FLIGHTnotes. Teamwork Makes a Difference in Ashland. Call Metro Life Flight: LIFE (5433)

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1 FLIGHTnotes Updates from Metro Life Flight Fall 2010 Teamwork Makes a Difference in Ashland Emergency Rooms often change dramatically within minutes when several trauma patients arrive along with a serious brain aneurysm. This rush can be overwhelming for all involved; however, the Samaritan Regional Hospital staff knows who to call when a critical patient needs to move fast: Metro Life Flight. Since Metro Life Flight moved to its Wayne County base one year ago, Samaritan staff have been elated with faster response times and greater accessibility. According to the Emergency Department Medical Director, Mark Grimes, MD, Metro Life Flight is the transport provider of choice at Samaritan. With each patient transport, Dr. Grimes says he is consistently impressed with Metro Life Flight s crew and how they interact with his staff while caring for the patient. Chad Kaufman, PA-C, Terry Dougan, PA-C and Mark Grimes, MD The crew is extremely competent and knowledgeable and they work with us as a team, explains Dr. Grimes. They come in and support our efforts; they never ask us to step aside so they can take charge. We work in conjunction and that s the way we like it. Furthermore, Dr. Grimes and two physician assistants, Terry Dougan, PA -C, and Chad Kaufman, PA-C, mentioned the improved patient follow-up process from the Flight Nurse Specialists. We want feedback on our patients and appreciate the follow-up phone calls from the nurses, says Dougan. MetroHealth Medical System provides auto acceptance for the majority of trauma and neuro patients from Samaritan, which keeps the doctors and PA s bedside as opposed to wasting time on the phone. Patient information includes feedback from transport to approximately hours after arriving at MetroHealth. Consequently, if patients are taken to another facility, Metro Life Flight is able to provide patient information on transport only. When discussing teamwork between the Samaritan staff and Life Flight crew, Kaufman referred to a recent incident with multiple traumas, which required two helicopters. While working with a complicated patient, Kaufman appreciated when one of the Metro Life Flight critical care physicians interjected and provided assistance when needed. It got pretty chaotic and he jumped in and helped out. We appreciate those efforts, says Kaufman. As Dr. Grimes rushed to return to his patients, he summarized the relationship between Metro Life Flight and Samaritan staff: Collectively, we have made a significant difference in a multitude of patients lives - and at the end of the day, that s what it s all about. The crew is extremely competent and knowledgeable and they work with us as a team, Call Metro Life Flight: LIFE (5433)

2 METRO LIFE FLIGHT Critical Care Ground Transport Services Metro Life Flight provides a dedicated ground mobile ICU for adult and pediatric patient transfers. Staffed by the Metro Life Flight Critical Care transport team, the unit is based at MetroHealth Medical Center and is readily available to serve your patient s critical care needs. When to Utilize Metro Life Flight Critical Care Ground Transport: Patient s acuity requires critical care transport Local patient transport No appropriate landing zone available for aircraft Patient management is critical, but not time-sensitive Weather prevents air transport * *Please allow our aviation experts to determine if weather is an issue for flight Why Utilize Metro Life Flight Critical Care Ground Transport Service: Only CAMTS (Commission on Accreditation of Medical Transport Systems) accredited program in Cuyahoga County for rotor-wing & critical care ground transport Advanced competency training for medical crew Provides complete critical care backup from the experts at MetroHealth and ability to obtain specialized consultation with MetroHealth physicians Positive patient outcomes depend on the expertise of the nursing and medical personnel as well as the technology available to the crew When it s critical, there is only ONE number to call: Metro Life Flight:

