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Human Factors, Incident Command, Extended Operations: What FEMA 100-200-800-900 Never Taught Me!
Donna G. Miller, RN/EMSRN, CMTE and Carl Bottorf, RN, EMSRN, EMT-P AMR Air / Life Guard International – Flying ICU
Formal courses in the Incident Command System generally are considered a requirement at all levels with the air medical transport community such as FEMA level 100, 200, 700, and 900. These courses introduce us to what encompasses a standardized approach to managing the delivery of essential services in the wake of a disaster. Through experiences extracted from the disasters of 2017, the presenters will introduce concepts that are not typically taught in traditional incident command training.
Cameras in the Cockpit: Embracing the Truth
Paul Spring, Phoenix Heli-Flight Inc.
Phoenix Heli-Flight has become an industry leader in the utilization of HFDM and CVVR recording devices since the company experienced a fatal helicopter crash in 2007. The presenter will explain how his organization overcame the fear and resistance of the company’s pilots to the installation of CVVR (Cockpit Voice Video Recorders) in their helicopters. The presenter will share examples of how the company uses cockpit video recordings to increase safety, enhance training and better spend money on maintenance.
When Your Pilot Knows Too Much
Teri Aguiar, RN, BSN, CFRN, C-NPT, ARCH Air Medical
This session will cover lessons-learned when too much information accelerates the decision to go. We will review a case that involves a 10 year old gunshot victim with wound to the head.
Tactical Trauma Response to the Active Shooter: Is Your Company Ready?
Zach Lyman, FP-C, TP-C NR-P, MBA, Classic Air Medical
With the increase in active shooters and acts of terrorism, there is a profound need for emergency responders to be ready and able to treat patients in these scenarios. These situations are overwhelming and require special equipment and training. The current literature shows the importance of upfront care and quick medical treatment when these catastrophic events occur. This session will help EMS and HEMS crews evaluate their ability to respond to these situations. It will discuss equipment and techniques needed to be successful in these high stress high paced situations. Time to get our crews out of the cold zone and prepared to enter the frontlines.
How to Drive Team-Members to Give Meaningful Participation in a Safety Program
Wendy Ord, BA, Angel MedFlight
Safety programs can be one of the most valuable tools within an organization. However, presentations on high level concepts are not everyone’s passion. The key to having a successful and active program is to have specific and relatable training materials and goals. While safety professionals can discuss risk mitigation strategies for hours, how do you gain the same engagement from line team-members or management? This lecture will discuss how to keep your team’s attention, improve participation, stay relevant throughout the year, and drive positive change in everyday operations.
OSI-HEMS: It’s Not How Safe You Fly, It’s How you Fly Safe
Ira Blumen, MD, FACEP, UCAN, University of Chicago Medicine
Vision Zero must be our ultimate objective, but it is more than not having an accident. It’s not how safe you fly, but it’s how you fly safe. While it may never be possible to prevent all helicopter EMS (HEMS) accidents, we may, however, be putting our crews and patients at unnecessary risk if we miss opportunities that could reduce the number of accidents and save lives. Since 1972, there have been over 340 HEMS accidents in the U.S. – over 220 since 1998. Over one-third of the accidents resulted in one or more fatalities. Over a 20 year period, these accidents have killed more than 160 of our colleagues and 21 patients whose lives were entrusted to us. This presentation will review the findings of the most extensive HEMS safety research to date. During this multi-year study, more than 40 air medical and aviation professionals spent more than 13,000 cumulative hours to analyze 144 HEMS accidents. The team reviewed nearly 3,000 electronic NTSB documents containing more than 12,500 pages and pictures. Following this extensive root cause analysis, the research group identified interventions and mitigating factors that may have prevented these accidents. Finally, objective recommendations will be made to provide decision-makers with an opportunity to determine how and where to make safety-related improvements that may prevent future accidents and save lives.
