STAT213

Having worked for STAT Flight and two other air medical programs, I can hopefully offer some useful tidbits to this discussion.
The helicopter is a resource like any other. It is supposed to provide faster transport and a higher level of care. If either of those will help your patient, then use it. There is VERY good evidence to show that two things are happening right now with helicopters. 1) getting patients to LEVEL ONE trauma centers quickly and efficiently helps them. 2) there is some overuse of aircraft leading to patients being discharged within 24 hours of arrival to the receiving facility.
The days of mechanism based transport should be done, just like mechanism based treatment. So, think. Will using the a/c benefit your patient? Will it get them there faster? I have done flights 6 miles from the med center. Stupid. It takes longer to fly in that case. I can tell you though, it's really tough for a number of different reasons to show up at a scene and not take the patient.
There are a number of STAT Flight horror stories from the early years. They made some poor choices in their staffing model and did not adequately train their crews as to the mission in the eyes of the pre hospital providers. Gotta ask your customers what THEY expect. There is a great photo somewhere of Air 1 on the sprain running with a patient in the back all by themselves. Rest of the wreck had cleared. ALL OF IT. and there they were stabilizing the patient as the capt said. Dumb. But, they thought they were doing the right thing. In a way, they were. In a way, they weren't.
Enough rambling. Peekskill may or may not be a good spot for a/c usage. Waiting for life star from CT with a patient who is lying in the road, prolly not. Load and go, do your best on the way.

Having worked for STAT Flight and two other air medical programs, I can hopefully offer some useful tidbits to this discussion.
The helicopter is a resource like any other. It is supposed to provide faster transport and a higher level of care. If either of those will help your patient, then use it. There is VERY good evidence to show that two things are happening right now with helicopters. 1) getting patients to LEVEL ONE trauma centers quickly and efficiently helps them. 2) there is some overuse of aircraft leading to patients being discharged within 24 hours of arrival to the receiving facility.
The days of mechanism based transport should be done, just like mechanism based treatment. So, think. Will using the a/c benefit your patient? Will it get them there faster? I have done flights 6 miles from the med center. Stupid. It takes longer to fly in that case. I can tell you though, it's really tough for a number of different reasons to show up at a scene and not take the patient.
There are a number of STAT Flight horror stories from the early years. They made some poor choices in their staffing model and did not adequately train their crews as to the mission in the eyes of the pre hospital providers. Gotta ask your customers what THEY expect. There is a great photo somewhere of Air 1 on the sprain running with a patient in the back all by themselves. Rest of the wreck had cleared. ALL OF IT. and there they were stabilizing the patient as the capt said. Dumb. But, they thought they were doing the right thing. In a way, they were. In a way, they weren't.
Enough rambling. Peekskill may or may not be a good spot for a/c usage. Waiting for life star from CT with a patient who is lying in the road, prolly not. Load and go, do your best on the way.

Having worked for STAT Flight and two other air medical programs, I can hopefully offer some useful tidbits to this discussion.
The helicopter is a resource like any other. It is supposed to provide faster transport and a higher level of care. If either of those will help your patient, then use it. There is VERY good evidence to show that two things are happening right now with helicopters. 1) getting patients to LEVEL ONE trauma centers quickly and efficiently helps them. 2) there is some overuse of aircraft leading to patients being discharged within 24 hours of arrival to the receiving facility.
The days of mechanism based transport should be done, just like mechanism based treatment. So, think. Will using the a/c benefit your patient? Will it get them there faster? I have done flights 6 miles from the med center. Stupid. It takes longer to fly in that case. I can tell you though, it's really tough for a number of different reasons to show up at a scene and not take the patient.
There are a number of STAT Flight horror stories from the early years. They made some poor choices in their staffing model and did not adequately train their crews as to the mission in the eyes of the pre hospital providers. Gotta ask your customers what THEY expect. There is a great photo somewhere of Air 1 on the sprain running with a patient in the back all by themselves. Rest of the wreck had cleared. ALL OF IT. and there they were stabilizing the patient as the capt said. Dumb. But, they thought they were doing the right thing. In a way, they were. In a way, they weren't.
Enough rambling. Peekskill may or may not be a good spot for a/c usage. Waiting for life star from CT with a patient who is lying in the road, prolly not. Load and go, do your best on the way.

Having worked for STAT Flight and two other air medical programs, I can hopefully offer some useful tidbits to this discussion.
The helicopter is a resource like any other. It is supposed to provide faster transport and a higher level of care. If either of those will help your patient, then use it. There is VERY good evidence to show that two things are happening right now with helicopters. 1) getting patients to LEVEL ONE trauma centers quickly and efficiently helps them. 2) there is some overuse of aircraft leading to patients being discharged within 24 hours of arrival to the receiving facility.
The days of mechanism based transport should be done, just like mechanism based treatment. So, think. Will using the a/c benefit your patient? Will it get them there faster? I have done flights 6 miles from the med center. Stupid. It takes longer to fly in that case. I can tell you though, it's really tough for a number of different reasons to show up at a scene and not take the patient.
There are a number of STAT Flight horror stories from the early years. They made some poor choices in their staffing model and did not adequately train their crews as to the mission in the eyes of the pre hospital providers. Gotta ask your customers what THEY expect. There is a great photo somewhere of Air 1 on the sprain running with a patient in the back all by themselves. Rest of the wreck had cleared. ALL OF IT. and there they were stabilizing the patient as the capt said. Dumb. But, they thought they were doing the right thing. In a way, they were. In a way, they weren't.
Enough rambling. Peekskill may or may not be a good spot for a/c usage. Waiting for life star from CT with a patient who is lying in the road, prolly not. Load and go, do your best on the way.

