When HEMS started up, road crews (generally speaking) thought it a load of hooray henries and joy riding johnnies, freeloading on the back of a hard earned professional ambulance service reputation, acquired over generations. After a few years, said jolly jockies realised that perhaps they might be better off treating road crews with the respect they deserve, and launched a policy of actively engaging crews on scene and working as a team.
Although there remains evidence of this active engagement, there is a worry that they have become a closed elitist club, and clinically, a law unto themselves. Unfavourable opinions of Charlie Chopper are only ever uttered in hushed tones, in the relative sanctity of the mess room. Should there not be some independent and subjective assessment made of what is in the HEMS patient's best interests? Should it not be the case that, just because someone is dead, does not mean you may honed up your surgical skills, or smash all their teeth out getting a et tube down for the exercise?
I have known many paramedics who have done a turn on HEMS, and many of those have spoken of thoracotomies being a HEMs doctor's rite of passage. In other words, yer haven't really done HEMs until you've popped your cherry and cracked a chest old thing.
Until recently, I had only heard reports off dubious uses of this street surgery. One alledged instance, included the cutting of a puffer jacket followed by cracking open the punter, and as a consequence liberally filling his thoracic cavity with choice duck down. I make that one fucked patient.
I know they review their procedures and do a job by job review, but is anyone really going to stand up and say "listen pal you didn't really have any justification for that procedure. You ensured his end, you left him in the gutter, and frankly, you stole his dignity from him too." You would probably get the same treatment if you told them they are shit in the sack, or criticise their golf-swing; namely banned from the club in perpetuity.
What does everyone else feel? I am seriously interested to know. Personally I seek to package and run with a punter before the butchers arrive. I also think TBWT might consider marketing medic alerts that read "HEMS? FUCK OFF." I'll reserve mine and a couple more for my family and loved ones now boss.
