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

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Ambulance Driver Talks About a Close Call

In Talk About a Close Call! there is some commentary from Ambulance Driver about the wisdom of transporting a patient by helicopter the extreme distance of –

I checked the distance: 1.87 miles, according to Mapquest.

Almost 2 miles? We need to fly the patient!

WTF?

They might be able to body surf the patient to the hospital faster than the helicopter could transport the patient. This does raise some questions –

How long did it take to set up the landing zone?

Where did they set up the landing zone?

How long did it take to transport the patient to the landing zone?

How long did it take to transfer care from ground EMS to the flight crew?

How long did it take to get from the landing zone to the hospital’s helipad?

How long did it take to get from the hospital’s helipad to the emergency department?

How much extra time did it take to transport this patient by helicopter compared with transport by ground EMS?

According to the map, this requires just heading down Broadway and bearing left onto 21st when Broadway bears left and becomes 21st.

501 Broadway, Nashville, Tennessee 37203 (Bridgestone Arena) to 1313 21st Ave. S. Nashville, TN 37232 (Vanderbilt Department of Emergency Medicine). 7 minutes by Google Maps.

Yes. Concert traffic can be heavy

Is Nashville unique in having heavy concert traffic?

No.

I have worked at concerts and sporting events in several cities larger than Nashville. These cities are known for worse traffic than Nashville. I have never considered flying any patient within any of these cities.

Was there a rush to initiate therapeutic hypothermia?

If there is a need to quickly start therapeutic hypothermia why not have EMS provide the treatment, rather than putting these patients in helicopters to turn on the super-cooling fan on top?

Is there any good reason why EMS cannot initiate therapeutic hypothermia?

No.

This does not seem to be any different from the Maryland method of providing paramedics. Encourage calling helicopters early and often, because Dr. Robert Bass – the Maryland State Medical Director and the CEO of MIEMSS (Maryland Institute for Emergency Medical Services Systems) does not trust paramedics that are not Trooper Medics to provide patient care. Dr. Bass states that the helicopters are his way of providing paramedics to rural areas, yet the patients already appear to be in the care of paramedics. What Dr. Bass seems to be saying is that he does not trust his paramedics.

Is the same thing is true in Nashville?

Are flight medics better than ground medics?

They should be, but I know of too many flight medics who are scary. There are plenty of excellent flight medics, but how is this different from what you get with ground medics? Many flight medics also work on ground ambulances. Do they lose skill when their feet touch the ground? The hiring of flight medics is just as dependent on politics as the hiring of ground medics. Flight medics should have more educational opportunities, but that is a symptom of the lack of attention we pay to the continual education of ground medics.

The problem with pretending that the flight medics are better than the ground medics is that this becomes just another excuse to put a patient in a helicopter and decrease the available experience for ground medics.

This becomes just another opportunity to decrease the abilities of ground medics.

Why are medical directors trying to decrease the abilities of ground paramedics?

Are helicopters just another way for absentee medical directors to protect themselves from liability for abandoning their medical oversight responsibilities?

Late addition – 04/26/2011 at 13:04

There are comments on AD’s post that suggest that the patient was transported by ambulance and that the reporters made the mistake because the ambulance is a critical care transport operated by the flight service. Although there is at least one attempt to justify such a ridiculously short flight with this kind of illogical rambling –

Don’t monday morning quarterback. Hindsight is always 20/20. Even if she was airlifted the crew had a reason. Vanderbilt is one of the best facilities in the nation with some of the best staff. Even if they did fly her, they probably had a good reason.

Comment by Robhub89
Talk About a Close Call!
A Day in the Life of an Ambulance Driver
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