Flyout Categories
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Aidey
Community Leader Emeritus
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Who is this "we" you speak of, and what is a fly out category?
Epi-do
I see dead people
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Flyout categories? I'm not even sure what you are asking about. Could you explain, or hopefully, someone else will have an answer for you and I can learn something new.
Aidey
Community Leader Emeritus
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First off, you should know you are posting on an international forum, and NOTHING is standardized. The terms and codes for things can change from county to county, let alone state to state. Considering you haven't given your location I don't know that you are going to get an answer.
Ok my bad. I'm new to this. Ok I'm talking about in Maryland. It might be the same for other states. It might not. In our state you would tell the flight medic that you have a Category B patient for example. Is anybody familiar with that terminology? I hope I'm making sense this time.
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Is the patient critical? Will flying the patient benefit them? Is HEMS going to be a faster than ground transport to definitive care? Is it safe for the flight crew to fly?
Those are some questions you have to ask yourself. We have flight criteria for trauma patients such as, MOI, CAO<3, two or more long bone fractures, absence of CMS distal to an injury, amputation proximal to the hand/foot, prolonged extrication time, burns >25% BSA. But these are just criteria to start your thought process, they aren't set in stone, treat your patient and not the mechanism.
Those are some questions you have to ask yourself. We have flight criteria for trauma patients such as, MOI, CAO<3, two or more long bone fractures, absence of CMS distal to an injury, amputation proximal to the hand/foot, prolonged extrication time, burns >25% BSA. But these are just criteria to start your thought process, they aren't set in stone, treat your patient and not the mechanism.
abckidsmom
Dances with Patients
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That is going to be completely local info. You could probably email the agency you deal with most often for an accurate response. There are people on here in MD, I'm interested to see this...seems like a terrific way to complicate a situation.
crazycajun
Forum Captain
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Agreed. When we call for air support it is a critical trauma (usually burn) and all we relay is condition of patient and if adult or child. We have also begun switching over to the NIMS protocol and getting away from codes. Too much confusion for newbies. Simple language always works the best.
usafmedic45
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It's a Maryland thing which means there's probably little basis for categorizing them other than simply grasping at straws to justify as many flights as they can for MSP Aviation. They probably came up with the "categories" just by pulling numbers out of their *** (kind of like how R. Adams Cowley (the guy Shock/Trauma is named after) came up with the idea of the "golden hour" as a marketing campaign on a cocktail napkin while drinking with some of his colleagues according to the most often cited story). Basically, I'm willing to bet dinner there is no scientifically valid evidence behind their categories.
Welcome to the joys that come from having the privilege of working in one of the most backwards, antiquated and "mother may I" states as far as EMS is concerned. MIEMSS likes to think of themselves as setting some sort of a standard or being at the forefront of EMS, but the rest of the country tends to just kind of point and snicker especially when it comes to the love affair they have with HEMS.
Unless you are more than an hour from a hospital (and I mean a Level II or above) there is practically no excuse for flying someone other than profit, ego or frank stupidity. There is no evidence to back up flying people by mechanism of injury or any other criteria commonly used except distance and severity of clinical condition. And as far as that last one goes, just remember that calling for the helicopter lengthens scene time. If you need proof, I'll be happy to get you the citations for the multiple articles that have proven this again and again and again. There's a reason why in 15 years in health care (a large swath of which was spent as an EMS provider in rural areas), I can still count on both hands the number of scene flights I called for.
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mikie
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Round of applause.
As for the Maryland trauma decision tree (whether they become a UMMS pt or other hosptial essentially) there was a thread a few months ago..
http://www.emtlife.com/showthread.php?t=21524
MSDeltaFlt
RRT/NRP
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I'm not sure about what is listed in your state's "categories", but I sincerely hope Mechanism Of Injury (MOI) isn't one of them. I almost died for MOI. Pt wasn't actually injured at all. Which means I almost died for nothing.
Aircraft should never fly without a detailed pt assessment. If you can't tell what's going on with them from your assessment, take them to a local MD, DO, CFNP/ACNP, or PA at the local ER in order for a better assessment.
