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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 Candy Caldwell on
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I have the fortune (or misfortune, depend on how you see it) as being both a paramedic and a nurse, I know this is a question I personally asked a million times. Here's is the short answer. Some are to lazy to transport the patient and some have a LONG transport time to the type of center they need. After having lived in the Chicago area I can appreciate a fast trip by ground to a good hospital. Having moved to North Carolina and knowing it will take 45 minutes to get to a trauma center (and this in on a good day) birds are a life saving choice that sometimes has to be done. Add to that the farm injuries and high speed injuries around here and its trouble! Sorry, it got a bit long, but I have seen the good and the bad of both sides.
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Permalink Reply by Liam on
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RSI is not allowed by our command docs. Therefor even if it's a medical scene call and you believe you need RSI to secure an airway the birdie flies.
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Permalink Reply by Dan Hoey on
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Where I used to be (So fla) depended on how much traffic there was. We had 2 patients at rush hour Refusals and ones that fly..lol..
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Permalink Reply by Katie Moon on
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Our neck of the woods is about 40 minutes by ground with NO traffic to the closest Level 1 Trauma Center.
We call for air transport when a patient meets criteria, or when multiple injuries require it.
I think of one time I called for air, when a guy fell out of a tree while trimming it, about 20+ft. He was pretty much an instant quad with some respiratory compromise. My partner and I couldn't safely turn him as we were surrounded by tree debris. Mutual aid arrived and helped us package him and cut a path out of the debris surrounding the base of the tree. The bird was circling as the ambulance arrived. They'd gone to the right road, wrong county.
Bet it's frustrating to get called for "critical" patients that aren't...kinda like a 2 a.m. blood pressure check.
When mechanism of injury suggests more injury than meets the eye, it's a good idea to fly. Unless you have to wait longer for the bird than it would take to drive.
I've heard some places call for air when they're working a trauma code. I wonder if they're just reluctant to call it and are passing it off for someone else to pronounce. -
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Permalink Reply by Angie on
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REFUSED HIM?? wow. i'd get canned on the spot for pulling a trick like that. i know laws differ from state to state. In PA we cannot release a patient to anyone with a 'lesser' certification without contacting medical command. i can't imagine refusing to fly a patient. our system flies any patient you request us to fly...regardless of their insurance status. that's apparently a big issue in other systems in other parts of the country.
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well, unless you have CT-scan eyes, you don't always have all the information. that can be frustrating at times. i've flown pts that i thought were BS, until i saw the CT or x-ray and discovered that they really were broken. goes both ways, i guess. AMIs and strokes out in the middle of nowhere...now that's a great reason to call. get that door-to-balloon time down. i love those flights!
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YES! "always act in the best interest of the patient." now you got it. :)
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Permalink Reply by IDLHgirl on
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Personally, I don't call as often as some people....they call for aviation based on ititial reports on dispatch. Unless it clearly meets the protocol criteria that basically requires me to request transport for the patient to a specialty hospital, I wait until I'm sure of what I've got. That might come from the BIR from the first in units...I cover a large rural area, but I can usually handle what gets dished out. There is the issue of long eta's to the scene and from the scene, but that is not usually problematic. I have a good level 3 trauma center in my area, and they have handled a lot of stuff that came their way....and even if they end up sending the patient on to another hospital they are certainly capable of stabilizing and providing initial care to help the patient survive the next step in their "journey" through the levels of care that they receive. No two calls are the same, so I never say never.....Anyway, by the time the Trooper lands (in my state, its state police that sends flight paramedics, and they don't carry much that we don't carry on the ground, but they CAN do RSI. It isn't like calling StatMedevac and getting the smorgasbord of drugs that they carry) I have everything done that they would do, and it really is just a quick transport to DC or Baltimore.
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Permalink Reply by EMT_I_FF_Froggie on
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Around this area, they have to have a roll over MVC, extrication time of no less than 45 min, trauma-wid pulse and Apnec, major head trauma and thats about it!
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Permalink Reply by Marc Allen on
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I don't know if I am unique or not but I am a paramedic that works for a fire department. We do not transport but we do provide ALS service. We carry a full compliment of drugs and equipment. With that said we will contact a "bird" if we have an extended extrication time or if the pt is going to require specialized care (pediatrics, burns ect.) because those hospitals are much further than our local trauma center. One of the things that we run in to is the private provider medic and the FD medic don't always see eye to eye on the need for Air transport. This can lead to some "interesting" on scene "discussions" if you know what I mean. Our Chief has given us the autonomy to decide what is best for our patients, using our best judgement on the scene at the time of the call.
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Permalink Reply by Chris Turner on
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I have two things...
First: I hate how my FD handles the bird. We have 3 EMT-Int, 15 Basics, and NO medics. We only do about 100 runs a year. (Yeah, I know) They call for a bird for EVERYTHING. We had a rollover the other night. The guy was GCS of 15 and had Abd tender and limb pain. We were 10 from out local bandaid station and the bird had a 10 min flight to us. Since I'm not an officer (but I was the most experienced and trained) I had no choice in calling for the bird.
Second: I don't know what the rest of the country is doing, but here in Central Ohio, there is a huge push to start flying all confirmed (confirmed to EMS standards) CVAs. I think it's a nice idea, but needs a lot of refinement. Any thoughts? -
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