Air Care Series is back! This time with one of the most feared procedures in pre-hospital medicine: the Resuscitative Hysterotomy (aka peri-mortem c-section). Pregnant patients scare us, but coding pregnant patients scare us even more. Read on to learn not only when to perform this procedure, but how to perform it properly and safely.
Read MoreThis is Case #2 of our Air Care Orientation Curriculum! This curriculum is designed to help prepare our rising R2's for their new responsibility as flight physicians. These cases are discussed amongst our training flight docs and this is the resultant learning points. In this case, we discuss a critical patient with a head injury. What interventions need to be performed? In what order? Who should do them? Read on to find out.
Read MoreThis is Case #1 of our Air Care Orientation Curriculum! This curriculum is designed to help prepare our rising R2's for their new responsibility as flight physicians. These cases are discussed amongst our training flight docs and this is the resultant learning points. In this case, we discuss a sick trauma patient that needs multiple interventions. But what interventions need to be done? In what order? And who should do them? Read on to find out!
Read MoreThe first installment of our new AirCare series! We start off with one of the most anxiety provoking scenarios we encounter on AirCare: the pediatric airway. Read on to learn how to calmly and methodically manage this difficult patient.
Read MoreThanks to all those who participated in the discussion and to those who tuned into the “Flights” cases throughout the spring and summer. The final "Flights" cases centered in on several challenging airway scenarios. Penetrating neck trauma with a tracheal injury; GSW to the face with significantly altered anatomy; and a tracheostomy displaced and a patient with critical hypoxia - airway management in the field requires a nimble mind and knowledge of one's own equipment. Take a look at our thoughts on the cases and see what you might do in similar situations.
Read MoreIt is a beautiful sunny Memorial Day and you arrive early for your C-pod shift, energized by the knowledge that you will be getting out early with time to enjoy the day. Your patients are an enjoyable mix of pathology and acuity and everyone is quite polite and gracious. The tones drop just before it is time to hand over the radio to the dedicated flight doc and you can’t but marvel at your good fortune. You grab the blood and head up to the helipad for your flight...
Read MoreApproximately 1 month ago we presented and talked through a particularly challenging patient flight scenario. As a refresher, if you don’t recall, check out the post here. Following the posting of the case, I sat down with ACMC Medical Director Dr. Bill Hinckley and Resident Assistant Medical Director for Air Care, Dr. Andrew Latimer, and recorded a podcast with their reaction to the case and to some of the curveball scenarios posed in the question and discussion section.
Read MoreIt is late on a blustery grey and rainy day in November and you are the dedicated flight doc on Air Care One (the “UH”) nearing the end of your shift. Your pilot has had to turn down two flights already due to high winds and reduced visibility as bands of storms moved through the area. Against your better judgment, you are standing in the sushi line in the hospital cafeteria to grab dinner when you hear “Air Care One Pilot, weather check for a patient coming back to the U” squawk out over your portable radio. Your excitement rises as “we can do that” echoes over the radio and you hear the tones drop for your flight. You grab the blood cooler and meet your crew for takeoff on the roof...
Read MoreIt’s true that sometimes critical care transport missions to transport STEMI patients to PCI are fairly uneventful. But if we allow ourselves to get lulled into a “Milk Run” mindset, it will most definitely come back to bite us. The jovial, normotensive, fairly comfortable-appearing STEMI patient may be only a couple of minutes away from V Fib arrest or florid cardiogenic shock. When that occurs, if we have expected and prepared for such a complication, it’s likely that we’ll be able to manage it successfully.
Read MoreIt is early October and you are the flight doc in C-pod on a brisk but clear Saturday morning. The day starts out with several challenging patients with vague complaints and has just begun to ramp up in volume when a patient rolls into your pod by EMS, restrained face-down to the cot, covered in feces and urine, screaming about hearing voices. You begin to take report from EMS when, as if by divine intervention, the tones drop and you are dispatched for an inter-facility transfer. You gleefully (almost too gleefully…) give a brief patient sign-out to your staff, grab the blood cooler, and head to the roof...
Read MoreA couple of weeks back, we kicked off our “Flights” portion of our Air Care Orientation Curriculum. Dr. Latimer outlined a challenging patient case for use to consider and an excellent discussion ensued. As a reminder of the case, here’s how it was posed:
Your patient is a 56 year-old male with unknown medical history who was an un-helmeted motorcyclist found in a ditch roughly 40 feet from his motorcycle which was discovered in the middle of the road by a passing motorist. The accident was un-witnessed, but the bike was found just beyond a sharp downhill curve in the rural farm road. EMS has BLS capabilities only and they have placed the patient on a backboard and loaded him into the unit.
Read MoreIt is mid July and your first shift as the coveted H2 Doc at Air Care 2 is finally upon you. It has been an especially warm and beautiful Saturday and you ponder the possible flights for the evening as you take the scenic drive to Butler County Regional Airport.
You finish checking the aircraft with the flight nurse and sit down to begin the 20:30 brief with the flight crew when the tones drop and you are dispatched for your first flight of the evening, a scene flight to Franklin County, Indiana for an “un-helmeted motorcyclist”. You grab the blood cooler, perform a safety walk-around the aircraft and strap yourself in back
Read MoreThanks to everybody who commented and contributed to the discussion on our final “Flight!” If you missed out on the case, check it out here. Below you’ll find a curation of the comments to each question and a podcast with expert commentary from Jenn Lakeberg, APRN. This was the final “Flight” for this spring/summer. Look for the cases to return again in January 2016 as we begin Flight MD Orientation with the next class of future Air Care Flight Docs.
Read MoreYou are sitting on the helipad during your UH shift talking with the flight nurse when the tones drop for a pediatric scene call. You gather yourself after you have that crap your pants moment that everyone has with pediatric scene calls and whip out your smart phone with your pediatric application of choice. You begin to write down doses and sizes on your tape on your leg based on the report of the patient’s weight from the providers on scene.
You land in an elementary school parking lot to the delight of the children at the local school. Cars begin to slow and pull over as you exit the helicopter and walk to the squad. You walk to the side door of the ambulance and find 6 EMTs crammed in the squad.
Read MoreThanks to everybody who chimed in on our last "Flight"! We had a great discussion on the management of the STEMI transfer patient. These aren't just "milk runs" as pointed out by Dr. Hinckley. The highlights of the discussion are below with additional commentary on the case by Dr. Bill Hinckley and Air Care Resident Assistant Medical Director Dr. Matt Chinn. Out final flight will be lifting off June 1 and it's a doozy - looking forward to the discussion!
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
