Thursday, March 15, 2007

OSF's Expansion Continues

OSF’s Expansion Continues
January 22nd, 2007
by Dr. John A. Carroll

I noticed in the Journal Star today that OSF is working on “two smaller expansion endeavors”. The two projects include a $2 million dollar hangar for LifeFlight and a $15 million dollar medical building.

“It is part of our dedication and commitment to having facilities that can take us into the next decades,” said spokesman Chris Lofgren. “It positions us to provide appropriate level of services for decades to come.”

Being transported by air when one is sick or injured makes good intuitive sense. However, in Rosen’s Emergency Medicine, 6th edition, the following paragraphs describe their view of Air Medical Transport (AMT):

“Traditional research in air medical care has identified what can be done in the AMT setting. Work has shifted the focus from simple observational studies to measurement of the value of the interventions. The most basic consideration is if AMT makes a difference to patient care. Older, subjective studies show a benefit to AMT in only 10% to 20% of patients flown.

Where AMT appears beneficial, the advantage seems related to the provision of on-site advanced life support care rather than to a unique advantage of the helicopter. AMT has long been assumed to save additional lives in trauma; however, it is now recognized that improvements in outcomes are more likely related to the provision of on-site ALS care within a comprehensive trauma system rather than to the aircraft itself. Studies have challenged the benefit of AMT in interfacility transports in urban areas. Although the speed of the aircraft is undoubtedly greater than that of any ground vehicles, small gains in transport time may be offset by higher costs without significant changes in patient outcome.

It is interesting to see that highly skilled care at the scene with advanced life support seems to be the crucial issue rather than the “unique advantage of the helicopter”.

Remember, the Peoria Fire Department (PFD) can’t give advanced life support or transport the patient. Seems to me that OSF, with their deep pockets, could help the PFD advance their status to advanced life support so immediate on-site care could be given to the patient. According to Rosen, that is key to improving patient outcomes…not building $2,000,000 helicopter hangars.

John A. Carroll, M.D.

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