Air medical journal
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Beginning in 1985, the Federal Aviation Administration (FAA) came to the realization that regulating crew rest for pilots was an overdue and effective risk-management tool. Fatigue was being increasingly recognized as a contributing factor in many emergency medical services (EMS) accidents. Federal aviation regulations were changed to include pilot crew rest and flight hour and duty time limitations.
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The helicopter air ambulance community has been very consistent lately: about once a month, we crash. A fifth of those crashes involve weather, the biggest category by far. Suppose we had a silver bullet, aiming all our safety emphasis on this one area; could we blow a hole in our accident rate?
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Airway management is an essential component of the air medical transport of critically ill or injured patients. Many controversies surround the use of rapid sequence intubation (RSI) in the prehospital setting. The challenges of establishing an airway in this environment may exceed those in the hospital. ⋯ Given their volume of high acuity patients, air medical providers are ideal candidates for performing prehospital RSI. Undertaking this responsibility requires commitment to training and quality improvement. We present the components required to establish and maintain a successful air medical RSI program.