Sanghavi studied decades of ambulance protocol and found the standard practice backwards for gunshot wounds: the minutes spent stabilising on scene are minutes the patient needed a surgeon. The 'scoop and run' approach police sometimes improvise outperforms the protocol.
…a lot of, you know, there are a lot of problems. The nice thing about police is because they have to respond to so many different kinds of things, they are everywhere and they are fast. They get to a scene before an ambulance very, very often and they can leave and get you to the hospital a lot
…you get some, if you get to a hospital faster, like, how is that not a better thing? But can you talk to us a little bit about kind of the actual differences between if you're going on a scoop and run or if you're going in a police car versus that ambulance that could potentially get you more care?
…of a hypothesis. The other two explanations have quite a bit of evidence behind them. One is a category of things that basically just shouldn't be done in the field and it should wait till the person's at the hospital. And the classic example of that, especially for trauma, is the provision of intravenous fluids. And there's evidence that actually shows, including clinical trial evidence. That in the case of a penetrating wound, you really want the fluids to happen at the hospital and that saves lives, not in the field. The third kind of explanation
is
that there are interventions, they're basically problems with the quality of the delivery of interventions. So it's not that the intervention itself shouldn't be provided. It's just that it's really hard to get it right in the field. And the classic example there is the use of endotracheal…
And