Forum Asst. Chief
A brief highlight of my background is that I want zero to hero and was lucky enough to get on a small but very progressive department, and for a while tried to get on big department. After quite a bit of effort I realized that wasn't going to work out so I went to nursing school. I worked for a while at a large peds level one program, got burned out of the politics and left.
I now work at a quaternary referral center and what I do really depends on the needs of the programs. I have been doing more inpatient critical care although I still work in our ED quite a bit; I work the vast majority of my time on the peds side of the house but I still do adults if they absolutely need it. I also do work with our EMS outreach and education although that is a smaller portion of what I do currsntly. I still do some EMS stuff, but mostly with our high risk peds programs and we mostly do everything we can to stay out in the field and not transport in.
I can appreciate your perspective, but I don't think that it was the case with this crew. They know my background and we were all in agreement about how the kid could have been a bls ground transfer, the kid didn't really need transfer and so on. We were all in agreement and everything was copacetic until I mentioned that flying is dangerous.
I guess I should have been more specific that when I say HEMS is dangerous I specifically mean that there are proportionally more fatalities in HEMS, not recoverable injuries.
Unfortunately as the recieving facility there is little we can do to affect how patients are delivered to us. We certainly try to give our advice but that is ultimately up to the spending facility. I think that there is so much competition to get HEMS flights that the medical director for our program, and likely most programs, isnt going to risk offending anyone else and just have them use a competing service.
Totally agree with the last paragraph, and it's frustrating. When I flew at a tertiary Children's Hospital they had a great triage and intake program setup where the Medical Control Officer who accepted the patient for transfer also kinda help guide some care with suggestions and also suggested mode of transport often times. This was often a suggestion to send kids via their dedicated aircraft for critical and time sensitive patients, and then either via ground for non-critical, and sub some stuff to the contract vendor that was lower level ALS or BLS transfer. I think that worked well in the Peds world because there are far more MD's who are less comfortable with Peds than Adults. If you're transferred to a larger/tertiary hospital I think the MD getting the patient should have a say in mode of transfer, but unfortunately that's in the hands of the referring MD, and often times these MD's at the sending facilities just want the patient gone and aren't concerned about mode, appropriateness, etc.