*subject to change
201. Initiation of a Brain Dead Transplant Donor Transport Program
Laura Lee Demmons, RN, MBA, University of Alabama at Birmingham Hospital – Critical Care Transport; Garry Taylor, Certified Respiratory Therapist, Certified Transplant Preservationist Alabama Organ Center; Randal Minton, RN, CCRN, University of Alabama at Birmingham Hospital – Critical Care Transport
Follow the journey of implementing transport of brain dead donors from the perspectives of the Organ Center and transport management and team. Each will share their experience to accommodate a very different kind of patient with the unique demands of organ procurement and recovery, a fascinating world of its own.
202. Use of an Education Committee to Develop and Maintain Staff Competencies for a Neonatal/Pediatric Critical Care Transport Team
Cynthia Japp, MSN, RN, APRN-CNS, C-NPT, Children’s Hospital & Medical Center
In a hospital based neonatal/pediatric critical care transport team, there is an institutional commitment to share governance. The transport program utilizes crew members in all aspects of program administration, including education. This lecture will outline the steps taken to develop the Education Committee, the role of the Education Committee in designing quarterly competencies and on-going education. This lecture will discuss those items that were easily accomplished and worked well and the lessons learned as the Education Committee developed processes.
203. Traumatically Injured Necks: Where’s the leak and how to stop it
Benjamin Nicholson, MD, NRP, Boston Medical Center
With a focus on the interplay between multiple vital structures in a relatively confined space, this lecture will integrate gross images, radiographs, and specific case examples to develop an appreciation for the anatomic and physiologic relationships between these vital structures after traumatic injury. Tracheal injuries are relatively uncommon but present unique challenges that require prompt and assertive interventions to prevent rapid death. These injuries will be discussed with a focus on the anatomic changes following injury and what to expect during airway management. There will be a discussion of pearls to consider when faced with this scenario. Finally, we will discuss hemorrhage control following traumatic neck injuries. Given the structures in this region, standard hemorrhage control measures to include direct pressure, elevation, and tourniquets are often inadequate or inappropriate. This discussion will focus on current literature and best practices for providers faced with these uncommon but severe injuries.
204. We’ve Got an App for That: Phase Two-the Web-based Version
Tammy Chatman, BS, CMTE, and Nick Burns, Flight For Life Transport System
In early 2013 we released the Flight For Life Central Mobile App. The App houses program information from educational references to social media platforms while at the same time offering a helicopter activation feature. It was following the release of FFL Central Mobile App that our customers immediately requested we produce a web-based version. Many customers-dispatch and hospital personnel in particular-wanted to use the App but were unable to due to organizational policies. After much research and behind the scenes work, the idea and eventual development of the web-based version was born.
205. Now be honest…. Have you been there?
This session will discuss the Enroute Decision Point. The attendees will learn how the Enroute Decision Point or “EDP” was developed and has evolved into a functional tool. When used properly, EDP will help provide good outcomes when weather conditions deteriorate. We will investigate how the need for it was discovered. I will explain effective ways to discuss EDP during your shift brief. Utilization of EDP will begin discussion and setting of hard numbers. We will discuss how EDP is another opportunity to establish open communications during your shift brief, while establishing a known trigger as well as choosing the appropriate path for an escape during deteriorating weather conditions.
206. My Patient is A Crime Scene: Evidence Preservation 101
Leonard Mascaro, NRP, CCEMT, Fairfax County Police Helicopter Division
Many scene flights involve patients related to criminal activities. Traumatic injuries such as shootings and stabbings often require evidence preservation during transport. This presentation will focus on preserving evidence, not only physical evidence, but also evidence contained inside the body.
207. When Two Hearts Collide: The Transport of Intubated Conjoined Twins
Stephanie Meier, RN, BSN, C-NPT and Greg Blackmon, RRT, C-NPT, Children’s Hospital CO – Flight for Life Colorado
Fixed wing transport of critically ill intubated thoracopagus conjoined twins, complicated by critical airways, acuity, distance, multiple modes of transportation, size constraints, complex cardiac physiology and shared circulations. We describe the complex pathophysiology, transport logistics, and planning involving telemedicine, team work, equipment utilized and safety considerations.
