 4 which they attributed to the more aggressive and advanced protocols of the air ambulance services. I have not researched other areas of trauma, but would wager that there are similar findings when comparing patient outcomes. This is not to say that the providers are better, but from what I read and from what I have done in my own practice Air Ambulance services tend to be more aggressive in their treatment protocols. This may have to do with factors such as crew complement and levels of training.

 

Greg Rupert

CCATT Clinical Coordinator

59MDW Wilford Hall Medical Center

-----Original Message-----
From: flightmed-admin@flightweb.com [mailto:flightmed-admin@flightweb.com]On Behalf Of JRLunde@aol.com
Sent: Tuesday, March 26, 2002 3:53 PM
To: flightmed@flightweb.com
Subject: Re: transport time (school assignment)

Mark,

I would like to reply to your stated question. The decision to wait for the air transport provider versus grounding the multiple trauma patient should take into consideration the level of care that can be provided. The air transport system may be able to provide more invasive and additional interventions not performed by the ground crew that could impact the patient's survivability. The program I work with provides rapid sequence intubation, cook catheter placement for pneumonthoraces, pericardiocentesis, and adult IO placement. None of these procedures are performed by the ground EMS providers and when we are looking at a 30-40 minute transport time could make the difference on delivering a viable patient to the trauma center. When looking at time related factors, the level of care and scope of practice of the providers should be viewed.

Thanks,
John Lunde, RN, MSN, CRNP, CFRN, NREMT-P
Clinical Director, Emory Flight
Griffin, Georgia Base