I got a good chuckle out of it since it wasn't me that did it this time.
Hope all works well for you. Will you be at AMTC this year??
Chuck Sheppard MD
St. John's Life Line
Springfield MO
----- Original Message -----
Sent: Tuesday, August 05, 2003 4:53
PM
Subject: Re: RE: High Risk OB
dilemma
Well, so much for keeping things quiet!! <considerably red
face> I guess that'll teach me not to look at the "sent from" address when
replying. Oh well, interesting things in the works, but no definites yet. My
apologies if my snafu causes any problems for
anyone!
Laurie
============================================================
From:
"Laurie A. Romig, MD" <laurie.romig@verizon.net>
Date:
2003/08/05 Tue PM 05:45:09 EDT
To: <flightmed@flightweb.com>
Subject:
Re: RE: High Risk OB dilemma
That was me on both counts. I had to give
up my Bayflite position when I took my job as Medical Director for Pinellas
County EMS because of potential conflict of interest issues. I hated to do it,
but the rewards of the change have been remarkable. I did maintain my status
with a LifeNet operation in Bartow, FL, and we're in the process of working
out something that may turn into an Executive Medical Director position for
all of the LifeNet operations in Florida. Part-time, do-able mostly via
various forms of telecommunication, and with each base having a local
operational medical director. The project is still a bit on the QT though, so
I ask you not to spread it about too much; it's not quite a done deal yet.
Sooo, I have my dream job in Pinellas and might get 5 or 6 helicopter bases to
boot before too long! Life is good.
Lou is still in Miami at Miami
Childrens and soon to appear at an EMS, disaster, or emergency management
conference near you! (And that's a safe bet to tell
anyone...)
Laurie
============================================================
From:
"Joe Kubitschek" <joekuby@sbcglobal.net>
Date:
2003/08/05 Tue PM 12:29:17 EDT
To: <flightmed@flightweb.com>
Subject:
RE: High Risk OB dilemma
Thanks Dr. Romig -- Thought you were with
BayFlite? Did you or was it Dr.
Lou that worked in the Sand in Indy
MO?
Joe
-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On
Behalf Of Laurie A. Romig, MD
Sent: Monday, August 04, 2003 5:14 PM
To:
flightmed@flightweb.com
Subject:
RE: High Risk OB dilemma
Joe:
Be a bit careful about reading
too much into the degree of comfort of the
sending and receiving
physicians. Unless a flight service works regularly
with docs at both ends,
those docs may not have a realistic degree of
knowledge of either your
training and experience or the limitations of the
aircraft you use. It may
very well be that the loudest inner voice that the
referring physician is
hearing is the "get this patient out of my
ED/L&D/office yesterday"
warning! It helps tremendously to have a formal
working relationship with
certain specialty physicians who can be taught
exactly what your
capabilities are, and who has a respect for and more than
nodding collegial
relationship with your medical director. (Emphasis on the
"collegial", not
"relationship", for those of you whose minds tend to drift
off the subject!
:-) )
Laurie Romig, MD
Lifenet, FL
PS: Has everyone
filled out the Air Medical Issues survey at
www.airmedleadership.com??
-----Original
Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On
Behalf Of Joe Kubitschek
Sent: Sunday, August 03, 2003 10:38 PM
To: flightmed@flightweb.com
Subject:
RE: High Risk OB dilemma
Dave your question has been a great
educational experience. I have to agree
with Pam, and acknowledge my
ignorance to the BO-105 and lack of access. I
still feel though that
if both Doc's sending and receiving feel comfortable
with sending Mom for a
20 minute flight it is better to be in the facility
that has the expertise
in delivery. Waiting for a perinatal team and NICU
team is wise
though. After spending time in a NICU I found that Mom's that
were
unable to travel with their baby(ies) suffered not only emotionally
but
physiologically. I am not saying that you should be gung ho and
fly by the
seat of your pants, but I am saying that time can be lost and
things can be
better for all by moving appropriately. After rereading
your scenario I did
see one key word that would make me nervous and that is
"bulging" membranes.
This baby is going to need a lot of assistance
quickly. As stated, sugar,
temperature, airway concerns are going to
be immediate and not to mention
infection risks. That is why I
thought go while the gettin is good. If the
physician at the
receiving hospital has accepted the patient under the
circumstance you
described though, from my understanding, the patient was
accepted and I
have to question if EMTALA issues do exist. I am curious
what
happened? Did you transport or not? How long did it take for
this
baby to be born? Pam is a better expert than I and I appreciate
you asking
the question and have learned
much.
Thanks
Joe
-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On
Behalf Of Dave Sharpe
Sent: Sunday, August 03, 2003 1:20 PM
To: flightmed@flightweb.com
Subject:
High Risk OB dilemna
Ok folks, here's a scenario for you.
Your service flies a BO-105
aircraft, and has an agreement with a local OB
receiving facility to
provide transport for high-risk OB patients. On
these flights, you
send the aircraft with one Flight Nurse to the receiving
facility to
pick up a Labor and Delivery Transport Nurse as part of your
team, then
respond to the sending facility 20 minutes away (90 minutes by
ground).
Upon arrival, you find a 26 week pregnant, G1P0
patient whose cervix
is dilated to 10 cm with intact but bulging
membranes. She came in the
day prior with contractions which were
controlled with a MagSo4 drip at
3gm/hr. She is no longer having
contractions. The sending physician
wants her transferred to the
receiving specialty center to manage her
pre-term labor, but does have the
capability to resuscitate a preemie
newborn if necessary.
1.) Would you
transport this patient?
2.) For the sake of discussison, lets stipulate
that you're not
comfortable with transporting the patient, but the L&D
specialty nurse
and the receiving Perinatologist feel the patient is stable
enough to
transport by air, and is not in danger of delivering
precipitously
enroute. Given this information, would you then
transport the
patient?
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