Air Transport Indications in Emergency Medicine

Questions and Answers

What is a primary consideration for air transport in a mass-casualty situation?

Availability of medical personnel on site

Potential for patient deterioration due to delays (correct)

Availability of road transport

Severity of injuries of all patients on site

Which of the following is an indication for air transport per SOP?

Patients with minor injuries requiring only basic life support

All patients requiring urgent care

Level 1 trauma center after prolonged extrication in a patient who meets criteria for level 1 Trauma Center (correct)

Patients with no vital signs

What is the primary responsibility of scene personnel during a scene survey?

Rapidly analyzing MOI and assessing injuries (correct)

Contacting OLMC physician for air transport authorization

Determining the number of patients requiring air transport

Initiating care per SOP

Who is responsible for contacting the aeromedical service closest to the incident site?

ECRN Signup and view all the answers

What is the purpose of contacting OLMC physician during a scene survey?

To obtain an order to utilize aeromedical transport Signup and view all the answers

What happens after OLMC physician approves aeromedical transport?

OLMC advises scene personnel, and aeromedical service contacts them to complete flight arrangements Signup and view all the answers

Who is responsible for communicating updated patient information to helicopter personnel?

Scene personnel Signup and view all the answers

What is the time frame for aeromedical service to contact scene personnel to complete flight arrangements?

Within 5-8 minutes Signup and view all the answers

What is the minimum perimeter requirement for a helicopter landing zone during the day?

100 feet Signup and view all the answers

What is the maximum slope allowed for a helicopter landing zone?

8 degrees Signup and view all the answers

What is the minimum number of lights required to mark a helicopter landing zone at night?

5 Signup and view all the answers

What is the minimum size of a landing zone required for a helicopter during the day?

100’ x 100’ Signup and view all the answers

What information is NOT required to be provided to the helicopter dispatcher for flight arrangements?

Patient's weight and height Signup and view all the answers

What should be done to the corners of the landing zone?

Mark with secured flags or flares Signup and view all the answers

Which of the following is NOT a requirement for a safe helicopter landing zone?

Presence of emergency vehicles Signup and view all the answers

Why should bystanders be kept at least 150’ away from the landing zone?

To prevent them from being injured by the helicopter Signup and view all the answers

Which of the following is NOT a factor to consider when establishing a helicopter landing zone?

Patient's medical history and vital signs Signup and view all the answers

What should be worn during helicopter operations?

Protective eye covering Signup and view all the answers

Why should the landing site be as smooth and flat as possible?

To reduce the risk of accidents Signup and view all the answers

Why is it important to mark a helicopter landing zone for the pilot, both during the day and at night?

All of the above Signup and view all the answers

What should be established once the helicopter is on the ground?

A tail guard Signup and view all the answers

What is the primary purpose of the information provided by the requesting agency to the helicopter dispatcher?

To allow the helicopter dispatcher to coordinate the flight arrangements Signup and view all the answers

What should be used to secure the landing zone?

Ropes or barricades Signup and view all the answers

What should be stationed nearby during helicopter operations?

An engine company with dry-chem and CO2 extinguishers Signup and view all the answers

Under what conditions should the ground crew assist the flight crew with opening or closing helicopter doors?

Never, ground crew members should never assist with opening or closing helicopter doors. Signup and view all the answers

What is the maximum recommended time for ground scene operations, including patient loading, assuming the ground crew is ready to assist and no critical interventions are required?

10 minutes Signup and view all the answers

What is the primary objective of establishing a Helicopter Division for landing zone activities?

To improve the efficiency and safety of helicopter operations. Signup and view all the answers

What specific action should the ground crew take if weather appears to be poor and a helicopter is needed for transport?

Request a ground ambulance as a backup option. Signup and view all the answers

What is the recommended procedure for a conscious patient prior to helicopter transport?

Briefly explain the situation and the reason for air transport. Signup and view all the answers

Which of the following actions should be taken before moving a patient to the helicopter?

