Transcript ALBANY MED FLIGHT LIFENET OF NEW YORK & ROCKY …

LifeNet of New York
Landing Zone Presentation
“BECAUSE MINUTES MAKE A
DIFFERENCE”
Administration
• Program Director – Dean Dow
• Medical Manager – John Fisher
• Medical Base Supervisors
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Jon Gryniuk
Shannon Martin
Mike Paulson
Craig Castioni
• Medical Directors
– Deb Funk MD, David Stuhlmiller MD
• Administrative Assistant – Desiree James
Pilots
• All pilots hold a
commercial certificate
with instrument rating
• Have at least 2000
hours of PIC time
• Completed specialized
training in EMS flight
operations
Medical Staff
• Available 24 hours a
day, 7 days/week, 365
days/year
• Medically dedicated
• Staffed by a
Paramedic/RN team
with equal training and
responsibility
• Provide advance
medical procedures
– advanced airway
management
– hemodynamic support
– advanced pharmacology
– ability to act
autonomously guided by
“standards of practice”
Life Net 7-1 , Albany
EC-135
• American Eurocopter
• Twin Pratt and Whitney 650 shp
engines
• Rear load for ONE patient
• 187 gallons Jet A
• Range of 300 on full load of fuel
• Cruise speed of 168 mph
Dimensions and Weight
• Total running length – 40 ft
• Main rotor diameter – 34 ft
• Main rotor height – 11 ft on level
ground
• Tail rotor height – 2.2 ft
• Maximum gross weight – 6250 lbs.
• Can carry up to 350 lb. patient
Life Net 7-2, Glen
BO105
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American Eurocopter
Twin 250hp Allison Engines
Rear load for ONE patient
150 gallons of jet A fuel on underside of AC
(similar properties to Kerosene)
• Range of 300 miles on a full load of fuel
• Cruising speed of 130-140 mph
Dimensions and Weight
• Total running length – 39 feet
• Main rotor diameter – 32 feet
• Main rotor height – 10 feet (level
ground)
• Tail rotor height – 7 feet (level ground)
• Maximum gross weight – 5500 lbs.
• Can carry up to 350 lbs. patient.
Air 1 / Air 2 , Kobelt & Valhalla
BK117
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American Eurocopter
Twin Lycoming 650 hp gas turbines
Rear load for ONE or TWO patients
187 gallons of jet A fuel on underside of AC
(similar properties to Kerosene)
• Range of 300 miles on a full load of fuel
• Cruising speed of 144-150 mph
Dimensions and Weight
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Total running length - 43 feet
Main rotor diameter - 36 feet
Main rotor height -10 feet (on level ground)
Tail rotor height - 6 feet (on level ground)
Maximum gross weight - 7055 lb
This aircraft has carried patients with
combined weight of > 500 lbs.
Scene Responses
• LifeNet NY can and has responded
within a 100 mile radius of the
respective bases
Equipment & Skills
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ECG Monitoring
Biphasic Defibrillator
ETCO2 monitoring
Ventilator
IV pumps
IV warmer
Transvenous Pacer
EZ IO
Jet Insufflator
Needle & Surgical
Cricothyroidotomy
Escharotomy
RSI Intubation
Neonatal Resuscitation Equipment
Over 70 medications
Why Utilize Air Transport ?
• To “bring the Emergency Room to the
patient”
• To provide the patient with early, needed and
advanced medical care
• To transport the patient to the “closest
appropriate facility” therefore decreasing time
to Definitive Care
GOLDEN HOUR
Transport Criteria: Physiologic
• GCS < 13
• Head injured with altered
mental status
• Confused/combative
• Unconscious/unresponsive
• Heart rate > 120
• Blood pressure < 90/p
• Pelvic fractures
• Limb paralysis
• Burn patients—greater
than >10% BSA 2nd and
3rd and >5% 3rd in any
population
– These patients will be
transported directly to a
burn facility @
Westchester, Worcester,
Syracuse University
Hospital and/or Boston
Children's…
Transport Criteria: Physiologic
• Chest trauma with
respiratory distress
• Respiratory rate >
29
• Severe shortness of
breath
• Difficulty speaking
• CO poisoning
• Amputations
proximal to the hand
or foot, not to
include single digits
• Penetrating trauma
– Gunshots
– Stabbings
– Impailments
Transport Criteria: Operational In
Conjunction with Physiologic
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Need for ALS otherwise unavailable
Extrication > 10 minutes
Fall of 20 feet or more
Patient ejected from a vehicle
Vehicle rollover with patient entrapped
High speed crash with significant intrusion
Motorcycle/Auto v. Pedestrian
Transport Criteria: Operational
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Surviving patient of a MVC with a death
Age of < 5 or > 55 years old
Significant associated medical conditions
Pregnancy
***These patients should be transported to a
regional Trauma Center (Albany Medical
Center, Bassett Health Care (Cooperstown),
Robert Packer, St. Elizabeth’s, University
Hospital, Wilson Memorial)***
Special Circumstances
• Patients without vital • A surviving patient
signs:
will be transported
before one in arrest
– there is usually no
survival from
• LifeNet of New York
traumatic death
can provide
– Hypothermic patients
assistance to local
being the exception
providers and
• No patient is too
transport by ground
critical to transport
Who can request?