Transporting Patients in the Clouds: IFR as a Game Changing Capability
Matthew Burton, Burton-Le Roy LLC
The development of helicopter IFR procedures in a program’s footprint builds an infrastructure for IFR operations. Many programs maintain aircraft and crews that are IFR certified but lack the necessary helicopter IFR procedures that allow them to take off and land at their bases and the trauma center. These procedures increase flight volume, but more importantly increase the safety of flight operations. Un-forecasted weather and inadvertent IMC are one of the most common causes of fatal crashes. IFR procedures allow for safe operations in low cloud ceilings and poor visibility. Pilots in programs with the necessary infrastructure to conduct regular IFR flights are more proficient than those that only fly IFR on check rides. When the weather is marginal, they have the capability to fly their procedures. When un-forecasted weather is encountered, proficient IFR pilots are able to make the critical transition from visual flight to instrument flight far more safely than their VFR only counterparts.
Modernizing HEMS Survival Training
David Weber, FP-C, Denali National Park & Intermountain Life Flight
This presentation will highlight the need to update survival training modules within the HEMS industry. Many programs teach outdated skills and information to team members not aligned with either best practices or modern survival equipment. The presenter, a mountaineering ranger at Denali and paramedic at Intermountain Life Flight, will discuss the critical components of survival techniques, available equipment and practical training agendas.
Safety Culture: Continuous Improvement Required
Christopher Young, Baldwin Aviation
Culture is to organizations what personality is to individuals — every person has one and every organization has one. Whether that culture is supportive or stifling, transparent or guarded, inclusive or selective, it represents the way an organization behaves. In air medical transport, a safety culture is more specific than organizational culture because all aspects of culture (values, beliefs, behaviors, standard operating procedures) are examined through the lens of safety. Aviation expert, Dr. James Reason said, “If you are convinced that your organization has a good safety culture, you are almost certainly mistaken… A safety culture is something that is strived for but rarely attained – the process is more important than the product.” Just like in a chemistry lab a “culture” grows given the conditions of its environment. In this interactive session we will explore the environment required to continuously nurture a strong safety culture.
Surviving an Incident: Tactics and Strategies to Survive in the Wild
Michael Shaffer, BSN, RN, PHRN, NRP, CFRN, CMTE, STAT MedEvac
This session will go over how to develop and execute a survival plan in the event of the flight or ground crew becoming involved in an incident. Preparation will be different for areas all across the country and it is this session’s goal to provide insight that will help everyone. We will review different types of survival equipment that is available, and discuss how it pertains to different regions. We will offer examples of training modules that will encompass all components of your organization, as well as explore various training options to include: classroom, small group outdoor sessions, and wilderness overnight sessions. Finally we will go over how to be compliant with the 10th edition CAMTS standards.
The Next Step in Fatigue Recognition, Mitigation, and Human Performance
Jenn Killeen, MHA RN NRP CMTE, Classic Air Medical and Jenny Nosker, MSW, Fielding Graduate University
Human errors lead to accidents, incidents, near misses, safety concerns, and all sorts of bad. How does fatigue correlate to human error and how does it correlate to human performance? Should we be worried about this? We established a stringent Fatigue Risk Management System. We implemented it across our various disciplines including our communication center, our mechanics, pilots, and medical crew members, but how do we know it is identifying fatigue and more importantly preventing errors? We worked to validate our measures and correlate our questions – but are they accurate? How can you take your system one step further to decreasing fatigue, decreasing risk, decreasing errors, and improving safety for all?
The Wizard of Oddz: A Statistical Analysis of HEMS Accidents and Risk
Ira Blumen, MD, FACEP, UCAN, University of Chicago Medicine
Since 1998, the HEMS community has averaged nearly 12 accidents and 4 fatal accidents every year. In one year alone, our accidents took the lives of 29 people. Despite the opportunity for lessons learned, new policies, practices and recommendations from various sources, we continue to see HEMS accidents and fatalities every year and we continue to have more questions than answers. Is there accurate data on HEMS accidents, accident rates and fatal accident rates? Do you have the answer? Does your program, your aviation operator, our community, the FAA, the NTSB? Sadly, one thing is certain there will be more accidents. What are we doing about it and how are you going to prevent being the next chapter of this tale. What are you doing to avoid being the next accident? This presentation will provide a statistical analysis of HEMS programs, the number of helicopters, total flight hours and annual accidents. Most important, the presentation will provide the most accurate calculation of HEMS accident rates and fatal accident rates available. The presentation will conclude with an overview of numerous risk-management strategies that could reduce the number of accidents and improve overall HEMS safety.
