A smart review

Our view: Maryland emergency medical officials take steps that should help address concerns

October 08, 2008

With a fatal accident on their watch and some lawmakers pressing for cutbacks to the state police helicopter fleet that ferries accident victims, Maryland's emergency medical professionals are on the defensive. They've revised the protocols paramedics use to identify which patients need to be airlifted to trauma centers and decided to bring in independent experts to assess the system's reliance on choppers. They're trying to get ahead of any attempt by the legislature to undercut the highly regarded system.

The review is certainly justified in response to the recent helicopter crash in Prince George's County in which four people died. Critics say the medevac system relies too heavily on helicopters for patients who could be taken to trauma centers just as safely by ambulance - and at less cost to the state. The dispute could have serious implications for medevac's future - the state has approved replacing the 12-chopper fleet at a total cost of $120 million, but it hasn't yet moved ahead with its first purchase.

The overwhelming majority of emergency medical patients at Maryland's nine trauma centers arrive by ambulance. According to state figures, the trauma centers with the largest percentage of air transport patients are Prince George's Hospital Center in Cheverly (39.7 percent) and the R Adams Cowley Shock Trauma Center in Baltimore (35.1 percent).

The Maryland Institute for Emergency Medical Services Systems will convene a panel of trauma specialists to determine whether the helicopters are overused, but it shouldn't be stacked with sympathetic colleagues. Those experts also should take another look at the paramedics' protocols, even though MIEMSS just spent two years revising them. The review should be rigorous enough to satisfy skeptics in Annapolis.

Trauma care is a highly specialized business in which lives are saved in miraculous ways but also lost despite heroic efforts. Maryland's system needs the best professional advice and counsel to ensure its continued success in the most efficient way.

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