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helicopters??
OK. so i'm curious.
what makes you want to call for an aircraft? when i was a ground provider, you'd have to show me a loop of your own bowel or be broken in many places in order for me to call for an aircraft. it seems like lately we get called for what i would classify as a BLS patient. what are they teaching in paramedic school these days?? and then there's the "medical scene call". wow. i love those.
now don't get me wrong...i'd rather be called and not really needed than needed and not called, if you know what i mean. but it just seems to me that ground providers ALS and BLS are calling for aircraft for the tiniest reasons.
let me know your thoughts. PLEASE!
what makes you want to call for an aircraft? when i was a ground provider, you'd have to show me a loop of your own bowel or be broken in many places in order for me to call for an aircraft. it seems like lately we get called for what i would classify as a BLS patient. what are they teaching in paramedic school these days?? and then there's the "medical scene call". wow. i love those.
now don't get me wrong...i'd rather be called and not really needed than needed and not called, if you know what i mean. but it just seems to me that ground providers ALS and BLS are calling for aircraft for the tiniest reasons.
let me know your thoughts. PLEASE!
Replies to This Discussion
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Permalink Reply by Christy on
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We primarly call when critical interventions are needed and pt is pinned or trapped. If I know that the pt is critical and our local hospital is going to fly them out then we will call for a helicopter to meet us on scene for long extrication or drive time or will call the ER and tell them they are going to need the chopper to send this pt out and request they get it en route to the hospital now. Our hospital has a lot of faith in the medics in my county and will generally go with the request.
Christy -
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Permalink Reply by Rachel Fulling on
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I coulndt agree with you more.. I have departments in my area that call a "bird" for the stupidest calls but yet dont call them when they really need them. As a pre-hospital provider I call a helicopter for a rapid transport to a trauma center with a prolonged extrication or off terrain trauma call!! But, I am fortunate where i live that i have 2 trauma center within 15 minutes ground transport. As a RN at the trauma center in the ED I know that we get EMS providers that call a trauma team activation wehn not need or under triage and dont call when they really need to... Where do we find the happy medium and educate them porperly??/
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Permalink Reply by Angie on
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OH GREAT. yeah...well if you're going to call me for all your pts....you'd better have either coffee or a milkshake waiting for me. :)
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oooooo. now that's a good point. I'm an ED RN in a Level I trauma center, too...and i see a good deal of alerts that are seriously NOT alertable. i just wonder what providers are thinking. i know we try to educate...help them to decide what is flyable and what isn't. i've heard some good thoughts here already. comfort level is a huge part of it, i believe. unfortunately...laziness might be a big factor as well. so now what?? LOL.
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faith in medics. how rare. i've worked in systems where i wasn't trusted AT ALL...and others where i could have done a field amputation and the doc wouldn't have batted an eyelash. weird huh?
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Permalink Reply by Shayna Orsen on
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Well, to be honest the helo service we have is more worried about getting reimbursed from insurance than critical care. They have set down patient requirements for us to activate them, but they don't always abide by them. Recently we had a serious entrapment with prolonged extrication, pt was unconscious, no obvious head wounds and had obvious bilateral fractures to the legs. We of course activated them and had the patient extricated upon their arrival. They landed, climbed in the back of the ambulance, took one look at the patient...and refused him. They then climbed back in the helo and left, we ended up ground transporting him to the trauma center they are based out of. He went into shock 5 minutes from the ER, and we found out later he had a big laceration to the femoral artery. I personally think he would have benefited from the helo...but hey it's their decision right?
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Our agency covers many barrier islands, with very rich residents who are of the slightly middle aged group. Mostly golfing communities really. When we have a serious cardiac or stroke emergencies we are allowed to activate, and they will fly as long as it's not a cardiac arrest. They wont fly for those types of emergencies on the mainland.
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Permalink Reply by emtp on
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I try to not activate air medical unless I am certain the patient needs it or their time to an appropriate facility is too long by ground.
