Air-Medical in ND by Mike Schultz

Report
Air-Medical in ND
Michael Schultz
Flight Paramedic
Educator
Sanford 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’s
 Trauma, 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 Paramedic
 RT 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!
 Strokes
 AMI’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
ND Helicopter Response
Times
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 roads
 GPS coordinates

The ground unit(s) responding
 Must have a ground ambulance respond
also
Communication

Need communication with:
 Local Dispatch Center
 Deputy
 Responding Fire Department
 First Responders
 Responding 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:
 Communication
 Early activation
 Teamwork
○ Local Dispatch Centers
○ Ambulance/FR/Fire/S.O.

We all have the same goal!
 What’s best for the patients.
Thank You!

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