Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Fly Everyone, Let the NTSB Accident Investigators Sort ‘Em Out

Many people think that my posts on science and logical fallacies are not related to EMS. For a Fantastic Feast of Fallacies, head on over to A Day in the Life of an Ambulance Driver. Read his post Is that helicopter really necessary? More important is to read the comments.

Ambulance Driver is referring to a post at M.D.O.D. by the title of Do You REALLY Need the Helicopter?

First, Ambulance Driver writes this:

Over at M.D.O.D., ERdoc85 wonders if some of his patients are being transported inappropriately via helicopter.

And the answer to that question is, “Hell yes, most of them.”

Ambulance Driver does not write a lot of words in his post, but he does provide a lot of evidence.

The Cult of Mechanism
ems1.com
The Ambulance Driver’s Perspective
by Kelly Grayson

Mechanism of Injury in Prehospital Trauma Triage
ems1.com
The EMS Contrarian
by Bryan E. Bledsoe

Alright, I’ll Say It
ems1.com
The EMS Contrarian
by Bryan E. Bledsoe

Two Dead in Oklahoma Medevac Crash
EagleMed chopper crashed enroute to pickup a patient

JEMS.com
by Ken Miller, Associated Press Writer
Friday, July 23, 2010

Ambulance Driver finishes up with this:

And if your primary justification for the flight is mechanism of injury, or the helicopter is the quickest way to clear an ER bed, or to allow your ground EMS crew to go back into service sooner, you’re part of the problem.

Nice and concise with a lot of evidence and some recent news about the real dangers of HEMS (Helicopter EMS).

Dr. Bryan Bledsoe, often wrongly accused of hating helicopters, hating flight crews, and just hating EMS, concluded Alright, I’ll Say It with this paragraph:

I had better bring this tirade to an end. While flying home today from Philadelphia, it hit me that I knew more people who have been killed in a medical helicopter accident than by virtually any other means. At some point in my life I have met or spoken with at least five people who later died in medical helicopter crashes. They were all great people and died doing what they loved. We owe it to their legacy to assure that not a single flight nurse, flight paramedic, pilot or patient dies unnecessarily.

The highlighting is mine. The hating is not there, no matter how much people would like to believe that the only way anyone could point out the problems with HEMS, or with EMS, is to hate HEMS, or to hate flight crews, or to hate EMS.

How many people spend as much time trying to improve EMS as Dr. Bledsoe does? Certainly not those who ignorantly criticize him.

You might think that any contrary opinions expressed in the comments would be well thought out, so that those commenting would not completely embarrass themselves. You would be a hopeless optimist. Maybe some quotes from the comments will cure you.

Reading the comments, I wonder how these Fly Everyone, Let the NTSB Accident Investigators Sort ‘Em Out types even mange to put decipherable sentences together. These comments certainly do not demonstrate anything that passes for understanding.

Even in the week since that post, there has been another fatal HEMS crash.

Arizona: Helicopter Crash Kills 3
By The Associated Press
Published: July 29, 2010

Here is a sampling of the commentary in defense of unnecessary helicopter flights and in defense of the unnecessary deaths of flight crews and patients.

I find this article insulting.

. . . and yes I have lost friends in airmedical crashes, but I still continue to fly and support our system.

Because if he were to admit that a lot of them died unnecessarily, that would really mess with his cognitive dissonance.

Did he read any of the linked articles?

Maybe.

Did he understand any of the articles?

Not much chance of that, assuming he did read any of them, with his cognitive dissonance protecting him from the truth.

Support our system, even if it is killing us! Go Team! Rah! Rah! Rah!

Better to be insulted, than to think.

Another writes:

I WOULD RATHER BE SAFE THAN SORRY.

This is safety?

This is not being sorry?

Then this clown accuses Ambulance Driver of being a city slicker.

Someone else criticizes a flight medic for agreeing with Ambulance Driver about the unnecessary flights.

i am sorry to hear that you get silly calls, but that is part of the job and you go when you are requested. if you dont take it then we get called as the ground crew, then you get to get back to your nap or tv show you are watching.

This one appears to think that the danger involved is limited to missing one’s favorite TV show and having to watch it later on TiVo®. He probably only remembers this bit of poetry:

Their’s not to make reply,
Their’s not to reason why,
Their’s but to do and die:

This from a raconteur wanna be:

Or better yet, when we get launched for an MVA and then declined because they end up taking the patient to the local hospital. Then invariably we’re called about 4 hours later to pick up a soup sandwhich and take them to the Level I trauma center. And what was the Rx given at the hospital, other than a cashechtomy?

Invariably?

adverb
in every case or on every occasion; always:

He is describing a problem. It might only be an imagined problem, since he does seem to have wandered, more than a little bit, from the path of the truth. He seems to be very interested in providing an entertaining story about how he could save the day, if only they would call him earlier. He does not seem to have much interest in improving anything for his patients, unless it involves him swooping in from the sky to rescue them.

Are any of these comments not great examples of the failure of logical thinking and the victory of bias?

Better safe than sorry imagines that transport by HEMS is not any more dangerous than transport by ground. Not only that, he claims that transport by HEMS is safer than transport by ground EMS. I do not doubt that this is the case, when he is the one treating patients in the ambulance. He does seem very dangerous.

Then he assumes that Ambulance Driver must not be familiar with rural EMS, even though Ambulance Driver regularly writes about rural EMS. Better safe than sorry seems to think that the only way anyone would not agree with him is to be unfamiliar with what he deals with. I do not know much about what he deals with, but I can tell you that it is not reality. In his mind, he redecorates reality with a Feng Shui that is pleasing to his prejudices.

Then there is the guy who thinks that the most dangerous part of HEMS is repetitive stress injury from overuse of the TV remote.

Picture Credit

A real medic would walk away from that, with the patient in one arm and the pilot over his shoulder. Piece of cake.

Just put down the remote and fly, you sissies! We need to sacrifice you on the altar of the Magic Rotor Cure! Think of the Glory!

EMS flight crew is only the most dangerous job in the US, so why not abuse them to death – the patients, too.

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Trackbacks

  1. […] Then the topic turned to the recent medical helicopter crashes, Ambulance Driver’s post Is that helicopter really necessary? in response to the M.D.O.D. post Do You REALLY Need the Helicopter? Before the podcast, I wrote a post mostly about the comments on Ambulance Driver’s post. Fly Everyone, Let the NTSB Accident Investigators Sort ‘Em Out. […]

  2. […] Fly Everyone, Let the NTSB Accident Investigators Sort ‘Em Out […]

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