2. OBJECTIVES Activation Guidelines Communications Weather Landing Zone

3. Air Medical Flight Crew  Based at Medical Center Hospital in Odessa, Texas  Highly Trained Flight Crew Pilot Registered Nurse EMT Paramedic

4. Rotorcraft – Bell 407 Length (rotor turning)…...41.8 ft Width (rotor turning)…..…35 ft Max Cruise Speed…………160 mph Maximum Range……………350 miles Length (rotor turning)…...41.8 ft Width (rotor turning)…..…35 ft Max Cruise Speed…………160 mph Maximum Range……………350 miles

5. RESPONSE TIME AUTO-LAUNCH  In Air In Less Than 5 Minutes From Dispatch  Patient Is Definitely In Need Of Air Transport  Ground Crew May Cancel Flight At Any Time If Patient Is Not In Need Of Air Transport

6. Service Area 150 Miles

7. COST $Please Inform Com. Center If Helicopter Is Not Needed, ASAP $Requesting Party Will Never Be Charged for Flight or Requesting Helicopter $Medical Necessity Is Key $Please Inform Com. Center If Helicopter Is Not Needed, ASAP $Requesting Party Will Never Be Charged for Flight or Requesting Helicopter $Medical Necessity Is Key $Lean On Side of “Just in Case” Rather Than “Wait To Be Sure” $Patient Care is Priority $Carestar Will Never Make Payment Arrangements or Ask for Proof of Insurance Before Accepting Patient $Lean On Side of “Just in Case” Rather Than “Wait To Be Sure” $Patient Care is Priority $Carestar Will Never Make Payment Arrangements or Ask for Proof of Insurance Before Accepting Patient

8. Activation & Landing Zone Guidelines

9. ACTIVATION CRITERIA Trauma relating to oil field accidents –Severe Head Injuries –Chest Injuries –Major Extremity Injuries and Fractures –Falls from over 20ft –Burns (Thermal, Electrical, Chemical) –All Other Medical Conditions (Heart Attack, Stroke, or Diabetic Emergencies)

10. ACTIVATION Scene Trauma –Situational factors Mass Casualty IncidentsMass Casualty Incidents Rural or Isolated AreasRural or Isolated Areas Limited Ground Ambulance Access or EgressLimited Ground Ambulance Access or Egress Limited Access to Medical CareLimited Access to Medical Care Scenes Involving Long Extrication Times Taking Time Away From The Golden HourScenes Involving Long Extrication Times Taking Time Away From The Golden Hour

11. CONTRAINDICATIONS Mission –To Provide Safe and Rapid Transport of Critically Ill or Injured Patients to the Most Appropriate Facility Contraindicated Transports –Traumatic Arrest Prior to the Arrival of Carestar –Recurrent Cardiac Arrest ALS Support Transport Post-Resuscitation –HAZMAT Patients

12. 1-877-730-0009 COMMUNICATIONS

13. Initial Information Who, What, When and Where Has EMS and Law Enforcement Been Contacted? Specific Location of Scene or Patient How Many Patients Do You Have? How Dispatch / Flight Crew Contact personnel at scene? GPS Coordinates Helpful - Use Degrees and Minutes Should Always Be Used in Conjunction with Other Directions

14.  Provides Flight Crew  Communications with LZ Coordinator  Minimize Radio Traffic  Must Have Clear and Concise Directions  Communication Priorities (Be Specific)  Scene Location  Landing Zone Description  Landing Zone Hazards  Patient Information Dispatch Information

15. WEATHER CONDITIONS  Always Call  Pilots Responsibility to Make Final Decision Decision  Do Not Assume Anything  Storms Can Be Localized  Weather Minimums  Vary depending on location, terrain, etc. terrain, etc.  Ceiling and visibility

16. WEATHER CANCELATIONS  Rendezvous Is An Option  If Forced to Abort Mission for Weather You Will Always be Notified Immediately by Dispatch

17. Night Considerations If EMS On Scene Scene Strobes Visible for Miles Scene Strobes Visible for Miles –Easier for Ground Units to See Aircraft Coming Please - No Lights Shining Toward Cockpit Small Amount of Light Dissipates Across Large Area of Windshield Small Amount of Light Dissipates Across Large Area of Windshield –Be sure to communicate every hazard in area even if you think the crew saw them

18. LANDING ZONE 100 x 100’ At Nighttime Hours 80 x 80’ During Daylight Hours Slope <10° Approach / Depart INTO Wind Treat LZ (Helicopter) as “HAZMAT” –Scene Should Be UPWIND of LZ –LZ Should Be DOWNWIND of Scene/Patient Location to Prevent Blowing Debris on Scene

20. LANDING ZONE SURFACE GrassGrass ConcreteConcrete GravelGravel PavementPavement Dusty groundDusty ground –Recommended To Wet, If Possible If Possible GrassGrass ConcreteConcrete GravelGravel PavementPavement Dusty groundDusty ground –Recommended To Wet, If Possible If Possible

21. LANDING ZONE HAZARDS Wires  Invisible From the Air  Advise Dispatch / Flight Crew of Location of Location  Shine Spotlights on Poles  Park Vehicles Underneath, if possible if possible Wires  Invisible From the Air  Advise Dispatch / Flight Crew of Location of Location  Shine Spotlights on Poles  Park Vehicles Underneath, if possible if possible

22. Landing Zone Preparation Perimeter Security / Safety Team –ALL ACCESS to LZ Must Be Secure –All Traffic Needs To Be Blocked With Vehicles, If Possible –Keep All Bystanders and Personnel At Least 100’ Away From LZ –Protect The Patient

23. GROUND OPERATIONS LZ Coordinator At End of LZ In Front of Helicopter Landing Site At End of LZ In Front of Helicopter Landing Site Maintains Communication With Both Scene Personnel and Helicopter Maintains Communication With Both Scene Personnel and Helicopter Communicates With Flight Crew, If Possible Communicates With Flight Crew, If Possible Provide Scene Safety Around Aircraft Provide Scene Safety Around Aircraft

24. GROUND GROUND OPERATIONS Always Approach And Depart As A Group (Follow The Instructions Of The Flight Crew Members)  Stay Within Full View Of The Pilot  Keep In Front Of The Aircraft  Keep Away From The Tail Rotor  Never Go Behind Tail Guard or Vertical Stabilizer  Controlled Slow, Purposeful Movement  No Running

26. SUMMARY Call 1-877-730-0009 To Activate CareStar Setup LZ While CareStar Is En Route Call Coordinates To Dispatcher Radio Description, Cell Phone Number, Winds, Contact Person Name, And Hazards To Helicopter, If Possible CareStar Treats, Packages and Transports Patient To The Nearest Appropriate Facility