1. Air Medical Access in Rural Communities Shaun Hale, BS/NREMT-P/CMTE Program Director – Air Evac Lifeteam

2. Presenter Bio: 29 years in Pre-Hospital Care Nationally Registered EMT-Paramedic Bachelor of Science / Safety Management Retired Engineer – Paramedic Flight Paramedic Program Director Air Evac Lifeteam 10 years Air Medical Experieince

3. Disclaimer: The content of this presentation is a representation of statistics and experiences related to the topic. The content and presenter are not endorsing any one system or organization and is providing actual cases and/or information that supports the presentation.

4. How are we effected living the Rural Way of Life?

5. Deer Cliff

6. Picture to be added.

7. It’s Our Way of Life…. Although we choose this way of life, it doesn’t mean that our access to health care should be any different than if we lived in an Urban area.

8. Although we choose the Rural Way of Life Doesn’t mean we are any less susceptible to any and all Medical Illnesses or Traumatic Injuries.

9. Cardiovascular Disease in the United States: Where do we rate Statistically in Tennessee??

11. Cardiovascular Disease The Impact: America's Heart Disease Burden About 600,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. Coronary heart disease is the most common type of heart disease, killing nearly 380,000 people annually. Every year about 720,000 Americans have a heart attack. Of these, 515,000 are a first heart attack and 205,000 happen in people who have already had a heart attack. Coronary heart disease alone costs the United States $108.9 billion each year. 3 This total includes the cost of health care services, medications, and lost productivity. 1: Source - CDC Cardiovascular facts published 2008-2010. rev. 10-29-14

12. Stroke Disease: Are we better Statistically? Tennessee Ranks in highest Category.

14. Stroke Disease: and its Impact Stroke in the United States Stroke kills almost 130,000 Americans each year—that’s 1 out of every 19 deaths. On average, one American dies from stroke every 4 minutes. Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes. About 185,00 strokes—nearly one of four—are in people who have had a previous stroke. About 87% of all strokes are ischemic, when blood flow to the brain is blocked. Stroke costs the United States an estimated $36.5 billion each year. 2 This total includes the cost of health care services, medications to treat stroke, and missed days of work. Stroke is a leading cause of serious long-term disability. 2: Source – CDC : Stroke Facts 2008-2010

15. Trauma: We cannot forget that Each year trauma accounts for 41 million emergency department visits and 2.3 million hospital admissions across the nation. Trauma injury accounts for 30% of all life years lost in the U.S. $406 billion a year, including both health care costs and lost productivity. Ranking as cause of death: #1 for age group 1-44, or 47% of all deaths in this age range #3 as leading cause of death overall, across all age groups. Source – National Trauma Institute: 2010 statistics via CDC updated Feb. 2014

16. So how do we get from… TO Its not an easy task and… Time is Critical!

17. Air Medical Access: From a Historical Standpoint Inception began approximately 30 years ago. Setup by Urban Trauma Centers to provide access for patients. Improvement in patient outcomes. But we had a historical geographic hurdle to overcome.

18. Air Medical Access: In the Beginning

19. The Need Now:

20. The Paradigm Shift: * Respond to the need for more rural access. *Assess the needs and current deficiencies that existed. *Improve and enhance systems already in place. *Does the need fit access required? *How is the AMI going to meet the need? Thus the Paradigm shift was created.

21. The Rural Model *The idea gave assessment to the need. *Placing aircraft in rural locations ready to respond. *Moving those assets from the Urban areas out into the Rural setting. *The desired effect sought were improved outcome and cutting time.

22. The Rural Model The Issues: Aircraft were not strategically located. How do we get those assets out there?

23. The Rural Model The Issues: Response time were long and at times delayed. *Response times in many instances double. *We as an industry were not meeting the GOLDEN HOUR!

24. The Rural Model The Issues: Patient outcomes were not at its level of potential and in some cases not favorable. The AMI was making an impact but it needed to provide better access.

25. The Rural Model The Results: *More assets were being placed in the rural areas. *Response times were drastically cut. *Patients were being delivered to definitive care in shorter time frames. *Patient outcomes were improved.

26. The Rural Model The Results: By placing these assets out in these areas was a win for patient care access.

27. How Does Tennessee Measure up? TN has a great Rural Air Medical Access System. At least 7 medical providers licensed providers by the State of Tennessee. In excess of 24 Licensed aircraft in areas ready to respond in the rural setting.

28. How Does Tennessee Measure up? Tennessee Measures up very well! Therefore our patient outcomes are improved.

29. Where do we go from here? Continue with our rural partners to provide the access needed. Constantly reassess needs for additional assets for underdeveloped areas. Move forward with Public Education detailing the need and utilization. Because time is critical. What would you do?

30. Questions: Thank you

31. References: 1.CDC: Cardiovascular Disease – US, revised 10/29/14; National Center for Disease prevention. 2.Kochanch, KD, XU JQ, Murphy SL, Minimo AM, Kung HC, re: Deaths reporting final date 2009. 3.National Trauma Institute; published with CDC, Feburary 2014, Finkelstein, E.A., Corso, P.S., & Miller, T.R. The Incidence and Economic Burden of Injuries in the United States. USA: Oxford University Press. 2006