3 Frequently Asked Questions By Craig Bates, MD, Medical Director Many referring physicians we collaborate with have questions regarding the Emergency Medical Treatment and Active Labor Act (EMTALA) relative to air medical transports. Following are some common questions: Q. There are several air medical programs that pick up patients from our facility. Does Metro Life Flight transport patients to other facilities and are we required by EMTALA to use specific air medical programs affiliated with the receiving facility? A. Metro Life Flight will transport the patients to any appropriate tertiary care facility. Metro Life Flight transports patients to Akron, Canton, Cleveland, Columbus, Cincinnati, Youngstown, Pittsburgh or further if necessary. There is no EMTALA mandate that requires use of a specific facility s air medical program. Actually, in some cases, it may be considered a violation of the EMTALA requirements for a receiving hospital to condition its acceptance of an appropriate transfer upon the use of a non-related air medical program utilized to transfer the patient. The referring physician has legal responsibility over transport arrangements and remains responsible for the patient until care is transferred to another physician, either as a member of the transport team or at the receiving hospital. Without a physician on the transport team, the referring physician remains responsible while patient is in transit. Mode of transport is a medical decision best left to the referring physician who is caring for the patient directly and can determine what is ultimately best for the patient s outcome. Q. We appreciate the autolaunch program Metro Life Flight offers for trauma, stroke or STEMI patients; however, does it violate EMTALA to launch your aircraft before obtaining acceptance at a receiving facility? A. Our autolaunch process is EMTALA compliant on a number of levels. Patients would never leave the referring facility before having acceptance from a receiving facility that can handle the medical issue. A patient requiring critical transport typically has an emergency medical condition that likely cannot be stabilized at the referring institution; therefore, these conditions have an EMTALA mandate to be transferred. Facilitating that process shows a good faith effort by all involved to meet the EMTALA obligations. EMTALA does not preclude having the means of transport ready to go before final acceptance is confirmed. Metro Life Flight will not depart from a facility without acceptance. Often times, our Flight Communication Specialists will provide assistance gaining acceptance if needed. For additional questions, please contact Craig Bates, MD, Medical Director at cbates@metrohealth.org or call Metro Life Flight Wins National Competition Metro Life Flight won the METI Cup, an annual critical care skills competition at the Air Medical Transport Conference. Metro Life Flight s two-person winning team, Nathan Hodgson, RN, and Christian Brienik, RN, both Flight Nurse Specialists, rocked the competition and made us proud! Teams consisted of flight nurses, paramedics and physicians competing head-to-head, demonstrating real time, real situation response skills on METI s state-of-the-art patient simulators. This shows the dedication of our staff and the support we receive from the hospital. It s a great honor to compete, but for our team to win is a wonderful example of the care we provide, said James Rutherford, RN, Interim Chief Flight Nurse. The Metro Life Flight team prepared for the competition with equipment provided by grants from Northern Ohio Golf Charities Foundation and the Mt. Sinai Skills & Simulation Center. Great job Chris and Nate! 3

4 Metro Life Flight s Newest Team Member METIman The safety of our patients and crew is paramount on every Metro Life Flight mission. Metro Life Flight - Exceeding Safety Standards Metro Life Flight has a long history of providing educational resources to better prepare Emergency Medical Personnel (EMS) in our communities. Emergency calls are inevitable and complicated medical or traumatic conditions require first responders to have the knowledge, skills and proper judgment to effectively treat patients. We thrive on training and we strive to make a difference in ensuring safer communities. Thanks to the generous financial support from Northern Ohio Golf Charities & Foundation, Metro Life Flight can now educate and challenge EMS professionals with the use of a METIman - a patient mannequin with cutting-edge simulation technology. Patient simulation provides similarities of actual patient care conditions, which helps improve clinical competency. This METIman interactive education will be conducted in a group setting under the watchful and critical eye of peers, thus fostering the necessary teamwork required under stressful circumstances. Proper care delivered by first responders can make a significant difference between life and death. Metro Life Flight is proud to partner with EMS to ensure positive patient outcomes. For more information about future METIman simulation training or to schedule an interactive training session after Jan. 1, 2011, please contact James Rutherford, MSN, RN, Metro Life Flight Chief Flight Nurse: jrutherford@metrohealth.org or call We thrive on training and we strive to make a difference in ensuring safer environments. According to a recent article in USA Today, the National Transportation Safety Board (NTSB) is pushing regulators to require new lifesaving technologies in the Helicopter Emergency Medical Services (HEMS) industry. While some air medical programs are opposing these requirements, Metro Life Flight has a long history of meeting and exceeding Federal Aviation Agency requirements and NTSB recommendations with the latest in aviation safety equipment, manning and training. Our aircraft have twin-turbine engines, autopilot systems, flight data recorders, Terrain Awareness Systems, Traffic Avoidance Systems and are Night Vision Imaging System capable, says David Reese, Metro Life Flight Lead Pilot. Reese explains that each helicopter is manned with a two pilot, instrumentrated team, allowing Metro Life Flight to fly on instruments when visibility and cloud ceilings are reduced. Other NTSB recommendations - which Metro Life Flight and its aviation vendor, Metro Aviation Inc., have - include a safety management system and simulator based training. The safety of our patients and crew is paramount on every Metro Life Flight mission. 4

5 Metro Life Flight Lecture Series First Monday of the Month 7:00-9:00 p.m. Metro Life Flight continuing education lectures are prepared for pre-hospital and hospital providers to enhance patient care and improve outcomes in the community. Refreshments provided. Lecture Location November 1, 2010 Caring for the Morbidly Obese Trauma Patient TBD December 6, 2010 Management of the Agitated and Violent Patient Brendan Hawthorn, MD Associate Medical Director, Metro Life Flight Tactical Medical Director, Cleveland Police Department January 3, 2011 Captain Hylton Baker Methamphetamines, an Epidemic February 7, 2011 Thomas Tallman, DO, FACEP Director, Emergency Preparedness & Disaster Medicine Chairman, Emergency Response and Resuscitation Director, EMS, Emergency Services Institute March 7, 2011 Gerald Maloney, DO, FACEP Assistant Professor of Emergency Medicine Case Western Reserve University April 4, 2011 Annual Trauma Case Review Spinal Cord Injury & The Patient Perspective Pain in the Gas Toxic Inhalations John J. Como, MD, FACS Associate Medical Director of Trauma, MetroHealth Medical Center Associate Professor of Surgery, Case Western Reserve University MetroHealth Medical Center Scott Auditorium 2500 MetroHealth Drive, Cleveland, OH Please bring parking ticket for validation Summa Health System Akron City Hospital Professional Center South Raymond C. Firestone Auditorium 55 Arch Street, Akron, MetroHealth Medical Center Scott Auditorium EMH Regional Healthcare System Gates Auditorium Summit County Drug Unit Summa Health System Akron City Hospital Professional Center South Raymond C. Firestone Auditorium MetroHealth Medical Center Scott Auditorium TriPoint Medical Center Physician Pavilion Lubrizol Conference Rooms MetroHealth Medical Center Scott Auditorium EMH Regional Healthcare System Gates Auditorium 125 East Broad Street, Elyria, OH TriPoint Medical Center Physician Pavilion Lubrizol Conference Rooms 7580 Auburn Road, Ground Floor, Concord, OH Parking fees apply Metro Life Flight Business Office: Please check our website, or the Metro Life Flight Facebook page for updates. 5