Perform a full spinal immobilization if required. Signup and view all the answers

What is the rationale for leaving the patient's arms free and chest exposed when possible during helicopter transport?

To facilitate the attachment of monitors and patient assessment by the flight crew. Signup and view all the answers

Which of the following is NOT a recommended action for ground crew members during helicopter transport?

Assist the flight crew with loading and unloading the patient. Signup and view all the answers

What is the minimum distance bystanders should be kept from the perimeter of the landing area?

150 feet Signup and view all the answers

What is the recommended angle to approach a helicopter?

30-45 degrees Signup and view all the answers

Where is the highest wind and greatest amount of flying debris produced during a helicopter landing?

Just before the helicopter touches the ground Signup and view all the answers

What should responders do if approaching a helicopter with a patient while the engines are running?

Secure straps on the cot over top of a blanket covering the patient, secure all loose objects, and carry equipment below the waist Signup and view all the answers

What should responders do if approaching a helicopter on sloped terrain?

Approach from the downhill side Signup and view all the answers

What is the minimum number of fire extinguishers that should be present during helicopter landings and takeoffs?

One dry chemical and one CO2 extinguisher Signup and view all the answers

When should responders approach a helicopter?

When the pilot signals to approach Signup and view all the answers

What is the reason for keeping all equipment below the waist when approaching a helicopter?

To prevent the equipment from hitting the main rotor Signup and view all the answers

Study Notes

Indications for Air Transport

Patients inaccessible due to weather, disasters, or mass-casualty situations, where there is a potential for delays
Level 1 trauma center after prolonged extrication in a patient who meets criteria for level 1 Trauma Center
Hyperbaric center for a severely confused patient (GCS 13 or less) with suspected CO/smoke inhalation or a diver with nitrogen narcosis
Need for access to a more distant trauma center, i.e., disaster/medium to large scale situation

Scene Personnel Responsibilities

Perform scene survey, analyze MOI, and determine need for air transport
Initiate care per SOP and contact OLMC physician for authorization
Obtain and document physician on PCR
If approved, OLMC will advise scene personnel, and aeromedical service will contact them to complete flight arrangements

Information Needed by OLMC and Helicopter Dispatcher

Name of requesting agency, requesting person, and call back number/radio frequency
Brief description of emergency scene
Number of patients requiring air transport, name, and age (if available)
Type of incident, mechanism, and/or extent of illness/injuries
Brief description of patient injury (vital signs and pertinent medical history, if available)
Care already performed
Landing site location and description
Ground contact person and radio frequency
When the patient is to be picked up
Special devices and personnel required to transport victims
Ambulance transporting to and from landing site (if indicated)
Weather conditions at scene (if adverse)

Establishing a Helicopter Landing Zone

Follow Hoffman Estates preplanned landing sites and Northwest Community EMS System policy
Site should have a 100-foot perimeter (150 feet at night or high winds)
Site should be clear of trees, wires, towers, emergency vehicles, signs, or hazards
Site should be smooth and flat as possible, with no more than a nominal (8 degree) slope
Mark for helicopter pilot using hand signal or flare
Ensure security, use rope, barricades, or vehicles to secure area
Keep bystanders at least 150 feet from the perimeter of the landing area
Request police assistance for crowd control

Approaching and Loading the Helicopter

Approach aircraft within a 30-45 angle from the front
Assign one assertive team member to ensure all responders stay clear of the tail rotor
Approach and depart the helicopter from the downhill side if a sloped terrain
Secure straps on cot over top of blanket covering the patient
Secure all loose objects and equipment
Allow flight crew to open and close helicopter doors
Follow "time savers" guidelines based on Northwest Community EMS System policy

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Description

Learn about the indications for air transport in emergency medicine, including situations where patients are inaccessible due to weather or disasters, and criteria for level 1 trauma centers and hyperbaric centers.