• Law enforcement
• Firefighters
• Industrial safety
officers
• First responders
• Paramedics
• EMTs
• First Responders
• RNs/MDs/Pas
• Many of the regional
counties are on
automatic stand-by
for “delta” calls:
• Rensselaer,
Saratoga, Columbia,
Washington, and
Schenectady
How To Request
1 800 525-6663
• Agency or comm.
Center calling
• Call back #
• State and county
• Lat/long or nearest
roadway and cross
street
• Ground frequency
with or without PL
• The AC can program
high/low and ultra
high frequencies
• Scene information
• Description of
landing area
• Hazards and their
position to the LZ
Delorme Street Atlas
STAND BY
• Automatic stand by/ launch currently
instituted in Rensselaer, Columbia,
Saratoga, Schenectady, and Washington
counties for all “delta-level trauma”
• Readies AC and FC for mission
• Second call is needed to launch or cancel
• No charge if cancelled enroute
• Automatic launch for areas > 30 nautical
miles
Early Call
• Lets YOU know if:
– the AC is out on another call
– unable to fly due to weather
– is on a maintenance delay or out of service
– may be a short delay only and still able to
be utilized
– an available AC will be found or we may be
able to intercept
Weather--Pilot’s Final Decision
• Minimum standards for
ceiling and visibility
– day versus night
• Weather based on
satellite readings,
current conditions, and
forecasts
• Pilot knows only
destination when
making decisions
Enroute Information
Scene (LZ) information only
FC will obtain patient report when
safely landed.
Landing Zone Officer
• One person assigned, landing the AC safely
the only responsibility
• AC will try to contact LZ officer ~ 5-10
minutes out
• LZO may need to be on apparatus radio;
portable may not transmit
• Focus all attention on managing
communications, approach/departure, and
landing site area
Landing Zone Officer
• Directs the AC into the scene. May be
required to use directions, “out your right
door and/or clock method--nose of AC is
1200, tail of AC 0600.
• Locating the scene in daylight is more
difficult, even with overhead lighting.
• AC/pilot may circle LZ numerous times before
landing.
Slide of LZ officer, in turnout
Choosing the Landing Zone
• Proximity to the
accident, utmost
importance
• 80’X70’
• Level surface
• Clear of obstructions
• Secured by LZ officer
• Approach and
departure path clear
of obstructions
Marking the Landing Zone
• DAY
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Flares (caution)
Cones
Rescue vehicles
Overhead lighting on
rescue vehicles both
for day or night
• NIGHT
– Flares (caution)
– Chemical light sticks
– Battery powered
flash lights (secured
to ground)
– Headlights from two
vehicles pointed at
LZ to form an X
Preparing Touchdown Area
• Secure loose debris (car
doors, trunk lids,
stretchers, linens,
baseball hats etc.)
• Protect yourselves!
Wear turnout gear,
goggles, protective eye
shields
• LZ walk through
• Secure nearby activity
– Moving traffic
– Rescue activity
– Apparatus and
ambulance doors closed
– Keep all spectators > 200
feet from LZ. Only those
assigned to protect the
AC allowed < 100feet
SAFETY FIRST AND FOR ALL:
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Fire Department
Pre-hospital providers
Police Department
Life Net of New York
All involved in the safe transfer of a
critically ill or injured patient
Take Off and Landing
“Most Critical Time of Flight”
AC will not land w/o first attempting to
make contact with LZ command
Arrival / Landing Information
• Obstructions: wires, power lines, light poles,
smoke stacks, antennas, etc.
