Category: CLINICAL

Three Souls…


Three Souls” – Bev Meade, MSN, RN, MHA, CEN, CCRN, CFRN, CTRN, TCRN, EMT-P. Flight Nurse, MedFlight 3.

Our pilot completed his safety checklist and risk assessment, and contacted our Columbus, Ohio, Communications Center with the first radio traffic of the morning: “MedComm, this is MedFlight 3. We have 3 souls, 1 hour 30 minutes in fuel, 8 minute ETA.”.  This radio transmission is always given before we lift from our helipad to begin our mission.  The response was as expected from our experienced Communication Specialists watching over all of us… they monitor us flying and driving our patients “to and fro” for this company.  They acknowledged us with “Copy MedFlight 3… 3 souls, 1 hour 30 minutes in fuel, 8 minute ETA”, and we lifted into the cool, pre-dawn calm with our Night Vision Goggles (NVG’s) down and activated.

 

Our mission was to transport a patient with an ST -elevation myocardial infarction (STEMI) from a rural area in Ohio to the closest cardiac interventional facility… rapidly, efficiently, and safely.  As we landed at the remote landing zone (LZ), we did as we were taught and as we have done hundreds of times on landing… We focused our attention outside diligently, looking through and around the NVG’s for hazards that could mean disaster for the “three souls” on board.

 

Safety is and has always been a top priority for my company, and I am thankful that we are recognized as one of the most safety-conscious critical-care transport organizations in the state.  We communicated succinctly with the local fire department at the LZ, and were acutely aware that our safe landing could mean the difference between life and death for our patient, whom we have yet to meet, and, of course, for us as well.  Even though the “three souls” on board have thousands of safe arrivals, each landing and takeoff still makes me alert, tensed, & ever-vigilant for the unseen hazards that we all know are out there.

 

“MedComm, MedFlight 3.  We’re ‘skids down’ safely”  is what we all wanted to hear, and that is exactly what transpired.  As usual, I thanked my pilot for a safe landing and waited until the blades came to a complete stop before exiting the aircraft to retrieve the necessary equipment, supplies, and of course… my paramedic! As we walked to the waiting EMS vehicle,  I contemplated what we might find, what might need to be done quickly, and what a difference we can make in this person’s life.

 

After assessing and placing appropriate monitoring equipment on our patient, we departed the EMS vehicle in under 7 minutes to rapidly load & secure our patient for the lifesaving transport he desperately needed.  Our pilot once more pierced the airwaves with “MedComm, MedFlight 3.  Lifting from scene with 4 souls, 1 hour 20 minutes in fuel, 30 minute ETA” and we departed the rural hills of Ohio for the center of the state, where critical interventions awaited this patient.

 

After arriving at the receiving hospital and transporting the patient to the cardiac catherization lab, we became “3 souls” again… the team of 3 who answer the call of duty, who respond without hesitation to help the sick and injured, whose life’s work and studies have led each soul to this place, at this time. And I know that there are others just like us at MedFlight around the nation that are awake at 0200, answering the incoming radio or telephone call, responding just as quickly and safely to save the life of another soul. 

 

The mission was completed, the cardiac vessel reopened, and the patient was recovering to resume his life in southeastern Ohio.  As each of the “three souls” completed the post-flight tasks, readying the aircraft for the flight home… me completing the patient care chart and sending it to the receiving facility, the medic restocking the aircraft for another mission if needed, and our pilot refueling for the flight home or to another destination as needed…  I paused for a moment to consider what we had just accomplished.  All of us played a part in the outcome of this patient: Family, EMS, our Communication Center, all of our ancillary personnel, the flight crew, and receiving facility… Each entity relying on the other to do their jobs and save a life.

 

As we were enroute to our base, I considered the new day dawning as the sunrise peaked above the hills of southeastern Ohio where I call home.  I announced “goggles up”, and I contemplated how each of us have a pivotal role in this mission.  I am still in awe after 20 years serving others in critical-care transport how all of this happens almost seamlessly to improve the outcome of our patients.  But, perhaps, more importantly…  I looked to the right toward my medic, and in front of me to my pilot, and I am thankful that each one of the “three souls” are where they are supposed to be, doing what they are supposed to do, and that each of us bear the burden of safety and excellent patient care and quality transport so that we can hear once more “MedComm, MedFlight 3 is safe on deck with three souls” as we land at our helipad…  Mission accomplished.



	

Why A Nurse/Medic Crew Configuration?

Since the inception of air medical transport in the early 1970’s,  the “ideal” crew composition has been the subject of much discussion.  There has been a variety of team types: RN/MD, RN/RN, RN/Medic, RN/RRT, etc.  While each type of crew configuration offers many theoretical benefits, there is little scientific research to support any specific mix of medical crew members.  Most air medical programs in the United States operate with a RN/Medic crew.

