flight-lp

As there is absolutely no relevence to treatment in the field and the fact that x-rays will delay care and cause further manipulation of the patient thus increasing pain, in field radiology is pointless IMHO. From a financial standpoint, as others have pointed out, the ones who could remotely have a general hypothesis for use are the ones who cannot afford it. Plus the "outlying" regions need to focus on what really needs to be accomplished; getting the patient to a definitive care facility, not playing radiologist. If distance is a factor, fly 'em. After all, thats why aeromedical evacuation was started in the first place..

Anemia perhaps???? Any hx. or iron deficiency?

I think this is an issue that is really misunderstood and undertreated. My personal thoughts (and the protocol of our medical director) is drug 'em till they drool!! Consider this........How can you objectively tell what a patients response to pain is. Answer, you can't. Pain is exactly what the patient tells you it is, plain and simple. Our analgesics that are routinely administered can be reversed should hemodynamic or respiratory side effects present. I do understand the frustration when you know that a patient is completely blowing smoke up your ass for meds, but can you without a shadow of a doubt objectively and factually state to the judge and jury that the patients pain was not what they described? I'll bet a years salary you can't. I don't like it, I don't agree with the stupidity and addictions of society, but I have learned to deal with it. Treat your patients with an assumptive attitude and you will be the one who thinks that the massive non Q-wave MI that the cocaine addict is having is only looking for an excuse to get some Morphine...................

North side of Houston, largest Emergency Services District in Texas. We should top around 23-24000 calls this year (maybe a few more courtesy of Rita and the clustered I-45 evacuation last week!!).

All of 'em have one or two bad apples!!!!! Since you Quoted MHHS-Hermann Hospital, I will offer another top reason why they are less than cooperative in giving pre-hospital orders, it is because most physicians that will actually talk to an EMS crew are residents and are not allowed to give on-line medical control orders per UT med school policy. Bottom line is these guys (and gals) are busy, they do not have time to consult with EMS. Hermann has a medical control officer on duty (a Paramedic in the LifeFlight office) who consults with the few agencies that are involved in an online medical control program. Most 911 providers in the area though are completely offline with standing orders, my service included. Usually the only reason why I transport to Hermann is for level I trauma cases, none of which should require any deviation from the basic trauma standards of care. Any medical patient that I have that would require such a deviation to save their life and that would require me to speak to a physician in the field would need to go to a closer facility. Houston is fortunate to have such a wide variety of services available in the outlying metropolitan areas, going "downtown to Hermann" isn't needed as often as it is used. The amount of time it takes to finally get through to a physician can also be used to thoroughly re-think and reassess your patient and then make an appropriate decision for their care. Just my .02 cents worth anyways.

the medics. Unfortunately as you and I both know, TDH is never wrong, even when they are!!!!

Arff - Six Flags is the coolest job in the world isn't it!!!!! I had a blast when I worked at Astroworld back in the early 90's. You are correct, but you have a distinct difference, you have a doc available who accepts the medical responsibility for your activities, just as Six Flags does. The activities in question concern offering of EMS services without protocols or any type of medical direction. there is a big difference, the MD aspect....

Aw now hold on a sec.......You are now talking about two distinct and separate animals. 1. License of the unit 2. License of the operating company You can run 2 medics out of a Yugo, but if those two medics are offering any level of care above that of a regular citizen, you are then providing emergency care which is subject to licensing. You cannot offer bandaging, splinting, c-spine, or even vitals unless you are a licensed ambulance company. In addition you must have protocols and you must have medical direction. There are variances to this ruling, but I would make sure that you have specific authorization from the Department of Health so there are no questions. But based on what was originally stated and reviewing TDH policy, they were wrong..............

Texas Administrative Code 157.5 and 157.11 clearly outline the state's licensing requirements for any EMS personnel providing any level of pre-hospital care. While I do agree that there are many more in violation, your organization is in the wrong sorry to say..................