208. Evolve or Die, Changing Your Communications Center And Planning For The Future
Kevin Haugh, CFC and Lisa Schlemmer, RN, BSN, CFRN, EMT-P, University of Cincinnati Air Care and Mobile Care
It’s time for change, your communications center is no longer effective. But where to start? From policies to sledge hammers, we will examine factors that go into evolving your communications center. Fixing the past, and planning for the future. Making your remodel more than just a change in scenery.
209. Is the HEAVEN assessment the new LEMON?
David Olvera, AS, FP-C, NREMT-P, CMTE, Air Methods Corporation
This presentation will review the new HEAVEN assessment tool for difficult and emergent airways. This tool looks at evidence based practice in airway and resuscitation practices to help improve first pass success and prevent adverse events, in relation to the HEAVEN assessment tool.
210. Every Breath You Take: Modes of Mechanical Ventilation and The Mechanical Breath Profile
Jon Inkrott, RRT, RRT-ACCS, Florida Hospital Orlando
There are many ventilator platforms available for critical care professionals, from the transport world to the intensive care unit. Ventilators offer a variety of ventilation modes, but what’s the best mode? Is there a best mode? Do I use volume or pressure? What is PCV, APRV, APV-CMV, PRVC, AC, or SIMV? This presentation will focus on the different ventilation modalities the transport practitioner may encounter and also, what the mechanical breath profile and individualized approach to mechanical ventilation really means to your patient.
211. Push or Pump? A Primer on Push-Dose Pressors
Jeff Lubin, MD, MPH, Life Lion Critical Care Transport & Penn State Hershey Medical Center
Originating in anesthesia, and increasingly promoted in emergency and critical care medicine, the use of push-dose pressors has been growing. In this presentation, we’ll use an interactive case-based format to discuss the what, why, and how of using push-dose pressors during critical care transport. They just might be the perfect solution to short-lived hypotension.
212. Valuation: The Market and Driving Value to Your Business
Stephan Peron, CVA, VMG Health
Overview of air ambulance market and how buyers value air ambulance. This session will contain a discussion of key value drivers along and how those drivers influence the sale of an organization.
213. Making The Transition to Your Own Operator’s Certificate
Charles Blathras, BS, EMT-P, FP-C and Richard Kenin, ATP, MPA, MS, Boston MedFlight
More and more hospital systems are looking away from the vendor model and to having more control over their operation. There are many advantages and disadvantages to making the transition to a part 135 certificate. This is one program’s experience with making the decision and putting all the right pieces in place for a successful transition. We will highlight the goals, essential components of, and lessons learned in this journey.
214. Hocus POCUS: Beyond the FAST exam… Next Level Aeromedical Ultrasound Applications
Sean Smith, BSN, NREMT-P, C-NPT, FP-C, TP-C, CCRN-CMC, CCRN-K, CEN, CFRN, CPEN Critical-Care Professionals International / Vector Aeromedical and Benjamin Abo, DO, NREMT-P, CCEMT-P, University of Florida Department of Emergency Medicine
Does your team do scene calls or transfers from rural ERs/ICUs? Point of Care Ultra Sound (POCUS) by now, the FAST exam (Focused Abdominal Sonography for Trauma) is old news. It was formally fully integrated into ATLS in 2012. Are you ready to take your ultrasound knowledge to the next level? Last year’s news is old news! Join us as we explore and share the rapidly evolving world of POCUS, cutting edge equipment, aeromedical relevance and how you can meaningfully integrate the latest developments into your clinical practice.
215. HEMS in SAR Operations
Dave Weber, BS, FP-C and Judi Carpenter, DNP, Intermountain Life Flight
This presentation will outline field-tested best practices and provide real-world examples for effective HEMS response to search and rescue (SAR) missions. A majority of the content will be presented through the context of a defined SAR response sequence and lessons learned during a recent incident case review. Judi Carpenter, a flight nurse with 28 years of HEMS experience with Intermountain Life Flight, and Dave Weber, a Denali National Park mountaineering ranger and Intermountain Life Flight paramedic, will discuss the critical elements of safe SAR operations, essential mission targets and the various transport modalities utilized in modern backcountry rescue. Participants will ultimately gain tangible tactics for SAR response through the incorporation of a SAR operation sequence within their respective HEMS program.
