Everything is going digital. It’s easier and more efficient to maintain your patient records digitally than have to drag around hard copies of documentation everywhere you go. So you’re probably considering switching to electronic patient care reports or ePCR’s for your air ambulance crews. Paramedics and doctors for air ambulances will find it much easier to carry around crucial information about their patients in an easily portable system. But there are a few things you need to learn about these systems before you decide to get one for your crew.
The Basics of ePCR Systems
Electronic patient care report systems are documentation software that can run on computers, tablets, and smartphones. It can help you store and retrieve information easily. But it’s important to remember that these systems aren’t mind readers. They can’t pull up information that doesn’t exist. You have to first feed it with raw data, after which you can retrieve useful information from the system.
Important of ePCR Systems for Air Ambulances
An ePC system can make it much easier to record, retrieve, and transfer useful patient info for your air ambulance. For example, when a crew responds to an incident, they can easily look up their systems to see if they already have patient record, medical history, treatment history, etc. If so, they can proceed with medical care and assistance promptly.
If there is no existing medical record, the crew can enter the patient records in their system for their reference and future use. There won’t be any need to dig up hundreds of hard copy records and documents to find the relevant info. Additionally, when handing off a patient from air ambulances, they can easily transfer the record to the receiving medical facilities for proper treatment.
You may be surprised to read the headline. Aren’t medical flight crews supposed to provide care and not the other way round? If you’re running an air ambulance operation, caring for the physical and emotional well-being of your in-flight crew is a crucial part of running an effective operation. Because overworked, overstressed, and overtired crew members could potentially risk the safety of their patients and fellow crew members.
Providing Emotional Care to Your Crew
You may already have programs set up for employee assistance and critical stress debriefing. These programs can help in providing essential emotional support to your employees in their hour of need. At the same time, they may not be able to realize when they should sign up for these programs unless you make them mandatory.
These programs are especially necessary when a medical flight paramedic or doctor goes through an unexpected clinical event. Such incidents can put them at risk of becoming “second victims”. Make sure your crew members go through a mandatory emotional support and debriefing program after going through the following:
- First patient death on their watch
- Caring for pediatric patients
- Unexpected death of a patient
- Caring for a patient that they personally know
- Experiencing multiple bad outcomes
Promoting Emotional Health and Support for Medical Flight Crews
As an air ambulance operator, you need to be aware of the fact that your employees will be experiencing high levels of physical and emotional stress. In addition to promoting healthy lifestyle, you should take care to promote emotional support among your employees. Take them through regular training and counseling sessions so as to raise awareness about emotional and mental issues.
This could potentially help them in identifying any problematic behavior in their colleagues. This could then lead to timely intervention. So promoting peer support and early intervention could seriously make an impact on the health and wellness of your employees.
As a medical flight paramedic, you would understand that many patients could have been saved if only you had the right equipment. Many air ambulance planes operate on charity and may not have sufficient equipment aside from the basics. If air ambulance operators can afford to supply their aircrafts with high-tech devices, however, portable ultrasounds are a crucial addition.
Importance of Portable Ultrasounds on Medical Flight Aircrafts
If your air ambulance aircraft is equipped with a portable ultrasound, here are some of the ways you can make use of it:
- Identifying OB emergencies – Pre-hospital ultrasound can be used to identify emergency cases like placenta abruption and ectopic pregnancy with around 95% accuracy.
- Confirming airway placement – A portable ultrasound can help you confirm the correct placement of endotracheal tube for airway management. Using this device, you will have better accuracy in differentiating main tracheal intubation from right mainstream intubation.
- Identifying dyspnea causes – With the help of a field ultrasound device, you can more accurately determine the cause of acute dyspnea. You will have a better idea whether it was caused by chronic obstructive pulmonary disease or pulmonary edema.
- Better evaluation of cardiac motion – Medical flight paramedics strive to safely deliver patients to the appropriate medical facility. But in many cases, lack of equipment may prevent you from thoroughly evaluating cardiac motion. This may result in incorrect pre-hospital treatment procedures.
But with a field ultrasound, you should be able to have better accuracy in evaluating cardiac motion. This can help you with correct diagnosis and treatment procedures, increasing the survival to hospital admission.
- Diagnosing strokes – An ultrasonic device can also help you accurately diagnose time-sensitive conditions like strokes. Timely stroke diagnosis can also ensure the transportation of the patient to the appropriate stroke center for specialized treatment.
