EDITOR'S NOTES

How to Cook Spaghetti William F. Rutherford, M D

I ate a lot of spaghe t t i in c o l l e g e - - because it was cheap. My first few at- tempts r e su l t ed in a p roduc t which ranged in consistency from what could have been used to reinforce concrete to something resembling red library paste. I asked an "older and wiser" roommate (he was a sophomore when I was a fresh- man) how I would know when the spaghetti was done. He responded by plucking a strand from the boiling pot, making a major-league windup and hurl- ing it towards the wall. When it stuck, he turned off the burner on the stove and smiled.

Our first paper ("Helmet Use: What Message Are We Sending to Patients?" see pp. 346-348) should settle one of the last issues regarding the wearing of hel- mets by air medical professionals. Mr. Ryan and his coauthors challenged the assertion that patients may perceive hel- met use negatively. In a well-designed study that surveyed awake, alert patients as to their perceptions, not a single pa- tient recalled thinking, "Why are they wearing helmets? What do they know that I don't? Shouldn't I be wearing one if they are?" A few patients thought that the helmets were a sign of professionalism, but most didn't notice them or give them a second thought. Perhaps patients have more on their minds when faced with an emergent transport.

In the discussion, the authors also make an interesting observation regard- ing the lack of helmets in promotional material. Just as some responsible televi- sion shows now have the hero buckle his or her seat belt as the chase scene be- gins, shouldn't we present a picture of professionalism at every opportunity? We surround our sensitive cardiac monitors with shock-absorbent padding. Should we do any less for the piece of "equip- ment" that monitors the monitor?

To review: 1) h e l m e t s save l ives; 2) helmets aren't really all that expensive, when compared to the cost of a head in- jury; 3) patients don't object to us wear- ing helmets; and 4) while it is possible that helmets diminish our ability to ren- der care to our patients, air medical ser- vices which do wear them have not re- ported such a degradation.

I think this piece of spaghetti is just about ready to stick to the wall.

The second paper in this issue ('q~he American Society for Testing Materials F-30 Commi t t ee on EMS" see pp. 349-352) concerns a process of which I suspect many of us were only marginally aware at best. I offer as evidence the fact that there were not a large number of qualif ied potent ia l rev iewers for this paper from our profession. In any case, Ms. Passini p resen t s the h is tory and work of an organization that has the po- tential to affect profoundly our profes- sion. You may take the stance that an- o ther "alphabet" organizat ion and its associated work product are unnecessary intrusions. Alternatively, you may decide that par t ic ipat ion in such an eclect ic group will promote coordination of emer- gency medical care at all levels. As with the question of paternalism versus indi- vidual rights during pregnancy among flight nurses, or the role of hel icopter transport during an acute myocardial in- farction, this strikes me as an area which may undergo healthy debate in the Air Medical Journal. Will the ASTM produce credible, meaningful s tandards? Here again , one may wish to see if the spaghetti sticks.

As we approach next month's confer- ence issue (which will contain the ab- stracts), I encourage all of you to submit your manusc r ip t s to the Air Medical Journal. I remind you that we will offer the expedited review process to all those

whose abstracts are accepted for presen- ta t ion at the Air Med ica l T r a n s p o r t Conference. Papers based on accepted abstracts that are received by the close of the conference will be r e tu rned with peer-review comments to the authors within four weeks of receipt. As always, the editorial staff stands ready to assist authors in producing publishable papers.

Not sure that your work is worthy of publication? You guessed it. Throw it against the wall--see if it sticks.

Air Medical Journal 13:9 September 1994 337