"Flights" - A Lonely Road

/
"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

Read More

Running a Code (in Tight Quarters)

/
Running a Code (in Tight Quarters)

How many hands does it take to run a code?   Think about that for a bit...

In the SRU, the available hands seem essentially limitless.  There's a train of PCAs and medical students lined up to perform CPR, a nurse to run the monitor and defib, a nurse and/or pharmacist pulling up meds and mixing drips, a nurse charting, a MD dedicated to the airway, a RT to help with bagging, not to mention the MD running the whole show.  At a minimum you probably have 10 hands ready to ensure compressions are as uninterrupted as possible, to keep a check on the respiratory rate, to hook up monitors, push meds, defib, and all the other tasks that are necessary to code a patient.

Now what do you do in the back of the helicopter when a patient loses a pulse?

Read More

Lessons in Transport - Plasma? We Got That...

/
Lessons in Transport - Plasma? We Got That...

Why is Air Care starting to transport and infuse plasma? Multiple studies, many from military combat zones, strongly suggest that clinical outcomes are improved by administration of plasma alongside RBCs in a 1:1 ratio. (1,2) Furthermore, the concept of damage control resuscitation advocates for minimizing crystalloid infusion and maximizing early aggressive resuscitation with blood products in patients with life threatening hemorrhage. Recent unpublished analysis suggests that expanding these resuscitation principles to the prehospital environment via helicopter EMS was associated with improved outcomes.

Read More

Application of Pelvic Binders

/
Application of Pelvic Binders

As we mentioned in the podcast that accompanied our most recent post, an injury that is critical to identify in blunt trauma yet easy to miss or forget is pelvic fractures and pelvic trauma.  Significant injuries occurring to the pelvic ring usually involved high mechanisms of injury such as high speed MVCs, motorcycle crashes, pedestrian struck, and falls from significant height.  Pelvic fractures can be associated with a significant amount of bleeding, hypotension, and increased mortality.  Mortality for all trauma patients with pelvic trauma ranges from 5-30%.  If there is associated hypotension, mortality rises to 10-42%

Read More

Survival and the Rule of 3's

/
Survival and the Rule of 3's

Thankfully survival situations are uncommon.  Because these situations are so uncommon, however, when confronted with a survival situation, we often find ourselves woefully unprepared.  Some of us have had formal survival training through Boy Scouts/Girl Scouts/military/Wilderness Medicine courses.  Many of us, however, have had to rely on the Air Care & Mobile Care training sessions or maybe even what we see on Survivorman or other such TV shows.  Some of us may hope just being near Dr. Mel Otten has allowed us to glean the crucial bits of knowledge we may need.

Read More