charlie hebdoTime does matter. So does level of care. Relying on EMS for care is not the same care as that in a Level I or II trauma center. And there is an NIH study that shows transport to a trauma center is faster by non-EMS transport (28 vs 15 minutes) for critically injured victims and another showing better outcomes for the non-EMS transported critical victims [ controlling for confounding factors, the adjusted mortality among patients with Injury Severity Score (ISS) greater than 15 was 28.2% for the EMS group and 17.9% for the non-EMS group .]
Indeed. "Stay and Play" is losing favor in such cases, much to the chagrin of some paramedics. About the only time that EMS support is important is if there are conditions (like a spinal injury) where moving the patient without proper care could have a very negative outcome.
As often as not, we get called for illness patients where the family lacks the ability to transport the patient themselves, not because the patient needs emergent transport.
It always bugs me to hear a crew stay on scene for 15 to 20 minutes, when in that time they could be at the hospital.
I used to be an advanced life support provider. I made every effort to do my treatments enroute to the hospital.
Larry Resident Microferroequinologist (at least at my house) Everyone goes home; Safety begins with you My Opinion. Standard Disclaimers Apply. No Expiration Date Come ride the rails with me! There's one thing about humility - the moment you think you've got it, you've lost it...
tree68 charlie hebdo Time does matter. So does level of care. Relying on EMS for care is not the same care as that in a Level I or II trauma center. And there is an NIH study that shows transport to a trauma center is faster by non-EMS transport (28 vs 15 minutes) for critically injured victims and another showing better outcomes for the non-EMS transported critical victims [ controlling for confounding factors, the adjusted mortality among patients with Injury Severity Score (ISS) greater than 15 was 28.2% for the EMS group and 17.9% for the non-EMS group .] Indeed. "Stay and Play" is losing favor in such cases, much to the chagrin of some paramedics. About the only time that EMS support is important is if there are conditions (like a spinal injury) where moving the patient without proper care could have a very negative outcome. As often as not, we get called for illness patients where the family lacks the ability to transport the patient themselves, not because the patient needs emergent transport. It always bugs me to hear a crew stay on scene for 15 to 20 minutes, when in that time they could be at the hospital. I used to be an advanced life support provider. I made every effort to do my treatments enroute to the hospital.
charlie hebdo Time does matter. So does level of care. Relying on EMS for care is not the same care as that in a Level I or II trauma center. And there is an NIH study that shows transport to a trauma center is faster by non-EMS transport (28 vs 15 minutes) for critically injured victims and another showing better outcomes for the non-EMS transported critical victims [ controlling for confounding factors, the adjusted mortality among patients with Injury Severity Score (ISS) greater than 15 was 28.2% for the EMS group and 17.9% for the non-EMS group .]
It's good to hear that. I hope the rest of what I posted about Barrington's access to ERs also makes sense.
charlie hebdoIt always bugs me to hear a crew stay on scene for 15 to 20 minutes, when in that time they could be at the hospital.
If you think of the discussed incident, the paramedic arrived at the hospital 20 later than usual. Not all of it is staying on scene but the long detour around the train.Regards, Volker
VOLKER LANDWEHRIf you think of the discussed incident, the paramedic arrived at the hospital 20 later than usual. Not all of it is staying on scene but the long detour around the train.
I believe if you review the discussed incident, the 'patients' were being transported from a traffic incident, and were not deemed serious casualties (which I personally think amounts to a considerable part of the "delay" - there was no perceived reason to hurry up and get them into the emergency room, so 20 minutes or more getting around the stopped train was of little consequence.
What would have been the interaction between ambulance crews and the stopped train had the situation required prompt attention is a different matter in this particular case. We do not know, reviewing the story and I think the available facts as subsequently developed so far, what the situation in Barrington might be if a significant emergency is declared. Will the ambulance crew be 'surprised' to find a crossing blocked, and sit for some number of minutes before trying to determine a way around? Would air response be called early if a crossing is known to be blocked with a noncalculable 'split time'? These are interesting subjects for discussion, and perhaps there are emergency-management plans in place that deal with them ... but those were not evoked, perhaps precisely because they did not need to be.
Overmodnd sit for some number of minutes before trying to determine a way around? Would air response be called early if a crossing is known to be blocked with a noncalculable 'split time'?
The first point is why I mentioned the "human factor" from "Sully." Most people are going to sit tight for at least a few minutes in hopes the train will move again.
The hospital they were heading for is far from the only one in the area, although it was the closest. If they had a critical patient they could have diverted to any of 8-10 hospitals within a reasonable distance and not blocked by trains.
While air medical may have been an option, I'd wager they could be at one of those other hospitals by the time the bird launched.
That doesn't change the fact that Barrington needs to get off their duff and deal with the issue. Complaining about it won't save a life in a true emergency.
Looking at Barrington, however, it appears that building a suitable overpass (or underpass) may have its problems - someone is going to lose a business or a home.
Direct radio communications with the railroad probably isn't the answer - but prompt notification by the railroad of the severity and longevity of the delay to local authorities might have reduced the delay of the ambulances, and helped Barrington notify surrounding communities of the need for auto mutual aid support.
tree68 Overmod nd sit for some number of minutes before trying to determine a way around? Would air response be called early if a crossing is known to be blocked with a noncalculable 'split time'? The first point is why I mentioned the "human factor" from "Sully." Most people are going to sit tight for at least a few minutes in hopes the train will move again. The hospital they were heading for is far from the only one in the area, although it was the closest. If they had a critical patient they could have diverted to any of 8-10 hospitals within a reasonable distance and not blocked by trains. While air medical may have been an option, I'd wager they could be at one of those other hospitals by the time the bird launched. That doesn't change the fact that Barrington needs to get off their duff and deal with the issue. Complaining about it won't save a life in a true emergency. Looking at Barrington, however, it appears that building a suitable overpass (or underpass) may have its problems - someone is going to lose a business or a home. Direct radio communications with the railroad probably isn't the answer - but prompt notification by the railroad of the severity and longevity of the delay to local authorities might have reduced the delay of the ambulances, and helped Barrington notify surrounding communities of the need for auto mutual aid support.
Overmod nd sit for some number of minutes before trying to determine a way around? Would air response be called early if a crossing is known to be blocked with a noncalculable 'split time'?
Barrington should get off its duff? Au contraire! As I pointed out, Barrington was there long before the EJ&E (and CNW/UP/Metra). The CN changed the frequency and length of trains dramatically. The way it was in EJ&E days did not block the four crossings so much. So now, CN needs to pick up the tab for an underpass.
charlie hebdoBarrington should get off its duff? Au contraire! As I pointed out, Barrington was there long before the EJ&E (and CNW/UP/Metra). The CN changed the frequency and length of trains dramatically. The way it was in EJ&E days did not block the four crossings so much. So now, CN needs to pick up the tab for an underpass.
Barrington has had 10 years to create a solution. Barrington should get off their duff and manufacture and implement a solution and then sue the other necessary parties to recoup their expenditures. To do anything less isn't even giving lip service to the issues.
Never too old to have a happy childhood!
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