Fly Guides to the Rescue!

Some situations leave health care providers uncertain whether an Air Care transfer to a trauma center is appropriate. Fly Guides to the rescue!  These handy reference cards are free from Air Care and have been sent to community hospitals, EMS agencies, and fire departments throughout Southwest Michigan. The old standards were based on mechanism of injury, but the new guidelines are based on the actual presentation of the patient.

If you’ve ever been in these tricky situations, the Fly Guides can help:

A motor vehicle rollover crash victim is walking about the crash site with an upper extremity fracture. Distal pulses are intact and the patient’s vital signs are stable. His Glascow Coma Score is 15 and he reports no loss of consciousness, but the car is damaged beyond recognition. Should you transport via helicopter to a trauma center based on mechanism of injury?

  • Firefighter: No. According to the First Responder Fly Guide, the patient does not meet physiologic criteria to require air transport and a trauma center.
  • Paramedic: No. Patient condition does not meet physiologic criteria according to the Paramedic Fly Guide. 
  • Community hospital: No. Patient does not require transfer to a specialist at a trauma center according to the Community Hospital Fly Guide.

The victim of a motorcycle vs. deer accident is lying in the middle of a county road. He has a closed right femur fracture and cannot move his legs. He has total recall of the accident. Should you launch or put Air Care on stand-by for this patient?

  • Firefighters: Stand-by. The patient is not able to move non-injured extremities on command.
  • Paramedics: Launch. Traumatic paralysis is present.
  • Community Hospitals: Launch. The patient has a time dependent need for neurosurgical evaluation and potential surgical intervention for spinal cord injury at a trauma center.

Your patient fell 10 feet from a tree stand and can’t recall prior events. His vital signs are stable but he loses and regains full consciousness repeatedly. Can I launch Air Care based on Fly Guide activation criteria?

  • Firefighters: No, but you can put Air Care “on stand-by” and assist paramedic evaluation with your prior observations.
  • Paramedics: Yes. Potential loss of airway may require rapid sequence intubation (RSI). RSI medications are very important to prevent increased pressure from further damaging the brain.
  • Community Hospitals: Yes. This patient will require specialist evaluation at a trauma center.

As you can see, the Fly Guides are helpful when you want to back up your decision-making with support from the Centers for Disease Control and the Michigan Trauma Coalition. West Michigan Air Care developed the Fly Guides using these national and state recommendations. Provider levels are carefully taken into account and 911 Dispatchers have their own Fly Guides as well. Both trauma centers in Kalamazoo have approved the Fly Guides. You can find copies of the Fly Guides online or contact us at 1-800-922-1234.

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