ATV Accident

[firefighter523]

Here's the senerio ladies and gentleman.

1700: Medic unit dispatched to a farm for a 27 yom that was riding his ATV, and after flying through his yard and hitting a jump, he lost control and was ejected from his vehicle.

12 minute ETA of MICU. Helicopter placed on standby. Fire on location shortly after dispatch, reporting a 27 yom, confused, in and out of conciousness. Longest period of LOC is 20 to 30 seconds witnessed by fire chief.

Helo flown after that report. MICU still 6 minutes out. Nearest trauma center 25 minutes from scene by ground. I just got my ass reemed by a supervisor because we didn't wait until we got on location before we flew the bird. Turns out this patient was found by us with anterograde amnesia, and slurred speach after the accident.

What would have you done in this situation. I think someone was pissed cause they couldn't bill for this.

Your thought please.

[ncmedic309]

Just based on the mechanism and your transport time to the trauma center warrants flight services. The information given to you over the radio by the fire chief on scene only confirms the reason you requested it in the first place. I don't have any problem requesting them if the situation warrants it or potentially warrants it. It's much easier to cancel them once you get on scene than to request them late when they could already be enroute, you made the right call...

[TechMedic05]

Did you, or the FD request the helicopter? Quite possibly only for placing the blame, but it's a legitimate consideration.

Confusion, loss of consciousness, mechanism of injury, and the helicopter was started early, so no waiting on the ground on scene or at a 'helispot' for intercept.

We can't quarterback a call, but I don't see any tremendous issues right off. Provided it was done within your protocol, medical direction if required, etc. etc.

Where I work - most people are either "Fly right off, and get it there" or their "wait and see, and just bring to the hospital anyways" Do what needs to get done. Every system is different.

[Ridryder 911]

This sounds very remotely strange, I have flown to so many ATV, all resulting with bad results. I totally disagree with awaiting for helo... remember..."olden Hours starts with the incidence, not our response or arrival. Why wait? That is asinine, and delays further treatment and transport. One can always cancel, I do it routinely.. with incidences of high speed ATV, injuries are usually associated TBI, Neuro/Spinal Injuries, etc.. This is not like a simple residential MVC scene.

Tell your Supv., next time if it is his kid or him, you will be sure evaluate then call the helo..... p.s. one can still bill, even if they don't transport... they might want to investigate this.

R/r 911

[ffmedic9588]

That is terrible we put the almighty dollar before our pts well being. I think that it is morally and ethically wrong and any supervisors/management that operates this way should be spoken to and dismissed if found to be true. So you safe a life or make it so the pt has a better outcome and you get into trouble what is wrong with this situation?? I am sorry about my rant but this really bothers me and has since I have started in EMS 6 years ago. I think you did the right thing for sure. Thumbs up.

PS I know all services and management personal are not all about the bottom dollar so I am not making a general blanket statement just for the record.

[SSaint]

Putting money before the patient is one reason I prefer to see municipality-run services over private companies.

I know not all private companies operate like that, but some do.

And I should be glad this isn't the fifties, or I'd be appearing in front of Joe McCarthy...

[FormerEMSLT297]

As I flight medic myself, i get the times after the call and sometimes wonder,,, call dispatch time 1400... first unit on scene 1410.. lifeflight requested 1430...... hmmm what took 20 minutes to request a helo.....

I dunno what your protocols say BUT....

When I was solely a ground provider,, i used to look at it this way,,,,, the fastest way to the trauma center is helo.... but waiting for them to warm up and fly 10 minutes to the scene,,, you could have driven 10 minutes closer to the hospital.

When I called for a helo ,, i tried to do it AS SOON AS POSSIBLE.... now sometimes u cant tell right away, by eye balling the patient.. but if you know you first due area,,, and what trauma centers are open/available..... you know what the traffic is like cause you just drove through it going to the call.... the sooner you call the helo the better.

It'd just good patient care..... don't feel bad about it don't feel you have to argue about it....

If your supervisor is worried about the all mighty dollar,, ask him this..... If I didn't call for the helo, and the patient DIED or suffered a debilitating injury, and the family SUED our company.... then what would have happened.

You acted in the BEST INTEREST OF THE PATIENT... which is all we can try to do..

[Ridryder 911]

This had nothing to do with money. Even companies that are ran private and want as much revenue as they can, know how to bill for initial care, and transfer of care to another organization. All our municipilaties bill, no matter private, city or volunteer, without the funding EMS is doomed. One that is financial savvy also performs risk management knowing the best care for the patient decreases liability.

R/r 911

[Coach Hohman]

Our motto is "When in doubt, fly them out"...Helicopter crews have told us if it remotely sounds bad get them on standby, if there's any extrication involved with the jaws generally we get them in route. In your case I think you were 100% right. The thing about the helicopter is, you can't really go wrong. So what if you fly them level 1 and they find out he had a concussion, atleast he had the best treatment avaiable had he had more problems. You're taught as a basic that MOI should be the basis of your decision, and in this cae...you have every right to call a helo.

[SSaint]

This had nothing to do with money. Even companies that are ran private and want as much revenue as they can, know how to bill for initial care, and transfer of care to another organization. All our municipilaties bill, no matter private, city or volunteer, without the funding EMS is doomed. One that is financial savvy also performs risk management knowing the best care for the patient decreases liability.

R/r 911

Oh, I'm not saying my municipal service doesnt bill. We bill at just a hair above cost, to pay the professional portion of our staff, and other expenses (insurance, etc)

I've heard of agencies that bill as much as $1,000 if a 'medic even RESPONDS to a call. That's just for showing up. Let's not even get into the expenses behind procedures, and transport mileage.