When to fly?

[Ridryder 911]

I fly when time is the element and is beneficial to the patient. Now, when doing this one has to consider time to fly and respond and of course transport. We automatically place our air service on stand-by when we have a potential major MVA, to reduce flight time.

The advantage of flying patients is time element, about half of ground speed. This of course depends upon terrain, weather, wind speed etc..

I agree with Dr. Bledsoe, we fly way too many and needless transports.

CAMTS used to have a protocol that many utilized.

R/r 911

[FormerEMSLT297]

At my full time job I make the decision to fly all my patients out.

The usual criteria is if the helicopter will get a patient to a trauma center within the "golden hour" or "golden period" which usually means within 1 hour of injury.

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. www.miemss.org/MdMedProtocols2006.pdf It should be on page 37 or so...

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. Opss,,, I forgot, thats right, I'm a flight medic LOL ..... check out the Maryland state protocols for medevacs at the link above.

[DwayneEMTP]

Take a peek at this page....

http://www.emtcity.com/phpBB2/viewtopic.ph...18&start=15

Dwayne

[iMac]

Thanks Dwayne, had never seen that post. Huge amount of interesting information.

[zippyRN]

What scenes have you all been on in which you have made the decision to fly that patient out?

it's a gut feeling

it's also situationally dependent

I've had a 'simple fall' flown out before ...

however the simple fall was off the top of an ice cream truck at the Moto GP just as the actual GP race was finishing ...

so the guy was immobilised becasue of MoI ( fallen 10 ft backwards off the top of a van) and ?LoC ...

normally load him up and take him the 10 ofr so miles down decent roads to one of the 2 nearer trauam recieving hospitals , however add 60,000 people trying to leave the circuit ... no brainer to get him flown no traffic jams in the skies

equally there's a few events i've covered where when you finally get to the event you start looking for LZs and where the wires are just because of the fun you've had getting to the site ( e.g. med cover for a Quad manufacuturer launching his next year's range to the farming and motorcycling press - in a big field at the back of the 18 hole golf course at the back of a nice country house hotel in the sticks of rural West Yorkshire ( up towards Nyorkshire for the Uk folks) - a couple of miles fro mthe road to the site on loose surfaced autmunal tracks including some pretty steep hills and humps ( had to put the none patient carrying response vehicle into low range to get up a couple of them)

fortunately no one fell off and a good day was had by all ...

[iMac]

Personal decision.Would be based on the pt's condition, distance to the nearest trauma centre, weather, extrication time, the golden hour.

If you have a serious trauma pt trapped in an vehicle, chances are you might want to have a chopper ready to get him to the horsepital to make it that "hour". There are so many things that can affect your decision. I have only flown one patient. He was presenting with your classic MI signs/symptoms, unstable vitals and we were over an hour away to closest ALS backup as well as medical facility that could actually handle this particular case.

Made the decision on the simple fact, to me he was very ill and we were away from everything (like always). I did second guess myself. Later learned it had been the right decision.

It all depends on the situation. I've worked in a air medical dispatch centre and know the list of your typical reasons for putting a chopper on pre-alert or launch them, but having said that I know I second guessed that day.

Situation dependant. I don't know it would be possible to make a solid yes or no list as to when you should or shouldn't send out a chopper. Just keep in mind that if you're flying your pt based more on you wanting a thrill, you're possibly putting someone's else's life at risk who might have actually needed that chopper. Use common sense.