AeroMedical Considerations By Don Hudson, D.O. Medical Director “LifeFlight”

Aeromedical Considerations

 As of 2001, there were approximately 270 air medical transport (AMT) programs in the U.S.  As of 2000 in Alaska:  9 Medevac Services  11 Critical Care Air Ambulances  1 Specialty Air Transport Team

Aeromedical Considerations  Most services in the U.S. are Rotor wing.  Most in Alaska are fixed wing.  AMT is an integral part of EMS, especially in Alaska.  Crew configuration of AMT is typically different than ground units.

Aeromedical Consideration  Nurse/Nurse  Paramedic/Nurse  EMT/?  MD/?  Medical equipment and scope of practice is typically advanced.  Integration with ground transport is critical.

Aeromedical Considerations  Often the MD for the ground transport is not the MD for the AMT.  Both MD’s must work well together.

Factors that Affect the Decision to Transport  Primary Principle- Do no further harm.  Know indications for transfer  Transfer agreements  Transfer protocols  Stabilize patient  Transfer with skilled personnel and adequate adjunctive equipment.

Planning Steps  Assess Patient  Escorts Available  Escort level  Required equipment

Planning Steps  Types of Aircraft  Landing Conditions  Number of Patients  Conditions of patients

Planning Steps  Notification  Receiving community  Air carrier  Family members

Planning Steps  Pre-Transport Records  Clinic or ambulance  Insurance Info.  Family contact number

 A successful Medevac starts before the patient gets ill.

Inventory your community resources.  Airfields  Air Carriers  Types of Aircraft  Escort qualifications  Medical equipment available

Rural Physician Medical Decision to Transfer  Decision is based on:  Weather  Plane availability  Staff availability and skill level  Type of patient (OB, Peds)  The rural physician is taking care of the patient without the current technological luxuries like CT scans, etc.

Things that will injure or kill the patient.  Illness  Trauma  Too much care  Too little care

Matching the Escort to the Patient  Skill Levels of:  EMT-I  EMT-II  EMT-III  Paramedic  Nurse  Critical Care Air-Ambulance  Match escort to worst pt. case scenario

You have a pt. with a possible ruptured appendix. Who do you use?  EMT-I  EMT-II  EMT-III  Paramedic  Nurse  Critical care Air-Ambulance

Matching escort to patient  Determine the potential problems escort could encounter should the patient deteriorate…..  The escort skill level and equipment should match the WORST possible patient problem.

Problem Solving Conflict Resolution- “A Walk in the Woods” Active listening & Active interaction Understanding other persons views Working to “move forward” Respect of others ideas & contributions

Critical Thinking Involves “thinking outside of the box” Consider all options Know you problem Talk to all of your resources Open dialogue with staff

Do Others See You As You See Yourself Articulate, interesting A leader in your field Caring & compassionate Knowledgeable & wise “User friendly” Suave & debonair Willing to share your time freely

How do you know when the Medevac was a success The crew tells you about the great flight The accepting Doc tells you about the great care the patient received The patient received the care they needed The flight went as planned!!!!!!!!!!!!