Re: transport time (school assignment)

["Mark Seeloff" <docmseeloff@hotmail.com>]

Mr..Bulkley:
Thank You for answering my question. I a big supporter of Mercy Flight and 
think the service is great. My data is unscientific in sense that I used 
times from data collected from our computer at work form the past three 
years. I did not collect data from Mercy flight so It will seem one sided. I 
am not stating ground transport is better but each has it place. Next time 
Mercy flight is in Lockport, I would love to talk with you. I'll buy the 
coffee. Once again thanks for you time with this assignment.

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


>From: Wildmedic75@cs.com
>Reply-To: flightmed@flightweb.com
>To: flightmed@flightweb.com
>Subject: Re: transport time (school assignment)
>Date: Wed, 27 Mar 2002 09:27:34 EST
>
><< 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 ? >>
>
>Mark,
>
>Hello there; my name is Allan Bulkley. I'm a full time flight medic at 
>Mercy
>Flight of WNY.
>
>Thank you for asking these legitimate questions. In fact. the questions you
>raise (there are actually 2) are so interesting and valid that they are 
>asked
>very often:
>
>1) Which method of transport truly is quicker; ground or air?
>2) Even if we have to wait a few extra minutes for the helicopter, will our
>patient still potentially benefit?
>
>     First, I am curious...where you got your data? I can tell you with
>absolute certainty that any info you have saying that helicopter transport
>time from Lockport to ECMC is 40 minutes is flawed; from the LZ in Lockport
>to the rooftop at ECMC it is about 7 minutes by air; obviously a 
>significant
>time savings over ground transport. I assume that the data you are looking 
>at
>is comparing time of initial dispatch (when you guys call us) to the time 
>we
>arrive at ECMC, vs the "ground data", which must look at the time you guys
>leave the scene to the time you get to ECMC. This really is apples and
>oranges.
>
>     One thing that we stress when we do ground schools is to ALWAYS CALL 
>US
>EARLY. This is the only way the system will work efficiently. If we are not
>called until you are at the scene, or worse yet, until after the patient is
>assessed and packaged, then there probably is little if any time savings in
>air transport, and the patient does not benefit from a shorter pre-hospital
>time.
>
>     However, if we are put on an "airborne standby" as soon as you are
>dispatched to a call that meets criteria, then we can be arriving at the LZ
>at about the same time as (quite possibly before) you, and as long as the
>patient is already properly assessed and immobilized (a BIG source of 
>wasted
>time for us is having to re-immobilize patients), and we DON'T have an 
>airway
>problem or other critical intervention to perform, we will be off the 
>ground
>headed to the county about 5 minutes after making patient contact - a net
>time savings of probably about 15 minutes.
>
>     Does this make a difference in outcome? Who knows...it depends on many
>factors....but shouldn't we always err on the side of caution?
>
>     As for the second question; "Does the patient benefit from air 
>transport
>even if it is not quicker?"; I have to honestly say that I don't know. The
>research in this area is inconclusive.
>
>     I can't make the "we can do more" argument because unfortunately, we
>don't operate under the same sort of expanded scope that many flight 
>services
>do (not yet - that is hopefully changing soon), so with the exception of 
>RSI
>for a patient who needs it, there's not alot we can do that you guys can't.
>
>     However, intervention capabilities aside, consider the benefit of 
>having
>care provided by two seasoned, well trained crew members (flight 
>medic/flight
>nurse) who assess and manage serious trauma patients on a regular basis vs.
>having a lone paramedic (I assume that's your crew configuration) in the 
>back
>of the ambulance with that patient. As a former full-time ground paramedic
>(still part-time) who is used to working alone with ALL TYPES of patients, 
>I
>can personally attest that with a serious patient, it can make a 
>significant
>difference in the quality of care provided enroute to the hospital.
>
>     There's also the local resource factor....if you guys are out of 
>service
>for 1.5 - 2 hours transporting a patient to ECMC, doing paperwork, cleaning
>your rig, and driving back to Lockport, who covers your city? I know you
>probably have more than one ambulance, but  the resource issue still may be 
>a
>factor to consider.
>
>     In summary, I want to emphasize that as long as we are dispatched when 
>we
>should be (at the same time as you guys for calls that meet criteria), then
>there is NO situation in which air transport is not SIGNIFICANTLY faster 
>than
>ground transport from your location to the regional trauma center.
>
>     Also, even if we aren't going to be significantly quicker, there may 
>be
>other totally appropriate reasons to use us as well.
>
>     I am interested in hearing more about your research, specifically 
>where
>you collected your data and how it was compiled. Maybe I can help...we've 
>got
>lots of retrospective data on file in our communications center. I'd also
>like to talk more about the practical aspect of your utilization of 
>us....in
>other words, how can we make it easier for you to use us, and how can we 
>work
>together to make the system smoother and more efficient? Please respond
>privately.....
>
>Thanks,
>
>Allan Bulkley
>Flight Paramedic
>Mercy Flight of WNY
>
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