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Fatigue Risk Management in Air Medical Transport Operations
Daniel Mollicone, PhD, Pulsar Informatics ;Joe Gallagher, BaSc, PHI Air Medical
Fatigue risk impacts all personnel involved in air medical transport operations, including both air crew (pilots and clinical staff) as well as ground crew (mechanics and ramp personnel) whose mission-critical activities ensure safe and effective transports. It is well known that fatigue-related deficits impair performance. But how much fatigue is too much? This presentation will demonstrate tools and approaches to assess fatigue risk and crewmember fitness for duty. Benchmarks will be provided to assist organizations with setting up an objective quantitative framework to manage fatigue risk with clear thresholds to trigger fatigue mitigation workflows. Lessons learned will be presented from a fatigue risk management implementation in a large air medical transport operation.
Listen to Your People: Measuring Safety Culture in Air Medical Services
Jennifer Fletcher, MBA, BSN, RN, Air Evac EMS; Lee Varner, MSEMS, CPPS, EMT-P, Center for Patient Safety; Krista Haugen, RN, MN, CEN, CMTE, Med-Trans Corporation
This session will discuss the experience undertaking an agency-wide safety survey in collaboration with the Center for Patient Safety. Leadership from Air Evac and MedTrans as well as the Center for Patient Safety will share data and findings from the assessment. The session will also explore how the leaders responded to the results and feedback of the assessment. In addition, what organizational changes have made as a result of the survey’s findings.
Acclimating to Safety
Robby Rhembrandt, FP-C, CCP-C, C-NPT, Air Link at Regional West Medical Center
This lecture is designed to give directors, managers, communication specialist and flight team members the ability to adjust to and develop new safety policies. Currently, I’m designing a State of Nebraska protocol for Air Medical Resources addressing Helicopter Shopping at the state level. The project consists of media involvement, program support, safety reporting, safety incentive and enacting legislation to support the industry. The lecture gives participants ideas to take to their programs along with lessons learned from the work completed by the committee.
One of These Things Is Not like the Other: High Reliability Organizations and Healthcare
Justin Koper, MS, GSP, MTSP-C, FP-C, HealthNet Aeromedical Services
Healthcare, especially in a developed nation such as the United States, is viewed as an industry which should be safe for both patients and providers. However, 20 years have passed since the release of To Err is Human: Building a Safer Health System and there is still a focus on individual human error rather than systemic improvements. Other industries such as commercial aviation and nuclear power generation operate in equally high risk environments but they have acknowledged to err is human and have designed systems which embrace this fact. This session will discuss high reliability organization principles and what we, as clinicians and leaders, can do to apply these principles to healthcare for the benefit of our peers, clinicians, and patients.
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 over 11 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 or the NTSB? Sadly, one thing is certain there will be more accidents. What are we doing about it and what are you doing not be 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.
SHARE THE AIR: Partnering WITH Unmanned Aircraft System Pilots For Safer Airspace.
Amanda Ball, AEMT, CFC, OCS, MedFlight of Ohio
“It’s just a matter of time before there’s an accident.” “They’re not REAL pilots.” How often have you said this to yourself after reading an online article regarding a near-miss between a drone and an aircraft? Drones are easy to buy, fairly easy to operate, and provide a great hobby or cashflow for many operators. While evolving governmental regulations are in the works, the Unmanned Aircraft System (UAS) world can feel like the wild, wild west… Especially to air medical organizations. Instead of solely focusing on potential dangers, perhaps another approach may work: Sharing the Air. The key to any disaster prevention is proactive relationship building, multi-disciplinary training, and just good old fashion conversation. Attendees will be supplied with tools & suggestions from a busy air medical organization who chose to proactively work with local UAS enthusiasts by means of local workshops and networking events.
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.
