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!