A Call For Collaboration, Coordination and Cooperation: A First Step Towards Airspace De-confliction Between Manned and Unmanned Aircraft
Tammy L. Chatman, CMTE, Flight for Life Transport System and Peter Menet, UAS Advocacy Network Menet Aero
The number of UAS (drone) sightings by manned aircraft has risen to more than 250/month in 2017 from approximately 100/month in 2016. With 2017 drone sales projected to be nearly 3 million, this number and the issues that unmanned aircraft pose to manned aircraft will only continue to increase. Has the FAA got this right? Wrong! It is up to the entire aviation community to find a way to co-exist in the national airspace with drones for the safety of all aircraft, especially air medical helicopters, and their occupants. This presentation will delve into the work of two groups in Wisconsin-the State of Wisconsin Air Coordination Group and the UAS Advocacy Network-who are making a difference by bringing stakeholders to the table to enhance safety, facilitate education and de-confliction in the airspace between manned and unmanned aircraft through collaboration, coordination and cooperation.
Time Outs and Ground EMS: Data-Driven Decision Making in Fatigue Management
Justin Koper, MTSP-C, FP-C, EMT, HealthNet Aeromedical Services
Fatigue is commonly identified as a proximate cause in ground EMS related incidents. However, institutional understanding of fatigue and management strategies varies widely across our industry. This session highlights one organization’s efforts to obtain sound operational data and the process used to implement proactive fatigue management policies based on that data.
Transitioning from 24 Hour Shifts to 12 Hour Shifts
Lisa Schlemmer, BSN, RN, CFRN, NR-P, Indiana University Health LifeLine
Decisions made in the name of safety can be unpopular. No safety decision in the 38-year history of LifeLine was as unpopular as the transition of 24 hour shifts to 12 hour shifts. Discussion will include LifeLine’s journey through this transition by sharing the background and lessons learned. Many of our team members traveled up to 2 hours one-way to work and had more than one job. As transport volume and average time on transport increased, it was evident the teams were fatigued. This presentation will include the process a 5-base, statewide program implemented to transition teams to 12 hour shifts. Highlights of the presentation will include the steps and timeline of discussing the change with the team and implementing the strategy, importance of messaging and delivery, planning and anticipating turnover, the emotional and financial impact of the transition and mistakes made to learn from.
What’s Wrong With My Pilot?!? Besides the Usual
Randal Endsley, RN, CFRN, CEN, LP,CMTE and Thomas Klassen, ATP, CMTE, HALO-Flight Inc.
What happens when a medical emergency occurs to the pilot in control of your helicopter? That’s exactly what happened to our crew. We’ll discuss the timeline of events that occurred when our pilot experienced a medical emergency during a patient mission with the patient on board. As the Chief Medical Officer and the Director of Operations/Executive Director, we’ll discuss the decisions made from our homes as we were immediately involved in the incident as it was on-going and how the crew mitigated further risk prior to our involvement. You will hear the actual radio calls from the pilot during the incident and we will discuss actions taken during the call and immediate post-incident actions. We will discuss what we felt we did right and what we felt we did wrong in an interactive discussion. We all have talked about what we would do if this was to happen to us, come hear our story about when it actually did.
When Pressure to Fly Gets Personal
Kenneth Cerney, ME-PD, Leader-Team Dynamics LLC
For years pilots have been talking about and training new pilots on something called hazardous attitudes. These are attitudes that can get an otherwise safe, professional pilot in trouble when allowed to affect their decision making, or place unusual amounts of pressure on themselves. What happens when the non-pilot crew members exhibit these hazardous attitudes? How does this affect the entire crew and create additional pressures to fly? How do our individual personalities and increased stress affect our propensity toward hazardous attitudes? Creating conflict and disagreement in our crew then pointing out the hazard in a positive and supporting manner may be the most effective way to help prevent these attitudes and reduce the pressure to continue.
Wings to Wheels: Applying Aviation Safety Concepts to Ground Transport Operations
Dennis Swick, RN, CMTE, MTSP-C, Nationwide Children’s Transport Program
Safety has been a keystone of the aviation industry for several years, and this has carried over to air medical operations, but what about ground based medical transport? Some concepts have trickled over, but application of these advanced safety concepts is still sporadic and even resisted in some cases. We will look at several safety concepts and practices of air medical safety and how they can be applied to your ground operations.