216. Lets Make Like and Tree and Get Outta Here!
Roxanne Fawson, EMD, and Breezi Ainsworth, AirMed, University of Utah
On December 9th 2015 the Flight Center for AirMed, University of Utah conducted a simulated drill, which was an evacuation of their flight center. This drill required flight coordinators to follow evacuation instructions including forwarding phones and relocating to the backup flight center area at the AirMed hangar located at the Salt Lake International Airport. In this presentation we will share what went wrong, what went well, and what improvements were made afterward including the results from a second drill conducted in spring 2017. We will also give tips and advice on how your program can implement an evacuation plan and share our policies and procedures for this plan.
218. Ups & Downs of BP Management in Head Injuries
Rick Erickson, NRP, FP-C, Air Methods and Klint Kloepping, NRP, FP-C, C-NPT, Midwest Medair
In the ever growing debate of what is the best blood pressure for head injuries and stroke, we examine where to target blood pressure based on the type of bleed and/or injury. We will look at the current research to address hypertension and hypotension and implement it into clinical practice.
219. Respiratory Management of the Pediatric Neuromuscular Patient 2.0: Keeping Raggedy Ann & Andy from Getting Intubated
Joie Hickenbottom, RN, CEN, EMT-P and Stu McVicar, RRT, FP-C, CCEMT-P, American Family Children’s Hospital
We spend COUNTLESS hours learning HOW to intubate to secure an airway. What about the populations of patients that might be near impossible to wean off the vent? One of the hardest populations to keep off the vent is the pediatric patient with a neuromuscular disorder. Spinal Muscular Atrophy is a disease that robs people of physical strength by affecting the motor nerves in the spinal cord, taking away the ability to walk, eat or breathe. It is the number one genetic cause of death for infants. This session will discuss transport considerations of the pediatric patient with a neuromuscular disorder. Two cases will be presented as well as some of the specialty equipment will be demonstrated.
220. Vasopressin: Who, When, Why and How
Michael Jasumback, MD, FACEP, PHI Air Medical
Vasopressin is a unique pressor agent that is being used more frequently in the critically ill. This discussion will focus on the utilization of vasopressin. It’s indications, utilization and how it affects outcome. This discussion will be based on the current evidence for the use of vasopressin and will include dosing and titration strategies.
221. Remembering Maslow: Developing Successful Employee Recognition Programs
Jason Clark, NRP, CCEMT-P, FP-C, C-NPT, CMTE, LIFE FORCE Air Medical
Maslow’s Hierarchy of Needs is a basic concept we learn during our primary education that teaches us the basic needs of a human. While a simple concept, it is one we are guilty of forgetting quickly in the workplace. Employees are the backbone of transport programs and we often fall short when it comes to recognizing our people for going above and beyond. A simple thank you goes a long way. The establishment of a structured employee recognition program can have a positive impact on the culture of the transport service and drive morale to new heights. This lecture will provide a step by step layout to design an employee recognition program that is tied to quality pillars to quantify the reasons for recognizing employees. With an established program, employees know the criteria in which they must meet to be considered for recognition and the perception of a popularity contest can be avoided. Employee recognition programs and how they relate to generational differences of employees will be discussed. A discussion on how the quality pillars can be directly related to the core values of the organization and how performance evaluations can be integrated with this program.
222. 5 to Go: 1 to Say No
Sunshine McCarthy, MA, BS, Baldwin Safety & Compliance
The idea behind this safety philosophy is a strong one. Everyone on the team (pilot, paramedic, flight nurse, and maintenance technician and operation control specialist) agrees on an acceptable level of risk, allowing the transport to proceed. However, what does it really take to say NO? Studies have shown that by nature we don’t like to standout, make waves, or second guess others with more experience or authority. So how then do we raise concerns when we have them? We will discuss what is behind the fear of speaking up, why it is critical for everyone involved to take responsibility and share concerns, the type of organizational cultural necessary to make this process successful, the skill to effectively communicate a concern and the benefits of performing a post-flight debriefing.
223. Lessons Learned From 25 Years on a Rescue Helicopter in New Zealand
Dave Greenberg Rescue Crew, EMT, The Life Flight Trust
I have recently completed 25 years of service for Life Flight in Wellington NZ. I completed nearly 4000 missions in the 25 years, mainly on the helicopter, some on the fixed wing. We do scene response, hospital transfers as well as search and rescue. Over that time I learned many lessons. The biggest ones always involved safety of my team, or myself.
224. Pediatric Trauma…. is not always accidental
Maria Dudley, BSN RN, CNPT, EMT Akron Children’s Medical Center
A case presentation of a devastating pediatric non-accidental trauma.