Speed of care without knowledge at the beginning does nothing but add names to the National Memorial.
usafmedic45
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The crew of Trooper 2 did die for nothing. along with one of their patients and the other patient wound up crippled because of the helicopter crash. Alcorta and Bass are both stupid enough to keep their protocols pretty much the same regardless of what the evidence says so I wouldn't doubt that it's MoI triggered.
usafmedic45
Forum Deputy Chief
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From the current Maryland protocols (highlighting is my way of pointing out the absolutely ridiculous stuff):
The second bolded option is how they are getting around the "We're not flying people on mechanism alone" issue apparently.
....and yes, the trauma categories do include MoI as a qualifier for "category Charlie". :censored::censored::censored::censored:ing morons. http://www.miemss.org/home/LinkClick.aspx?fileticket=pw9w-1JsO24=&tabid=106&mid=537
The second bolded option is how they are getting around the "We're not flying people on mechanism alone" issue apparently.
....and yes, the trauma categories do include MoI as a qualifier for "category Charlie". :censored::censored::censored::censored:ing morons. http://www.miemss.org/home/LinkClick.aspx?fileticket=pw9w-1JsO24=&tabid=106&mid=537
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MSDeltaFlt
RRT/NRP
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And that's an auto launch criteria which is fine with me. Auto launch does not mean auto transport. Get on scene, assess the pt(s), and the aircraft is not needed, CALL THEM OFF.
What gets me is when services, EMS cultures, etc encourage their crews to have an auto erectile dysfunction from scene flight priapism meaning just because the aircraft is launched that the aircraft has to fly the pt and they don't have to do any further assessment.
You don't risk your pt just because you might think it's cool. Even if you think their neck is broken. So was mine. Bilateral foramen fractures of C2. Still laid in bed for through 2 surgeries (anterior and posterior), for 10 days before the halo was placed.
Assessment and intervention are not the same thing.
What gets me is when services, EMS cultures, etc encourage their crews to have an auto erectile dysfunction from scene flight priapism meaning just because the aircraft is launched that the aircraft has to fly the pt and they don't have to do any further assessment.
You don't risk your pt just because you might think it's cool. Even if you think their neck is broken. So was mine. Bilateral foramen fractures of C2. Still laid in bed for through 2 surgeries (anterior and posterior), for 10 days before the halo was placed.
Assessment and intervention are not the same thing.
mycrofft
Still crazy but elsewhere
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Maybe the ALS section here cold benefit from a discussion of LifeFlight, yes/no/when?
My unit's PAVEHAWK's couldn't spool up and leave in a half hour or so, but they could gather their stuff and launch to rescue crew off ships west of the Hawai'ian Islands, or the Pacific Coast nearly to Central America. On the other-other hand, if helos are called in urban and suburban settings for events where "seconds count" and the time to get the helo on scene exceeds or nearly equals a ground response including arrival to tx facility, what good are they? Locally, the response was to centralize service and to stop landing on tree-lined streets, etc.
What about using helos to drop off staff and equip beyond the scope of land-launchers? Or "red-zoning" areas where a response makes sense for certain patients, etc?
I don't know, but I do know there is a pressure to use choppers once they are leased.
My unit's PAVEHAWK's couldn't spool up and leave in a half hour or so, but they could gather their stuff and launch to rescue crew off ships west of the Hawai'ian Islands, or the Pacific Coast nearly to Central America. On the other-other hand, if helos are called in urban and suburban settings for events where "seconds count" and the time to get the helo on scene exceeds or nearly equals a ground response including arrival to tx facility, what good are they? Locally, the response was to centralize service and to stop landing on tree-lined streets, etc.
What about using helos to drop off staff and equip beyond the scope of land-launchers? Or "red-zoning" areas where a response makes sense for certain patients, etc?
I don't know, but I do know there is a pressure to use choppers once they are leased.
mikie
Forum Lurker
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They do, I witnessed one last week. MVA 2 counties away from trauma center (excuse me.. "Primary Adult Resource Center") around 11am...they auto-launched Trooper 1. 10 minutes later it was back...
usafmedic45
Forum Deputy Chief
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Good luck with that one in Maryland. That's a fast way to get your *** chewed. Speaking from personal experience.
Patient must have died before they got there. Yeah, remember....Shock/Trauma is not technically or legally a "trauma center".