Air medical journal
-
Air medical journal · Oct 2000
Delay in ED arrival resulting from a remote helipad at a trauma center.
Ground transport from a remote helipad at a trauma center may delay patient arrival in the ED and affect patient morbidity and mortality. Prehospital care providers must be aware of the magnitude of any delay when selecting the most expedient means of transport for trauma patients. This study quantifies the time required for a 0.6-mile ground transport from a remote trauma center helipad to an ED through two traffic signals along one city street. ⋯ The need for ground ambulance transport from this remotely located trauma center helipad adds more than 5 minutes to total prehospital time. This delay in ED arrival may be significant for some patients and should be taken into account when selecting the most appropriate mechanism of patient transport and planning helipad construction.
-
Effective crew resource management (CRM) may play a major role in decreasing the number of accidents and increasing overall safety of air medical programs. The purpose of the study was to compare the responses of crew members, in a variety of situations, who received CRM training and those who did not. The numerical results of the responses were used to evaluate the effectiveness of CRM in increasing crew awareness and promoting team concepts. ⋯ Based on the results, CRM training increases crew awareness and promotes team concepts in both everyday and emergent situations.
-
Air medical journal · Oct 2000
Confusing extrication with immobilization: the inappropriate use of hard spine boards for interhospital transfers.
To determine if air medical interhospital transport of patients with spinal injuries is done with techniques that minimize ischemic skin damage. ⋯ Air medical services often transport patients several hours after injury. Patients, particularly those unable to move because of their injuries, medication, or paralysis, are at risk for ischemic necroses of their skin. Decubitus ulcers are a major cause of morbidity and mortality, and preventing ulcers requires a very soft, conforming surface. Despite these facts, the highly select services surveyed continue to use hard, slippery boards designed for extrication at trauma scenes to immobilize patients for transport.
-
Air medical journal · Jul 2000
ReviewA literature review of the prehospital use of neuromuscular blocking agents by air medical personnel to facilitate endotracheal intubation.
Air medical personnel in the United States have used neuromuscular blocking agents to facilitate endotracheal intubation in the field for more than a decade. This literature review examines 15 studies to investigate their experience and explores the following specific areas: the intubation success rate in patients who did or did not receive these agents, the intubation success rate of air medical personnel before and after they incorporated these agents into their practice, the neuromuscular blocking agents and adjunct medications used by air medical personnel, and the disposition of patients who could not be intubated after an agent was given. The data suggest that, overall, air medical personnel use these agents safely and effectively. Suggestions are offered for future studies, including examining ground time when agents are used to facilitate intubation, complications of their use in this setting, and the use of simulators to train personnel in the administration of these medications.
-
Air medical services can use aircraft equipped to fly under visual flight rules (VFR) or instrument flight rules (IFR). IFR allows the pilot to fly safely into lower weather minimums, potentially increasing the number of EMS flights that can be completed. We examined the advantages and disadvantages of both methods of helicopter flight, the potential service gain with IFR capability, and the financial feasibility of using IFR in an urban air medical program. ⋯ Implementing an IFR program increases the safety margin and allows better EMS service to the community.