Rombout (Dutchess) Medevac for Fall Victim 9/29/12

[JetPhoto 626]

Customer who fell inside Sams Club and had a serious head injury. Life Net transported to Westchester Med.

All Photos are property of myself and may not be used without my written consent.

[INIT915 1,119]

Fell from a standing position and required Medevac? Or fell from some elevated platform?

[RJB896 12]

Great Shots Thanks for Sharing

[JetPhoto 626]

Fell from a standing position and required Medevac? Or fell from some elevated platform?

Reportedly standing

[x129K 1,393]

Reportedly standing

Ahhhhh....some good old locker room justice.

[Ladder44 73]

Any trauma centers nort of I-84?

Besides danbury medical

[grumpyff 1,159]

http://www.health.ny.gov/nysdoh/ems/trauma2.htm

St Francis in Poughkeepsie listed as area trauma center. Outside of that next closest regional trauma center is in Albany.

[50-65 205]

Ahhhhh....some good old locker room justice.

Mmm.. Fall from standing position. Slipped, tripped, syncope. could be any number of reasons. Add in concrete floors, any number of shelving units, displays, etc to hit your head on, it's not out of the realm of possibility to sustain major head trauma. We don't know the age of the victim or any underlying conditions.

As far choice of trauma centers, that is up to the medevac crew. The pt was intubated. I'm going to hazard a guess here and suspect that the pt may be in need of neuro services. Since this occurred on a weekend, St Francis, being a level 2 trauma center, would likely not have a neuro in house. Westchester would. So yeah, I would pick WCMC. The extra 15 minutes or so of flight time to get the pt to a hospital where all the services are there vs. a shorter run where the pt will wait those minutes and more before neuro is even called to evaluate

[x1243 141]

Easy Killer, just a joke. I am not sure if you have met X129 but he seems to have a little sense of humor, like most of us.

But good job on the CSI work.

JetPhoto as always awesome shots...... When are you going to give me a Photo for Dummies class?

Edited October 2, 2012 by x1243

[JetPhoto 626]

JetPhoto as always awesome shots...... When are you going to give me a Photo for Dummies class?

Thanks, Anytime

[INIT915 1,119]

Mmm.. Fall from standing position. Slipped, tripped, syncope. could be any number of reasons. Add in concrete floors, any number of shelving units, displays, etc to hit your head on, it's not out of the realm of possibility to sustain major head trauma. We don't know the age of the victim or any underlying conditions.

As far choice of trauma centers, that is up to the medevac crew. The pt was intubated. I'm going to hazard a guess here and suspect that the pt may be in need of neuro services. Since this occurred on a weekend, St Francis, being a level 2 trauma center, would likely not have a neuro in house. Westchester would. So yeah, I would pick WCMC. The extra 15 minutes or so of flight time to get the pt to a hospital where all the services are there vs. a shorter run where the pt will wait those minutes and more before neuro is even called to evaluate

Do you make transport decisions based on your hypothetical understanding of what staffing trauma centers may or may not have on any given day???

[x129K 1,393]

Easy Killer, just a joke. I am not sure if you have met X129 but he seems to have a little sense of humor, like most of us.

But good job on the CSI work.

JetPhoto as always awesome shots...... When are you going to give me a Photo for Dummies class?

"I didn't pass the bar but I know a little bit....................."

[50-65 205]

Do you make transport decisions based on your hypothetical understanding of what staffing trauma centers may or may not have on any given day???

"Hypothetical". No. But I do know* that maxillofacial and mandible trauma will (likely) go to WCMC, even if you take the pt to St. Francis first.They do not handle that there as a specialty. I also know* that they (St Francis) don't have neuro in house after hours and on weekends. As a level 2 trauma center, they are not required to.

* My "knowledge" is not "hypothetical understanding" but based on personal and professional experiance. Disclaimer: Some of the services offered by various hospitals may have changed since my last involvement with EMS and hospital based patient care.

[INIT915 1,119]

"Hypothetical". No. But I do know* that maxillofacial and mandible trauma will (likely) go to WCMC, even if you take the pt to St. Francis first.They do not handle that there as a specialty. I also know* that they (St Francis) don't have neuro in house after hours and on weekends. As a level 2 trauma center, they are not required to.

* My "knowledge" is not "hypothetical understanding" but based on personal and professional experiance. Disclaimer: Some of the services offered by various hospitals may have changed since my last involvement with EMS and hospital based patient care.

WMC isn't required to have them in-house either and often doesn't, they must just be able to respond within 30 minutes, per 10 NYCRR. Area Trauma Centers (such as SFH) are also required to have maxillofacial surgeons available within the same 30 minute time frame. Are you alleging that SFH cannot provide specialty back-up as required by law? If so, that should be investigated.

[mvfire8989 22]

WMC isn't required to have them in-house either and often doesn't, they must just be able to respond within 30 minutes, per 10 NYCRR. Area Trauma Centers (such as SFH) are also required to have maxillofacial surgeons available within the same 30 minute time frame. Are you alleging that SFH cannot provide specialty back-up as required by law? If so, that should be investigated.

But there IS a different requirement for neurosurgery between area and regional trauma centers. I would argue that this can and should impact your choice of destination for some patients, especially in a case with relatively equal transit times to the receiving facilities. This may have been a good case to consult with on-line medical control while the air medical resource was en route. We don't always need to make the destination choice on our own.

[INIT915 1,119]

But there IS a different requirement for neurosurgery between area and regional trauma centers. I would argue that this can and should impact your choice of destination for some patients, especially in a case with relatively equal transit times to the receiving facilities. This may have been a good case to consult with on-line medical control while the air medical resource was en route. We don't always need to make the destination choice on our own.

But there IS a different requirement for neurosurgery between area and regional trauma centers. I would argue that this can and should impact your choice of destination for some patients, especially in a case with relatively equal transit times to the receiving facilities. This may have been a good case to consult with on-line medical control while the air medical resource was en route. We don't always need to make the destination choice on our own.

Both Level I and Level II have NS requirements. And I disagree, I don't need to contact medical control for something like this. It is imperative upon me as a provider to know what the resources and options are.