Air-Medical in ND

Michael SchultzFlight Paramedic

EducatorSanford LifeFlight

Objectives Define what Air-Medical is and what they offer.

What Auto-Launch is and how it works.

Understand the best use of the Air-Medical programs in ND.

Communication with the Air-Medical groups in ND.

What is Air-Medical? It is a 24/7/365 ALS or critical care transport

resource to the communities that we serve.

All have the same philosophy and goals for pre-hospital care.

Highest level of care for the shortest period of time to the most appropriate facility.

What is Air-Medical? Emergency Transportation

High Acuity patient’sTrauma, Medical, Pediatric, OB, NICU

Local resources not available.

Patient is in a remote or difficult location to access by vehicle.

Transport to the most appropriate facility.Bypassing facilities.

What is Air Medical? Each ND HEMS offers different care

RN and ParamedicRT and other specialty care

Patient needs a higher level of care.

Time is spent with 2 critical care attendants during the transport.

The Golden Hour “Emphasizes the urgency necessary for

successful management to maximize outcome of the injured patient” American College of Surgeons, Advanced

Trauma Life Support. 1997.

This is not just for trauma anymore!StrokesAMI’s

Pitfalls of EMS in ND Few ALS services. Call volumes of the BLS/ALS

ambulance. Response times/distances. Time to a rural facility. Often rely heavily on Volunteers Level 4 and 5 trauma centers

Pitfalls of HEMS in ND Helicopters are located at or near the receiving

hospitals. Most are hospital based Few and far between HEMS have a 10 min lift off goal. Long distances to rural areas ND Weather

March and November… Few fueling stations in ND

Very Few with 24 hour coverage

Fargo222

Aberdeen407

Minot407

Bismarck206

ND Helicopter Response Times

Fargo222

Aberdeen407

Minot407

Bismarck206

15 minutes

Fargo222

Minot407

Bismarck206

30 minutes15 minutes

Aberdeen407

Fargo222

Minot407

Bismarck206

30 minutes 45 minutes15 minutes

Aberdeen407

Fargo222

Minot407

Bismarck206

30 minutes 45 minutes 60 minutes15 minutes

Aberdeen407

How to combat pitfalls? HEMS AutoLaunch When the criteria is met send most appropriate

level of care.BLS, ALS, and Helicopter

Remember the golden hour.To definitive care.

Do not wait until Responders are on the scene! HEMS is an additional resource

Still need standard EMS response per local protocol

Autolaunch How would it work?

Scenario – Rural Carrington○ Severe Anhydrous Ammonia burns○ Face, Chest, legs, and groin >18%

7 C-3 (>18%) or 7 C-4 (Facial Burns)○ Difficulty Breathing

7 C-2

Where does he need to go?Fargo?Bismarck?Minneapolis?

Who can activate Air-Medical?

Autolaunch? 911 call for a Male

trapped in a Grain Elevator

22 D-4

Autolaunch? S.O. reports MVA

rollover with entrapment in rural Jamestown area.What kind of

entrapment?29 D4

Why Autolaunch Trauma center locations

The Golden Hour of Trauma

Highest level of care for the shortest period of time.

Time is always against the brain, heart, and trauma survival.

HEMS MYTHS

Only activate when someone is on scene.

If you cancel the helicopter, you will get a bill…

Can’t bill them.

Replaces the responding ground Ambulance.

Too windy for a helicopter to fly. Partially true

“The weather is beautiful here.”

Helicopters can only land on the road.

“Too unstable to fly.”

When to utilize Autolaunch

Any medical or trauma pt requires emergent and/or critical care transport.

The most appropriate facility to handle patients acuity is in a major ND city.

Local resources not available.

Not on anyone's arrival.

Not after loaded and enroute to the hospital.

Autolaunch Trauma High speed Ejection Rollovers Extended extrication Multiple patients Death in vehicle Trauma center >20

minutes away

Burns Amputations Changes in LOC Falls >3 x pts height MCC >20 MPH Unstable or possibly

unstable airway Car vs Pedestrian

Autolaunch Medical Cardiac or post arrest STEMI Stroke like symptoms Unstable vital signs Any trauma/medical patient needing

quick access to specialized critical care and immediate transport.

Contacting Air-Medical Fargo, Sanford LifeFlight 800-437-6886 Minot, NorthStar CritiCare 701-852-2222 Bismarck, Angel AirCare 855-254-5655 Aberdeen, CareFlight 800-592-1889

HEMS does not count fixed wing transport.

What Air-Medical needs to know Usual dispatch information Nature of the call Where is the scene?

Closest town and intersecting roadsGPS coordinates

The ground unit(s) respondingMust have a ground ambulance respond

also

Communication Need communication with:

Local Dispatch CenterDeputyResponding Fire DepartmentFirst RespondersResponding Ambulance

Radio Communication State Wide EMS ND State Radio MNSEF ND Mutual Aid

Channel 3 Regional Channels

Information for LZ Flat and level 100’ X 100’ Relay obstacles Wind direction Wires

“Together we save lives” Air-Medical can’t do their job, without you! HEMS is an excellent additional resource We need:

CommunicationEarly activationTeamwork

○ Local Dispatch Centers○ Ambulance/FR/Fire/S.O.

We all have the same goal!What’s best for the patients.

Thank You!