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IRELAND DOES NOT have a helicopter emergency medical service (HEMS) up to the standard of its peer nations in the UK or the EU.
Starker still is that across the border in Northern Ireland, there is such a HEMS capability that has saved many lives since its inception.
As an Irish ex-pat doctor working in the trauma system in Sydney, Australia, both pre-hospital and in-hospital for the last 20 years, I’m dismayed that Ireland has been left behind when it comes to this key element in trauma system development.
Australia, although a massive country by comparison with Ireland, is similar in that the inverse care law exists: those in the most need are the furthest away from help.
This tyranny of distance has driven the health system in Australia to put in place a mantle of safety when it comes to acute care, be that severe trauma or illness.
Hence, in New South Wales where I work, when a severe trauma occurs there’s a cascade of responses that occurs to maximise that person’s chance of survival.
A Rapid Launch Trauma Coordinator working in the Sydney Control Centre of NSW Ambulance, monitors the system for a case that would benefit from a HEMS launch. That can be from the 999 caller or from the paramedics on scene.
Once launched, there is a convergence of care on that patient: the HEMS team en route liaise with the treating paramedics on scene and arrange a rendezvous point.
At that point, the patient receives the same treatment they would receive in the Emergency Department of a Major Trauma Centre (MTC). Following stabilisation the patient is rapidly transported to the MTC where further interventions to stop the bleeding are carried out – often directly from the helipad to the Operating Theatre.
Severe trauma does not respect time or geography. Injury affects the lives of young and old, urban and rural.
Furthermore, the rural population is overrepresented in severe trauma statistics and is the furthest from definitive care.
Life or death
There are time critical interventions and decision making that must occur early in that initial golden hour that makes the difference between life or death; the difference between return to family, friends and work versus severe long-term disability and lifetime care.
In other countries, that hospital resuscitation room level care is delivered by a doctor and paramedic team HEMS configuration. The combined skills of this team have a compound beneficial effect for the patient.
There is a shortage of emergency medicine (EM) consultants in Ireland. Advertising EM consultant jobs combined with a HEMS role will attract Irish ex-pats with prehospital expertise back to Ireland.
This will also retain those doctors and bring the advanced critical care skills that these doctors possess to Irish hospitals.
Furthermore, Irish patients will get those critical life-saving interventions earlier and closer to the point of injury, than in an often crowded and overwhelmed emergency department.
This will save lives. This strategy was done by the health service in Northern Ireland and it has worked.
I support the development of a trauma system in Ireland, bringing severely injured patients directly to a Major Trauma Centre, rather than to a local hospital that may not have the skills or services for definitive care.
To enable that to happen, a HEMS model must be in place.
If there’s a road traffic accident in rural northern areas of Ireland today and a teenager is critically injured, it is in my opinion unethical that the Northern Ireland Hems advanced trauma capability isn’t systematically tasked to resuscitate and stabilise that patient followed by rapid transport directly to the Major Trauma Centre in Belfast for definitive care.
These kinds of accidents, be it on the road or at a farm, are occurring regularly.
The status quo is that such cross-border co-operation occurs only on an ad hoc basis, rather than as part of a systematic all-island approach.
This is an area where an all-Ireland approach makes sense, and I would implore the Irish government to enable such an approach in conjunction with the Northern Ireland government.
As a precedent, a whole-island approach to paediatric interventional cardiology has been highly successful.
There are prehospital trained doctors in Ireland, UK and further afield who could be employed alongside paramedics to assist the Irish National Ambulance Service in staffing a highly functional HEMS in a relatively short period of time.
Lastly, clinicians such as myself are more than willing to assist in this and share governance structures and training that have been in place and proven over many years.
There is no time left to waste.
Dr Brian Burns is an emergency physician, prehospital and retrieval medicine specialist and trauma specialist. He works at the Aeromedical Operations of the New South Wales Ambulance and at North Beaches and Royal North Shore Hospitals, and is a Clinical Professor at the Faculties of Medicine and Health at the University Sydney and at Macquarie University.
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So the man who incited the hate condemns it?
@James Lyons: did he incite hate???? Link please.
@Danny foley: how long have you got Danny? Come on you can use Google. I have plenty of faith in you. Even Ask Jeeves about the wall Trump wants to build and you’ll get some evidence
@Danny foley: “Did he incite hate?” Bwahahahaha
@James Lyons: so proper enforcement of the immigration law in any country is hateful and racist. Anyone who questions your type of society is racist?????
