BICYCLIST FLOWN AFTER CRASH
A 22-year-old bicyclist was flown to MetroHealth Medical Center in Cleveland early this morning after being struck by a car. The crash took place on North Abbe Road just south of Route 57 in Elyria. From the scene LifeCare Paramedics requested Metro Life Flight to land at Lorain County Community College to fly the victim to Metro in Cleveland. Paramedics packaged the victim and drove him the mile or so to the soccer fields at the college where Elyria Firefighters had set up a landing zone for the helicopter. Moments later Life Flight touched down and took over patient care, flying him to Cleveland.
posted by TMC NEWS at 1:52 AM
25 Comments:
Why would they take him to the college to be flown when there is a hospital right down the street?
Apparently the injuries were of the nature that a higher level of care would be needed, ie. Metro. EMH is not a Level 1 trauma center.
True that Metro is a Level 1 Trauma Center, however, how much time was wasted on the scene and waiting for the helicopter to arrive, time that the victim could have been in an Emergency Room with Doctors and Nurses instead of just paramedics. Who made this decision anyway?
I hope if this ever happens to me that I will be taken to the hospital 5 minutes away to be treated instead of waiting for 15 minutes for a helicopter!
They were on Abbe near 57, what is that 2 miles from Elyria Memorial? To make that victim wait for a helicopter instead of getting them to a hospital that is right around the corner is ridiculous. I hope TMC News brings us more information a about what condition the victim was in and how they are doing now. Maybe that will shed some light on why this happened.
I think its funny that you have a new feature called WHAT WERE THEY THINKING because this dumbass call makes many people ask what were they thinking? Sounds like a cowboy medic making some stupid decisions out there.
Even if they transported the patient to EMH. The injuries might be severe enough to still have the patient flown to Metro. EMH is not a level 1 trauma center. Paramedics are capable enough to give patient care until a helicopter arrives. That decision was in the best intrest of the patient. If you were not there, you should not make any comments.
I think we have just heard from the cowboy medic. It is true that medics can take care of patients until helicopters arrive, if necessary. If you are out on a county road miles and miles away from a hospital then it could be necessary, if you are a mile or two away in a populated area, it is not necessary.
The job of a medic is to access, treat and transport a patient to the nearest emergency room. Unlike you, I was not there, but I will tell you that if I had been in a location similar that victim would have been taken to the emergency room and turned over to the er staff, who although is not a level 1 trauma center, they are higher trained and more qualified then medics.
There is no way this call can be justified.
Dave from Lorain County
No I'm not the cowboy medic. No I was not there. I'm defending the decision the the medic made. It does not matter if your on a county road miles away, or two miles away. It is a trauma patient, and should be taken to a trauma center where they will recieve the proper care. EMH can only do so much. The patient will be flown from EMH to Metro anyway.
So if the patient is miles, and miles away. It's ok to wait for a helicopter, but it's not ok if your two miles away. What's the difference. It's a trauma patient.
Are you guys kidding? EMH Emergency room STINKS!!! He was much better off being flown somewhere else.
EMH is the worst hospital around.. I live a block away from it and i'd go to Oberlin Hospital first!!! What difference does it make that they flew him to METRO? I'm sure that he had much better care there and they found all that was wrong with him!!!
Do you ever think that maybe the paramedic was in contact with the ER and had permission to call a helicopter?
Even if they would have taken him to the ER, once the Dr takes a look at the patient, decides to call a helicopter.... he's not gonna do anything for the patient but the basics, that I've witnessed first hand with a family member.
So before you criticize someone that is there to help someone in need, remember, they might be coming for you in your time of need and will give you the best treatment available rather on the way to the ER or waiting for a helicopter.
As the senior "cowboy medic" (as tim nr has refered me) that was on the scene of the incident known on tmcnews.net as "Bicylist Flown After Crash", I'd like to take a few minutes to explain not just the decision making process involved in this particular incident but the utilization of trauma center triage criteria in Ohio by EMS personnel. Due to federal HIPPA privacy laws (and common decency) I will not make ANY direct statements about this particular victim beyond generalities. So let's get school in session...
1. The Ohio Revised Code (a.k.a. "the law") requires the transportation of tramua victims who do not need immediate life threat stabilization at a local non-trauma certified ER directly to a trauma care facility. The criteria for which patients quailfy as trauma victims may be found in ORC sections 4765-14-01 and -02 and were met by the patient referenced in this article.
2. EMH Regional Medical Center is NOT CERTIFIED at ANY level as a trauma facility. As such, no matter how well EMS and EMH ER personnel are able to stabilize an eligible trauma patient, they must be transferred to a trauma facility. The closest trauma facility to Lorain County is St John Westshore Hospital, at a Level III - this means they can generally handle all patients except for those with neurologic or cardiothoracic injury. If the latter is the case then the patient should go to a Level I or II trauma center (both are equal in their direct patient care though Level I facilities provide educational/research activities not supported at a II). While Fairview Hospital is the closest Level II facility, we usually opt to send the patient to MetroHealth which is a Level I facility for two reasons: they have their own flight service and Fairview does not have an ER accessable landing pad. We decided to transfer this patient to MetroHealth though I have used SJWS with great results for patients who have injuries allowing their transport there.
