Transcript Liberty`s Franchised FTC (Flight Training Center)

Liberty’s Franchised Air Ambulance Program
© Copyright 1985-2013 All
Right Reserved Liberty
Technologies Inc and Liberty
Helicopters Ltd.
Outline for Liberty Strategic Cooperation
Framework for Air Ambulance Program in SA
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AA OPERATIONS CENTER
• Liberty is planning deployment of 44 Air Ambulances thru a network
of more than 22 FTC Centers scheduled for completion in SA by 2017.
• Each FTC will be required to maintain a minimum of 2 Air
Ambulances in flight ready mode for dispatch throughout 12 over
lapping operational zones.
• Up to 90 percent of the 22 FTC training and leasing aircraft including
Air Ambulances may be dispatched into SAR mission services for
National Disasters and National Emergencies, when requested.
• The overall program is controlled and directed from the AA Operations
Center at the company's SA corporate headquarters.
12 Air Ambulance Operation Zones
© Copyright 1985-2013 All
Right Reserved Liberty
Technologies Inc and Liberty
Helicopters Ltd.
AA Operational Center
Air Ambulance Operational Center
Teams consist of:
MD
Medical Directors
CS
Communication Specialist
VCP
Virtual Co-Pilot
Goals of the AA Operational Control Center
• The goal of the AA Operational Control Center is to provide pilots
with the information they need when they need it; when they are on a
flight and the weather suddenly starts deteriorating or they have been
asked to alter their route.
• Liberty ‘s AA Team also employs a staff of Registered Flight Nurses
with previous flight, critical care and management experience within
its AA Operations Center to serve as MedLink, a clinical resource
available to medical flight crews 24 hours a day, 7 days a week. Flight
crews can speak directly with the MedLink RFNs through the Liberty
AA team Operations Center.
• From protocol clarification, policy and procedure reference or
equipment problem solving, the MedLink RFN provides immediate
information to the crews.
Goals Cont
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These RFNs have the ability to readily contact the company's Medical
Directors, transferring physicians or the receiving facilities while the crew is
in-flight to discuss current situations and immediately pass information from
the physicians to the crews.
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RFNs are trained to sort patients needs by the five-level triage system
developed by the military. This helps establish each patients Emergency
Severity Index prior to transport.
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In addition to crew resource utilization, MedLink offers assistance to
transferring hospitals in locating a receiving hospital for patients in need of a
higher level of care.
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Through a significant investment in its highly-skilled personnel and a capital
investment of over $xxxxx million in collaboration with technology leaders
such as Avaya and Cisco, By 2017, SA fleet of 44 Air Ambulances fleet will
provide a future successful model to expand throughout the continent of Africa
providing a centralized approach that facilitates tight operational control and
rapid response, ultimately resulting in safe, reliable aviation operations and
timely, high-quality patient care.
RE-MAN COMPLETION CENTER
• Liberty Air Ambulance is planning a 60,000-square-foot Re-Man
Completion Center, scheduled for completion in 2015. This site will
employ more than 60 aviation professionals proficient in mechanics,
avionics, composite and sheet metal fabrication, aircraft painting, with
a deep technical expertise developed through servicing the Liberty
Air Ambulance helicopters.
• At the end of 2500 flight hours, each aircraft undergoes a rigorous
FAA/CAA-approved refurbishment process, whereby the aircraft is
largely remanufactured, including a complete overhaul or replacement
of all rotational parts; time limited parts components, structures and
avionics upgrades.
• The end result is an essentially new aircraft in the Company's
standardized configuration, with either an Allison Rolls-Royce C30
engine or Liberty new high efficiency Series 2 or Series 3 gas turbine
engine and Liberty Evac's proprietary litter system.
CLINICAL CARE
• Liberty AA Team will employs over 100+ registered nurses and 100+
paramedics who serve on its medical flight crews, with one nurse and
one paramedic serving on each mission with 100+ PIC.
• The Company's registered nurses average 12 years of critical care
experience, with a minimum requirement of 3 years experience.
• The paramedics average 13 years of active pre-hospital experience,
with a minimum requirement of 3 years ES (emergency services) or
ambulatory experience.
