Scene times....

[Ace844]

You've lost me, mate! I think it's meant as a joke, so I'm probably just being a bit thick. Please explain (sorry for ruining the pun)

"Welsh,"

I spent the last month and a half or so traveling in Eastern Europe and even abit out your way. While on my trip, I noticed something pretty much universal. Unless you ask for 'still water'; i.e.: no-carbonation-gas. You got carbonated instead. Next, it cost more $$'s for non-carbonated water, which is relatively cheap here. Anyway, Iw as more being facetious than anything so never mind..

ACe844

[WelshMedic]

Oh, now I get it! Ordering water in a restaurant isn't particularly common here, if you ask for water you're likely to get tap water - which is obviously free. But there are lots of things about you lot that make us raise our eyebrows as well..... :wink:

I mean, why is it that whenever I pay a bill in a restaurant I have to add the tax as extra?

Why does the waiter/shopassistant always ask "How are you today?" when I really don't think he/she could really give a toss?

An ex-movie star (may he RIP) as President?

Barney / oh no, forget that one, my kids love him!!!

Dan Quayle

Need I go on.....................

WM:

[pmedic623]

alot of variant responses here. Does any employer "gig" you on going beyond a certain scene time?

BTW, when I say "scene" time, I mean from your on scene time to your transporting to hospital time...

PRPG

[vs-eh?]

Okay.....(ducks wooden shoe being thrown).... in response to this question PRPG we get a 15 min status check so we know where we are at time wise and our medical director gets us with over 20min scene times if there is no explanation given in the report....Alright keep throwing the wooden clogs....623

That's ridiculous. Patient assessment doesn't need an egg timer. Your medical director doesn't have a pager telling him he has been assessing this patient for 15mins and to move it along or else the hospital gets pissed.

This again falls into the algorithmic approach that I find far too many people take towards calls. BSI, scene safety, O2, 2 large bore IV's, monitor, stairchair...Phew, did that in 15mins...This isn't school, you should have proven you could do things quickly when needed then, not on the road as a presumed professional.

Like do you get this page, and then go to the patient, "Ok sir we need to move this along..." Like seriously, it's silly.

So on every form do you just say "family issues", "patient movement problems", whatever every time?

It goes to show what profit motivation does. Thirty minutes or free, right?

[pmedic623]

That's ridiculous. Patient assessment doesn't need an egg timer. Your medical director doesn't have a pager telling him he has been assessing this patient for 15mins and to move it along or else the hospital gets pissed.

This again falls into the algorithmic approach that I find far too many people take towards calls. BSI, scene safety, O2, 2 large bore IV's, monitor, stairchair...Phew, did that in 15mins...This isn't school, you should have proven you could do things quickly when needed then, not on the road as a presumed professional.

Like do you get this page, and then go to the patient, "Ok sir we need to move this along..." Like seriously, it's silly.

So on every form do you just say "family issues", "patient movement problems", whatever every time?

It goes to show what profit motivation does. Thirty minutes or free, right?

Well put.......623

[Ace844]

Hi Everyone,

Since we're discussing 'scene times' here's a recent abstract to a 'Meta-analysis study' published in JPHEC.

(Prehospital Emergency Care Publisher: Taylor & Francis Health Sciences @ part of the Taylor & Francis Group; Issue: Volume 10, Number 2 / April-June 2006; Pages: 198 - 206; DOI: 10.1080/10903120500541324; A Meta-Analysis of Prehospital Care Times for Trauma;

Brendan G. Carr A1, Joel M. Caplan A2, John P. Pryor A1, Charles C. Branas A3 ;A1 Trauma Center, Penn; A2 School of Social Work, University of Pennsylvania; A3 Department of Biostatistics and Epidemiology)

Abstract:

Background. Time to definitive care is a major determinant of trauma patient outcomes yet little is empirically known about prehospital times at the national level. We sought to determine national averages for prehospital times based on a systematic review of published literature. Methods. We performed a systematic literature search for all articles reporting prehospital times for trauma patients transported by helicopter and ground ambulance over a 30-year period. Forty-nine articles were included in a final meta-analysis. Activation time, response time, on-scene time, and transport time were abstracted from these articles. Prehospital times were also divided into urban, suburban, rural, and air transports. Statistical tests were computed using weighted arithmetic means and standard deviations. Results. The data were drawn from 20 states in all four U.S. Census Regions and represent the prehospital experience of 155,179 patients. Average duration in minutes for urban, suburban, and rural ground ambulances for the total prehospital interval were 30.96, 30.97, and 43.17; for the response interval were 5.25, 5.21, and 7.72; for the on-scene interval were 13.40, 13.39, and 14.59; and for the transport interval were 10.77, 10.86, and 17.28. Average helicopter ambulance times were response 23.25, on-scene 20.43, and transport 29.80 minutes. Conclusions. Despite the emphasis on time in the prehospital and trauma literature there has been no national effort to empirically define average prehospital time intervals for trauma patients. We provide points of reference for prehospital intervals so that policymakers can compare individual emergency medical systems to national norms.