As a medical flight paramedic, you will come across different situations and patients with various conditions. You might even come across patients undergoing a seizure, in which case you will need to carry out immediate and correct intervention to improve the patient outcome. Many seizure patients will even encounter respiratory issues, making the situation even more critical. This post will help you find out some useful facts about seizures and the accompanying respiratory issues.
Assessment Process for Seizure Patients
Seizures often last for only a few minutes and by the time you arrive on scene, the patient might be unconscious or in a postictal phase. But sometimes, seizures may last more than 20 minutes or even recur before the patient becomes conscious again. These cases are life-threatening and are known as status epilepticus.
Medical flight paramedics should carry out the following assessment steps for seizure patients:
- Determine the duration of the seizure and how many seizures they have had
- Determine whether or not the patient had regained consciousness after each seizure
- Try to determine the underlying cause of the seizure – any medical condition, injury, or trauma that could result in it
- Enquire about any complaints the patient had before the seizure
Airway Management Tips for Medical Flight Paramedics
When carrying out airway management for seizure patients, protecting the upper airway is crucial. You will also need to administer high-flow oxygen and ensure proper ventilation. In case a patient is still seizing or positical, you need to use a non-rebreather mask to administer oxygen and set it at 12-15 liters per minute.
Additionally, stopping the seizure is crucial to ensure proper airway management. So if the patient is still actively seizing you might need to consider administering anti-seizure medication because seizures that last more than 5 minutes might not stop unless you intervene.
When you’re working in medical air transport, you would encounter all kinds of patients. There will be times you have to care for and transport pediatric patients. While the experience may be highly rewarding, it can also be extremely challenging. As a result of this, many air ambulance paramedics and EMS providers are at risk of making pediatric treatment errors.
Reasons and Risk Factors of Pediatric Treatment Errors
Due to the delicate nature of their bodies, children are susceptible of getting critically ill in just a matter of seconds. This is where the skill and expertise of the medical air transport paramedic will make a huge difference. Be aware of the following risk factors of errors in pediatric treatment so you can provide better quality of care:
- Insufficient training regarding pediatric patients
- Infrequent hands-on experience dealing with pediatric patients
- High stress levels compelling providers to scoop and run instead of staying and treating pediatric patients
- Lack of appropriate equipment to care for and/or transport children in an air ambulance
Basics in Pediatric Treatment for Medical Air Transport Paramedics
In addition to the above risk factors, be aware of the following basic tips that will help you provide better care to pediatric patients:
- Thoroughly assess pediatric patients to identify less-obvious medical conditions
- Cross check everything before administering medications
- Instead of relying on memory, contact medical control in case you have any queries
- Coordinate with administrators regarding any system flaws or setbacks so as to improve on pediatric patient care
It’ll be important to stay calm and composed no matter how stressed you may feel in the beginning. If you panic, there’s a high risk of making mistakes in patient assessment and medicine administration.
When you’re working as an air ambulance paramedic or doctor, many of the cases you’ll be responding to will include trauma. In assessing trauma patients, it’s important that you thoroughly understand the trauma’s mechanisms and how those mechanisms can affect different body functions and organs. This is especially crucial when you’re working with pediatric patients who need medical air transport.
Pediatric Trauma Patient Assessment Tips in Medical Air Transport
Take a look at some of these tips and make the most of them when you have to care for a kid who has undergone physical trauma:
These basic tips should be able to guide you in the assessment of pediatric trauma patients, which can result in successful patient hand-offs. Look out for the next post to find out more tips on pediatric trauma patient assessment.
As an air ambulance paramedic, your job is to improve the outcome for different medical conditions and injuries. So when it comes to stroke patients, you would be faced with a time-sensitive issue that needs to be addressed as quickly as possible. You will need to transport the patient immediately to a facility that is equipped with a CT scanner and other equipment for stroke care. However, you can also make some effort to provide pre-hospital care during the medical flight to further improve the outcome.
Pre-Hospital Stroke Care for Medical Flight Paramedics
When it comes to stroke care, the goal is to help the brain cells survive. So your responsibility involves attending to the ups and downs that may occur during homeostasis. You can prevent serious issues through the medical flight by caring for the issues listed below:
- Hypothermia – Although this may be beneficial for treatment in the future, you need to focus on maintaining normal body temperature for now. Try to prevent hyperthermia by removing any excess clothing and regulating the temperature in the aircraft. You should also prevent shivering, as this can increase body temperature.
- Hypoxia – This decreases the oxygen supply to the brain cells, which calls for supplemental oxygen to ensure normal oxygen saturation.