@Francis Mc Carthy: link please? More leftist hysterical behaviour. Ridiculous.
@Danny foley: No being racist and saying racist things makes you racist… are you suggesting that the Ku Klux Klan who formed part of yesterdays protest or the ultra white militias are just misunderstood?
@Danny foley: what a way to twist words there. I said he incited hate.
Not all Trump supporters are racist but I’d go out on a limb and say most racists are Trump supporters
@Danny foley: Had a look at your twitter feed there danny – where does all the hate come from bud? Were you not held enough as a child… ? Harbouring some illicit thoughts about your sexuality?… come on danny have a coke and a smile.. the world is great.
@Old Gabby Johnson: the deputy mayor was tweeting about hating white culture and demanding the general Lee statue be removed and people protested as is their right. The situation is much more complicated than the media would have or like to have us believe.
@Old Gabby Johnson: stalking me now? LOL the world is never black and white. What hate??
Hmmmm..I wonder were those protesters that were ploughed down yesterday,were they being “loud & obnoxious” like the Black Lives Matter activist who was kicked and punched at a Trump campaign rally ? Do you remember the words that he said? Let me remind you : “Maybe he should have been roughed up because it was absolutely disgusting what he was doing.” Trump also said that the man deserved the treatment because he had been “very obnoxious” and “so loud.”
Or this beauty : “Try not to hurt him. If you do, I’ll defend you in court, don’t worry about it.”
@Danny foley: Not stalking no – just curious – your feed is a mish-mash of anti-immigrant propaganda, brexit nonsense and a load of other sh**e. The general lee statue is a symbol of red neck racism – are you with those guys? – and before you say freedom of speech – the south in the civil war wanted to maintain slavery – and the confederate flag is a racist wolf whistle…as you well know.
@Danny foley: just check his tweets and listen to some of his tweets.
@Paul Furey: I don’t want to see what Gabby tweets.
@Danny foley: no that’s not racist, sweeping generalisations of whole nations based on a minorities actions is. You’re profile picture is a bit telling too. Can you tell me what benefit leaving the EU would be to us at a time when we finally have the upper hand when dealing with our neighbours. I presume it’s love of your country and not just uncontrolled anger has you feeling that way
@Danny foley: Be quiet you clown.
Hiring Alt-Right fascists in his administration.
The Orange Clown likes anyone who praises him.
@Danny foley: you need help
@neilo: I think it would be more democratic if rather than mouthing off like the silly Mayor and holding a referendum as they do in Switzerland to have symbols of history removed might be more democratic. Change is good but because some Mayor has an axe to grind and manages to offend the majority of people in his state – then you get conflict and conflict is not good. It brings out the worst types and America seems to be full of it.
@Danny foley: what was this march called again? Surely the name of the event would reflect what it was about? Oh yeah, that’s right, it was called United the Right, nothing about a statue and nothing about a deputy mayor. Most marchers were out of towners
What the hell are they doing, pulling down statues of heroes of times past? Do they have no respect for their own history, brief as it is? What is wrong with americans
@Zx5vZulB: that is the modern left for you, the real fascists.
@neilo: there’s no view from Nelsons column anymore.
@Zx5vZulB: Cromwell is a hero to some people on this island.
Pick up a history book champ.
@Diarmuid: Hitler is a hero to some on this island as well, I never understood the contradiction of loyalists celebrating the men of WW2 in one hand while flying the swastika with the other, maybe they should read a book.
@Zx5vZulB: only happy when they are out robbing oil.
This element was always there, Trump used it to win his election and now he’s lost control of it. He can’t fully condemn his alt right following because he wants another term but he has to say something because he is their president so he gives the most bland condemnation ever. These lunatics see that as an endorsement.
@Dell: what has Trump done to America? Is this making America great again? We’re back in the racist 60s again.
@Deborah Behan: no Deborah he’s made America hate again..
Trumps comments pleased a lot of his fan base,except David Puke,whom wasn’t too amused with Trumps comments..But lets’s stay with the “positive” replies of Trumps fan base..
“Trump comments were good. He didn’t attack us. He just said the nation should come together. Nothing specific against us. … No condemnation at all. When asked to condemn, he just walked out of the room. Really, really good. God bless him.” — Daily Stormer
@neilo: Like saying the Jewish resistance in the Warsaw Ghetto Uprising were equally as responsible for violence as the Nazis.