Medical Crew Training Includes:
All medical crewmembers must be certified in:
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Basic Life Support
Advanced Cardiac Life Support
Pediatric Advanced Life Support
Pre-Hospital Trauma Life Support (PHTLS) or International Trauma
Life Support (ITLS)
Additional certifications include:
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Neonatal Resuscitation Provider
Critical Care Emergency Medical Technician - Paramedic (preferred)
Ongoing competency standards are achieved through:
Skills Lab Training
Simulated Patient Care Experiences
Helicopter Safety and Landing Zone Instruction
Quarterly and Annual Competency Training
6 Month Clinical Internship Program
Flight nurses and flight paramedics selected to work for Liberty AA
team are enrolled in a six-month Clinical Internship Program. The
Clinical Internship offers didactic training, unique hands-on skills
training, simulated patient care experiences, flight training and safety
training.
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Advanced critical care topics include:
Cardiac Emergency Management
Hemodynamic Monitoring
Flight Physiology
Drug Assisted Intubation
Traumatic Brain Injury Management
Advanced skill level labs include:
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Advanced Airway Management including Surgical Cricothyrotomylso
Radiological and 12-lead EKG Interpretation
Ventilator Management
A Advanced Airway Management including Surgical
Cricothyrotomylso included:
Simulated Patient Care Experience with Experienced Liberty AA Team
Crewmembers
Night Vision Training Scenarios
Landing Zone and Helicopter Safety Class
Air Medical Resource Management
Additional Patient Care Services Training include:
The Liberty AA Team Training Center, under the auspices of Patient
Care Services, is responsible for the oversight of internal and external
training programs. These programs include, but are not limited to:
• American Heart Association (AHA) courses
• National Association of Emergency Medical Technicians (NAEMT)
courses
• Educational programs in which Continuing Education Units (CEUs) and
Contact Hours are awarded.
Future Accreditations Planned:
• By 2014, Liberty AA Team will earn additional accredited by the
Commission on Accreditation of Medical Transport Systems (CAMTS)
and American Heart Association Training Center.
• EMS, Inc., is also an approved provider of the Continuing Education
Coordinating Board of Emergency Medical Services (CECBEMS) for
Continuing Education Units (CEUs) in the categories of First Responder,
Basic and Advanced Provider.
METI Emergency Care Simulators
• Liberty AA Team uses METI Emergency Care Simulators as part of its
initial training process and recurrent training. The Emergency Care
Simulator is a life-size computerized mannequin utilized for clinical
skill set training from basic airway management to high level advanced
procedures, such as chest tube insertion and central line placement.
• The simulator provides the ability to approach training from a
scenario-based situation through the aspects of critical thinking and
hands-on critical patient care.
• Liberty AA Team employs 15 such Emergency Care Simulators
throughout its service area, representing an investment of more than
$xxx,000, to conduct competency training for its medical staff in the
field to continue to ensure its personnel are well-trained and providing
top-quality patient care.
AA Operational Center Chart
44 Air Ambulances Flight Teams
Consist of:
PIC
Pilot in Command
RFN
Registered Flight Nurses
FP
Flight Paramedics
Support Team
Air Ambulance Support Team at
Operational Center consist of:
MD
Medical Directors
CS
Communication Specialist
VCP
Virtual Co-Pilot
PIC Certifications:
Liberty Air Ambulance program trains instrument-rated
pilots who are skilled aviators to become proficient air
medical pilots by completion of transition training under
Liberty’s proprietary training course or Liberty 2 year AA
PIC AA Internships. The classes deliver both operational
and procedural instruction, as well as aircraft and missionspecific training in the Liberty Air Ambulance helicopters.
• Each Liberty AA pilot meets stringent FAA/CAA standards and
has more than 1,000 rotary hours or has recently completed 2 year
AA PIC internship with 200 hours in type, plus completed both
IFR and Commercial ratings.
Pilot Certification Cont
• Pilots must also achieve standards established in Liberty Air
Ambulance proprietary FAA/CAA-approved training program.
• As part of their continuous improvement program, all pilots are
required to complete recurrent training, which includes a Part
135/NVG check-ride, on an annual basis.
• Mission-specific training includes flying at night and landing on
unimproved rural terrain, such as pastures and fields.
• Base assignment requires rigorous local flight orientation training
to become an authority on local terrain, hospitals and landmarks.
Cinergy Benefits
Liberty AA team realizes many benefits from its use of one Family of aircraft,
including:
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efficiencies in basic thru advanced training programs,
• cockpit and instrument layout,
• maintenance and inventory management,
• internships for all levels of Liberty’s Air Ambulance Program.