3. The only ORC listed exceptions to direct transport to a trauma center are listed in it's section 4765-14-05. There are five exceptions which I won't list in entirety here due to space constraints. I can assure you, though, that the patient from the article did NOT meet ANY of those exceptions - ensuring his direct transport to MetroHealth was appropriate in this case. The exception which weighs on my mind the most when determining where to transport the victim is exception 1 which lists that transport to a local ER is allowed if the patient needs stabilization measures prior to transfer to a trauma center. Again, this patient did NOT fall under that exception.
The patient in this case received the excellent advanced life support trauma care that we strive for at LifeCare through emphasis on mandatory trauma care education and direct supervisor and medical director oversight of skills - plus a quicker arrival at a trauma certified facility than would have been accomplished if transported to EMH's ER first. A winning combination that, in no doubt, helped lead to a successful outcome for this patient.
If any of you have questions or comments that you would like addressed, whether about this incident or EMS in general, feel free to contact me directly - if I can't find you the answer, I'll refer you to someone who can.
Robert Mabe, EMT-Paramedic, EMS-Instructor
LifeCare Ambulance
rmabe@lifecareambulance.com
i am also a paramedic and i completly agree with the decision that was made. i wasn't on the scene but think of it this way, obviously the patient needed to be taken to a level 1 trauma center. it takes time to "package" the patient with all the necessary safety equipment. if the helicopter is already enroute they will arrive about the same time that the patient is fully immobiled. why waste time to drive to the er, the patient now has to wait even longer to get the treatment that they need at the right facility. this was done in the patient's best interest. good job mabe!
Cowboy Medic Robert....Wonderful, PROFESSIONAL response to a lot of arm-chair medics. You made a decision, based on protocol and law, as should any intelligent EMS provider. Congrats and more importantly, you should be commended for a VERY professional rebuttal.
Cowboy Mabe. Great job. I would disagree with your interpretation of the Ohio Revised Code to work in your favor. Are you stating that you feel in the field you and your partner have more skills and capability than a "team" working in a hospital. So, just out of curiosity, what was your on-scene time? You carefully have used the Ohio Revised Code to your advantage, yet left out those statistics. I will have to look up on the website where the Lorain County Protocols state to wait on-sscen for a helicoptor. In the county I run, our interpretation of our county protocols is that you take the patient to the closest facility if the ETA is longer for the the helicopter than going to the hospital. You selectively elected to omit how long you had to wait for the helicopter. Metro has a great service and great trauma center and I would expect to go there. But I would prefer you take me to the closest facility where there is team trained at all levels of care to wait for a helicopter. If there had been an in flight emergency and the helicopter aborted, how would you explain that when the patient sued you for wrongful death for waiting on a scene instead of going to a hospital? (which there are documented caases where the paitent won this lawsuit against an EMS provider and paramedic)
If the patient did not need stabiliztion as you state, then you sent the patient to metro based on what?
LETS PUT THIS CASE TO REST ONCE AND FOR ALL. IT YOU WERE NOT ON SCENE TO WITNESS THE MECHANISM OF INJURY, THE PTS INITIAL AND ON-GOING CONDITION, AND PTS RESPONSE TO THE CARE ON SCENE THEN YOU CANNOT MAKE THESE JUDGEMENT CALLS. WE ALL KNOW THAT EACH CASE IS DIFFERENT AND EACH REQUIRES THEIR OWN UNIQUE TREATMENTS. SO WHY DO WE EVEN QUESTION THE CARE OF THE ON SCENE CREW. THE CREW ON SCENE HAS A COMBINED 11+ YEARS OF EMS EXPERIENCE AND I'M SURE THEY CAREFULLY DECIDED WHAT WOULD BEST SUIT THEIR PT.
KNOWING FROM PERSONAL EXPERIENCE WITH TRAUMA PTS, SOMETIMES ERRORS ARE MADE IN HOSPITALS AS WELL AS EMERGENCY ROOMS SITTING ON TRAUMA PTS FOR EXTENDED PERIODS OF TIME BEFORE THE CALL FOR A HELICOPTOR IS MADE. THESE ARE SOME OTHER POINTS OF INTEREST THAT CAN BE BROUGHT UP, BUT THAT WOULD JUST OPEN UP ANOTHER CAN OF WORMS. SO NEXT TIME YOU DECIDE TO MAKE A CALL FROM YOUR ARM CHAIR, ASK YOURSELF WERE YOU THERE???
Is that another smoke screen?
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For some reason this story has generated a lot of comments. Personal attacks are being removed. If you address the medic involved in this story please sign your name to your comment or it will be removed. As long as your true name is attached to the comment the post will stay.
Brilliant!!!! Go get em Dr. Mabe, youre a real American hero!!!
Let me see....Patient had a pulse and breathing, are you sure it wasn't another "CODE WHITE?"
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