AeroMedical Considerations

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AeroMedical Considerations

• By
• Don Hudson, D.O.
• Medical Director LifeFlight

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Aeromedical Considerations
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Aeromedical Considerations

• As of 2001, there were approximately 270 air
  medical transport (AMT) programs in the U.S.
• As of 2000 in Alaska
• 9 Medevac Services
• 11 Critical Care Air Ambulances
• 1 Specialty Air Transport Team

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Aeromedical Considerations

• Most services in the U.S. are Rotor wing.
• Most in Alaska are fixed wing.
• AMT is an integral part of EMS, especially in
  Alaska.
• Crew configuration of AMT is typically different
  than ground units.

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Aeromedical Consideration

• Nurse/Nurse
• Paramedic/Nurse
• EMT/?
• MD/?
• Medical equipment and scope of practice is
  typically advanced.
• Integration with ground transport is critical.

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Aeromedical Considerations

• Often the MD for the ground transport is not the
  MD for the AMT.
• Both MDs must work well together.

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Factors that Affect the Decision to Transport

• Primary Principle- Do no further harm.
• Know indications for transfer
• Transfer agreements
• Transfer protocols
• Stabilize patient
• Transfer with skilled personnel and adequate
  adjunctive equipment.

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Planning Steps

• Assess Patient
• Escorts Available
• Escort level
• Required equipment

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Planning Steps

• Types of Aircraft
• Landing Conditions
• Number of Patients
• Conditions of patients

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Planning Steps

• Notification
• Receiving community
• Air carrier
• Family members

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Planning Steps

• Pre-Transport Records
• Clinic or ambulance
• Insurance Info.
• Family contact number

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• A successful Medevac starts before the patient
  gets ill.

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Inventory your community resources.

• Airfields
• Air Carriers
• Types of Aircraft
• Escort qualifications
• Medical equipment available

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Rural Physician Medical Decision to Transfer

• Decision is based on
• Weather
• Plane availability
• Staff availability and skill level
• Type of patient (OB, Peds)
• The rural physician is taking care of the
  patient without the current technological
  luxuries like CT scans, etc.

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Things that will injure or kill the patient.

• Illness
• Trauma
• Too much care
• Too little care

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Matching the Escort to the Patient

• Skill Levels of
• EMT-I
• EMT-II
• EMT-III
• Paramedic
• Nurse
• Critical Care Air-Ambulance
• Match escort to worst pt. case scenario

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You have a pt. with a possible ruptured appendix.
Who do you use?

• EMT-I
• EMT-II
• EMT-III
• Paramedic
• Nurse
• Critical care Air-Ambulance

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Matching escort to patient

• Determine the potential problems escort could
  encounter should the patient deteriorate..
• The escort skill level and equipment should
  match the WORST possible patient problem.

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Problem Solving

• Conflict Resolution- A Walk in the Woods
• Active listening Active interaction
• Understanding other persons views
• Working to move forward
• Respect of others ideas contributions

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Critical Thinking

• Involves thinking outside of the box
• Consider all options
• Know you problem
• Talk to all of your resources
• Open dialogue with staff

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Do Others See You As You See Yourself

• Articulate, interesting
• A leader in your field
• Caring compassionate
• Knowledgeable wise
• User friendly
• Suave debonair
• Willing to share your time freely

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How do you know when the Medevac was a success

• The crew tells you about the great flight
• The accepting Doc tells you about the great care
  the patient received
• The patient received the care they needed
• The flight went as planned!!!!!!!!!!!!