225. Logistic Considerations for ECMO Transports
Travis Byerly, EMT-P, FP-C and David Zook, BSN, CFRN Life Lion Critical Care Transport
A look at the logistics involved for ECMO transports primarily in the rotor wing environment. Discussing specialized equipment, equipment configuration, packaging of patient and equipment, and crew configuration based on current practices in place at Penn State Health Life Lion Critical Care Transport.
226. Alphabet Soup of Stroke Assessment in the Acute Stroke Patient
Ray Bennett, BSN, RN, SCRN, CEN, CFRN, CTRN, NRP, RWJ Barnabas Health
This session will improve the assessment of the Acute Stroke patient by breaking down the various stroke scales and incorporating neuro assessment tools and tips to build a systematic approach to identifying the various stroke syndromes and ruling out stroke mimics.
227. Tight head? An Etc02 of 40 with a square wave form may not be a good thing
Chad Hegge, EMT-P, BHSc Shock Trauma Air Rescue Service (STARS)
Tight control of arterial C02 seems to be an important indicator of morbidity while ventilating patients with traumatic brain injuries. Using EtC02 and Venous C02 to guide minute ventilation titrations as our organization does can lead to inappropriate ventilation as EtC02 can be an unreliable surrogate for arterial C02 and venous C02 is often not much better. We will explore why EtC02 and Venous C02 results can be misleading and what the STARS organization is doing to avoid having their practitioners mislead by their results.
228. Anger Management: Principles for Assessing and Managing the Combative or Potentially Combative Patient
Craig Bates, MD, MS, FACEP, Metro Life Flight – MetroHealth Medical Center
Combative patients represent a significant danger to themselves and to healthcare providers. There are a diverse variety of reasons why patients become combative and understanding those reasons will help providers appropriately manage patients to avoid violent episodes or to manage them as safely as possible once they occur. There are often (but not always) a series of warning signs that violence in more likely to occur and it is critical that providers are able to recognize those signs and intervene appropriately before events escalate. This session will provide insight into understanding the underlying causes to combative behavior and provide intervention options specifically tailored to the critical care transport environment. The discussion will include considerations for safe physical restraint of patients, pharmacological interventions, and legal considerations when managing these patients. Because there can be significant variation in scope of practice, medication availability, and practice settings this presentation will provide a variety of options that can be tailored to your specific needs.
229. Impact of Ineffective Leadership – How to Grow Your Program and Not Hurt Your People.
Brett Henyon, FP-C, University of Virginia – Pegasus
Transitioning from a lower management position to a higher position or a clinical position to a leadership position happens for a variety of reasons. Often this transition creates a perceived (or actual) leadership gap. The most important thing, safety, may become unconsciously shadowed. We can very accurately predict what type of person is going to be a great leader – and who is not. We can also accurately predict what type of team is going to be successful and who is not. Through research we have determined the behavioral traits of good leaders and the behavioral traits of a great leadership team. If we look at the overall behavior of the team, once we know everyone’s individual behavior, the dynamics of team leadership transforms.
230. The Next Outbreak: How Well do We Disinfect Our Medical Equipment and Transport Vehicles?
Ronald Estanislao, BA, NRP, FP-C, C-NPT, Boston Medflight
The healthcare industry paradigm is to provide high quality patient care while preventing nosocomial infection and disease. It is also well known in the industry that medical equipment and hospitals are harbingers of infectious agents. Therefore, it is vital that we adopt the best practices for infection control and disinfection. There are very clear vectors and infectious agents that cause infections in patients as well as healthcare workers. There are documented studies regarding medical equipment disinfection and environment cleaning in the hospital environment, but very little if any studies exist for the pre-hospital arena. How well do we really disinfect our medical equipment and transport vehicles in the air medical transport industry?
231. Literature Review for Neonatology and Pediatric Critical Care
Linda Thompson, MD and Jonathan Nedrelo, MD, Cook Children’s Medical Center
A review of the pertinent pediatric critical care and neonatology literature for the past year.
232. LUCAS Device in Flight
William Selde, MD, Kerry Barker & Ben McCarlson, Wyoming Life Flight
This session will include a case report of the LUCAS Device used in flight for cardiac arrest. It will explore the details of the case, lessons learned, and potential future uses and implications.
233. Writing for Publication
Dawn Nahlen, Associate Publisher, ELSEVIER, Health and Medical Sciences Journals
This course is meant for the novice writer and outlines the steps necessary to prepare a manuscript for publication in a peer-reviewed journal.
