On Tourniquets and Lives Saved

On Tourniquets and Lives Saved

Though tourniquets were likely in use since Roman times, the term “tourniquet” was originally turned by Louis Petit, the 18th century inventor of the screw tourniquet.  Though numerous design advancements have occurred and new devices have been made in the centuries that have followed, the basic principles of tourniquet use are essentially unchanged.  A tourniquet applies an external pressure to a limb (usually) that exceeds the arterial pressure in that extremity.  In this way the inflow of arterial blood to an extremity is stopped.  For a surgeon, in the setting of a prospective extremity surgery, this allows for the creation of a bloodless operative field.  For Emergency Medicine providers, tourniquets can aid in the exploration of extremity wounds, allowing the identification of injuries to tendons, joints, and vascular structures.  And perhaps most importantly, tourniquets applied proximal to the site of penetrating traumatic extremity injuries can cease bleeding from arterial injuries.

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Reconfiguring the EC145 for Two Patients

Reconfiguring the EC145 for Two Patients

Our EC145 aircraft have the capability to fly two patients.  However, doing this is never our preference.  Those of us who have had the chance to fly two patients can attest that it’s quite challenging, especially if one or both are truly critically injured.  Your crew:patient ratio is halved.  And if you’ve ever thought that ergonomically your space was limited in the helicopter with only one patient, it’s much worse when there are two.  Therefore, we always teach our EMS colleagues: if you’ve got two patients you need to fly, ask for two helicopters.

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Multiple Helicopter Scenes

Multiple Helicopter Scenes

It is not uncommon for multiple helicopters to land on the scene of a multi-car accident or a single vehicle accident with multiple seriously injured victims.  Assessing, caring for, and transporting multiple victims adds a significant amount of complexity to these scene flights.  With multiple helicopters flying in, it is especially crucial that we heed all the lessons of crew resource management.  Situational awareness both in the air and on the ground is key.  But the challenges of multiple helicopter scenes are not limited only to safety considerations.

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Survival and the Rule of 3's

Survival and the Rule of 3's

Thankfully survival situations are uncommon.  Because these situations are so uncommon, however, when confronted with a survival situation, we often find ourselves woefully unprepared.  Some of us have had formal survival training through Boy Scouts/Girl Scouts/military/Wilderness Medicine courses.  Many of us, however, have had to rely on the Air Care & Mobile Care training sessions or maybe even what we see on Survivorman or other such TV shows.  Some of us may hope just being near Dr. Mel Otten has allowed us to glean the crucial bits of knowledge we may need.

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Keep Calm and Don't Walk into the Tail Rotor

Keep Calm and Don't Walk into the Tail Rotor

Funny things happen when you start work in new environments.  Surely most clinicians have experienced this first hand.  Think back to that first time you scrubbed in and walked into an operating room, the first time you set foot in an ICU, the first time you worked in an ED different than the one you trained in.  What was that like? overwhelming? empowering? disorientating?  Did you ever get caught up in just trying to figure out where the heck the 25 gauge needles and 10 ml syringes were in the supply closet?

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Crew Resource Management: Lessons from the World of #FOAMed

Crew Resource Management: Lessons from the World of #FOAMed

On Monday we published our first post in the Air Care and Mobile Care Online Flight Physician Orientation on Crew Resource Management.  Also on Monday afternoon we were able to tweet with some of the leaders in Prehospital Medicine and Helicopter EMS from around the globe.  We'll try to do this throughout the course so we can leverage the full power of free online access to medical education.  If you follow on twitter you may have caught the conversation, but in case you missed it, I've storify'd the tweets (embedded below) for you.

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Crew Resource Management

Crew Resource Management

We kick off the Air Care & Mobile Care Online Orientation with posts on some of the most important aspects of helicopter EMS - safety, survival and the basics of operating around the helicopter as a crew member.  We’ll start off by talking about Crew Resource Management (CRM).  In this first podcast, chief pilot Bob Francis, flight nurse Dennis Schmidt, and Dr. Ryan Gerecht sit down and talk about the basics of CRM and what it means to pilots and flight crew.

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