6 Kudos to our Crew By Betty Kovach, RN, Metro Life Flight Program Director Congratulations! Life Flight Survival Training Days Flight Nurse Specialist, John Singleton, RN and Lead Pilot, Dave Reese, recently achieved CMTE - Certified Medical Transport Executive credential. Life Flight Survival Training Days Flight Nurse Specialists, Wendy Atkinson, RN and Scott Russell, RN for planning and executing the Life Flight Survival Training Days for the nursing crew. Nice job! Air Medical Transport Conference (AMTC) Each year, Metro Life Flight is represented at the Air Medical Transport Conference (AMTC). This annual conference provides up-to-date information on the latest techniques and innovative approaches to air medical practice from community experts. This year, we are extremely pleased to have four speakers lending their expertise to colleagues in the industry at this annual conference Metro Life Flight educational speakers: Craig Bates, MD, FACEP, Medical Director Lecture: Xrays and CTs as an Extension of the Primary Survey in Critical Care Transport Brendan Hawthorn, MD, FACEP, Associate Medical Director Craig Bates, MD, FACEP, Medical Director Lecture: Using Bedside Ultrasound as a Diagnostic and Therapeutic Tool in Critical Care Transport James Rutherford, MSN, RN, ACNP -BC Interim Chief Flight Nurse Lecture: DR STAT: Drip-less Regimen for Stemi Treatment in Air Medical Transport Flight Nurse Specialists, Wendy Atkinson, RN (top) and Scott Russell, RN (bottom photo). July Wayne County Lecture Cookout Scott Kunkel RN, MBA, NREMT-P, CFRN, CMTE, FP-C Lecture: Beyond Bricks and Motor: Expanding the Contribution of Your Organization through a Project Management Strategy Special Thanks Great job Skip Gentry, RN, Flight Nurse Specialist and Wayne County Base Lead, for organizing the successful Wayne County Summer Lecture Series. 6 Flight Nurse Specialists, John Singleton, RN (left) and Skip Gentry, RN (cooking).

7 Metro Life Flight is pleased to share the following letter from Euclid Fire Department: On a Sunday evening in August, the Euclid Fire Department responded to a motorcycle accident. On arrival, we requested Life Flight to respond to Euclid Hospital. The patient was provided with excellent pre-hospital care that included airway treatment, spinal immobilization, intravenous therapy and chest decompression. On arrival, your team consisted of Pilots Kevin Freaney and Fin Molloy; Dr. Jimmy Servatas and Flight Nurse Specialist, John Singleton. I ve only been involved in EMS for 15 years, but I must tell you that I have never been as impressed with any one medical provider as I was with Flight Nurse Specialist, John Singleton. He demonstrated excellent command presence from the beginning while remaining calm, cool and collected the entire time. His confidence in his own abilities seemed to make the situation easier for all to handle. He knew EXACTLY what to do, how to do it and what to do next if that didn t work. Our personnel felt honored to work with, and next to, such a proficient medical professional. Please extend our gratitude and thanks to the entire crew for such a display of teamwork and professionalism. Sincerely, Will Anderson, Captain, Euclid Fire Department Kudos to the entire Metro Life Flight team... Our program was recently re-accredited by Commission on Accreditation of Medical Transport Systems (CAMTS). CAMTS is a peer review organization dedicated to improving patient care and transport safety by providing a dynamic accreditation process through the development of standards, education and services that support its vision, which is: All patients are transported safely by qualified personnel using the appropriate mode of transport. Our re-accreditation is a testament to how hard the entire team works each and every day. Thank you to the entire team for making a difference! 7

8 Presort Std U.S. Postage PAID Cleveland, Ohio Permit No. 1 Metro Life Flight MetroHealth Medical Center 2500 MetroHealth Drive Cleveland, Ohio Thanks to Sarah Gentry for providing this great photo from the Annual Wayne County Fire School Training. Become a fan of Metro Life Flight on Facebook Receive updates about our program and learn about community events and education classes in your area. 8