234. Flying Elvis: Transport Considerations for the Patient with a Trach
Stu McVicar RRT, FP-C, CCEMT-P, American Family Children’s Hospital
When asking about airway considerations for a patient with a trach as a medic student, I was told you have a better chance of picking up Elvis than a patient with a trach… Trachs are out there and can be the most stable airway however in this talk we’ll discuss when a very stable airway can turn into a nightmare. Broken down into a nice to know vs. NEED to know format, many of the small idiosyncrasies of trachs will be discussed as well as two case presentations of trached flights that could have gone horribly wrong.
235. What to Expect When You’re Expecting
Michelle Oddi, MSN, RN, CCRN, CFRN, C-NPT, Children’s Hospital of University of California Davis Medical Center
Preterm neonates comprise the majority of the effected infants that require transport due to services not available at outlying facilities. Transport teams are often requested to be present during high risk deliveries. In this lecture we will discuss neonatal resuscitation, ventilation, and key aspects of care for the critical neonate.
236. Today’s Heroin Epidemic
Frank Tift, MD, Life Force Air Medical Service
This lecture will review the current Centers for Disease Control (CDC) (US) data of mortality from heroin and opiate overdoses in the USA. It will then discuss the CDC recommendations of what should be done and will emphasize the importance of pre-hospital naloxone use, expanded naloxone use to non-EMS providers and the need for high doses with some emerging synthetic opiates.
237. Work/Life Imbalance – Tipping The Scales To Find A True Work/Life Balance In Air Medical Management
Bryan Peterson, BSN, RN, CMTE, CFRN, CCRN, PHRN, STAT MedEvac
What is work/life balance? Does this actually exist in our line of work? The Air Medical Industry is managed by very high functioning Type A individuals that thrive on being involved in everything that goes on in their program. Long hours and 24/7 on-call requirements in a fast paced industry that is rapidly changing leads many managers to lose sight of assuring they have an effective work/life Balance. This program will explore ways to tip the scales in favor of a true balance between the non-stop management of Air Medical leadership and a healthy personal and family life outside of the workplace.
238. Helmet Fire
James Marshall, Enloe FlightCare
Task saturation is having too much to do without enough time, tools, or resources to do it. As task saturation increases a flight crew member(s) may be unable to continue performing efficiently. Until an organization recognizes this risk they cannot effectively address it.
239. The Clinical Nurse Specialist in the Transport Setting: What is a CNS?
Susan Toberman, MSN, RN, APRN, ACCNS-AG, CCRN, CFRN, EMT, University of Tennessee Medical Center
This presentation will introduce the role of the clinical nurse specialist in transport. The presentation will speak to the advantages of having the Clinical Nurse Specialist oversee the clinical operations of the critical care transport team. The clinical nurse specialist works in partnership with the Medical Director to commit to patient safety, improve outcomes and seek evidence-based best practices. The CNS oversees orientation, clinical practice, protocols, clinical QA/QI and clinical research.
240. The Unconventional ECMO Adventure- 2 Case Studies & Subsequent Program Development
Jenny Humphries, RN, BSN, MBA, MICN, CFRN and Bob Hayes, CCP Enloe Medical Center
In March of 2016 a 65 year old male patient was brought out of the operating room to the ICU/CCU at Enloe Medical Center on ECMO- this was unplanned and the first time this had ever happened. The patient needed transport to a tertiary ventricular assist device and transplant center, as we started the transfer coordination process it became evident that the options were extremely limited. A Perfusionist/Flight RN team successfully transported the patient via H130 helicopter and he survived. Some months later at 25 year old patient with completely different clinical presentation was placed on ECMO and successfully transported by the same team and survived. This session will cover the cases, the logistics, hurdles, and incredible collaboration and teamwork that it took to give these patients a second chance they would not have had otherwise. We will cover the device we utilize, logistics of transport as well as program development including patient selection criteria, crew training and CAMTS considerations. From the chief executive officer to the interdisciplinary critical care team and hospital based flight crew, it was all hands on deck.
241. The Top Ten List: Articles from 2016-2017 That May Influence Your Practice
Russell MacDonald, MD, MPH, FRCPC, Ornge Transport Medicine / University of Toronto
This presentation provides a summary and critical appraisal of ten articles taken from the EMS and transport medicine literature in 2016-2017 that may influence your transport medicine practice.