Trauma Docs with lights and sirens?? What do you think?

[AnthonyM83]

Remember not to compare apples and oranges.

We have to consider the different factors that come with physicians driving their personal vehicles. How far away do they live without traffic? (20 minutes?) How far with traffic? (60 minutes?) I'm sure you guys can think of even more factors. I know here it can take me 5 to 15 minutes to go one freeway exit in certain stretches of the freeway during your regular rush hour (without any bad accidents). L/S would help significantly in these cases.

If there are specific concerns, you can always add in policies like no running red lights or stop signs...just use it to request vehicles to yield or to drive on the freeway shoulder...simpler stuff like that. Or whatever would fit your area best.

Asysin, I think it's a great idea to look into.

[Mediclcems]

In Fla where I work the trauma docs do have lights. Lights on a Viper! Who'd of thunk it. Anyway. I have overheard many times when we pull in "if I just had 2 more minutes" from the doc. Can't say I agree that they should have lights, but it may make a difference to someone, someday.

As for the docs staying at the hospital. We have a level 2 trauma center and not enough docs to staff 24/7. Not enough money to staff 24/7. Guess you can only do your best with what you have.

[Ace844]

In Fla where I work the trauma docs do have lights. Lights on a Viper! Who'd of thunk it. Anyway. I have overheard many times when we pull in "if I just had 2 more minutes" from the doc. Can't say I agree that they should have lights, but it may make a difference to someone, someday.

As for the docs staying at the hospital. We have a level 2 trauma center and not enough docs to staff 24/7. Not enough money to staff 24/7. Guess you can only do your best with what you have.

This is easily fixed as mentioned previously by "Rid, ASYS, & others," Compel the surgeons to stay in house and take call like most other hospitals, then it's a mere matter of getting them out of bed. They had to know what lifestyle they were getting into when they got accepted into residency. I don't think there is any justification to a doc having L&S in a POV just so he can sleep at home rather than; "in house,". They're quite well compensate dfor this...and there is little to no excuse for this not to be happening.

out here,

ACE844

[Ridryder 911]

I also question why a community would have 2 level II centers and can adequately pay for them in lieu of 1 Level I Trauma Center.. Sounds like the typical politics of medicine and hospital bureaucracy.

Wonder what the private insurance rate would be like on a viper with L/S ?.. I know, when I investigated most private insurance companies prefer not to cover p.o.v.. Again, we are not exploring options best for the patient..

Early recognition and appropriate trauma alert

Rapid & appropriate trauma assessment with no delay & expedite transport (not haul arse or diesel medicine) for tx in pre-hospital phase.

Early recognition of surgical candidate and radiological services upon arrival to ER or Trauma Bay.

Surgical team available with appropriate surgeon and all pre-surgical work up performed.

Yes, we can not treat trauma.. having a Board Certified Thoracic Surgeon riding in the back of an EMS unit would not change outcomes, be realistic they are not-educated for prehospital care and are totally out of their surroundings. Look at them in an ER their lost & I have seen them in the field.they usually are clueless... . Folks, these are people too.. I worked in Level I and you have to do certain thing(s) prior to surgery..Surgeons are physicians with a specific role, not gods. .. Their main emphasis is to stop the internal bleeding and repair and remove organs that are injured. But, before they go in .. again there are certain things that have to be done & performed.

Trauma is leading killer between the ages of 4 & 35 the 4'th leading cause of death over all. Trauma kills.. short and simple, if traumatic arrest occurs the chances of successful resuscitation is very poor. Study TRISS scores, and see outcomes are poor.

Again, simple mathematics in response times... to reduce the time in half, you have to double your speed, no matter where or how far. To increase the time by additional seconds you have to increase speed and to increase that number you have to increase distance. Again, mathematics.. not, including stopping time, etc..

Be safe,

R/R 911

[AnthonyM83]

This is easily fixed as mentioned previously by "Rid, ASYS, & others," Compel the surgeons to stay in house and take call like most other hospitals, then it's a mere matter of getting them out of bed. They had to know what lifestyle they were getting into when they got accepted into residency. I don't think there is any justification to a doc having L&S in a POV just so he can sleep at home rather than; "in house,". They're quite well compensate dfor this...and there is little to no excuse for this not to be happening.

Not necessarily. See the previous post about Fla where they have L/S...if this is how things were done during residency, then they weren't getting themselves into. I'd hate to be be on call with not much to do, especially if I had kids and a family.

[AnthonyM83]

Again, simple mathematics in response times... to reduce the time in half, you have to double your speed, no matter where or how far. To increase the time by additional seconds you have to increase speed and to increase that number you have to increase distance. Again, mathematics.. not, including stopping time, etc..

That's using statistics in a misleading manner. During rush hour on the gridlocked freeways, the traffic speed might be 5-10 MPH. So, by having L/S, you could ride the shoulder and cut your travel time by 1/3 or 1/4 or even more. That's pretty good! You do NOT have to be going 130 on the freeway to cut your time in half.

[flight-lp]

I can't believe this is even being debated. Physicians need to be in or go to their hospital if they are called for service. The presence of a "trauma doc" on scene cannot and will not change an outcome. These patients need the OR and a surgeon, not a lighted out BMW on scene with a doc doing the exact same things that can be done by Medics.

I also believe that a big problem with outcomes is ignorance on the part of EMS. Crews need to know exactly what capabilities each and every hospital in their service area has and check that availability daily. All too often I get a call picking up a neuro trauma from the local ER to take to the trauma center 45 minutes away because the local EMS didn't transport to the appropriate facility in the first place. This delay in care is a big factor in overall poor income. We have to know what to transport to where. And keep the docs where they belong.................

True, it only saves three or four minutes.... but can YOU go that long without oxygen? If you can't, should the patients have to if we can help it?

What does this have to do with a doctor being on scene or not? The airway will still be managed by EMS on scene................

[Dustdevil]

Uhhh... LP, it is often useful to read the original post before replying to a topic. :?

A certain hospital which was designated a trauma center (obviously not a level I) put forward the idea that the on call trauma surgeons be allowed to equip their personal vehicles with warning devices and be allowed to respond, to the hospital only, with the same rules applying as an emergency vehicle, if a critical trauma came in.

This has nothing to do with scene responses.

[flight-lp]

Whoops, so much for attention to detail............... :oops:

I still think it is a dumb idea though.........

If the patients condition requires an immediate surgical need, then perhaps they need to be at a hospital with that capability, i.e. a level one vs. a local "doc in the box" ER. My point being the medics need to have the thought processes to evaluate the most appropriate facility instead of taking these patients to the closest ER. Distance isn't always the highest priority factor................

[Asysin2leads]

I agree a properly funded level I trauma center is the gold standard for trauma care, but as you know, many places have to make due with what they have. I say a surgeon responding to the local level II trauma center is a heck of a lot safer than trying to pull off a medivac to a level I. Yes, believe it or not landing a helicopter is really dangerous.