It's a tricky spot for any health care provider to be in: Is this patient hurt enough or sick enough to call Air Care? Should I put Air Care on standby or wait for the paramedic to arrive? Making a decision under high pressure is difficult without clear guidance, but West Michigan Air Care is here to help.
"People don't want to make a mistake," said Kevin Franklin, flight nurse and Utilization Review Coordinator for Air Care. That's why Kevin created regional helicopter activation criteria or Fly Guides, a portable "advisor" that indicates when to call Air Care for critical medical or trauma patients. Doctors, nurses, EMS providers, first responders, and even dispatchers can consult their respective Fly Guides to determine whether to call Air Care. Borgess and Bronson Trauma Services fully support the Fly Guides.
Air Care's new helicopter activation criteria for trauma are based on recommendations handed down from the CDC and the Michigan Trauma Coalition which are more helpful and specific than the old "mechanism of injury" criteria. Our Fly Guides have been adapted specifically to southwest Michigan's trauma system and provide physiologic criteria, which helps providers activate the helicopter earlier and with more confidence that they're sending an appropriate patient.
It's easy to find your Fly Guide at www.AirCare.org. Just click on the When to Request tab and then select the version for your level: Community Hospital, Paramedic, First Responder or Public Safety Access Point (911 Dispatchers).
Jackson County Ambulance Uses Air Care's Paramedic Fly Guide Principles
On July 12, 2010 at 8:22 p.m., the Air Care "ship check" and nightly duties had just been completed when the tones went off for a "go-scene flight". At 8:26 p.m. Air Care's Dauphin helicopter lifted from the helipad en route to Jackson County for a scene rendezvous with an ALS ambulance. During the 60+mile, 21-minute flight to the rendezvous point, it was reported that Jackson County Ambulance Service was transporting a 15-year-old patient when they encountered significant complications and were still more than an hour from their destination hospital.
When the Air Care medical crew arrived, the patient was found to be in respiratory failure and hypoxic despite maneuvers attempted by EMS. The ground crew also reported prolonged seizure activity prior to Air Care's arrival. Air Care's medical crew quickly performed a rapid sequence induction (RSI) with an optical laryngoscope to secure the airway. Since the patient had recently been diagnosed with a neural abnormality, transport was resumed via air to a specialized pediatric neurosurgical facility and ventilations were supported with the on-board ventilator. A loading dose of the anticonvulsant Dilantin was administered to prevent a recurrence of seizure activity.
As Air Care arrived at the pediatric neurosurgical hospital, the patient's vital signs were stable and within normal limits. Oxygen saturations, EtCO2, and minute ventilation had been maintained throughout his care and no further seizures were encountered. The patient remained hospitalized and completed a neurosurgical repair without further incident.
This is just one real-life example of regional EMS crews calling Air Care appropriately for the definitive care and speed of transport we bring to the bedside of every patient. Air Care's Fly Guides can help you do this every time. Whether you are calling from the field or from a regional facility, requesting Air Care not only extends your resources, but can also lead to improved patient outcomes.
By Kevin Franklin, CFRN/EMT-P
West Michigan Air Care