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#1 bobbyz777

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Posted 12 April 2012 - 11:19 PM

We are the ground arm of a peds/neo team (RN/RT) that has a rotor program (MD/RN) at the same hospital. We are looking into the "insertion" of the ground team (getting dropped off by helicopter, then waiting for ground ambulance). We can take one, albeit large bag, plus our med bag. However, the flight team will be available after dropping us off, so we do not get any of their equipment (pumps/fluids/ETT/LMA/etc). Are there any other programs out there that have been doing this for a while? Since we do not need to re-invent the wheel, any important items, par level, etc. that we need? Other advice for insertion?


Thanks for any input.
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#2 Tmed725

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Posted 12 April 2012 - 11:41 PM

We are the ground arm of a peds/neo team (RN/RT) that has a rotor program (MD/RN) at the same hospital. We are looking into the "insertion" of the ground team (getting dropped off by helicopter, then waiting for ground ambulance). We can take one, albeit large bag, plus our med bag. However, the flight team will be available after dropping us off, so we do not get any of their equipment (pumps/fluids/ETT/LMA/etc). Are there any other programs out there that have been doing this for a while? Since we do not need to re-invent the wheel, any important items, par level, etc. that we need? Other advice for insertion?


Thanks for any input.

My first question is why you are looking into this model?
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#3 Macgyver

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Posted 13 April 2012 - 03:13 AM

Contact the the Portland Oregon pede/neo teams (RN/RT) at OSHU and Legacy, as LifeFlight Network operates this way. RW is RARELY used as a result.
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Ken BHSc, RN, REMT-P

#4 Macgyver

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Posted 13 April 2012 - 03:33 AM

My first question is why you are looking into this model?


I'm assuming the MD based RW team is also a pede/neo specialty team not the typical generalist adult/pede one..... if the latter then the case is even more pronounced and the neonatologists and pediatric intensivists need to push back harder.

Non PC response, BTDT-GTTS: Since the "ground" team is Hospital based and the RW wants to remain available for other flights and not hang around waiting for a pede or neo team to complete the assessment/packaging (for 60 min to 3 hrs) but at the same time wants to improve customer service (kind of) by a faster ETA than a completely ground response. More a PR excercise than a way of improving pt care. If the RW is available to fly there - it should be available to take the pt. Arriving with no specialised equipment (just a soft bag full of supplies) is sub-optimal.

They'd have enough weight for all their gear (less isolette) if the RW only sent a single safety officer - which would meet the objective of a fast "insertion" and return to service area. But since taking both RW crew that sends me the signal the RW team does not value flying the "ground" Pede/Neo team to the requesting facility as a valid use of their service. 'Cause the single bag concept doesn't work at all well for the pt. No vent, Nitric, monitor etc so a bunch of time spent after the ground unit arrives to actually package the pt. Not much use at an outlying ER with a crashing neo and no vent...

A secondary factor may be the hospital does not want to invest the training time and familiarisation flights/requirements to get all 'team' members through all the CAMTS requirements and 135 cert holders requirements so that a safety officer can be left behind. Do that and then the isolette can be taken. But then you have created another RW team without a bird...

Really what is needed is a realistic evaluation of the service model. Is ground still an appropriate option? When and where? Response times/packaging times? Pt acuity? Call volumes and payment mix etc. Ditto for the RW arm of the service. Perhaps a second helicopter is needed, or a team composition / assignment change, or new dispatch criteria with more outlying facilities covered by the RW instead of ground (shrinking the "donut hole" in the RW service area map...)
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Ken BHSc, RN, REMT-P

#5 old school

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Posted 16 April 2012 - 12:05 PM

To the OP: our NICU folks bring A LOT of stuff with them on these transports. Several bags and I think they have a couple of syringe pumps stuffed in them as well, and they definitely have all of their meds, fluids, and airway equipment.


Non PC response, BTDT-GTTS: Since the "ground" team is Hospital based and the RW wants to remain available for other flights and not hang around waiting for a pede or neo team to complete the assessment/packaging (for 60 min to 3 hrs) but at the same time wants to improve customer service (kind of) by a faster ETA than a completely ground response. More a PR excercise than a way of improving pt care. If the RW is available to fly there - it should be available to take the pt. Arriving with no specialised equipment (just a soft bag full of supplies) is sub-optimal.


