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DwayneEMTP

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flight medic checking in .... I agree with what Dr. B. said. When the private operator makes a go/no go decsion, it can be based on the all mighty dollar. Govt and state run operators rely more on safety, weather minimums, etc. Before we axcept any flight our pilots check the weather radar in our hangar. This is especially important during the summer when pop up thunderstorms can reek havoc with an aircraft. I also agree that the bigger airframe's that the State and Govt operators fly can be a difference. As far as maintenence the standards are the same as for Private and Govt. operators so I don't know if that is so much a factor.

As far as what ground providers can do. Only fly a patient that will really benefit from arriving within the golden hour.

I have a friend whose husband was flown by a Pvt. operator from a local hosp. to a cardiac cath lab. The Dr. strong armed my friend into using a helo. Needs to gat there right away, don't you wnat him to get the best care ,,, blah blah blah... Well they flew him, and after landing at the cardiac Cath hospital, they waited about 30-45 minutes before he was taken into the cath lab. My friend was like ,, why did we rush and fly only to wait?..... later she got the bill for i think 10K and she was like this was a 10 minute flight why was is so expensive?????

She was pissed. No to mention the ground transport would have only been 20-30 minutes and only a few hundred not thousand dollars....

My thoughts are my own and do not represent my agency or dept.

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Well they flew him, and after landing at the cardiac Cath hospital, they waited about 30-45 minutes before he was taken into the cath lab. My friend was like ,, why did we rush and fly only to wait?

Far be it from me to defend the overuse of HEMS. Not in this lifetime. But in fairness to this situation, it seems apparent to me that valuable time was indeed saved. I suspect that that they would have had that 30-45 minute wait, no matter how fast or slow they had arrived. Hospital bureaucracy time exists irrespective of transport time.

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I think the impression given to my friend, and I just went thru refresher and a Doc said this to. Was that he would land, and be wisked into the cath lab right away, bypassing the ER and directly into the cath lab. That didn't happen in my friends case. They waited in the ER. And her point was she thought that her husband would be bypassing the ER and directly into the lab.. thats all.

As far as what on in the refresher class, the Doc from a particular hospital assured us that if a patient had ST elevation in 2 continuous leads, and we did a pre-hospital 12 lead the ambulance could by pass the ER and go straight to the cath lab and use the medics EKG as documentation.

My friend felt that the price of the helo in dont remember the numbers was very high for a few minute flight, and that the time saved by the flight was eaten up waiting in the ER.

My thoughts are my own and don't represent my agency or dept.

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I understand the concern of costs, however; it is not the referring or helo fault. Shameful, that the patient ever was received into the ER instead of being to sent directly to the cath lab. Appears the receiving hospital needs to get aboard with new national standards of door to cath... As well, I am surprised that the cardiologist is not having someones arse on a silver platter.. I know when either I have flown (usually Doc perceive those flown as being more serious) them in or go by ground.. the awaiting cath team is ready and the Doc is awaiting and time is money.. as well time is heart muscle.

I would have my friend discuss the situation with the patient representative of the hospital. Doubtful they will assist in payment of helicopter but, they may change the policies or better communications.

R/r 911

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for those that don't know why all the adulation for Dr. Bledsoe, he is, in the vernacular, an EMS Stud (note the capitalization of Stud).

from www.bryanbledsoe.com

Dr. Bryan Bledsoe is an emergency physician and EMS author from Midlothian, Texas. He entered EMS in 1974 as an EMT and attended one of the first paramedic programs in north Texas. Dr. Bledsoe worked for several years in Fort Worth as a paramedic and went on to become an EMS Instructor and Coordinator. Dr. Bledsoe has a B.S. from the University of Texas and a D.O. from the University of North Texas. He completed a residency at Texas Tech University Health Sciences Center and at Scott and White Memorial Hospital/Texas A&M College of Medicine. He is board-certified in emergency medicine.

Dr. Bledsoe has served as the Medical Director for two hospital emergency departments as well as for numerous EMS agencies in north Texas. He is the author of numerous EMS textbooks including: Paramedic Care: Principles & Practice, Paramedic Emergency Care, Prehospital Emergency Pharmacology, Anatomy and Physiology for Emergency Care, and many others. He is a frequent contributor to EMS magazines and presenter at national and international EMS conferences. He is married and lives in Midlothian, Texas. He enjoys salt-water fishing.

Dr. Bledsoe is an Adjunct Associate Professor of Emergency Medicine at the George Washington University Medical Center in Washington, DC. He is co-chair of the Curriculum and Education Board for the United States Special Operations Command (USSOCOM) at MacDill AFB, FL.

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Well, don't I look the turnip!

An EMS Stud, a Rapper, Texan and a Fisherman.

DCMed124: (I think you left out that he drives a beat up Toyota Truck too, hey, he can't be all bad)

cheers and salutations.

:twisted:

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Married to a beautiful hispanic lady, and has a son who is a United States Marine veteran of Iraq.

Yes, that makes him quite the guy in my book. :thumbright:

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