Hot vs. Not!

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bzirk

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I am putting together a presentation on the topic of volunteer ambulance services transporting patients to hospital either with lights and siren, or without. My presentation will highlight when is it advantageous to transport hot, and when it is safer to just transport normal.

I am interested in any statistics that anyone can provide. I will need to cite the source as well.

Thank-you in advance for any help anyone can give.

Thanks

Bill
 
Good luck finding research. You may be luckier if you expand to international sources. I would start by just putting EMS into the search field on your database and seeing what came up. As usafmedic45 told me earlier this year, research is lacking in our field.

I can attest to that personally, be prepared to spend hours looking through articles that wont help, or are older then you.

I would highly suggest finding a college student to help you as we have access to a large number of databases and ILL capabilities. And its free.
 
And from the newest protocol revisions here in PA
"
In most situations, the use of L&S during patient transport is not indicated: 4
a. Emergent transport should be used in any situation in which the most highly trained EMS
practitioner believes that the patient’s condition will be worsened by a delay equivalent to
the time that can be gained by emergent transport. Medical command may be used to
assist with this decision. The justification for using this criterion should be documented
on the patient care report.
b. Examples of Medical Conditions that May Benefit by L&S Transport
1) Inability to obtain or maintain a patent airway
2) Critically unstable patient with impending cardiac arrest.
c. The vast majority of patient’s will not have better medical outcomes by decreasing
transport time by the time saved by L&S transport.
d. The patient’s physiologic responses to L&S use (increased tachycardia and blood
pressure) may be detrimental to some patient’s medical conditions.
e. When EMS providers are not restrained, the increased risk of EMS vehicle crash while
using L&S may increase the risk of injury to EMS providers. The extremely poor
prognosis for patients transported with CPR in progress does not justify the use of L&S transport for most patients in cardiac arrest."
 
Presentation

Happy,

Thank you for your informative posting. Its great to hear from intellectual geniuses such as yourself. This information will certainly assist me in gathering a collective opinion and information from great EMS professionals like yourself.

I conduct EMS and Fire training on a volunteer basis to help our local EMS services. By the way, this presentation IS for teaching. It is not a high school science project or college assignment. I asked to include sources so that proper credit can go to people that take the time to respond to my post.

Sooooooo I would again like to thank you for your interest, and if you actually possess any useful knowledge, I look forward to hearing from you!
 
94H,


Thank you very much for this input! I am currently pulling specific date from our local services, and have a good collection. I was hoping to get a little broader view as well. Your information on the PA protocols is great and I will certainly incorporate it.

I do appreciate this information!
 
The problem with those studies though is they always take place in urban centers with minimal transport times anyhow, and not rural /suburban areas with lengthy trip times.


I have a 1hr transport to the nearest stroke center and/or trauma center... God forbid the chopper gets grounded when needed most, the patient needs to be taken the fastest way possible, and that is not contingent with waiting at stop lights for minutes at a time.



I'm not a huge fan of LS returns to hospitals, but I do it and have no problem doing it when the situation warrants, and even the few studies on it admit that it is beneficial to subsets of patients.
 
Last edited by a moderator:
Awesome information 18G!!! Thanks for the information!!!


Thanks again!
 
Linuss said:
I have a 1hr transport to the nearest stroke center and/or trauma center... God forbid the chopper gets grounded when needed most, the patient needs to be taken the fastest way possible, and that is not contingent with waiting at stop lights for minutes at a time.
Click to expand...

How long does that transport take without L/S?
 
Linuss said:
The problem with those studies though is they always take place in urban centers with minimal transport times anyhow, and not rural /suburban areas with lengthy trip times.


I have a 1hr transport to the nearest stroke center and/or trauma center... God forbid the chopper gets grounded when needed most, the patient needs to be taken the fastest way possible, and that is not contingent with waiting at stop lights for minutes at a time.



I'm not a huge fan of LS returns to hospitals, but I do it and have no problem doing it when the situation warrants, and even the few studies on it admit that it is beneficial to subsets of patients.
Click to expand...

How much time is saved going 60 miles at 80mph compared to 70mph? If the patient dies in that short difference they were going to die anyway 99.9% if I were to venture an educated guess.

I transport futher to the nearest hospital which is only a level 4 than you do to your specialty centers and have found it is not worth the risk, plus the extra vibration actually lessens the accuracy of your equipment. If you can not get accurate vitals it is hard to properly treat your patient. It is better to go a little slower and be able to treat a patient rather than relying on speed. I am not saying never go above 80mph, in my area posted speeds are 80mph but make sure you can properly treat your patient at the speed, sometimes it is better to go slower than the speed limit.

You city medics that think you are rural make me laugh.
 
bzirk said:
I am putting together a presentation on the topic of volunteer ambulance services transporting patients to hospital either with lights and siren, or without. My presentation will highlight when is it advantageous to transport hot, and when it is safer to just transport normal.

I am interested in any statistics that anyone can provide. I will need to cite the source as well.

Thank-you in advance for any help anyone can give.

Thanks

Bill
Click to expand...


The insurance institute of America has some great stats on it. Call them, they were eager to help me when I was researching this.

But the long and short of it is both the traffic risks and lack of medical necessity accordingly make driving code 3 far more risk than reward.

Everyone I have met that has researched this topic has come to the same conclusion. One service tried to eliminate it, but there was a public uproar.
 
Why just volunteer services?
 
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