I will fly medical patients if I am in BFE and they need time sensitive care, such as in a CVA or an obvious acute MI.
I have flown pts based on mechanism, but I try to only do that if there are co morbid factors like substance abuse or age.
It is easy sometimes to get caught up in the call and when we frequently don't get the whole story, it is hard to make perfect decision all the time. I've flown pts before that I was sure had major injuries only to find out later that there was nothing wrong with them and had I had more (all) information, I would have taken them by ground.
Where I work, certain stations fall under our destination guidelines and others don't. So a patient might get flown if they were picked up in one zone, but not another. I believe that if you always act in the best interest of the patient, the you can't go wrong. -
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Permalink Reply by dusty on
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I agree with emtp, I think sometimes we call for air transport thinking injuries are a lot worse than they are. But, thats how we are trained. We are trained to expect the worse. Some people just don't pay attention to the obvious, and they act before thinking. We have had people call for air transport and walk the patient to the aircraft. If the patient is well enough to walk to the aircraft, then they don't need to be in it. In my district, we are not allowed to call for air transport for any medical calls, even if you are in BFE. Some of our transport times can be 30 min or more. I really don't understand that policy. I think it could be beneficial for some medical patients to go by air depending on the transport time. But we do use air transport for trauma and that decision is left up to the paramedic or the ems supervisoron scene.
Angie, I do believe that a lot of this comes back to school. Unfortunately all instructors don't teach exactly the same. There is not any way to really track and be sure intructors are teaching really what they should. We all like to hear war stories but I think some instructors get caught up in the war stories too much, which can reflect on a student. -
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Permalink Reply by TealGunner on
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Helos are great. They are also much more plentiful in my area than ever before. When I started in New Mexico, we had ONE helo--UNMH's Lifeguard I. Since then, I've actually lost count of how many are flying. I don't usually use them as I work in the middle of Albuquerque and am only about 8 minutes from UNMH by ground. On the edges of the city and other rural areas, great response and transport times. We call as we need them--trauma or medical. Odd response from many years ago--snowstorm with very muddy roads and call for active MI. Ground crews hiked over a mile and a half in waist deep snow and freezing mud, the helo responded, landed, made patient contact, treated and transported the patient without any ground crew contact as they were still hiking when the patient left scene--strange, yes, appropriate, yes.
Oh yeah, we also hear from air crews on a continuing basis, "We love to fly, call us, you can always cancel."
There's also the issue of the amount of non-emergency calls that ground crews are responding to and the resulting burnout and dissatisfaction and therefore the human nature for the ALS helo to start getting its turn in the barrel in regards to calls that are below an "appropriate" level of severity. Nothing implied here, just some food for thought.
All in all, at the end of the day, we all have jobs to do and if that means hauling a non-emergent patient by air or ground or whatever, that's the job and it's our turn in the barrel. -
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Permalink Reply by John on
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I am an ALS provider in a rural area closest hospital about 20mins closest Level 1 Hospital is about 40mins away. So lengthy extrications, Type of injury, I have never called one for a medical call but would if i thought this person could receive help *much* quicker by air. But if your calling for a *Bird* helicopter and it is going to take 5 mins to get crew together and 8 mins to fly here then 8 mins to trauma 1 hospital that is 21 mins so if no extrication and pt isn't going in toilet land transport. I think alot of ALS providers feel it is the easier way out and panic. I am not sure why others do it. Whether they are right, wrong or indifferent. One thing to think about is the patient you have going to be using the bird and not really need it and now the bird is not available for a patient who surely needs it. I have been an ALS provider for 7years and BLS 4 before that and have been head EMT even as BLS no ALS and have transported ground.
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Permalink Reply by Michael Corns on
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Calling the helicopter? At times I think it depends on how close it is to the end of the shift.
As for he RN in the ED wondering why trauma alerts are called on some patients that don't seem to need it...I would offer, some things are out of the prehospital providers hands. We have to call a trauma alert when certain criteria is met even though the patient has only a small abrasion. Welcome to the world of protocols. -
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