Turning Tragedy into Positive Action
Karen Mahaney, CRNA, BSN; David Repsher, BSN, NRP
This session will chronicle and display, in great detail, the HEMS crash of July 3, 2015 in Frisco, CO, which out of two separate, but very desperate survival stories has led to a renewed focus on helicopter safety improvements. Discussions will center around previously enacted, but never fully implemented legislation, and current pending legislation that, if approved, could enhance future survivalbility and occupant outcomes. Additional discussion will highlight the persuasive lack of awareness of available safety features, or lack thereof, that is known throughout the ranks of the entire helicopter industry. It is our hope that by sharing our deeply personal and painful stories, the attendees will feel empowered to bring safety to the forefront in their respective organizations.
Preparing Your Program For a Storm’s Disaster: Preparing for the Hurricane Florence Landfall
Kevin Collopy, BA, FP-C, CCEMT-P, NRP, CMTE, NHRMC AirLink/VitaLink Critical Care Transport
Hurricane Florence set a direct course over Wilmington, NC in September 2018 and was forecasted to strike the coast as a catastrophic category 4 hurricane with hurricane force winds stretching hundreds of miles from its center. As a coastal program, AirLink/VitaLink has long had a disaster plan, a plan that had been executed in the past decade for two winter storms and two hurricanes and had been tested during many hurricane forecast models Florence however was destined to strike. This presentation will take you step by step through annual pre-season disaster planning, and our organizations preparations, response, and recovery from disaster. Come hear how our organization prepared our program and team for an anticipated disaster, how we planned vehicle positioning, and how we improvised in the days after the hurricane passed. Enjoy our pearls and best practice tips, and opportunity for improvement so that you can prepare your program for disasters that may strike your own region.
Shop Til You Drop: Why NOT to Helicopter Shop
Jason Haynes, RN, CFRN, NR-P, CMTE, MedCenter Air; Abby Walden-Peterson, MHA, CMTE, Atrium Health – Mobile Medicine
How stubborn is your local EMS agency in not doing what’s right for the patient? Encountering aviation dangers associated with helicopter shopping also resulting in delay in treatment during the ‘Golden Hour’ and family members being split up and transported to various tertiary care centers? Is it time to break up? Learn from three different scene calls, one county, and two flight programs.
Survival Training – A Different Approach
Chip Henderson, CMTE, MTSP-C, Nationwide Children’s Hospital
Many times, EMS survival training is taught with the focus on how to survive in the wilderness for extended periods. The trainers talk about things like the “Rule of Threes,” finding and purifying water, building shelters and starting fires. While these skills are important and have benefit, in this day and age of satellite and GPS tracking systems, the chances that an EMS flight crew member will find themselves needing to survive in the wild for more than a few hours is slight. When a Communications Center loses contact or tracking of an EMS aircraft, steps are being taken to locate the aircraft and/or the team on board within minutes. This session will focus on steps that should be taken before a crew gets into a survival situation and more importantly avoiding a long-term survival situation by focusing on actions crew members can take to aid in getting rescued as soon as possible.
How Do You Manage a Fleet of Helipads? From Landing on the South Lawn to landing a Helipad Safety System
Martin Fisher, Atrium Health/MedCenter Air; Michael Middleton, Bayards International
The design and development of a helipad monitoring and safety system. The system helps to monitor multiple locations while maintaining the overall safety of the fleet.
Helicopter Underwater Emergency Egress and Sea Survival
Craig Dunham, MS, NRP, PhD, National Association of Emergency Medical Technicians
Basic one hour ground school presentation for Air Medical and Rescue flight crews to include ,pilots, healthcare practitioners, mechanics, and administrators. And in support of FAA bi annual on going training and education recommendations. A highly motivated and experienced instructional cadre introduces and discusses the need for CRM/AMRM training, the BRACE acronym and self extrication technique, reviews and comments on personal safety equipment (life jackets,helmets,flight suits,signaling devices,life rafts) and utilization , and presents valuable tips and demonstrations for sea survival in the post crash phase. In water laboratory / practice sessions using the 1 and 2 person MacMillan Confidence Builders will be available shortly after the ground school segment , and are highly recommended. Evidence based research indicates a great tool for controlling panic and promoting an understanding of spatial disorientation, as well as, review and practical application of the BRACE acronym.