Should Heart Attack Care be More Like Trauma Care?

[flight-lp]

Thats what I said, pediatric trauma goes to Hermann. The only thing we take to TCH is medical, and I have yet to find to many people who have transported to Ben Taub with a pediatric patient (even though they have a pedi ER).

I thought Conroe was nearing Level 2 status. I know that the new Katy Hermann is suppose to be a Level 3 and there was a rumor that a Level 2 hospital was going to be built around Highway 3/Beltway 8/I-45 to service Pasadena, South Houston, and Clear Lake. Is Mainland even ranked?

Ben Taub is no longer accepting pedi trauma or surgical patients. TCH is a wonderful trauma facility, but unknown to most, you can not fly a primary scene trauma patient to them as you have to land at Methodist and then travel through the "tunnel". Apparantly during this 12 minute walk, a pt. had a deterioration and thus no more helo flights into TCH.

Conroe is no longer a rated trauma center, they dropped their level III which has screwed up Montgomery County beyond belief. MHHS-The Woodlands is now MCHD's dumping ground and it is severly overtasking them. Kingwood should have their level III soon, we are hoping by summer.

People have talked for years about another level I or Level II. Bottom line is tax payers never approve it! Everyone is supportive until they find out that they have to pay for it!!!!!

Mainland isn't a rated trauma center, no need as UTMB is only 12 minutes away.................

[Nate]

Freaking nurses telling me lies, they told me TCH wasn't a trauma center for pedis. :evil:

[flight-lp]

I stand corrected Nate, your nurses didn't technically lie, they are not a rated level 1, but they do have the capability............

[Nate]

I stand corrected Nate, your nurses didn't technically lie, they are not a rated level 1, but they do have the capability............

The only thing that sucks about TCH is the very long triage times if your stable.

[kevkei]

Anybody out there using thrombolytics in the pre-hospital environment?

Yes we are. We either go to the cath lab or administer thrombolytics prehospitally.

Here is our protocol for establishing which treatment the patient gets.

[web:fddd0e3b53]http://ecity/EmpSupervisor/News/EmergencyResponse/EMSParade/ProgramDevelopment/VHRPrehospWorksheet.pdf[/web:fddd0e3b53]

[Guest DELETED]

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[Nate]

I was called out to a patient last Monday who was reported to be c/o chest pain that felt just like her prior MI in Feb. 2003. Patient rated the pain a 10, raidating to the left arm, was a sharp pain, nothing made it better/worse, and she had taken 3 nitro with no effect. She refused to go to the local ER (which can handle an MI just fine), instead wanting to go to St. Luke's (Texas Medical Center area, also the Texas Heart Inst.) because that is where her doctors are. I tried to get her to go to local ER (CYA), but she refused AMA (no problem).

Turns out she had a minor MI (I had to argue with the staff to get a doctor to read the EKG and he saw the MI that I was seeing) and was in the ICU until Thursday. Well Sunday morning (two hours before we were to get off) she calls again saying she is having CP. Put her on the monitor, same thing she wants to go back to the ER at St. Luke's. So off we go. I ended up getting jumped on by a supervisor for taking her there.

So when I got back to the station I spend 30 minutes explaining what an MI is, how to treat it, the proper treatment upon arrival at the hospital, the benefits of St. Luke's vs. local ER (who on the weekends can get a team together in 30 minutes to 3 hours), and patient rights. He shut up, then again this is the same man who gets V-Tach and Sinus Tach confused. :shock:

[antc]

We currently use lifepak 12 for stemi and go directly to the cath lab. We see the benefits as sometimes we will watch the procedure whilst completing paperwork or if it's quiet. Watching a bradycardic patient with a blocked RCA being reperfused and their heart rate increase and discharged the next day is amazing. We have patients who have arrested, been defibed back into a perfusing rhythm enroute and still bypass a hospital and straight into the lab.

Take them to the local hospital and shorten / end their life or wreck their quality of life. Lots of our patients have been reperfused in less than one hour from when they ring.