The answer to non-white identity politics must not be white identity politics, we must get back to placing the individual at the centre of our societies. Individual rights and responsibilities not group rights. This has been escalating for awhile now, people have retreated to ideological echo chambers. The Alt-right and Antifa are a mirror image of each other. Race based politics will lead to more division, if we continue down this road I do not hold out much hope for the future.
@John Mc Grath: the alt right isn’t race based it’s individual based just as you described, antifa are basically militant communists that are sick of playing video games
@Dean Burroughs: it wasn’t only antifa who gathered to oppose the racists. Countering pathetic white supremacists is not the preserve of the far left.
@Dean Burroughs: Antifa weren’t the ones playing Call of Duty with automatic weapons and beer bellies (evidence of a sedentary lifestyle) hanging out, it was the Alt-Right racists.
@Atheos Euripides: Defending antifa? Why don’t we all just agree that both sides are a bunch of violent knobs? Member the G20 protests? I member
@Liam flag: let’s just agree that one side attempted to kill as many people as possible and it wasn’t antifa
@Liam flag: Where did I defend Antifa, I just said they didn’t have weapons, you’re a paranoid wreck.
@John Mc Grath: only one side drove a car into a crowd to kill maximum amount of people. You’re pathetic excuse to try to equate racist, sexist, homophobic arseholes with people who oppose them is a joke.
@Dave O Keeffe: Complete nonsense Dave. United the right had armed militias walking around. If they wanted to kill as many people as possible, they would have done so. Derp
@Deborah Behan: yet again your ability to read what was not written , or to see this is not a one sided problem is astounding.
Did Trump condemn himself?
@Seth Cheffetz: all these antifa BLM crowd want is freedom of speech and tolerance of alternative view’s. They should never be questioned on their own behaviour cause that in its self would be racist
@Danny foley: anti EU but pro Nazi…pull yer neck in ye muppet
@Charlie Kavanagh: I’m pro Nazi?
@Danny foley: Oh God yes.
@Danny foley: probably more pro stupid to be fair to ye
@Danny foley: Anti-EU avatar with a line through it…
So you’re Pro-EU?
Making as much sense as your beloved Orange Clown.
@neilo: Kettle calling kettle black there. Still in the bubble I see
@Warthog: go back to yer cave troglodyte
@Warthog: It’s actually pot calling kettle black.
@Atheos Euripides: Duh
@neilo: hahahaha your funny and so far off the mark. Need to to pay a visit to SpecSavers.
Trump’s base supporters were on display yesterday….ignorant and violent people. America is eating itself under his leadership. And “for evil to succeed” all needs happen is for good men to do noyhing.
@gowfc@yahoo.com W: that is some wide brush your wielding there.
@Danny foley: If the MAGA cap fits and all
@Danny foley: Simple people have simple solutions to complex problems – that’s why they feel empowered from someone who acts and talks like an eight year old to lead them. Bigly!
Why did Barack Obama never condem the violence and murders committed by Black Lives Matter???
@neilo: it’s important to highlight the blazing double standards at work here. Black Lives Matter is a black supremacist group which is supported and endorsed by the left and members of the media and political class.
@neilo: I condemn all political violence. I will point out that the white nationalists were engaging their constitutional right to assembly when set upon and attacked by AntiFa and assorted leftist thugs. People fight back when their constitutional and civil rights are infringed upon.
@Chris M.: Get a life will you and read a history book, first of all the so called Confederate States commeted treason trying to break away from a Union while the British Empire where supporting the confederates. Also Lee broke away from his milatary rank and commeted treason himself where he supported a bunch states that still refuse to acknowledge the loss of the Civil War, which caused the loss of thousends of life to this very day that they are still calling it the aggresion from the north in their sourthern schools.
@Chris M.: By meaning of driving a car inro the anti-racism protesters and rolling back and forth, you really are dellusional. How is that a peaceful protest Chris m tell me.
@Ossi Fritsche: The original protest was not a support for Facism or Racism (Both sides can attach those labels to their collars). The march from what I read was organised to protest against the intended removal of a statue that has meeaning to an awful lot of people. The other group organized a counter protest and they would also not be the cream of the crop of American society! BOTH sides were spoiling for a fight. The authorities hardly had enough resources to manage the original protest and therefore should have banned the counter protest. So to my mind blame lies with the perp driving the car, the authorities, the counter protest and finally the members of the original monument removal protest. All by the way in that order.
@neilo: LOL… He learnt that trick from you.
@Warthog: The people of the town voted in favour of the removal of the statue, just because the KKK thugs you are defending don’t like democracy, doesn’t mean they can go mowing peaceful protesters down with their cars.
