Transcript Air-Medical in ND by Mike Schultz

Air-Medical in ND
Michael Schultz
Flight Paramedic
Educator
Sanford LifeFlight
Objectives

Define what Air-Medical is and what they
offer.
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What Auto-Launch is and how it works.
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Understand the best use of the Air-Medical
programs in ND.
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Communication with the Air-Medical groups
in ND.
What is Air-Medical?
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It is a 24/7/365 ALS or critical care
transport resource to the communities that
we serve.
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All have the same philosophy and goals for
pre-hospital care.
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Highest level of care for the shortest period
of time to the most appropriate facility.
What is Air-Medical?

Emergency Transportation
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High Acuity patient’s
 Trauma, Medical, Pediatric, OB, NICU
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Local resources not available.
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Patient is in a remote or difficult location to access
by vehicle.
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Transport to the most appropriate facility.
 Bypassing facilities.
What is Air Medical?
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Each ND HEMS offers different care
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RN and Paramedic
 RT and other specialty care
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Patient needs a higher level of care.
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Time is spent with 2 critical care
attendants during the transport.
The Golden Hour
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“Emphasizes the urgency necessary for
successful management to maximize
outcome of the injured patient”
 American College of Surgeons, Advanced
Trauma Life Support. 1997.
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This is not just for trauma anymore!
 Strokes
 AMI’s
Pitfalls of EMS in ND
Few ALS services.
 Call volumes of the BLS/ALS
ambulance.
 Response times/distances.
 Time to a rural facility.
 Often rely heavily on Volunteers
 Level 4 and 5 trauma centers
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Pitfalls of HEMS in ND
Helicopters are located at or near the
receiving hospitals.
 Most are hospital based
 Few and far between
 HEMS have a 10 min lift off goal.
 Long distances to rural areas
 ND Weather
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 March and November…
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Few fueling stations in ND
 Very Few with 24 hour coverage
ND Helicopter Response
Times
How to combat pitfalls?
HEMS AutoLaunch
 When the criteria is met send most appropriate
level of care.

 BLS, ALS, and Helicopter
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Remember the golden hour.
 To definitive care.
Do not wait until Responders are on the scene!
 HEMS is an additional resource
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 Still need standard EMS response per local protocol
Autolaunch
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How would it work?
 Scenario – Rural Carrington
○ Severe Anhydrous Ammonia burns
○ Face, Chest, legs, and groin >18%
 7 C-3 (>18%) or 7 C-4 (Facial Burns)
○ Difficulty Breathing
 7 C-2
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Where does he need to go?
 Fargo?
 Bismarck?
 Minneapolis?
Who can activate Air-Medical?
Autolaunch?

911 call for a Male
trapped in a Grain
Elevator
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22 D-4
Autolaunch?
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S.O. reports MVA
rollover with
entrapment in rural
Jamestown area.
 What kind of
entrapment?
29 D4
Why Autolaunch

Trauma center locations
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The Golden Hour of Trauma
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Highest level of care for the shortest
period of time.
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Time is always against the brain, heart,
and trauma survival.
HEMS MYTHS

Only activate when
someone is on scene.

If you cancel the
helicopter, you will get a
bill…

Can’t bill them.
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Replaces the responding
ground Ambulance.
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Too windy for a
helicopter to fly.
 Partially true

“The weather is beautiful
here.”
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Helicopters can only
land on the road.
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“Too unstable to fly.”
When to utilize Autolaunch
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Any medical or trauma pt requires emergent and/or
critical care transport.
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The most appropriate facility to handle patients
acuity is in a major ND city.
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Local resources not available.
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Not on anyone's arrival.
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Not after loaded and enroute to the hospital.
Autolaunch Trauma
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High speed
Ejection
Rollovers
Extended extrication
Multiple patients
Death in vehicle
Trauma center >20
minutes away
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Burns
Amputations
Changes in LOC
Falls >3 x pts height
MCC >20 MPH
Unstable or possibly
unstable airway
Car vs Pedestrian
Autolaunch Medical
Cardiac or post arrest
 STEMI
 Stroke like symptoms
 Unstable vital signs
 Any trauma/medical patient needing
quick access to specialized critical care
and immediate transport.

Contacting Air-Medical
Fargo, Sanford LifeFlight 800-437-6886
 Minot, NorthStar CritiCare 701-852-2222
 Bismarck, Angel AirCare 855-254-5655
 Aberdeen, CareFlight 800-592-1889
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 HEMS does not count fixed wing transport.
What Air-Medical needs to know
Usual dispatch information
 Nature of the call
 Where is the scene?
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 Closest town and intersecting roads
 GPS coordinates
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The ground unit(s) responding
 Must have a ground ambulance respond
also
Communication
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Need communication with:
 Local Dispatch Center
 Deputy
 Responding Fire Department
 First Responders
 Responding Ambulance
Radio Communication
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State Wide EMS
ND State Radio
MNSEF
ND Mutual Aid
Channel 3
Regional Channels
Information for LZ
Flat and level
 100’ X 100’
 Relay obstacles
 Wind direction
 Wires
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“Together we save lives”
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Air-Medical can’t do their job, without you!
HEMS is an excellent additional resource
We need:
 Communication
 Early activation
 Teamwork
○ Local Dispatch Centers
○ Ambulance/FR/Fire/S.O.

We all have the same goal!
 What’s best for the patients.
Thank You!