- Hypoglycemia – This withholds the primary energy source for the brain cells, meaning you will need to replenish the glucose supply without causing hyperglycemia.
- Hypotension – This needs to be controlled through fluid resuscitation so as to ensure that the brain cells get enough oxygen and nutrients for survival. If the patient has normal blood pressure, use a saline lock to make sure it remains that way. In case of hypertension, you will need to follow directions given by the in-flight doctor.
You transport a patient to a hospital but after you leave, the hospital staff is left with vague information about the patient’s medical history and medications as well as allergies and assessment details. So the staff has to track you down to find out more information, resulting in a lot of wasted time and resources. The end result is a delay in providing emergency care in a potentially critical situation despite a quick medial flight. This makes it crucial to successfully carry out your patient hand-offs with all the vital information.
Come up with a Standard Procedure to Compile Hand-Off Report
The patient hand-off period should be considered as the point of contact between providers, where they share crucial information about the patient. Although there may be several differences in the setting and circumstances surrounding this contact point, you can still ensure to standardize how the information is shared.
Medical flight crews and ground ambulance crews alike can make use of the SBAR approach developed by TeamSTEPPS. This approach provides you with a framework to effectively communicate with other medical care providers. It involves providing information about:
- Situation – Let them know exactly what’s going on with the patient
- Background – Let them know about the clinical background and/or context
- Assessment – Let them know about the details of the assessment you have carried out and what you think is the problem based on those reports
- Recommendation – Let them know what you recommend should be the next step in medical care for the patient
Importance of Standardizing Report Procedure for Medical Flight Crews
Having a set framework to compile and communicate your hand-off report helps other medical teams in providing quick and efficient care without wasting much time. They can see to it that the patient gets the right kind of care they need when they need it.
When you’re in the healthcare industry, you’re going to come across hundreds of different cases in your lifetime. This is especially true for medical flight crews who have to deal with emergency cases and patients who have undergone a traumatic experience. At some point of time, you may even come across patients with behavioral emergencies or violent tendencies. It is in such situations that you need to be extra cautious and employ your non-medical skills as well when dealing with such patients.
Dealing with Violent Patients for Medical Flight Crews
When you’re in the medical flight industry, your only focus cannot be on the patients’ safety. You have to think about your safety as well. This might prove to be a challenge when dealing with violent patients or patients displaying behavioral emergencies and hallucinations. Here are a few tips that will make your task easier:
- Make sure the air ambulance aircraft is equipped with soft arm restraints. These restraints will keep the patients in place without harming them. So you can prevent them from pulling out their IV or oxygen or even from taking a swing at you.
- Try to determine the medical reason for the behavior instead of immediately concluding that the patient has a mental illness. For instance, some patients may have had a head injury resulting in them being angry, violent, combative, or anxious. Try to conduct a thorough assessment in order to get to the root of the problem and take necessary action on time.
Try to remain calm despite the situation as your angst can further aggravate the patient. You can try to create a more relaxing environment for the patient by removing any stimuli of negative emotions. For instance, bright lights and loud noises could prove to be a negative trigger for such patients.
You’ve just pulled a long shift and now have to respond to another call. The life of a medical air transport paramedic can be exhausting and many of you may suffer from fatigue every now and then. Prolonged suffering from fatigue can have a serious impact on your health in the long run, making it crucial to take care of the issue before it’s too late.
Preventing Fatigue from Impacting the Lives of Medical Air Transport Paramedics
Since the job calls for it, fatigue is often unpreventable but you can reduce its impacts to a significant extent. This helps you do your job properly and also enables you to prevent the long-term negative effects. Take a look at some of the key steps you can take:
- Staying hydrated – Make sure you maintain proper fluid levels in your body. This ensures that the different body systems continue to function normally and you remain alert for longer.
- Maintaining healthy lifestyle – As a medical air transport paramedic, proper health is crucial for ensuring that you carry out your duties as necessary. So make sure you maintain a healthy lifestyle by staying in shape and minimizing your intake of fat and sugar. This also enables you to be less tired even while you’re suffering from fatigue.
- Avoiding tobacco and caffeine – When you’re feeling fatigued, you may feel compelled to use stimulants like caffeine and tobacco to help you stay alert. Excessively indulging in these substances can have a serious impact on your health in the long run.
Maintaining proper sleep schedules – Abrupt changes in your sleep pattern may disrupt your sleep and even result in sleeplessness. So it’s important to avoid aggravating the symptoms of fatigue by maintaining a proper sleep schedule according to your shift. This means continuing with the schedule even during your days off.