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Reconfiguring the EC145 for Two Patients
Air Care Orientation Curriculum, Prehospital Medicine Bill Hinckley, MD Air Care Orientation Curriculum, Prehospital Medicine Bill Hinckley, MD

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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Lessons in Transport - Surviving Sepsis Part 2
Prehospital Medicine Ryan Gerecht, MD Prehospital Medicine Ryan Gerecht, MD

Lessons in Transport - Surviving Sepsis Part 2

"Around every 3rd heartbeat someone dies of sepsis"

Blood Product Administration:

  • Once tissue hypoperfusion has resolved and in the absence of extenuating circumstances, such as myocardial ischemia, severe hypoxemia, acute hemorrhage, or ischemic heart disease, we recommend that red blood cell transfusion occur only when hemoglobin concentration has decreased to < 7.0 g/dL to target a hemoglobin concentration of 7.0-9.0 g/dL in adults (grade 1B).
  • FFP NOT be used to correct laboratory clotting abnormalities in the absence of bleeding or planned invasive procedures (grade 2D).
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Lessons in Transport - Surviving Sepsis
Prehospital Medicine Ryan Gerecht, MD Prehospital Medicine Ryan Gerecht, MD

Lessons in Transport - Surviving Sepsis

We routinely transport patients with severe sepsis and septic shock by both air and ground. Take a few moments to review these high yield management pearls from the 3rd edition of the Surviving Sepsis Campaign Guidelines.

Initial Resuscitation:

  • Goals during the first 6 hours of resuscitation:
  • CVP 8-12 mmHg (a debate on the utility of CVP or lack their of is beyond the scope of this LIT)
  • MAP >  65 mmHg
  • Urine output >  0.5ml/kg/hr
  • Central venous or mixed venous oxygen saturation 70% or 65% respectively (grade 1c)
  • In patients with elevated lacate levels we should target resuscitation to normalize lactate (grade 2c)
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