We do this exact thing this sometimes, and it's never as a "PR exercise".

Our neonate team (in conjunction with their neonatologist medical director) takes telephone report and triages every patient based on diagnosis, acuity, and distance. Quite often they do the entire transport by RW, and quite often they respond and transport by ground. Sometimes, however, a more creative approach is most appropriate.

Here's the thing: Very few neonates require rapid transport. What they often DO require, however, is for someone to arrive quickly who can provide expert stabilization. Responding the NICU crew by RW gets them there much quicker than a ground ambulance would. Then, with an average 30-90 min bedside time (sometimes longer), the driver has plenty of time to arrive with the ambulance and isolette before the patient is ready for transport. And the helicopter isn't tied up waiting for an hour and a half; they are back in service for other transports as soon as the NICU team unloads at the referring hospital.

It's a good way to offer a fast response to the patient, without unnecessarily tying up a valuable resource (the RW) for an extended period of time.
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bring it in for the real thing

#6 SerendepitySaki

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Posted 16 April 2012 - 12:51 PM

one of the best, most clear, concise, thoughtful and informative (with NEW information, vs rehash) threads on FW in recent times. Much appreciated and enjoyed.

PS: in related news, I have posted a link to the latest Baby Ann neonatal case study in the Neonatal section... pretty easy peasy dx on X-Ray, but still, good stuff.... (and nope! hopefully, with good prenatal care, the featured little kiddo isn't being transported anywhere, but rather, was born in a facility w/ appropriate resources...)
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LET THE WILD RUMPUS BEGIN !!!!!!
Sean G. Smith, RN-Alphabet Soup

#7 Macgyver

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Posted 17 April 2012 - 05:09 AM

Sorry - was too brief.

Was getting at the fact that a neo crew with a small "Go" or jump bag won't have much of the gear needed to stabilise and monitor the neo much more than already possible at the sending - particularly "rescue" hospitals with GP's in the ER. The most useful thing they bring is their comfort level, knowledge base/experience and links to neonatology. But to be an effective physician extender (eyes and hands) you still need more than can be stuffed in a single lightweight jump bag...Especially in the vent area as those hopitals rarely have neo specific vents and tubing.
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Ken BHSc, RN, REMT-P

#8 CheetahBreath

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Posted 01 May 2012 - 04:44 AM

To the OP: our NICU folks bring A LOT of stuff with them on these transports. Several bags and I think they have a couple of syringe pumps stuffed in them as well, and they definitely have all of their meds, fluids, and airway equipment.




We do this exact thing this sometimes, and it's never as a "PR exercise".

Our neonate team (in conjunction with their neonatologist medical director) takes telephone report and triages every patient based on diagnosis, acuity, and distance. Quite often they do the entire transport by RW, and quite often they respond and transport by ground. Sometimes, however, a more creative approach is most appropriate.

Here's the thing: Very few neonates require rapid transport. What they often DO require, however, is for someone to arrive quickly who can provide expert stabilization. Responding the NICU crew by RW gets them there much quicker than a ground ambulance would. Then, with an average 30-90 min bedside time (sometimes longer), the driver has plenty of time to arrive with the ambulance and isolette before the patient is ready for transport. And the helicopter isn't tied up waiting for an hour and a half; they are back in service for other transports as soon as the NICU team unloads at the referring hospital.

It's a good way to offer a fast response to the patient, without unnecessarily tying up a valuable resource (the RW) for an extended period of time.


Thanks for your thoughtful reply!
The things we have in the ambulance are indeed specialized and many. Peds/neos often really need our immediate expertise rather than our stuff, though. The OP and I were trying to hash out what we think the outlying hospital ED probably wouldn't have. Things like all the neo/ peds airway stuff, high-flow NC, tiny suction caths and ETT securing devices and things of that nature.
Really any and all advice is appreciated since we are forging into new territory. Thanks to all, in advance!




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