Your point would be made better if you could refrain from profane insults. This first responder expended considerable effort getting his certification, roughly the equivalent of a couple of full time semesters, PLUS having to work along side of various areas of the hospital including the ER. I ain't no bumbledfark, thank you.
The decision is not made just by some gut instinct. We've got defined protocols defined by the state medical head under whose authority we operate. It specifies where we transport the patients and by what means. The helicopter only gets called for multisystem trauma cases. Broken bones and some serious bleeding wouldn't cut it. When you've pulled a few bodies out of wrecks, you don't have a hard time deciding when it is appropriate or not.
Despite the "inaccurate" statements in the video, there's no "stabilizing" of a multi-trauma patient in the field. We may stop the external bleeding and start fluids and perhaps even mast trousers, but we can't perform surgery in the field and these cases NEED surgery rapidly (that's what the golden hour is all about). Not only do you have to get them to the trauma center fast, but the trauma center has to be ready to start cutting.
Most of the other cases, for example, cardiac cases, we carry a lot of things that we can do (in coordination with the doctor in the ER) on the scene. We can do CPR, administer oxygen, adminster fluids, epinephrine, bicarb, monitor and diagnose arrhythmia, perform defibrillation and cardioversions. In that case, transport is wasting time. The patient needs certain intervention (defib, CPR) more than he needs to be in a hospital, even if he does end up needing angioplasty or the like.
