I used to work as a paramedic where I ran calls that were generally, at the most 20 miles from a level one trauma center, and that was if we were third or fourth due on the call. My primary call area was less then five miles in any direction to said trauma center.
I ran a nasty motorcycle v. car accident several months ago where the motorcycle guy was unconscious with multiple upper extremity fractures, a head injury, agonal respirations, I'm saying, really headed for the light. I was, no s**t, less then four miles from the trauma center, about a 7 minute drive in the middle of the night, so barely any traffic. The fire department attempted to chew my butt on scene about canceling HEMS while I'm working this guy. "It's county protocol," "we're going to report you," "you paramedics think you're God." You name it, they threw it at me. Seriously, I'm going to launch a helicopter that would be coming from a base some 20 miles away, that has at least a 12 minute ETA to my scene, set up a landing zone, pass off patient care, and let them fly him the 2 minute trip to the hospital? Hell, no.
So I come to find out after this call that the county does automatically launch HEMS if the MVC has an unconscious person and it is outside the York City Limits. Automatically. Seriously, these people that live or die off of their ability to use HEMS need to purchase a clue.
I don't know the whole story with that call in TN, but I bet the fire fighter
first responder was freaking out, and the
paramedic did an assessment and declined the need for HEMS based on that assessment. I could be wrong, but I've seen that more times then I care to remember in my neck of the woods, and it's about as backwards as you can get in this area.
Or the fire department has an axe to grind with the ambulance service.