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.
You have a dream of working as a paramedic for air ambulances. Now you’ve completed your certification and have all the necessary qualifications to apply for your first job as one. This may be one of the biggest hurdles you face in your career. Although some basic interview tips apply here like any other job, there are a few additional things you need to do to impress your future employers.
Learn About the Agency
Having an in-depth knowledge about the air ambulance provider you’re interviewing for could be crucial for interview success. Do some background research before the interview and learn about some useful details like the company’s core values, how they raise funds, how many operations they averaged at recently, etc. So you’ll be prepared to answer some agency-related questions if they come up.
Otherwise, you can also use this information to impress the interviewer unexpectedly. For instance, they might ask you why you’re applying for a job with them and not with other air ambulances. You can tell them how your personal values coincide with the company’s core values, so it would be ideal for you to work where your values are respected.
Show your Preparedness to work as a Paramedic for Air Ambulances
Another crucial step for successful interviews is to help your prospective employer in envisioning you in the role. When you walk into the room, make sure you demonstrate the kind of command presence and attentiveness you would on an emergency call. Try your best to hide your nervousness and display confidence. Look your interviewers in the eye and make sure you start off and/or end with a firm handshake.
When answering questions, avoid using fillers and starting off with “umm” or “uhh”. Any sign displaying indecisiveness could hinder your efforts so try taking a few seconds to think about your response instead. These may all seem like small elements, but they can be crucial for helping you bag a job as an air ambulance paramedic.
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.
As a US air ambulance paramedic, it’s your duty to prevent the spread of infectious disease to others. You’re dealing with different kinds of patients on a daily basis, some of who may be suffering from a highly infectious disease. Even if you’re doing what you can to avoid catching the illness, you may still be contributing to the transmission of the disease to other people. In fact, influenza, mumps, measles, etc. have been known to be transmitted through unvaccinated health workers. Plus, such infectious diseases may pose a problem to the healthcare professionals themselves.
Tips for US Air Ambulance Paramedics to Handle Infectious Diseases
The steps you’ve learnt years ago to prevent infectious disease transmission may be out of date. With new diseases being discovered, it’s important that you stay updated with the following latest tips that will help you in preventing the transmission of infectious diseases:
- Make sure you regularly use personal protective equipment so that you can minimize the exposure to OPIM and blood.
- Make sure you get your annual vaccinations on time and stay up to date as new transmittable diseases are discovered.
- Make sure you annually go for your 2-step tuberculosis skin test.
- Make sure you use disinfection supplies and processes as recommended by the CDC so as to ensure you kill off even the toughest of microorganisms.
- Come up with a protocol to carry out a routine disinfection of your medical devices and patient care area within the US air ambulance.
- Make sure you maintain the hand hygiene standards and sanitize your hands multiple times throughout the process of care and patient contact.
These are just a few of the steps you need to carry out in order to prevent the transmission of infectious diseases. Stay updated with latest regulations and standards from the CDC.
If you are part of an air ambulance crew, it’s likely that you get through some days working overtime and having to respond to multiple calls in a day. While this is all part of the job, it’s important to remember that long shifts and over-exhausted can leave you feeling drained – both physically and mentally. The result will be impaired consciousness, which can prevent you from doing your job properly. This is why US air ambulance paramedics need to ensure that they get proper sleep whenever possible.
Signs US Air Ambulance Paramedics Should Watch Out For
Whether you work for an air ambulance or a ground ambulance, being an EMS provider means there is a high risk of chronic sleep deprivation. Maybe you are secretly proud of yourself for being able to perform well despite lack of sleep. While you may be able to do so for a few days, over time you’re just going to experience impaired consciousness. This can be dangerous for your job, for the lives of your patients, and for yourself.
As a US air ambulance paramedic, here are some signs you should watch out for telling you that you need to get some sleep ASAP:
- Inability to remember the last call you responded to
- Inability to distinguish one patient from the other
- More than normal illegible writing
- Strong smell of coffee and/or Red Bull while urinating
- Impaired ability to read patients’ vital signs
- Impaired ability to distinguish reality from dreams
These are just a few of the more common signs of impaired consciousness among EMS providers. It may be easy to be in denial, making it difficult for you to honestly assess yourself using these signs. Get help from a partner or a fellow crew member that you trust.
Acute coronary syndrome or ACS is a term used for describing different myocardial (heart) conditions caused by a sudden reduction of blood flow to the heart muscle. This could result in heart attacks, cardiac arrests, and more. The patients suffering from these conditions require immediate care, making ACS a time-sensitive condition. So as an air medical transport crew, you need to administer the necessary pre-hospital care aiming towards rapid reperfusion, which involves the suddenly blocked coronary artery.