All these contribute to sustaining a high average aircraft availability; insuring
safe operations and a streamlined cost structure that ensures financial viability.
FIXED-WING OPERATIONS
• Liberty AA team offers airplane medical transport services at all
international airport locations in SA. The fixed-wing service serves as
an adjunct to the helicopter service by providing a faster means of
transportation for long transports, IFR (instrument flight rules)
capabilities for flights in inclement weather the helicopter is not able to
accept, and as an additional asset when the helicopter is committed on
another flight.
• Liberty AA team has contracted with xxxMed, a Part 135 operator, to
operate the aircraft and provide pilots for the services, while Liberty
AA team provides the medical crew. This AA team partner has several
long distance aircraft including a King Air E90 and Citation used for
long distance services.
Mission
• Providing service to the medically underserved areas of SA, often in
rural areas that other ambulance companies may not adequately
service;
• Responding rapidly through a contiguous footprint of mutuallysupporting bases in collaboration with numerous hospitals, physicians,
emergency 911 centers and EMS agencies;
• Taking an active role in the advancement of health care services in the
communities it services, through local interest and public relationships
in each community it serves;
• Providing superior patient care and aviation operations associated with
substantial financial resources, a professionally managed, common
infrastructure and standardized, centrally controlled operations.
Mission Driven Culture Serving Those Most in Need
Liberty AA team is committed to providing increased access to
emergency trauma care to rural SA.
• In a life- or limb-threatening medical emergency, a successful patient
recovery often depends on the amount of time it takes to deliver that
patient to the emergency room.
• 50 million South Africans live in both metropolitan and rural areas,
approximately 90% of Liberty AA's patient transports are expected to
originate from rural areas.
• Agriculture: 9%
• Industry including mining: 26%
• Services including transportation of products: 65%
Critical Facts: Access to Definitive Health Care for Rural South
Africans
• Liberty AA team believes that those who choose a rural way of life
should have the same benefits when it comes to emergency care as
those who choose to live in a metropolitan community.
• Workers that are more than an hour away from a Level 1 or 2 trauma
center • Rural trauma victims are twice as likely to die from an
accident or medical condition versus an urban victim due to failure to
arrive at a hospital within the "Golden Hour". (2)
• Numerous changes in the nation's delivery of health care have made
the trauma and tertiary care centers a vital hub for outlying hospitals.
The result is an increasing need to transport a greater number of
patient’s longer distances for complex, time-dependent care, such as
primary cardiac intervention, strokes and complex surgery. (3)
Flight Team Nurses Credentials:
Prior to active flight status, all medical personnel must have the
following current certifications and must maintain them in a
current status.
Flight Team Nurses
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Minimum 3 years current critical care experience
State RFN license (Must have license for states served)
BLS (Basic Life Support for Health Care Providers
ACLS (American Heart Association Advanced Cardiac Life Support)
PALS (American Heart Association Pediatric Advanced Life Support)
PHTLS (National Association of Emergency Medical Technicians PreHospital Trauma Life support OR
• ITLS (International Trauma Life Support)
• All nurses are required to hold an advanced certification (CFRN, CEN,
and CCRN) within 2 years of hire.
Flight Team Paramedics Requirements:
• Minimum 3 years current experience as a paramedic on an ALS
unit
• State Paramedic License (Must have License for states served)
• BLS (Basic Life Support for Health Care Providers
• ACLS (American Heart Association Advanced Cardiac Life
Support)
• PALS (American Heart Association Pediatric Advanced Life
Support)
• PHTLS (National Association of Emergency Medical Technicians
Pre-Hospital Trauma Life support OR
• ITLS (International Trauma Life Support)
Flight Team PIC Requirements:
Our pilots flying the Liberty 2500 or Liberty 4000 must meet the
following requirements:
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FAA/CAA Requirements
Minimum, commercial rotorcraft-helicopter rating
Helicopter Instrument rating
Class II flight physical
Additional Liberty AA Team Requirements:
1000 hours total flight time
750 hours helicopter time
750 hours helicopter pilot command time (PIC)
100 hours un-aided night flying 250 hours turbine
Flight Team MECHANICS
FTC mechanics are responsible for the inspection and
maintenance of all FTC aircraft daily inspections and on going
service requirements to maintain Flight Readiness. The lead
mechanic must have the following credentials:
• Minimum 10 years experience in helicopter maintenance or 12
month Liberty internship training in type.
