Air Care Orientation Case #1

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Air Care Orientation Case #1

This 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!

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Protect Me! "Flights" #4 Recap

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Protect Me! "Flights" #4 Recap

Welcome to the Final Recap of our “Flights” Case Series!

Thanks 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.

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"Protect Me" - Flights Case 4

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"Protect Me" - Flights Case 4

Welcome to the Fourth Case in our Air Care and Mobile Care Flight Orientation Curriculum for 2016! 

It 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...

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Out of Hospital Cardiac Arrest - Part 2

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Out of Hospital Cardiac Arrest - Part 2

The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016.  We are honored to be able to engage EMS Providers throughout the world with this forum.  If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments.  For this podcast, we were joined by Dr. Dustin Calhoun, Associate Director of the UC Division of EMS, as well as two of this year’s UC EMS Fellows, Dr. Mike Bohanske and Dr. Justin Benoit.

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Out of Hospital Cardiac Arrest - Part 1

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Out of Hospital Cardiac Arrest - Part 1

The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016.  We are honored to be able to engage EMS Providers throughout the world with this forum.  If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments.  For this podcast, we were joined by Dr. Dustin Calhoun, Associate Director of the UC Division of EMS, as well as two of this year’s UC EMS Fellows, Dr. Mike Bohanske and Dr. Justin Benoit.

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Pre-Hospital Trauma Care – Lessons Learned From the Front

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Pre-Hospital Trauma Care – Lessons Learned From the Front

The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016.  We are honored to be able to engage EMS Providers throughout the world with this forum.  If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments.  For this podcast, we were joined by Dr. Jay Johannigman, Chief of the Division of Trauma and Critical Care at the University of Cincinnati.  Dr. Johannigman has over thirty years of military experience which includes 6 deployments to Iraq and Afghanistan.  Dr. Johannigman joined us to discuss how the military experience has changed civilian trauma care in the United States.    

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Pre-Hospital STEMI Care

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Pre-Hospital STEMI Care

The UC Division of EMS has recorded a series of podcasts to celebrate EMS Week 2016.  We are honored to be able to engage EMS Providers throughout the world with this forum.  If you practice pre-hospital medicine, we would like to say thank you and that we appreciate everything you do to provide a high level of care to ill and injured patients in a wide variety of austere environments.  For this podcast, we were joined by Dr. Tim Smith, an Interventional Cardiologist and Director of the Cardiovascular Intensive Care Unit at the University of Cincinnati Medical Center.  Dr. Smith joined us to discuss our region’s partnership with the American Heart Association’s Mission Lifeline program to bring a regionalized system of care for STEMI patients to our area.  

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Pre-Hospital Stroke Care

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Pre-Hospital Stroke Care

Pre-hospital stroke care begins with a quick, simple assessment tool used to help identify patients that are suffering a stroke.  In Southwest Ohio, this tool is the Cincinnati Pre-hospital Stroke Scale (CPSS).  There are three simple components of the CPSS – facial droop, arm drift, and slurred speech.  When assessing for facial droop, it is best to ask patients to bear their teeth.  Arm drift is assessed by asking the patient to hold both arms outstretched in front of them with their palms facing up.  If one arm drifts down or one hand rotates to a palm-down position, this aspect of the scale is positive.  Lastly, ask the patient to repeat a sentence to assess for slurred speech or any other type of speech abnormality.

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Grey Matters - Flights Case 3

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Grey Matters - Flights Case 3

It 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...

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A Look into the Code STEMI - Flights Case 2 Recap

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A Look into the Code STEMI - Flights Case 2 Recap

It’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.

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Flights - Un-Break My Heart

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Flights - Un-Break My Heart

It 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...

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A Lonely Road - Recap and Expert Commentary

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A Lonely Road - Recap and Expert Commentary

A 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.

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"Flights" - A Lonely Road

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"Flights" - A Lonely Road

It 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

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The Little Things that Matter

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The Little Things that Matter

We were fortunate, a couple weeks back, to have Dr. Brian Burns of Sydney HEMS come and speak to us.  In his lecture, “When the 1% Makes All the Difference” which you can find here, Dr. Burns hit on a number of excellent points.  We sat down and talked with Dr. Burns a bit more extensively over a couple of the themes of his lecture.

In this podcast, we cover some of the plus/minuses of checklists, the importance of high fidelity continuous training practices (simulation, routine case debriefing, intensive induction training), and the role of cognitive factors in running resuscitations.

Should resuscitations run like a jazz quartet or a Formula 1 pit crew?  Are checklists simply in the way or do they cognitively unload the team members to improve performance?  How do you train cognitive factors in resuscitation?

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