You guys done yet?
Thought we were here to find ways to IMPROVE things?! You guys are griping about what is under what roof. Enough already.

You guys done yet?
Thought we were here to find ways to IMPROVE things?! You guys are griping about what is under what roof. Enough already.

You guys done yet?
Thought we were here to find ways to IMPROVE things?! You guys are griping about what is under what roof. Enough already.

Because in selling it, you reduce maintenance costs, insurance costs, replacement costs and the overall burden to the taxpayer. You can free up budgetary monies for other items. The list goes on and on. There just isn't a good reason for departments like the one I mentioned to have the size fleet that they do.
Same goes for many of the westchester fleets. You take a department with a few square mile coverage area who consistently can only put one piece on the road for calls. WHY do they need a fleet with three pumps? Or more? Why is there a county in NY with something like 57 heavy rescues with a smaller population than NYC who has 5?
It goes back to ones motivation and why you do what you do. Are your decisions made with the taxpayer in mind? Or your departments collective ego? Can you do it better with less? Do you need everything on that floor? Do you even use everything on that floor? Could you join forces with a neighbor and share services?

Because in selling it, you reduce maintenance costs, insurance costs, replacement costs and the overall burden to the taxpayer. You can free up budgetary monies for other items. The list goes on and on. There just isn't a good reason for departments like the one I mentioned to have the size fleet that they do.
Same goes for many of the westchester fleets. You take a department with a few square mile coverage area who consistently can only put one piece on the road for calls. WHY do they need a fleet with three pumps? Or more? Why is there a county in NY with something like 57 heavy rescues with a smaller population than NYC who has 5?
It goes back to ones motivation and why you do what you do. Are your decisions made with the taxpayer in mind? Or your departments collective ego? Can you do it better with less? Do you need everything on that floor? Do you even use everything on that floor? Could you join forces with a neighbor and share services?

Because in selling it, you reduce maintenance costs, insurance costs, replacement costs and the overall burden to the taxpayer. You can free up budgetary monies for other items. The list goes on and on. There just isn't a good reason for departments like the one I mentioned to have the size fleet that they do.
Same goes for many of the westchester fleets. You take a department with a few square mile coverage area who consistently can only put one piece on the road for calls. WHY do they need a fleet with three pumps? Or more? Why is there a county in NY with something like 57 heavy rescues with a smaller population than NYC who has 5?
It goes back to ones motivation and why you do what you do. Are your decisions made with the taxpayer in mind? Or your departments collective ego? Can you do it better with less? Do you need everything on that floor? Do you even use everything on that floor? Could you join forces with a neighbor and share services?

Many fire departments could sell off at least one engine and NEVER notice the difference. Dept near me with five guys on duty. They have FOUR engines and a quint. WASTE OF TAXPAYER money. Plain and simple. I commend Hawthorne for downsizing a bit.

All 'bout the Benjamin's.

Meriden, CT just fired one of their Officers after several videos surfaced of him beating handcuffed, minority suspects on multiple occasions. IAD tried investigating him, but being the Chief's son, it took a federal civil rights charge to finally get him gone.
Is it annoying when people video the police? Absolutely. Does it get edited by those with an agenda? Sure does. Does it sometimes catch a good cop on a bad day? Without a doubt. Do we live in America, where people have a right to videotape in public? You're goddamned right we do.

All 'bout the Benjamin's.

All 'bout the Benjamin's.

All 'bout the Benjamin's.

Additionally, there is ZERO evidence that advanced life support helps increase cardiac arrest survival outcome. Or surgery for that matter. With a very few exceptions, YOU will save their life in the field or they won't walk out of the hospital undamaged.

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.
Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.
I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.
Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.
I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.
Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.
I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Those violent reactions usually occur when the drug is given too fast via the IV route. I haven't seen it happen when given IN.
Like ALL drugs, narcan must be given carefully, with good judgement and when indicated.
I think we're forgetting an important fact though. The issue is respiratory depression. This is easily managed by any BLS trained provider. You don't need a magic drug to fix it. You need a BVM.

Having been assaulted and witnessing other responders being assaulted (after 1 individual was "agitated" he attacked ER staff member causing serious head trauma, then he pulled a knife on security. it took 6 responders to restrain him including 1 ESU officer, who almost lost his gun during the fight). Since that was about 25 years ago and I'm still in it, I am not worried as I KNOW how to titrate (adjust) the dose to bring back respirations, but keep them mellow enough that no one is put in danger. My concern is this is not being taught to all these minimally trained responders.
And a BVM will keep them alive. I would rather see that in every PD car before narcan. Since it could help many people, while narcan only helps a small % of that.

Finally. After months of teasing us, our new protocol is here. We will no longer be using backboards. Even for patients with spinal injuries. Collar and stretcher only. A fantastic evidence based change for EMS. MY favorite line in the new protocol...backboards have no place in the transport of injured patients. Or something along those lines. If we use a board for removal or extrication, the patient is to be removed from it once they are on our cot. FANTASTIC, isn't it!?
Here's the (somewhat cheesy) rollout video from our bureau of EMS.

Finally. After months of teasing us, our new protocol is here. We will no longer be using backboards. Even for patients with spinal injuries. Collar and stretcher only. A fantastic evidence based change for EMS. MY favorite line in the new protocol...backboards have no place in the transport of injured patients. Or something along those lines. If we use a board for removal or extrication, the patient is to be removed from it once they are on our cot. FANTASTIC, isn't it!?
Here's the (somewhat cheesy) rollout video from our bureau of EMS.

Holy Hannah, that is one ugly f$&*%ng truck.