med copters collide

[Timothy Craig Hardcastle]

Pret

I hear you, but I think what Bill is calling for is a set of
quazi-evidence-based callout criteria that are patient focused rather
than income-focused as most of the apparently commercial programs seem
to be (my take on the recent discussions). Also there would need to be a
system similar to what Mark Rustuccia suggested to collate calls so that
one service is not played off against another - maybe a central Medical
Director based dispatch per region rather than Hospital-based???

Just my suggestion
Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban
 
Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal
 
timothyhar at ialch.co.za 
 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Bjorn, Pret
Sent: 01 July 2008 22:04
To: Trauma & Critical Care mailing list
Subject: RE: med copters collide

Dr. Bromberg,

I take it that I'm the scolder to whom you refer.

I don't recall anybody ever arguing that medical helicopters are safe,
nor that they're used appropriately even most of the time.  I emphasized
that some programs are much better than others.  Indeed, if asked, I'd
eagerly support any reasonable efforts to enforce mission standards and
safe practices.  All the same, it remains that there are many Mainers
who owe their lives directly to our helicopters, and who would take
harsh offense to the suggestion that their sorry skins weren't worth
your arbitrary and obtuse quantification of the risks in play.  I
remember merely asserting that we shouldn't be so quick to soil the
sacrifices of good individual men and women through ill-informed
guesswork as to the causes and conditions of their tragic deaths. 

Something like a hundred firefighters will die in the United States this
year, most in the process of rescuing evacuated (or altogether
abandoned) physical property.  Some of these -- perhaps even most --
will be downright senseless wastes of life, by any accounting.  Yet we
don't line up on the Trauma-List to collectively ridicule them with
shallow evidence and anecdote.  What the hell are all those guys doing
on the roof anyway?

Nor do we take any time at all to give credit those cases in which
helicopters bring otherwise inaccessible skills and tools to remote
crash scenes or rural emergency departments, or cut the transit times of
critically ill and injured patients by minutes or hours.

You seem quick to radically regulate medical helicopters in order to
save a dozen peers and patients per year -- this criminal litany.  I'm
curious: would you as soon place reasonable restrictions on firearms,
and save hundreds more?

Pret Bjorn, RN
Bangor, ME USA






-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of William Bromberg
Sent: Tuesday, July 01, 2008 1:30 PM
To: trauma-list at trauma.org
Subject: RE: med copters collide


Every time something like this happens, someone points out that medical
flights are being overused and that there is poor data to support it's
efficacy in general. The next posting scolds the original questioner for
the question, usually pointing out that you should not  "hurt the
feelings" or trivialize the sacrifice of the victims and that it's "not
the right time" to have the discussion.  Then it's forgotten about until
 a few weeks later when the next aircraft goes down. The cycle continues
and the conversation is never held.

Fine - I want a date. If now isn't the right time I propose we set a
date to discuss the appropriate use of aeromedical transportation in the
civilian setting because frankly I'm sick of these stories and I'm sick
of my flight crew being called out in all kinds of weather for
uninjured, intoxicated patients. For times when the ground crew is about
to go off shift and don't want to drive the hour round trip. For a dog
bite to the foot. And it goes on and on and on.

Each death is a tragedy. The unending litany of deaths is a crime.

But that's just my opinion..
Bill Bromberg

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