• Report all obstructions to the pilot as the AC
is over the landing zone, never assume pilot
has seen all obstructions.
• Winds: wind direction and intensity helps the
pilot better plan the landing. Helicopter lands
and takes off with nose into the wind.
Arrival / Landing Information
– Condition of the touchdown surface: be
specific, ie: slope, surface (mud, packed snow,
dust).
– Security: assure crowd is secure and all traffic
is stopped for landing and take-off.
– LZ officer will be notified of “final approach”. If
any unsafe or potentially unsafe situation
arises, contact pilot to make aware. Use short
simple commands: “STOP! WIRES!”, etc.
Hazards
WIRES, POLES, CHURCH STEEPLES, LIGHT
POLES, UNLIT TOWERS (Cell), STREET
SIGNS, PLOW STAKES, etc...
High Hazards
Do not assume the AC cannot land
in the presence of wires near the
roadway.
Landing / Lift-off Safety
During night operations, NEVER allow
white lights to shine into the cockpit.
Night vision will be compromised
Final Approach
• As the AC is on “final approach” the
pilot or FC may ask the LZ officer to
have all white lights, shining toward the
LZ, extinguished before touchdown.
• The AC can produce > 70 mile per hour
winds with short final. Protect
yourselves.
Ground Operations
– Always approach the
AC from the nose.
– Never approach the
AC unless directed
by the FC or pilot.
– If asked to get
equipment by FC in
AC, never approach
w/o the getting
pilot’s attention.
– Keep all personnel
and others at least
50 feet away from
the AC when
running.
– May post a safety
officer 50 feet behind
the tail rotor
– NEVER APPROACH
OR GO NEAR THE
TAIL ROTOR OF THE
AC.
Ground Operations
– Let the FC come to
you
– FC does NOT require
assistance offloading equipment
– Keep apparatus and
EMS vehicle doors
and windows closed.
– Leave patient in
ambulance
– Nothing carried above
the waist level.
– No smoking within 50
feet of the AC
– No sheets, blankets,
baseball hats near AC
– Firefighters should
have turnout gear and
helmets with shields
down.
Keep All vehicles > 50 feet
from AC
• Cartoon of pic of EMS vehicle damage by
rotor blades.
Patient Preparation
• Flight Team will
perform:
– patient assessment
– required
interventions
– transfer patient to FC
stretcher
– load into AC
Patient Loading
• Only FOUR people to
carry patient/stretcher
into the AC
• One person on each
corner
• Follow the directions of
the FC
• Load patient into AC
feet first
Patient Loading
• Approach AC toward
nose and watch pilot
and FC for directions
• Stay close to body
of AC
• After patient is
loaded, FC and/or
pilot will secure
stretcher and
equipment
After Loading Patient
Depart AC off the nose when directed by
FC or Pilot
Departure Information
Limit Communications to Hazards Only
– Assure AC and tail
rotor is clear of any
obstructions
– Maintain visual
contact with the AC
until clear of LZ
– Maintain radio
communications with
the pilot until the AC
is safely in forward
flight
– Immediately report
any safety concerns
to the pilot, again
using short, simple
commands
Hazmat Situation
– Preparation and consideration for everyone’s
safety
– Give AC and FC advance warning, if possible
– Land AC at least 1/2 mile from hazardous scene
– FC do not carry protective suits or breathing
apparatus for protection. Early warning is
recommended
– Patients will be completely decontaminated prior
to being placed in the AC
Wind direction
Hazmat
1/2 mile
75 x 75
MCI Situation
• Consider utilizing LifeNet of New York as part of
your MCI plan
• FC will be available to the transport officer
• Patients are able to be dispersed with available
AC not overwhelming one facility
• If multiple patients are involved in a situation,
multiple AC can be activated using the LifeComm
dispatch center.
• Have separate LZ areas for each AC called to
incident. Each LZ does not require separate FD
Equipment Return
Be sure all equipment is well
marked. LifeNet will make every
effort to return all equipment by
ground or mail.
Post flight contact
• Any concerns should be addressed as
soon as possible
• Please complete and return our
customer survey to allow us to continue
to improve our service
• (518) 262-8800
QUESTIONS ?