From a lurker ...
Someone wrote: 'I have no interest in prehospital care' as the opening line
of their discussion about the value of doctors at the roadside. I think this
really underlines the problem ambulance services have faced from the medical
profession and the specialty. Pre-hospital immediate care is a specialist
field and the same rules should apply as for other specialist fields. If
all doctors who 'lead teams' that deploy to the scene had specialist pre-
hospital care training(knowledge, skills and attitudes) then ambulance
services and trapped patients would be better served !
Remember that medical responses to ambulance service calls for help in the
UK are generally unpredictable and the skills and experience of the people
who deploy are very (? unacceptably) variable. Combine this with the fact
that the individual ambulance crews have very little experience of major
trauma themselves and I can understand entirely why cases go wrong and
arguments develop at the scene.
No one questions the needs of a critically injured patient in the ER so why
do we doubt the needs of the same patient when trapped in the wreckage of
their car ? We stand around with our gowns and gloves and wait for the
ambulance service to bring the patient to us. Then we have a go at them
because they haven't done this or that. It is my view that A&E departments
MUST take an interest in these patients, MUST develop effective retrieval
systems that are responsive to the needs of the ambulance service and MUST
understand the specialist nature of pre-hospital care. If it is
unacceptable for an SHO to manage a seriously injured patient on their own
then surely it is equally unacceptable for a technician or paramedic crew
to manage that same patient without experienced specialist medical help !
Back to ruminating ...
Rod
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