WayP INTS - Air Evac Lifeteam

CelebraƟng Our 30th Year
Summer | 2015
Volume 1 Issue 1
WayP INTS
www.lifeteam.net
1-800-AIR-EVAC
Intra-AorƟc Balloon Pump Program Expands
Air Evac Lifeteam is excited to expand its
intra-aor c balloon pump (IABP) service in
Kentucky, in both helicopter and fixed wing
aircra .
Air Evac Lifeteam began offering IABP
service in July, 2012, from its Danville, Ky.,
base, which is accredited by the Commission on Accredita on of Medical Transport
Systems for IABP transports. The service
Danville Flight Nurse Mandy
Sikes adjusts the IABP while
loading the pa ent.
IABP Competencies
All medical flight personnel at our bases
which offer IABP services complete quarterly competencies.
First and third quarter competency
requirements consist of on-line learning
modules with associated exams. Competency requirements for second and fourth
quarters consist of hands-on educa on,
loading and un-loading, and equipment
check off verifica on.
is now available at our
helicopter and fixed-wing
bases in Whitley County.
In addi on to our three
Kentucky bases that offer
IABP service, southwestern Kentucky is further
supported by IABP
transfer service from our
neighboring Lafaye e, Tenn.,
base. Air Evac’s The Danville flight crew
Whitley County prepares to load a pa ent
who is receiving circulatory
and Poplar
assistance from the IABP
Bluff, Mo., fixed device into their helicopter.
wing bases can
myocardial oxygen demand.
support the other 13 Kentucky
The IABP is used as a suppor ve treatbases which don’t currently offer
ment tool in:
IABP service.
The IABP service is available
• cardiogenic shock;
24/7, and all medical personnel
• post bypass;
at our IABP bases have met their
• post MI;
competencies for using the IABP.
• cardiomyopathy;
Air Evac Lifeteam uses the Maquet CAR• severe Ischemic Heart Disease awai ng
DIOSAVE Rescue IABP. This is the smallest
surgery or sten ng;
and lightest intra-aor c balloon pump produced by Maquet and is designed to meet
• severe acute mitral regurgita on awai ng
the rigorous requirements of transpor ng
surgery;
pa ents by ground or aircra ambulances.
• prophylac cally in high risk pa ent preThe size and weight reduc on make for
sten ng/cardiac surgery;
significantly easier li ing and placement
•
post myocardial contusion which is exinto the vehicle, while the hot-swappable
pected to recover with me.
lithium ion ba eries offer poten ally unlimited run- me with spare
The IABP is loaded into our
ba eries.
Whitley County fixed-wing
aircra for transport.
The IABP is a mechanical pa ent care device
that increases myocardial oxygen perfusion and
cardiac output. The device controls a polyethylene balloon which is
placed in the aorta that
ac vely deflates during
systole and inflates in
diastole, increasing perfusion to the coronary
arteries and decreasing
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WayP INTS: Summer 2015
1-800-AIR-EVAC
www.lifeteam.net
Neurogenic Shock
versus Spinal Shock
By Samantha Greer, RN
Air Evac supports
prom safety in its
communiƟes
Spring is a wonderful me of the year,
especially for our high school students
as they prepare to magically step into
the spotlight and shine with the arrival
of prom season.
Air Evac Lifeteam is honored to partner with high schools, police, fire and
EMS agencies in our many communi es,
working together to help make prom a
very happy memory instead of a tragic
one.
High schools in many of our communi es require seniors to a end a
“Prom Promise” demonstra on where
the damaging effects of poor choices
are emphasized. Many of these programs educate student leaders in smart
choices before the demonstra on, so
that the message ul mately comes
from their peers and those whom other
students respect.
Air Evac Lifeteam feels this is me
and money well spent. If you would like
more informa on on this program for
next year, please contact your local Air Evac Lifeteam base.
A mock pa ent is loaded
into Air Evac 62 for “transport” during an Edmonson
County Prom Promise
demonsta on.
Neurogenic shock and spinal shock are two
completely different terms and are very different condi ons, although many healthcare
providers use the terms interchangeably.
Spinal shock is a term that simply means
that the pa ent has lost reflexes below the
level of the injury which can occur at any
level of the spinal column.
Neurogenic shock, on the other hand, is
very different. It is a form of hypovolemic
shock and affects the hemodynamic status of
the pa ent.
Spinal shock has no effects on the hemodynamic status of the pa ent.
Listed below are some of the key factors
associated with neurogenic shock.
Neurogenic shock and pathophysiology:
Pa ents lose sympathe c tone. They are
unable to vasoconstrict because the sympathe c nervous system cannot be
inac vated. This results in massive
vasodila on.
Neurogenic shock typically occurs
with injuries in T6 or above. Spinal
shock can occur at any level.
pressor you are using in stock, especially
for long transports, because pa ents in
neurogenic shock some mes require large
amounts of vasopressors.
Be sure your pump is set up and ready
to go and that there are no bubbles in the
line. Pa ents are very sensi ve and do not
respond well to a pause in the vasopressor —
even for a couple of minutes — so you must
ensure that the pump is set up and ready to
go, thereby reducing the risk of hypotension.
Pa ents are at high risk for hypothermia.
Remember to assess for poikilothermia and
provide warming or cooling methods based
on the temperature.
Also keep in mind that the pa ent has
poten al for compromise in airway and
breathing status due to the spinal injury.
That risk increases when the injury is higher
on the spinal cord. Do everything you can to
maintain spinal precau ons and have airway
equipment ready if the pa ent is not
already intubated.
Signs and symptoms of neurogenic
shock:
•
•
•
•
Bradycardia
Hypotension
Warm, dry skin
Priapism, which results due to
loss of sympathe c tone
• Poikilothermia, the inability to
regulate core body temperature.
