Listen To The Man

 h/t In The Middle Of The Right

Somebody needs medical help.

ER doctor in newspaper article says "Call 911".

B thinks his situation is the exception to the rule, because time/distance.

Sorry, B. But almost certainly, no.

Ditto for the rest of you. I don't care where you live (unless it's Alaska, 200 miles from town, and you and your float/ski Super Cub are 9-1-1).

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Suture Self approach: You elected to self-identify as an Ambulance/Driver.

Points To Ponder:

So, if things go to total shit while you're driving someone to the ER, do you stop, pull over, and hope the ambulance - which you'll now have to call anyways - can try to find you somewhere between home and the hospital? What have you got in the car that you didn't have at home for that eventuality? Starting with space, and a well-lit area?

Or do you step on it, trusting to your cat-like reflexes and total lack of red lights and sirens to get them to the ER yourself, and hope that 14 minutes without a heartbeat or oxygen, or sufficient blood flow, can be overcome by medical arts and luck? And that you won't crash on the way, and injure or kill more people in a vehicle neither designed nor intended to transport critical patients at high speeds, with a totally untrained and emotionally compromised driver at the wheel?

What if there's a Big Accident halfway there that you can't get around or through, lacking flashing red lights and a siren?

What if the person you're bringing crumps in the parking lot of the ER, at night, and now you have to go get the ER staff to play Hide-and-Seek, in the dark, with your unconscious (or dead) relative?

What if you went to the wrong ER, because they're not the place equipped to handle the problem? What if they're closed to certain patients, because their CT scanner is down, or they have no cath lab team for a heart attack, or they're so overcrowded there's literally nowhere to treat the patient but the parking lot?

The ambulance would have known that before they got to your house; you don't.

The reason you call an ambulance is that the ambulance brings the ER to you. Paramedics were literally invented 50 years ago to prevent the exact scenario you're describing.

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I had some poor (well-meaning) jackass once decide to bring his elderly wife, with a history of cardiac problems, to the ER for chest pain, from only five minutes from the hospital. In town. With the FD's paramedics two minutes away from his house.

She went into full arrest two minutes out, and arrived DOA, and a lovely shade of gray.

And received no treatment for another couple of minutes on top of that for the time it took us to get a gurney and a team, pull her dead ass out of the car and onto the gurney as a sack of jello with sticks, start CPR in the driveway outside the waiting room, and get her inside to a treatment area.

We managed to restore a pulse after several minutes. I don't know her long-term outcome, or if she had any resultant brain damage.

I do know if he'd called 911, she would have received vastly better care, from beginning to arrival. And he wouldn't have been kicking himself for risking killing his wife because of panic.

All of the care she needed would have happened before she got to us in the back of an ambulance, i.e. instantaneously.

Every minute you go without CPR decreases your survival chances by about 7%.

And that's best-case.

(i.e., except for cold-water immersion drownings, after 15 minutes with no heartbeat, we're probably just saving the body for organ donation, and making the family feel better. Hard truth. Do CPR as long as you want. Reality is still a bitch.)

And you can't do CPR and drive a car.

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Serious bleeding?

Traumatic Full Arrest, because the victim bled out, which you can't monitor, nor do anything about while driving a car, can be managed and headed off en route by paramedics just by starting an IV and administering fluids (which you can't do either of from behind the wheel), as well as by applying the tourniquet you probably don't have, and positioning the patient better in a vehicle designed for a stretcher with a critical patient on it.

OTOH, the survival rate for TFA runs into single digits.

And that's if you're smart enough to go to a trauma hospital (which - NewsFlash! - isn't every ER).

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Anaphylactic shock, with closure of the airway?

What, you have no meds for treating that on hand? You can't intubate en route? Bummer.

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And on and on.

There are rare exceptions to the rule, and there's always sheer dumb luck, but as a general rule, the impulse to scoop-and-go on your own with no medical capability en route is a foolish one, with statistics to match, and you're throwing dice with Death with someone near and dear to you as the chip pile, every time you do it.

Anybody that survived riding with you could have waited for paramedics at home, where you don't have your hands full of steering wheel, and can do things that can actually help if they get worse.

You fly planes, B.

In your terms, you're the guy telling the CFI/CATP with 20,000 hours you know better, and hoping you get back to the field before you run out of altitude, airspeed, and ideas.

Some few times, it might work.

Mostly, not.

The quote about bold pilots comes to mind.

If arrival time of medical aid is an issue, you're far better off getting medical training yourself and having a basic kit, than you are trying to be Mario Andretti.

Even if you live in BFEgypt.

The only transport that should ever be contemplated is to move them to a more advantageous location for either a handoff (say, at the dirt road where a maze of unmarked country roads meets paved highway), or getting them out of a forest or canyon to someplace where emergency vehicles or a helicopter can make a rendezvous/find an LZ.

Even then, all the drawbacks I noted still apply.

You should probably have at minimum two people to transport, so somebody is monitoring the patient at all times, with enough kit to intervene, within your training and abilities. If you haven't got that, the odds of making things worse rather than better just multiply.

And the time to play what-if, just like with flying, isn't after all the yellow and red lights on your panel start coming on.

You grok flight plans to the max, amirite?

So make a Medical Action Plan.

Talk with somebody local with serious medical training, and work out now what to do ahead of time for your exact area/situation, instead of trying it on-the-fly after your adrenaline has pegged at 11. 

At 3 AM. 

When it's raining.

Fail to plan: plan to fail.