MedFlight believes that critical care nurses and paramedics can be trained in skill performance to the level of a physician.  In addition to conducting ongoing quality reviews of the procedures performed by our crews, an annual competency program, and continuing education to enhance clinical skills, each MedFlight transport is supervised by an identified Medical Control Physician who is immediately available to the crew and who provides input regarding the care of the patient.  Each MCP has specialty training in adult emergency medicine, pediatrics, neonatology or high-risk obstetrical care, depending on the patient’s condition.

MedFlight crews are trained to perform and well-versed in, among other skillsets:

  • Rapid Sequence Intubation using paralytic agents
  • Oral and Nasotracheal Intubation
  • Surgical and Needle Cricothyroidotomy
  • Conversion of peripheral IV line to 8.5 Fr introducer for rapid fluid administration
  • IO insertion
  • Pericardiocentesis
  • Needle chest decompression
  • Intra-Aortic Balloon Pump management and transport
  • Ventilator management
  • Monitoring of arterial catheters and Swan-Ganz catheters
  • Monitoring of pulse oximetry and end-tidal CO2
  • Transcutaneous pacing
  • Maintenance of transvenous pacemaker
  • Burn escharotomy

Mobile ICU and Flight Teams also maintain several clinical certifications above and beyond their RN and Paramedic licensures.

The RN/Medic crew configuration offers the most cost-effective method of medical care delivery in the critical care transport environment.  MedFlight is committed to providing the highest level of care for the lowest cost to patients, receiving hospitals, and third-party payors.

We’re proud of the quality work and dedication our clinical crews produce daily.  There are decades of experience at each MedFlight base.  If you have additional questions regarding MedFlight and our capabilities, please visit our website or on social:  @MedFlightOhio.  Partners for Life.

Dr. Howie Werman, Medical Director of MedFlight & Emergency Physician at The Ohio State University Wexner Medical Center

 

 

20 Years: The MedFlight Mobile ICU Division

“It was 20 years ago today that I started as a Mobile ICU paramedic for MedFlight…they had just acquired the Riverside Methodist Hospital Critical Care Transport team where I had previously worked.  On October 20th, 1996, my last shift at Riverside, we were asked to bring the Mobile ICU vehicles to MedFlight as our final task.

I remember MedFlight leadership standing at the hangar door, welcoming us to MedFlight.  I think all of us were excited about this new chapter in our careers.

I have seen many changes through the last 20 years and worked with so many talented people that it boggles my mind.  Working for MedFlight has been awesome, and I wouldn’t have missed the experience for anything.”

~ Lou Hoyer, MedFlight Mobile ICU Paramedic for 20 Years

What a great resource our critical-care  Mobile ICU teams have been for Ohio patients.  This excellent division of MedFlight doesn’t get the limelight it deserves, but, without it, MedFlight would not be who we are today.  To all of our partners that have served and continue to serve on the Mobile ICU teams…. THANK YOU.  And congratulations on 20 great years of service.

~ Tom Allenstein, President and CEO of MedFlight

MedFlight Trialing Transport Telemedicine

telemedicine

MedFlight is beginning an exciting new venture!  Our Columbus-based Mobile ICU team, MedFlight 12, will be involved in a groundbreaking Critical-Care Transport Telemedicine trial.

For 60 days, our teams will partner with Ohio State University Wexner Medical Center physicians to further our over-arching goal of enhancing patient care. An interactive, handheld audio/visual device will be placed in the back of the Mobile ICU, and will be moved throughout the vehicle to test to effectiveness of the device on our transports.  Each time the Mobile ICU team contacts MedComm to be connected with the on-call Medical Control Physician (MCP), the physician at Wexner Medical Center will log into a computer and “beam in” to the telemedicine device.  The physician will get to see the patient in real-time and help guide the care based on both what the MedFlight team tells them and also what they visualize.

“Historically, when physician medical direction is needed, the physician speaks to the transport crew either on the phone or on the radio, limiting our patient assessment to a mental picture and voice communication,” states MedFlight Medical Director Dr. Howie Werman.  “This telemedicine device allows the physician to see the patient, their symptoms, and their reaction to treatment, allowing for a better overall assessment during the transport phase.”

We will be tracking and surveying transports that include transport telemedicine with our transport debrief system that occurs at the completion of each MedFlight patient transport.  This quick and easy 10-question survey will help the Telemedicine team at Wexner Medical Center evaluate the usefulness of this device in the intra-hospital transport setting.

We’re proud to work with The Ohio State University Wexner Medical Center on this venture.  This effort is only part of our constant drive to enhance patient care and recovery.  Partners for Life.

MedFlight is proudly owned and preferred by both The Ohio State University Wexner Medical Center and OhioHealth.

 

–  Caitlin Mazer, MedFlight Mobile ICU RN