Hope this helps,

ACE844

[PRPGfirerescuetech]

Hi Everyone,

Since we're discussing 'scene times' here's a recent abstract to a 'Meta-analysis study' published in JPHEC.

(Prehospital Emergency Care Publisher: Taylor & Francis Health Sciences @ part of the Taylor & Francis Group; Issue: Volume 10, Number 2 / April-June 2006; Pages: 198 - 206; DOI: 10.1080/10903120500541324; A Meta-Analysis of Prehospital Care Times for Trauma;

Brendan G. Carr A1, Joel M. Caplan A2, John P. Pryor A1, Charles C. Branas A3 ;A1 Trauma Center, Penn; A2 School of Social Work, University of Pennsylvania; A3 Department of Biostatistics and Epidemiology)

Abstract:

Background. Time to definitive care is a major determinant of trauma patient outcomes yet little is empirically known about prehospital times at the national level. We sought to determine national averages for prehospital times based on a systematic review of published literature. Methods. We performed a systematic literature search for all articles reporting prehospital times for trauma patients transported by helicopter and ground ambulance over a 30-year period. Forty-nine articles were included in a final meta-analysis. Activation time, response time, on-scene time, and transport time were abstracted from these articles. Prehospital times were also divided into urban, suburban, rural, and air transports. Statistical tests were computed using weighted arithmetic means and standard deviations. Results. The data were drawn from 20 states in all four U.S. Census Regions and represent the prehospital experience of 155,179 patients. Average duration in minutes for urban, suburban, and rural ground ambulances for the total prehospital interval were 30.96, 30.97, and 43.17; for the response interval were 5.25, 5.21, and 7.72; for the on-scene interval were 13.40, 13.39, and 14.59; and for the transport interval were 10.77, 10.86, and 17.28. Average helicopter ambulance times were response 23.25, on-scene 20.43, and transport 29.80 minutes. Conclusions. Despite the emphasis on time in the prehospital and trauma literature there has been no national effort to empirically define average prehospital time intervals for trauma patients. We provide points of reference for prehospital intervals so that policymakers can compare individual emergency medical systems to national norms.

Hope this helps,

ACE844

Hmmm. So know one knows if scene times matter? Am I reading that right Ace?

[JPINFV]

Hmmm. So know one knows if scene times matter? Am I reading that right Ace?

If I'm reading that abstract correctly, it just shows how long the average length of a trauma call (activation, response, on-scene, and transport times) for urban, sub-urban, rural, and aeromed, but it makes no conclusions on if the time has an effect on patient outcome. My guess would be that the time element is greatly over exaggerated. Saving a minute or two is not going to change patient outcome. Saving 10, 15, 20, etc minutes, might change the outcome (the greater the savings, the better the outcome). It's important to not be on scene with a thumb stuck firmly up your butt, but there is no reason to rush. Its better to take a bit of time and get an IV/intubation/etc right the first time then to mess it up and take longer as you give it another try. You want that grey area between "waste makes haste" and "idle hands are the Devil's tools."

[Mediclcems]

Good morning!

I havent stirred the pot here in awhile. Time to give it a try.

What is an acceptable scene time? What is the boundary between acceptable and too long?

Can you even define too long? Can there even be a definable amount of time?

I've always thought 25 minutes was the longest time, outside of special circumstances.

Thoughts? Comments?

Acceptable scene time varies for each patient.... Some take less time to assess that others. Severity of condition and time to hospital should also be considered. If the hospital is 2 minutes away, it would take me longer to put on the CPAP than to get to the hospital where respiratory is waiting for us...unless the patient needs a tube NOW, I'd be hauling butt. I have partners who load and go and partners who stay and play. Guess everyone has a differing opinion.

[shade]

Trauma=10minutes, Medical= 20 minutes. I try to watch it, but providing the best care is #1. Usually can make it unless something out of the ordinary, like----- fall Pt. in a bathroom (How come???), etc. Only time I usually take a little longer is a diabetic. If I can assess and get that changed, I do. Hospital takes forever to do the diabetic stuff, they worry about ekg's, etc first. Employer is really satisfied with our crews performance. 8)