Devil49
I am not saying that it isn't possible but emphasising that it cannot be put into widespread operation and so that night ops are part of the typical EMS operation.
Swamp76
I agree with what you say and I note that you don't see NVGs as a panacea. Of course they will help, a great tool to have in the box. When we started UK EMS Ops back in 1987 we actually had three mission profiles. 'Secondary transfers' became tertiary missions and were replaced in the taxonomy by 'secondary missions' that were conducted in exactly the way you outlined with pre-surveyed sites.
The clinical advantages back in those days came from the time/distance equation but funnily enough not so much from from initial response time but the 'time to hospital'. Their was a hidden trap in all the government targets that meant that a fast response within 20 minutes got a tick in the box but the 15 minute into hospital was ignored. Clinicians may say 'so what' but us ambulance service guys new only too well that this 15 minutes to hospital in the rural south west saved the ambulance one and a half hours on blues and twos, plus a one hour turn around plus another two hours to get back into the operating area allocated. The patient benefited and the whole service was enhanced. As most calls were not critical it meant that you could get the guy with the nosebleed out of the system quickly so that the road vehicle would be there for the heart attack victim who may be the next call.
Digressing slightly but now we are on the subject it's worth mentioning. When you stand in the ambulance control centre and watch the activity levels fluctuating you can observe that there is little rhyme nor reason behind the lack of pattern. It's not unusual to see all the ambulances covering one part of the country disappear as they answer callouts and the controller frantically sends vehicles from another area to cover the huge gap. But, if you have an Air Ambulance you can temporarily allocate this huge area to that and sit out the tense period of waiting without having to play 'checkers' trying to cover the gap. Note - no flying undertaken, no missions accomplished but still this powerful tool contributed to raisiing the service level without even turning a blade. This is not bulls***t, it happened to us many many times.
Next time the analysts come down to check out the value of your unit's contribution to the Primary Care effort don't forget to chuck that one into the calculations.
In the Navy we called it 'The power if the Fleet in Being'. Just by being there folk had to pay attention.
G
