erraticating trauma alerts

[VentMedic]

No, I don't. That was kind of my point. It was the hospitals stance that it did nothing to help the pt. in the long run. I have no numbers to support that claim, nor can I find any out there. So my question is, why do they feel it necessary to tell us this, if they cannot support that claim with facts.

Ran across a great debate subject the other day at work. I was talking with a fellow employee about calling trauma alerts when he told me that our state was looking into eliminating them all together. Their justification for all this was that we (emt's) didn't call them properly, and in the long run, didn't do much to change the overall mortality rates.

So, is this hospital pulling out of the trauma registry?

Are they going to still report their data?

Their status change should be listed. That should be easy enough to check out before unsubstantiated rumors are started or any more speculation gets you more upset.

This still may be an effort for them to appease the patients who are getting billed heavily each time you activate the alert. It may just mean a change in criteria for alert activation.

[sevenball]

I wish it were just to get the activation criteria to change, and I'm sure that it is just to keep cost down, but there is industry wide speculation (and I stress speculation) that trauma alerts will no longer be used, that the call will be from the accepting physician based on the information provided to him from EMS. That would be fine, but that takes away from the "hunch" aspect, that takes away from the simple fact that the physician cannot see the pt. and will only go by mechanism of injury, and if the pt. is hemodynamically stable, which can provide false readings if the pt. is compensating.

[VentMedic]

. Their justification for all this was that we (emt's) didn't call them properly, and in the long run, didn't do much to change the overall mortality rates.

Is your service BLS or ALS?

You may just have to transslate your "hunches" into assessible findings to allow the physician to get a better picture of the patient.

[akroeze]

be or p,

No, I don't. That was kind of my point. It was the hospitals stance that it did nothing to help the pt. in the long run. I have no numbers to support that claim, nor can I find any out there. So my question is, why do they feel it necessary to tell us this, if they cannot support that claim with facts.

Actually, I think he was asking you to support your claim that calling a trauma alert saves lives? He was asking for your facts.

[BEorP]

Actually, I think he was asking you to support your claim that calling a trauma alert saves lives? He was asking for your facts.

That is exactly it. If the hospital is wrong, show us.

[BEorP]

As for the desk jockey comment, sorry if it offended you, but lets face it, EMS has changed. If someone has been riding a desk for the last 15 years, they are out of touch. Much like the politician who has been in senate for 30 years, there is no way they can relate to a street medic, or common man. You have to be able to work the streets to know the caliber of medic that is out there. Granted, the system isn't perfect, this I know, but certainly, we are able to think outside the box alot better now than we ever had in the past.

The comment didn't offend me personally (I work on the road currently) but I just think that all too often uneducated field providers disregard what more educated people say because "they don't know what it is like on the road." I know that this is often true, but it is not always the case. I am curious now though about your education since you seem very confident in your ability to always do what is best for the patient. If so don't mind me asking, when is the last time you read an EMS research paper and what is your level of education?

[BEorP]

I wish it were just to get the activation criteria to change, and I'm sure that it is just to keep cost down, but there is industry wide speculation (and I stress speculation) that trauma alerts will no longer be used, that the call will be from the accepting physician based on the information provided to him from EMS. That would be fine, but that takes away from the "hunch" aspect, that takes away from the simple fact that the physician cannot see the pt. and will only go by mechanism of injury, and if the pt. is hemodynamically stable, which can provide false readings if the pt. is compensating.

Sounds like the physician has done their homework then... "Initial trauma team evaluation of hemodynamically stable blunt trauma victims whose only reason for trauma center transport is mechanism of injury is needlessly labor intensive and is not cost effective." (from http://www.jtrauma.com/pt/re/jtrauma/abstr...195629!8091!-1)

And yes I know that cost should not be the only factor to consider but if there are high costs then that means resources being used (or wasted) also that could be better allocated to other patients.

[Asysin2leads]

Our notification system is very brief, including usually only patient's age, vitals, mechanism of injury, and care given (Sometimes simply saying ALS established) with an ETA. Sometimes they get through, sometimes the dispatcher is too busy. Honestly, a properly equipped Level I should be ready to throw down whether they get a note or not. Personally I think its goes a little smoother when we call ahead, but nothing stunning. First of all, an EMT's assessment skills, in the grand scheme of things, are very limited. Secondly, they'll redo everything once you get to the ER, with lots of people and bright lights to work under. That's probably what the desk jockey was getting at. Relax a little.

[Dustdevil]

How could some desk jockey tell me that I didn't know the difference between a surgical candidate, and one that needed some boo boo tape. Maybe I'm overly sensitive on this one, but I was enraged.

Yeah, I think you are being oversensitive. He wasn't telling you that you personally don't know the difference. He's saying that it is painfully apparent that the majority of providers in your area cannot. If you are the exception to the rule, congratulations.

You have to be able to work the streets to know the caliber of medic that is out there.

No, you don't. The proof is in the results, and you deliver your results to the ER after every run, resulting in the statistics the "desk jockey" is using. But, to be honest (and admitting that I know nothing about your local system other than the very unfortunate fact that they utilise EMTs), I'd be willing to bet that the more the desk jockey actually knew about your providers, the less impressed he'd be. What could he possibly see in the field that would change the statistical fact that the trauma alerts are not working?

[Richard B the EMT]

In the FDNY EMS, we call in "notes" (notifications) when we feel the patient may benefit by having the ER crews advised prior to our arrival of what is coming their way.

Asysin2leads' statement of "Our notification system is very brief, including usually only patient's age, vitals, mechanism of injury, and care given (Sometimes simply saying ALS established) with an ETA" is accurate, and usually done when going to an area trauma center. Then, again, I have heard over the scanner, that it seems to be mandated that any ambulance in New Jersey heading to an ER sends a "note" prior to the arrival, from the stubbed toe, to the patient pulled from the wrecked car in traumatic arrest from the gun shot wound (I seem to like drama, don't I?).