Because the pa ent cannot control his/her body temperature,
the body temperature adopts the
room temperature.
Treatment and transport consideraƟons:
Pa ents typically have enough volume
unless they are in hypovolemic shock simultaneously, so they only need a small bolus
before vasopressors are ini ated. Vasopressors allow the pa ent to constrict since the
sympathe c nervous system no longer works.
Make sure you have plenty of the vaso-
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It should be noted
that the pa ent with
spinal cord injury and
neurogenic shock as a
result of trauma o en
has other injuries that
could result in hemorrhagic shock.
1-800-AIR-EVAC
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Customer Spotlight:
Taylor Regional Hospital
Taylor Regional Hospital is located in
Campbellsville, right in the center of Kentucky. The county-run hospital is also home
to Air Evac 43.
The 90-bed hospital serves 110,000
residents living and working in the regional
area and was the first of only two Level III
Trauma Centers in Kentucky. Taylor Regional
Hospital is also the longest consistently
verified Level III trauma center in the United
States.
Air Evac Lifeteam opened its Campbellsville base, located at the rear of the hospital
next to the helipad, in November, 2004. Air
Evac is very proud of the partnership it has
built over the years with Taylor Regional
Hospital, as is the hospital.
“We know we have a partner that we can
call on for commi ee advice, con nuing
educa on classes, and their exper se working together for what’s best for our pa ent,”
said hospital CEO Jane Wheatley.
“This is one of the closest rela onships
that I have seen in our company,” said
Dan Durham, senior program director for
Air Evac 43. “From the beginning Taylor
Regional Hospital made a commitment to
Air Evac Lifeteam and embraced us as a true
partner.”
Wheatley explained that this has to be a
true partnership, so her hospital is committed to suppor ng the Air Evac Lifeteam base
just as much as Air Evac supports Taylor
Regional Hospital.
“We give them space for classes, and allow their staff to join our classes,” she said.
Taylor Regional CEO Jane
Wheatley and Air Evac
43 Program Director Dan
Durham at the hospital
entrance.
WayP INTS: Summer 2015
“People in our community look at Air Evac
as part of the hospital.”
When Taylor Regional Hospital planned to
construct its new surgery center, displacing
the Air Evac base and helipad, the hospital
worked with Air Evac facility managers to
find the best physical loca on for the base
and helipad on campus. For Wheatley, this
exemplifies the success of the partnership.
“Our availability to them to provide
access for their pa ents has greatly improved the care of their pa ents,” Durham
explained. “This is a partnership that has
already stood the test of me, and I see it
las ng a long me. Taylor Regional Hospital
and Air Evac Lifeteam have both proved
their commitment to each other.”
“Taylor Regional Hospital is very special
to me,” Durham said. “I have worked there,
I met my wife there, and all three of my
children were born there.”
“In 2005, I fully believe the partnership
made a real difference in my life,” Durham
con nued. “While serving as director of the
local EMS service, I suffered a STEMI. The
fact that AEL was on campus meant I got to
the Cath Lab in Louisville in less than two
hours of my onset of symptoms.”
Wheatley is very complimentary of the Air
Evac flight crew members.
“People in our community are pre y
protec ve,” she said. “They want someone
they know taking care of them.”
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WayP INTS : Summer 2015
www.lifeteam.net
AdvocaƟng for EMS
Air Evac Lifeteam’s Joe Bradshaw, Mark
Harrison, and John Hultgren spent Na onal
EMS Week in Washington, D.C., as members
of the Kentucky Ambulance Providers Associa on Congressional Delega on, mee ng
with Kentucky’s members of congress to
advocate for emergency medical services.
Ambulance services are a cri cal component of our local and na onal health
care and emergency response systems, but
ambulance providers are facing a serious
financial crisis due to chronic below-cost
Medicare reimbursement.
The delega on explained the scope of the
problem in Kentucky to members of the U.S.
Congress. The group provided local facts
and financial figures, and then asked their
congressmen to support H.R. 745, H.R. 822,
and S. 377. These bills, known as the Medicare Ambulance Access, Fraud PrevenƟon
and Reform Act, would address the problem
with a permanent 2 percent increase for
urban ambulance transports, a 3 percent increase for rural area transports, and a bonus
reimbursement for ambulance transports
origina ng in super rural areas. The bills
would also address fraud and abuse and
would change the status of ambulance service suppliers to providers and collect cost
data from a sta s cally significant number
of each type of ambulance service provider
to help determine actual costs.
The delega on also provided an update
on generic emergency medica on shortages
to the congressmen.
Air Evac Lifeteam is
commi ed to ac vely suppor ng our partner
organiza ons.
From le , U. S. Representave Bre Guthrie (KY-2) discusses permanent Medicare ambulance
reform with Kentucky Ambulance
Providers Associa on President Tom
Adams and board members Mark
Harrison and Joe Bradshaw in
his Congressional office.
A ACCOUNTABILITY
C COMMITMENT
C COMMUNITY
E EXCELLENCE
S SAFETY
S STEWARDSHIP
Air Evac Lifeteam provides ACCESS. In its
simplest form, we provide ACCESS to cri cal medical care for those who may not be
close to cri cal medical services when they
are needed. We do that very well. But to us,
ACCESS means so much more.
Access is our road map — it’s the guide to
our values-based culture. And these values
are very important to us. They are how we
hire, they are how we grow, and they are at
the heart of our culture. ACCESS is the essence of our company’s iden ty.
These values guide us in our decision-
4
making process, and they help
us help educate our pa ents and
customers about Air Evac Lifeteam.
Every employee learns these values, and every employee is expected
to commit to them.
When you interact with one of our
staff, you should expect this same level
of commitment. Please
hold us accountable.
1-800-AIR-EVAC