Re: MDs for field amputations

[Wildmedic17@aol.com]

       This is probably the most interesting thread I've seen on here in a 
while....I have wondered in the past if RN/EMT-P flight crews anywhere were 
trained in this type of surgical procedure....not unlike the whole 
"field-cesarean controversy".

       We don't have a policy specific to transporting MDs for amputations, 
since we already have a prehospital physician program in place in our 
area....it's sponsored and run jointly by the local university medical school 
and the local level 1 trauma center. Many of the ED physicians are members of 
the SMART team (Specialized Medical Assistance and Response)....they have 2 
fly cars; 1 which is kept at the ED, and one that the EMS fellows rotate onto 
for 30 days at a time. 

       At any time, if we (or any other EMS personnel) need a physician on 
scene, our diaspatch only needs to notify the county emergency dispatch 
center, who pages the SMART team and gets an MD headed our way in the flycar. 
It is fully stocked with just about ANYTHING you would find in a trauma 
center ED, to include surgical equipment and a massive pharmacy. The docs are 
trained in EVOC and such.

       In the rare event that need to fly a doc to a scene, our dispatch 
would notify the ED, and one of the SMART docs would simply meet us on the 
rooftop with their gear from the SMART car. Incidentally, this is the same 
procedure we follow when picking up a critical patient in Canada for tx to 
the US....the Canadian hospitals for some reason often require us to have an 
MD on board for serious patients (is this the standard throughout Canada, or 
just a quirk the hospitals in southern Ontario have...?).

       Fly safe.....

Allan Bulkley, FP-C
Mercy Flight of WNY
Buffalo, NY

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