It would have been better for family to immediately loaded and transported as they would have reached hospital before the basic crew was even ready to begin transporting and hospital would have hopefully gotten the meds in time for them.
The public needs to be educated that patient care is not equal at all levels. Honestly city's/towns/communities/counties should have to post an ad every day that lists what level of patient care is available.
No, I don't think it's fair. I think it gives them a false sense of security. If they live within 10-15 minutes to the hospital, it may actually be faster for them to just drive themselves to definitive care, however if they think they can get treatment enroute, why would you drive yourself?
I think the public should be educated to what is really available to their areas and what each level does. Not just "This area has basic EMTs." But "This area has basic EMTs, they are not capable of invasive procedures except for a combitube. They cannot control your pain, they can not provide drug interventions for your medical emergency."
Undoubtedly in some circumstances it is better to drive, or be driven, to hospital. Trauma is a good example. Also, we actually have a program here for rural areas in which families of people with asthma have an action plan that gets them to definitive care quicker. If that involves driving themselves to hospital depending on where they are, then so be it.
That program involves specific education regarding a specific problem, tailored to the normal severity of that specific individual's condition.
What you're asking is that a complex approach be applied, in some sort of public health message, covering areas with different levels of responses and different traveling times to the pt and to the hospital and perhaps involving different kinds of conditions.
You're asking untrained people, in an emergency to:
-properly identify the condition.
-consider the severity of the condition.
-know and consider the response time.
-know and UNDERSTAND the responders scope of practice, specific to location.
-considerthe distance to the hospital.
Then expecting them to drive safely to hospital.
You can't send the public a message saying:, "If you're in situation X, Y distance away from a hospital and the problem is N level of severity, and you're sure its specifically problem X and not problem Z, and prehospital providers of level 3 not level 2 are available (in some areas level 2 is acceptable, see appendix), and their response time is Q, then call an ambulance/drive to hospital".
CNN can't tell America that; no one will listen and if they did, they sure couldn't make a good decision based on information that complex.
These are clinical decisions that are difficult to make correctly for us (and are still widely debated amongst highly educated professionals), let alone a panicked member of the community.
Public health requires a reductionist approach to information and is based on the payoff principle. You simplify everything, even if the ultimate message is wrong sometimes, so that most of the time you bring about a better outcome. Somewhere, someone has weighed the risks of people sitting at home and waiting for an ambulance with the risk of driving frantically to hospital, and decided this was a better message to send.
Compressions only CPR is a good example. People are so likely to bugger up ventilation, take up too much time ventilating, or be too scared to even try CPR because they can't remember it, that it may be better off just teaching people the more simple message of doing compressions only. That doesn't mean that compressions only is always the best thing, and in fact in many situations it is not what you want, but it may provide statistically better outcomes as a public health policy. (I'm not advocating this, it's just an example).
