Auckland HEMS

Report
Auckland HEMS
Helicopter Emergency Medical Services
Christopher Denny, MD, MSc, FRCPC, FACEP, FACEM
SMO Emergency Medicine, Auckland City Hospital, ADHB
• Senior Medical Officer in Emergency Medicine,
Auckland City Hospital
• HEMS Medical Director, Auckland Rescue Helicopter
Trust (ARHT)
• Clinical Team Leader, New Zealand Medical Assistance
Team (MOH NZMAT)
Disclosure
OBJECTIVES
1.
2.
3.
Increase awareness of Auckland HEMS
Explore Pre-Hospital and Retrieval Medicine
Compare patient care on the road with in hospital
• 1970: Auckland established the first civilian rescue
helicopter service in the southern hemisphere
• Rescue helicopter originally based on the west coast of
Auckland @ Piha
• Now the busiest rescue helicopter trust in New Zealand
• The only service in NZ with a doctor as a core member of
the flight crew
Introduction
• Memorandum of Understanding established in 2011
• Specialists in Emergency Medicine, Critical Care and
Anaesthetics
• Purpose: to augment the clinical capabilities of the flight
crew
ADHB & ARHT
Mission type
SAR
1%
Interfacility 1%
Trauma
43%
Medical 55%
HEMS Mission profiles
• BK-117 x 2
• Cruise speed 120 knots (222km/hr)
• Cruise altitude ~1500 feet
• Crew configuration: Pilot, crewman, paramedic & doctor
• Instrument Flight Rules (IFR) capable
• Winch capable
• 600lb capacity
Helicopters
Why doctors?
• Airway: Rapid sequence intubation (RSI), video
laryngoscopy (VL), surgical airway
• Breathing: Mechanical ventilation, chest drains
• Circulation: Tranexamic acid (TXA), Point-of-care
ultrasound (POCUS), blood products
• Disability: Reduction of dislocations and fractures;
ultrasound-guided regional nerve blocks, field
amputations, antidote therapies
Critical interventions
• Time to critical intervention:
•
•
•
•
Airway management
CT
Operating theatre
Interventional radiology
Accelerating time to
definitive care
Clinical governance
• Galvagno. JAMA 2012: HEMS and Survival after Major
Trauma.
• 223,475 patients in USA with age >15y & ISS>15
• HEMS Odds Ratio for survival 1.16, 95%CI 1.14-1.17
(ARR 1.5%)
Evidence
• From roadside to bedside in definitive care
• Standardized communications (METHANE, MIST,
SBAR)
Seamless care
• Coordinated Incident Management System (CIMS)
• Inter-agency collaboration with St John Ambulance, NZ
Fire Services, Police SAR
• Aeromedical reconnaissance
Disaster preparedness
• “To turn a team of experts into an expert team.”
• Eduardo Salas
High performing teams
• High task interdependency
• Cooperation, coordination, communication, cognition,
coaching and conflict
Teamwork
• Integration
• Coordination
• Clinical networks
The future
Thank you.
www.aucklandhems.com

similar documents