Global Case Studies

Trading Places: Lessons Learned from the Haiti Air Ambulance Exchange Program
Stacy Wolf, NRP, CCP-C, FP-C, MTSP-C, Haiti Air Ambulance and Susan Smith, EMT, BSN, CFRN, MBA, CMTE, Carilion Clinic Life-Guard

First and third world countries certainly have their differences, but as far as HEMS programs go, you may be surprised to learn how many similarities there actually are! Join us for a presentation on how a typical USA HEMS program compares to the new (and ONLY) HEMS program in Haiti. We will also share information about the USA-Haiti volunteer Flight RN / Flight NRP program, the exchange program established between one USA program and the Haiti EMT’s, how the Flight EMTs are trained and what their roles are as well as a look at the country of Haiti itself: the land, the challenges, and the people.

Case Studies

Get This Truck off Me:  A Conversation about Traumatic Hemicorporectomy and the Psychological Aftermath
Carol Anne Doll, RN and Jamey Myers, EMT-P, Shock Trauma Air Rescue Service (STARS)

As my partner and I are enroute to another flight we get redirected to an isolated community for a person pinned under a vehicle. Having no other information we are asked to land in town (one block from the hospital).  We arrived to find our patient had suffered a traumatic hemicorporectomy which took the skills of an entire rural fire department, four doctors, eight nurses, six units of blood, two critical care flight crews, and two helicopters, all before getting the patient to the trauma center.  Sharing this experience will allow us to have discussion on acute stress reactions as well as post-traumatic stress.

A Tale of Two Balloons
Jamie L. Feick, RN, CEN, CFRN, BSN, Mike Fadale, RN, CEN, CFRN, BSN and Amanda Rosito, EMT-P, FPC, Penn State Hershey Life Lion

This session will present a case study of two balloon pump transfers done on the same day in the same program. Both presented challenges like less experienced cath labs, IFR conditions, as well as an air and ground component to completing both missions. One transfer went perfect and one didn’t. The session will also include a review of care and transport of a balloon pump patient as well as review of Impella devices. New technology should eventually phase out balloon pumps, however smaller hospitals with less invasive cath labs are still out there and will be slower to implement newer technology. Critical care transport crews must still be aware of the challenges these patients present in a transport setting.

Mayday! Mayday! My Pilot Is Unresponsive!
Tom Baldwin, MBA, Air Evac Lifeteam

In early 2018 a Helicopter Air Ambulance flight team experienced an event that many have considered but may not have been prepared to face. The flight team was transporting a patient from a scene flight when the pilot suffered a medical emergency that impaired his ability to operate the aircraft.  The pilot had engaged the stability augmentation system and autopilot systems (Helisas) after departure from the scene, and moments later stopped responding to the medical crew over the ICS. This session will examine the response to this event from the crew, communication/operations control center, and organizational perspectives.

Stroke Care: A Rapid Approach
Jason Bazelow, FP-C CCEMTP, Vidant EastCare

In the US, someone is diagnosed with a stroke every 40 seconds. North Carolina has the 6th highest number of stroke related deaths nation-wide and a vast majority of them reside in eastern part of the state. In 2015, Vidant Health decided to deal with this problem in a multifaceted way. It grew its internal neurological services, advocated for other regional hospitals to achieve their stroke credentialing and provided outreach and education to emergency services throughout the region.  Now stroke patients that were once delivered to local hospitals and waited for transport to stroke centers hours away are being flown to Vidant Health from the scene.  They are being identified faster, treated more appropriately and receiving swifter transport.  This lecture will discuss the past, present and future of stroke care throughout our region, how we are striving to improve that care as a critical care transport service that is part of a larger health system, what our quality improvement processes are, as well as discuss the different types of strokes, stroke identification and rapid treatment and transport of those patients.

Chest Compressions in Flight: A Waste of Time?
Dean Hoffman, FP-C, NREMT-P, Guardian Air Transport, Northern Arizona Healthcare

If your helicopter didn’t start 50% of the time would you still fly in it?  If your IV pump did not turn on 70% of the time would you still use it?  If your cardiac monitor did not deliver electricity 80% of the time would you even bother hooking it up?  If a new hire Flight Nurse, Paramedic, or EMT was unable to perform Basic Life Support any of the time would you still hire them?  Chances are the answer is no.  This session will review the research and data collected regarding the effectiveness of chest compressions in the Bell 407 and discuss the challenges of compressions in flight and explore alternatives and the pros and cons of each.  This research was completed with the assistance of Guardian Air Transport in Flagstaff.

In-attentional Blindness – Not Seeing is Believing
Jonathan Gryniuk, FP-C, CCP-C, NRP, RRT, CMTE, Air Methods Corporation and Jeff Currin, Life Flight Network

This session will review a true and extraordinary account of distraction and in-attentional blindness that occurred in an air medical transport setting. An EC135 aircraft received multiple walk-around inspections prior to flight yet none of the crew members involved noted a panel that was at first unsecured and then later departed the aircraft entirely. Despite a large piece of the aircraft being missing, crew members still failed to note the absence of the affected part during various points during the transport.

Near-Infrared Spectroscopy Use in Transport of Pediatric Patient with Multifactorial Shock
Tanya Walenta, RN, BSN, and Jeffrey Parker, RN, BSN, CCRN, Children’s Hospital of Wisconsin

It’s night, and you are on an inter-facility flight with a pre-coding patient. The darkness makes it difficult to assess perfusion and the vibrations make your standard monitors useless because of artifact. What do you do? Near-infrared spectroscopy (NIRS) is a tool used to measure regional oxyhemoglobin saturations. This session will be a case analysis of how NIRS was instrumental in escalating inotropic and vasopressor drips during transportation of a critically ill pediatric patient in multifactorial shock. The presenters will also discuss how it’s feasibility and real time results are especially usefulness in the transport environment.