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

- Rogue Medic

Was a helicopter necessary to save 5 minutes?

 

news-press.com file photo

There is a big kerfuffle in Florida over the dispatch of a helicopter to a scene not far from the destination hospital.

Or were they transported to different hospitals? The articles do not include enough information to tell, but they want us to be upset at the lack of a helicopter for unknown injuries in a vehicle crash not far from the hospital.

Was the patient critically injured?

According to three of the four articles I found, Yes. The only basis for that is the people quoted using the word critical.

Critical because of extrication time? Critical because of mechanism of injury? Critical because of something else?

Nobody even suggests that either patient had a scratch, but they keep using the term critical – whatever that means to them.
 

It happened early Friday, when 2 teens struck a power pole with their truck. Both were critically injured, requiring extrication. Estero’s paramedics requested Lee County to send a helicopter. This is where problems began.[1]

That helicopter, Wahlig said, was needed to carry a critically injured 19-year-old from the scene of an auto accident.[2]

First responders who were working to pry a critically injured 19-year-old from the passenger seat of a truck canceled the helicopter once they learned its estimated time of arrival, according to county documents and Estero Fire Rescue officials.[3]

Why wasn’t a helicopter available right away?

The government’s Medstar helicopter service has been suspended. Why was it suspended? That depends on whom you listen to –

Those pilots were terminated last month under the guise of suspending the county’s emergency medical flight program to obtain a voluntary accreditation that no other government in the state possesses.[2]

A Sarasota-based helicopter has become the second option in medical emergencies here, after Lee County officials last month grounded both taxpayer-funded helicopters, according to a county statement released Monday.[3]

A billing scandal grounded Lee County’s Medstar program.[1]

In the meantime, the FAA is in town working with county leaders to determine just how $3-million in flights were billed without the proper certification.[4]

How long did it take to get to the hospital?

It took 22 minutes to carry the truck’s driver to the hospital and 16 minutes to bring the passenger, once he was freed from wreckage.[2]

The 19-year-old arrived at Lee Memorial hospital 53 minutes after the first ambulance was dispatched, according to documents.

That time includes the 16 minute ambulance ride, according to documents. The truck’s driver had a 24 minute ambulance ride, according to documents.[3]

But now public safety officials claim a helicopter wasn’t even necessary in this case since…”The incident did not meet the Lee County Guidelines for Air Transport….because a chopper is only sent for patients that exceed a ground transport time of 30 minutes.”[1]

One transport took 16 minutes, but the other took 24 minutes (one and a half times as long)?

Why?

Nobody explained in the articles.

Was the helicopter requested according to protocol?

If the protocols do have a mechanism of injury criterion for greater than 20 minutes, or 25 minutes, of extrication time, then it is technically within protocol, but if extrication is the only reason, then there is no good reason to fly the patient. These articles do not provide any information about any injuries that would be so critical that saving 5 minutes would matter.

5 minutes?

A 16 minute drive vs a trip to the landing zone, a transfer of care, a flight, moving from the helipad to the trauma room – how much less than 16 minutes will that be? Not much.
 

Would saving 5 minutes matter?
 

Were either of these critical patients even admitted to the hospital for observation, or were they discharged while the ambulance was still at the hospital?

We do not know.

Though no one can prove whether Friday’s accident victims would have benefited from air support, Wahlig says it’s not the first – or last time – it will be needed.[4]

 
5 minutes.
 

“When precious time is consumed untangling occupants of serious crash such as this one, utilizing medical air transport can give that time pack to the patient by dramatically reducing time to the trauma center,” he explained.[4]

Maybe that explains why there was so much drama described in these articles.

This drama is all about 5 minutes.
 

Would saving 5 minutes matter?
 

PS – The main complaint appears to be coming from one of the flight medics laid off when the government helicopter service was suspended.

Footnotes:

[1] Lee County officials under fire for Medstar mess…again.
Estero Fire Rescue doesn’t want to be blamed for county’s mistake

By Mike Mason
Created Sep. 24, 2012
FOX4 News WFTX-TV
Article

[2] Veteran paramedic resigns over ‘continued lies’ in Medstar controversy
2:14 PM, Sep. 25, 2012
Written by Thomas Himes
news-press.com
Article

[3] Sarasota chopper becomes fallback in emergencies
12:35 PM, Sep. 25, 2012
Written by Thomas Himes
news-press.com
Article

[4] Lee EMS administrators called ‘disgraceful’
Posted: Sep 25, 2012 4:39 PM EDT
Updated: Sep 25, 2012 6:18 PM EDT
By Karla Ray, NBC2 Investigator
nbc2.com
Article

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Comments

  1. Here’s a common problem. Medical directors that somehow made it through medical school, should understand research and all. But, in the name of not angering those they work with, continue these silly traditions such as flying patients that don’t require it. Remember, ultimately to some of these “doctors” you’re nothing but a glorified taxi driver. My two angry cents.

    • there have been a lot of stories on the Lee county ems
      there has bee a lack of truth from the public safety dept.
      the commissioners were not told it was shutting down and they were told a lie afterwords.
      and the county manager did not understand the ems explanation and left it that way.

      a previous crash of a chopper several yrs ago it was disclosed that they had night vision equipment but it
      sat in the storeroom for yrs because no pilot was trained to use them.
      in the middle of the mess the rate was raised to $8500 for transport

      • jr23,

        I do not know how many of the people involved have been telling lies, or what they have been telling lies about.

        The story does not provide enough information to determine who is lying.

        If the times reported are accurate, they were calling a helicopter to fly a patient who is only 16 minutes from the hospital by ground.

        That would be a horrible decision by EMS.

        .

    • Can’t say, clowns will eat me,

      Here’s a common problem. Medical directors that somehow made it through medical school, should understand research and all. But, in the name of not angering those they work with, continue these silly traditions such as flying patients that don’t require it.

      How many medical schools require any understanding of research?

      Many of those that do require understanding of research have probably added that requirement recently.

      Remember, ultimately to some of these “doctors” you’re nothing but a glorified taxi driver. My two angry cents.

      I just want to be able to wear the cool taxi driver hat and have a medallion. 😉

      Maybe I should tell doctors that I have an obsession with Jodie Foster and I should start calling the ignorant doctors Sport. 😉 😉 😉

      .

  2. and you thought it was all a joke…. check the end of the clip http://www.youtube.com/watch?v=YzYxz_uvtSI

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