Responses to air ambulance story

There are some interesting letters to the editor of the Wall Street Journal defending the use of air ambulances. (See Air ambulances: costly, dangerous, slow?)They key points are:

• ER physicians, scared of liability, are overreacting and sending even minor cases to specialty centers. (This echoes the comment from a Health business blog reader.)
• When a rural community transports a patient a long distance in a ground ambulance, they put their own community at risk by losing their ambulance for most of the day
• Once a patient is stabilized, sending them by fixed wing aircraft over a long distance is more comfortable than riding in a bumpy ambulance

However, a physician I know offered another argument against air ambulance use in trauma cases:

Due to noise in the helicopter and the close quarters, helicopter based paramedics are far less able to treat their patients en route than their colleagues in ground ambulances.