• Current A & P Certificate
• Current Pass Port and Province or Valid State Drivers License
Total Airports in SA (567 in 2013)
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Airports with Paved Runways
total: 145 over 3,047 m:
112, 438 to 3,047 m:
61, 524 to 2,437 m:
53, 914 to 1,523 m:
66 under 914 m: 9
Airports - with unpaved runways:
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total: 422
2, 438 to 3,047 m:
11, 524 to 2,437 m:
29 914 to 1,523 m:
260 under 914 m: 132 (2013)
Heliports 2013
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Key Infrastructure Points
• Communications Centers are Bloemfontein, Cape Town, Durban,
Johannesburg, Port Elizabeth, and Pretoria
• Mobile Cellular 50.372 million (2009)
• Major Ports and Terminals: Cape Town, Durban, Port Elizabeth,
Richards Bay, Saldanha Bay
• Land Boundaries: total: 4,862 km
• border countries: Botswana 1,840 km, Lesotho 909 km, Mozambique
491 km, Namibia 967 km, Swaziland 430 km, Zimbabwe 225 km
• Coastline 2,798 km
• Maritime claims: territorial sea: 12 nm contiguous zone: 24 nm
exclusive economic zone: 200 nm continental shelf: 200 nm or to
edge of the continental margin
• Elevation extremes: lowest point: Atlantic Ocean 0 m highest point:
Njesuthi 3,408 m
• Terrain: vast interior plateau rimmed by rugged hills and narrow
coastal plain
• Climate: mostly semiarid; subtropical along east coast; sunny days,
cool nights
• Natural resources: gold, chromium, antimony, coal, iron ore,
manganese, nickel, phosphates, tin, rare earth elements, uranium, gem
diamonds, platinum, copper, vanadium, salt, natural gas
• Land use: arable land: 12.1%permanent crops: 0.79%other:
87.11% (2005)
• Irrigated land: 14,980 sq km (2003)
• Total renewable water resources: 50 cu km (1990)
• Freshwater withdrawal (domestic/industrial/agricultural): total:
12.5 cu km/yr (31%/6%/63%)per capita: 264 cu m/yr (2000)
• Environment - current issues: lack of important arterial rivers or
lakes requires extensive water conservation and control measures;
growth in water usage outpacing supply; pollution of rivers from
agricultural runoff and urban discharge; air pollution resulting in acid
rain; soil erosion; desertification
• Environment - international agreements: party to: AntarcticEnvironmental Protocol, Antarctic-Marine Living Resources, Antarctic
Seals, Antarctic Treaty, Biodiversity, Climate Change, Climate
Change-Kyoto Protocol, Desertification, Endangered Species,
Hazardous Wastes, Law of the Sea, Marine Dumping, Marine Life
Conservation, Ozone Layer Protection, Ship Pollution, Wetlands,
Whaling signed, but not ratified: none of the selected agreements
• GDP - composition by sector: agriculture: 2.5%industry:
31.6%services: 65.9% (2011 est.)
• Labor force: 17.66 million (2011 est.) country comparison to the
world: 35
• Labor force - by occupation: agriculture: 9%industry:
26%services: 65% (2007 est.)
AA Flight Crew consist Pilot, RFN and Flight Paramedics
Each AA most essential medical equipment consist of:
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Cardiac Monitors
Defibrillators
IV pumps & solutions
Infusion pumps
Oxygen
Oxygen supplies, regulators and
Pulse Oximeter
Portable suction units
Intubation equipment
Respirator/Ventilator
Oropharyneal airways
Hand operated bag-valve
mask resuscitators
Blood pressure cuffs
Drug box
FAA approved stretcher
gauges
Liberty FTC Hanger and Office Layout
Liberty’s AA Office and Hanger Portion of FTC
Typical Response within a Zone
911 Emergency Call initiated.
In this example, management or local emergency
responders report a local explosion at Flour Processing
Plant. The report indicates possible multiple injuries
expected, CS immediately dispatch 4 rotorcraft
from two Zones to respond.
CS request dispatch
2 AA from Zone 5
CS request dispatch
2 AA from Zone 6
As the1st RFN arrives by air to the accident site, triage training allows
5 levels of necessary care. The most serious will be transported
first to the appropriate hospital where ER physicians make final
evaluation and establish appropriate emergency treatment for patients.
End of AA Presentation
• Any Questions?