Air-Medical in ND by Mike Schultz

Air-Medical in ND
Michael Schultz
Flight Paramedic
Sanford LifeFlight
Define what Air-Medical is and what they
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
 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
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
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?
911 call for a Male
trapped in a Grain
22 D-4
S.O. reports MVA
rollover with
entrapment in rural
Jamestown area.
 What kind of
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.
Only activate when
someone is on scene.
If you cancel the
helicopter, you will get a
Can’t bill them.
Replaces the responding
ground Ambulance.
Too windy for a
helicopter to fly.
 Partially true
“The weather is beautiful
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
Extended extrication
Multiple patients
Death in vehicle
Trauma center >20
minutes away
Changes in LOC
Falls >3 x pts height
Unstable or possibly
unstable airway
Car vs Pedestrian
Autolaunch Medical
Cardiac or post arrest
 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
Need communication with:
 Local Dispatch Center
 Deputy
 Responding Fire Department
 First Responders
 Responding Ambulance
Radio Communication
State Wide EMS
ND State Radio
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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