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Squad puts patient's needs first when arranging transport

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GUEST EDITORIAL

Jason Felts of Galax is 1st Lieutenant with Pipers Gap Rescue Squad Inc.

This letter is in response to the caller in the May 27 edition of The Hotline, who questioned decisions made by members of Pipers Gap Rescue Squad in the care of patients.
Any patient care decision made by EMS providers at Pipers Gap is based on the needs of and in the best interests of our patients.
The caller stated their displeasure with our decision to call for an aircraft to transport two different patients and the location where the helicopter landed.
First, the caller needs to understand that Pipers Gap follows national standards of care and written protocols approved by our operational medical director when deciding if a patient meets criteria for air transport.
Our protocol states “every patient shall be transported to the closest, most appropriate facility.” For 99 percent of our patients, Twin County Regional Hospital is the closest and most appropriate. The staff at TCRH provides a high quality of care and we are happy to partner with them in emergency medicine.
The caller stated they could not understand why we would fly a patient experiencing a stroke when our local hospital is a certified “stroke center.”
TCRH is a “primary” stroke center, which for many patients is exactly what is needed. However, some patients require a “comprehensive” stroke center, which must have neurovascular surgical services onsite 24 hours a day and a critical care environment to properly manage patients. The only hospitals in our region with this capability are Forsyth Medical Center, Wake Forest Baptist Hospital and Roanoke Memorial Hospital.
Depending on our assessment of the patient, including the time of onset of symptoms, our providers are trained to decide which stroke center is appropriate. In the incidents noted by the caller, the ER physician at TCRH agreed with our decisions.
The same policy applies to some patients experiencing heart attacks. We are trained to make a field diagnosis of certain types of heart attacks and provide rapid transport to a facility with the capability to properly manage them.
Second, the caller questioned the location where the aircraft landed, stating they could not understand why we would use a school or Felts Park when the hospital is in sight and has a helipad.
Hospital administration has asked that we not routinely use the helipad for landing because once the patient is on hospital property, they should be seen by their staff. We have tried to honor this request when possible, as this would be counterproductive when time is a concern.
Therefore, a remote landing zone is chosen. The children at Gladeville School were not “panicked” as the caller stated. In fact, the children seemed to enjoy watching the aircraft land and take off from an adjacent play field. There was never a safety issue.
The school is not an ideal landing zone, so for this reason we have decided to discontinue the use of this site and move to another location less than a mile away.
We have never been told by firefighters that they were “bothered,” as the caller stated, when requested to set up a landing zone. We work closely with both Galax and Hillsville fire departments and we appreciate their efforts.
Thirdly, when requesting a helicopter it is our policy to use the closest aircraft available.
The caller is correct that we had to wait at the landing zone for the helicopter. This is out of our control, as the closest aircraft on both of these events was not available when requested and a more distant aircraft was utilized.
Generally, the closest aircraft is a 10-minute flight from our area and usually is waiting on us to arrive instead of the other way around.
I ask anyone who has a question about our policies and practices to please contact us directly. We are happy to discuss any concern a member of the community might have.
We want all who entrust us with their care to know that we will continue to do everything within our power and training to provide the best medical care that we can and ensure that patients are transported to the most appropriate medical facility for their needs in a timely fashion.