Important Pre-Hospital ACS care Tips for Air Medical Transport Crew
When providing pre-hospital care to patients suffering from any kind of ACS, here are some important tips you can make use of:
- If the patient has a normal oxygen saturation level, it may be harmful to administer supplemental oxygen. So make sure you consider their SpO2 readings before you resort to supplemental oxygen use.
- If the patient doe not have an allergy towards aspirin or is suffering from active gastrointestinal bleeding, immediate administration of aspirin is highly recommended. In order to ensure that the aspirin enters the bloodstream more rapidly, make sure the pill is chewed instead of being swallowed whole.
- Although air medical transport crews can safely administer fibrinolytic therapy, it is not recommended if you can get the patient to a PCI center quickly. It is only recommended for use if the transport time is greater than 30 minutes.
- Transporting a cardiac arrest patient to a PCI center at least 24 hours after the arrest is essential for better chance of survival.
When you are a part of an in-flight medical crew, it’s highly likely that you’ll encounter patients with chest pain every now and then. This makes it crucial to educate yourself on the latest assessment and treatment guidelines for acute coronary syndrome.
Sepsis is commonly referred to as blood poisoning. It takes more lives than cancer and is more common than a heart attack. In fact, more than 4,000 children die in the U.S. every year because of sepsis. This makes it crucial for medical flight paramedics to proactively assess and care for patients with suspected sepsis. So here’s a brief guide to help you understand how to care for patients with this condition.
Initial Assessment for Septic Patients
Properly assessing a patient is crucial for medical flight paramedics and EMS providers alike. This speeds up the medical treatment process and also ensures the administration of appropriate care. In order to assess a patient suspected of having sepsis, it’s important to measure the body temperature accurately. A fever or a body temperature lower than normal may be detected if a patient has sepsis.
Fevers, chills, and body aches are some common symptoms of an infection. But not all patients may experience this especially when it comes to older individuals. Enquire about recent procedures like diagnostic tests or surgery, which may expose the patient to an infection risk. In addition, it’s important to measure the lactate level of a patient. If it’s greater than 4 mmols, it could be a strong indicator of sepsis.
To further confirm your suspicion of sepsis, it’s important to measure the exhaled carbon dioxide level of a patient. While a normal capnography reading may range between 35 and 45 mm Hg, a patient with sepsis generally exhibits a reading lower than 25 mm Hg. If this level of reading coincides with other vital signs that drove your suspicion of sepsis, the patient may be in need of immediate medical care.
Sepsis Treatment for Medical Flight Paramedics
It’s crucial to initiate sepsis treatment by administering large amounts of fluid to the patient. While you initiate antibiotic therapy, you may also need to maintain vascular tone through vasopressors like dopamine or norepinephrine.
Stroke is one of the top causes of death and long-term disability in the United States. Leaving a stroke untreated for one minute would result in about 1.9 million neurons being destroyed. If it’s untreated for an hour, the brain loses neurons equal to neuron loss occurring from 3.6 years of regular aging. This makes it crucial for a medical flight crew to conduct thorough assessment and provide necessary care for stroke patients or suspected stroke patients.
Detecting Symptoms of Stroke
If stroke is suspected, it is crucial to rush the patient to a facility that can rapidly assess and diagnose the condition in addition to providing treatment. However, many patients deny the symptoms. As a medical flight crew responding to a call in such cases, it’s important that you try to determine if the patient experienced or is experiencing some or all of the following symptoms:
- Sudden confusion
- Sudden vision trouble (one eye or both eyes)
- Sudden severe headache
- Sudden trouble with walking
- Sudden numbness or weakness around the face, arm, or leg
- Dizziness/loss of coordination
- Speech issues/trouble understanding
Providing Necessary Care to Stroke Patients as a Medical Flight Crew
Managing patients showcasing stroke symptoms requires team effort. With it being a time-dependent patient, you will need to have a protocol in place for providing organized and quick pre-hospital care to such patients. Although you may have a limited ability in terms of resources to provide care for a stroke patient, it would make a huge difference for you to alert a Stroke Team or make plans for rapid transportation to a stroke center.
During the transportation, try to carry out general neurological assessments as possible. Providing oxygen and, monitoring cardiac function, and drawing blood for labs, etc. should be quickly accomplished to streamline and expedite the care process.