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The Baltimore Sun

Independent review of medevac protocols

The Baltimore Sun's editorial "A smart review" (Oct. 8) threw up a red flag concerning the planned reassessment of protocols for medevac flights.

In June 2004, the Maryland Institute for Emergency Medical Services Systems invited the National Highway Traffic Safety Administration to perform a reassessment of Maryland's trauma and emergency medicine systems. NHTSA issued a "report card" on MIEMSS that suggested its regulatory oversight of the system was incomplete, and made 54 recommendations on the optimum effectiveness of the medevac system. The editorial zeroed in on one of NHTSA's recommendations: "Re-evaluate the current triage criteria with respect to the over-triage rate and potential overutilization of air medical transports."

A "smart review" of the system must be conducted by third parties who are not invested in the current system.

Dick Johnson, Baltimore

The writer is the founder and curator of the Golden Hour Coalition Inc.

No need to outsource trauma treatment

The system of medical triage and transport of critically injured patients in Maryland has been a center of excellence since it was developed by Dr. R Adams Cowley 40 years ago. Trauma systems around the world have been modeled after Maryland's program ("Maryland to revise medevac guidelines," Oct. 7).

Dr. Cowley pioneered the concept of "the golden hour," during which critically injured patients have the best chance for survival, and a system of transportation was developed to ensure that the citizens of Maryland had equal access to the best trauma care available in the world.

I am deeply sorry for the loss of the medevac helicopter, its crew and its patient in the recent accident. If the helicopters need better maintenance, let's ensure that this issue is addressed.

But the announcement that a panel of national experts is being convened to assess Maryland trauma services and identify opportunities for improvement is ridiculous. I hope that this review isn't a ploy by the governor to lay the groundwork to outsource medevac services to private contractors, an idea that some people have suggested.

Linda Kelly, Monkton

The writer is a registered nurse.

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