@Warthog: also, the march was not about the statue, it was called Unite the Right. I’d guess most in attendance weren’t even from the area but that was the point, it was about getting far right minded people from all over the country in the same place at the same time.
@Atheos: I am NOT defending the KKK and their buddies. The perp driving the car hopefully will be locked up for life. I was pointing out those responsible for this atrocity. The authorities knew the importance to this particular monument in the town, surrounding area and throughout The South. It was intentionally provocative. It was also an unnecessary provocation.
@Warthog: There are a lot of monuments around the world which many would love to retain and many others would love to pull down. This statue wasn’t doing any harm, it was a historical connection and a reminder of the past. Where does this stop? Oh lets pull down the Vietnam memorial as we dont agree with the US involvement in indochina. This is the Governor an Co stirring the sheeite, pbly appeasing the other (Black) Supremacist group BLM. They screwed up badly and a women is dead (maybe others) and many injured.. For what?
@neilo: Deflection, Redirection, Whataboutery and finally hypocritical righteous indignation…
@Dave O Keeffe:… and yr point is Dave-No.8?
Race identity politics were perfected by the democrats, Obama, Hillary and soros, please see the Dallas police massacres or the trump supporter shot in the head by his Hillary supporting neighbor the other day. None of you bashing trump have a leg to stand on lol
@Dean Burroughs: 2 points each for Obama and Hilary and I’m going to give you a bonus 5 points for squeezing George Soros on, so 9 points in total for Bigot Bingo, go you!
@Dean Burroughs: whataboutery is the reserves of the one without a leg to stand on. Stfu.
@Dean Burroughs: tell it to the people that were run over yesterday. Do you believe Trump when he says things have never been worse in America for black people and that he’ll save them? That’s both a lie and identity politics.
@Dean Burroughs: I like how the 3 people who replied to you, didn’t bother questioning your comment, but instead attacked you instead.
Blazing double standards.
@Chris Cantwell: would that make you the fourth? Third really though seeing as I asked him a question based on his comment.
@Dave O Keeffe: I hit the “3″ by mistake, only noticed it when I pressed the post button after it. Apologises.
The Trump phenomenon shows that we urgently need an alternative to the obsolete capitalism
http://bit.ly/2oNPIF0
@failedevolution: what do you suggest? Socialism? Communism? Free sh*t for everyone?
That country is heading to an other civil war
The world’s gone mad. A lot of nasty individuals out there.
@Mark Jones: Bad dudes
@Mark Jones: the world was always mad sadly. that poor girl ,
@Mark Jones: They were always there but now they’re crawling out of the woodwork.
Anyone who self-identifies as alt-right owns this disgusting behaviour. It has nothing to do with traditional American conservatism which stands for limited govt, individual liberty, personal responsibilty, free enterprise, Judeo-Christian values. These people are tainting the brand
@Squarepeg01: ‘Judeo-Christian’ values nearly destroyed Ireland, amazing how some consider those values to be a good thing.
@Atheos Euripides: there were more historical forces at work than just judeo-Christian values. Don’t murder, don’t steal, don’t worship idols, don’t be promiscuous. Sound like good ideas to me.
@Atheos Euripides: Oh STFU you hypocritical Christophobe. Your like a needle stuck in the groove. Grow up.
@Warthog: ‘STFU’ – tells me to ‘grow up’, lol!
@Warthog: A white christian was radicalised and comitted a terrorist act and murdered an innocent woman. Why didnt his family or pastor report him for his radical views? Where are the christian leaders telling their followers not to be violent nazi terrorists? We need a travel ban on these dangerous radicalised christians. They could kill anywhere.
@DaisyChainsaw: I agree as long as it applies to your Islamic buddies as well.
@Warthog: YOU’RE
Greatest country in the world!! Hmmm
Idiots on both sides of the protest. Both as authoritarian in their views. Ironically, Robert E. Lee, whose statue they’re fighting about, would disapprove of and loathe both sides equally.
@Ths Fer: only one side flying swastikas, carrying automatic weapons and murdering people.
@Ths Fer: Can I come to your next séance with General Lee?
@Dave Bruen: Dublin Pegida march… who attacked who? Who was carrying flags that day?
@Warthog: The Whataboutery is strong in this pig.
Trump going out of his way not to upset his hardcore base of brain-dead supporters #sad #sickening
THE BIGGEST QUESTION HERE IS: WAS THIS KILLED WOMAN A NAZI ?????
@Time to Wake Up: I can’t believe this got one thumbs-up
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