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HOFFMAN ESTATES FIRE DEPARTMENT STANDARD OPERATING GUIDELINES SOG Category & Identification Number: EFFECTIVE DATE: SPECIALIZED OPERATION - 013 January 1, 2022 NIMS COMPLIANT SOG Title: Hel...

HOFFMAN ESTATES FIRE DEPARTMENT STANDARD OPERATING GUIDELINES SOG Category & Identification Number: EFFECTIVE DATE: SPECIALIZED OPERATION - 013 January 1, 2022 NIMS COMPLIANT SOG Title: Helicopter Use for Medical Emergencies Revision: 5 APPROVED BY: NUMBER OF PAGES: Re-evaluation Date: Alan Wax January 1, 2025 Fire Chief 5 PURPOSE POLICY The use of a helicopter for medical emergencies is regulated by a Northwest Community EMS System policy, Use of Aeromedical Transport Vehicles A-2. In addition to this guideline, the following standard operating guidelines are established: The NWC EMSS strongly encourages ground transportation. The decision to transport a patient by Aeromedical transport is a medical decision that should be made by a physician after a risk benefit analysis. Under select circumstances, it may be in the patient’s best interest to be transported by an aeromedical service. After consultation with, and approved by, the OLMS physician at NWCH, initial arrangements for aeromedical transport shall be made by OLMC personnel. Completion of these arrangements will be made by scene/ground personnel. PROCEDURE Circumstances potentially requiring helicopters  Patients requiring transport to a trauma center involving circumstances in which scene and ground transport time will be significantly greater than 40 minutes (e.g., acceptable 10-minute scene and 30-minute transport time).  Special skills or equipment are needed at the scene (e.g., blood products, chest tubes, paralytics for RSI) that are not allowed or otherwise available.  Patients inaccessible due to weather, disasters, or mass-casualty situations, i.e., where there is a potential for delays, including road obstacles and traffic conditions which might allow patient deterioration. Examples: Indications for air transport per SOP:  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 1  scale situation. Scene personnel responsibilities:  Scene survey: Rapidly analyze MOI; number of victims, nature and severity of injuries. Perform initial assessment and triage as necessary. Determine need for air transport.  Initiate care per SOP.  As soon as possible – contact OLMC physician at NWCH for an order to utilize aeromedical transport. Obtain and document physician on PCR. If aeromedical transport is approved by OLMC physician:  OLMC will advise scene personnel, aeromedical service will contact them to complete flight arrangements, and if they do not hear from them within 5-8 minutes to recontact NWCH for follow-up.  An ECRN shall contact the aeromedical service closest to the incident site.  Once the authorization for lift-off has been given by NWCH, all further communication will take place directly between scene and helicopter personnel to coordinate a landing zone and communicate updated patient information. Scene Personnel Responsibilities – Information Needed by OLMC and Helicopter Dispatcher to Complete Flight Arrangements:  Name of requesting agency, your name, ground contact person, and call back number or radio frequency or call sign.  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 (address, cross streets, major landmarks or hazards, description of landing zone)  ground contact person and radio frequency (usually IREACH, but could be MERCI)  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)  Establish a helicopter landing zone based on Hoffman Estates preplanned landing sites (see hydrant books) and Northwest Community EMS System policy, Use of Aeromedical Transport Vehicles A-2) and following the attached sample landing zone. 2   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 presence of any hazards (i.e., fires, drones)  Site should be smooth and flat as possible, no more than a nominal (8 degree) slope.  Mark for helicopter pilot: DAY: hand signal on upward side (when signaling, stand with back to wind. NIGHT: One light (flare) at each corner (fasten down). Fifth light upwind (helpful to place a vehicle at two corners with their headlights crossing in the center of the area).  Emergency vehicles present with overhead revolving light flashing.  If roadway use, have traffic stopped in both directions.  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. Pilot may refuse to land if too many people are in the landing zone.  If two or more persons are at the landing site, they should be in one place (within the pilot’s view). In general, if you can see the pilot, he can see you.  Fire department personnel to stand by during landings/takeoffs. At minimum, provide one dry chemical and one CO2 extinguisher.  Protect yourself and the patient from dust and debris whipped up by the rotor wash. The highest winds and the greatest amount of flying debris are produced just before the helicopter touches the ground. Wear protective eye covering.  No Vehicles, smoking or running within 50 feet of the aircraft.  Follow approaching/loading guidelines based on Northwest Community EMS System policy, Use of Aeromedical Transport Vehicles A-2.  Do not approach a helicopter until it has settled firmly on the landing site and the pilot has signaled you to approach.  Approach aircraft within a 30-45 angle from the front. One assertive team member should be assigned to ensure that all responders stay clear of the tail rotor (may be invisible).  Approach and depart the helicopter from the downhill side if a sloped terrain.  When approaching aircraft with patient while engines running: secure straps on cot over top of blanket covering the patient. Secure all loose objects such as long hair, hats, stethoscopes, clothing, and equipment.  Carry all equipment below the waist and walk in a crouched position. Never raise anything above your head near the helicopter, since the main rotor dips lowest at the very front of the aircraft.  Allow flight crew to open and close helicopter doors.  Flight personnel will direct loading and unloading of patients. Do not assist unless asked to do so. Do not assist crew members with opening or closing helicopter doors.  Establish a Helicopter Division to handle all landing zone activities (i.e., zone preparation, lighting, vehicle locations, helicopter landing, helicopter take-off) 3   Provide the Helicopter Division with an appropriate number of personnel (at least two personnel) and resources (at least one engine or truck company).  Follow “time savers” guidelines based on Northwest Community EMS System policy, Use of Aeromedical Transport Vehicles A-2.  Request authorization to transport by helicopter early in the incident.  Direct the helicopter to land as closely as is safely possible to the scene. If impossible, get the patient to the landing site as soon as possible.  Perform full spinal immobilization on those patients who require it. The patient must be immobilized before moving to the aircraft.  Leave the patient’s arms free and chest exposed if possible. This makes it easier for the flight crew to attach monitors and assess the patient enroute.  Explain to the conscious patient that he or she will be transported by air and the reasons why. Help reduce flight anxiety.  Restrain combative patients.  Search patients for weapons.  Give a brief but complete report to the flight crew. Total ground scene time for the helicopter should be no more than 10 minutes, including the load time if the ground crew is ready to assist the flight crew, no critical interventions are necessary, and the aircraft is able to land at the accident scene.  If weather appears to be poor, call for the helicopter if needed, but have a back-up plan of ground transportation available. Helicopters can not safely operate in fog, hail, storms, heavy snow, zero visibility, or winds over 40 miles per hour. DEFINITIONS EXCEPTIONS REFERENCES NWCH Use of Aeromedical Transport Vehicles A-2 4  HELICOPTER LANDING ZONE LANDING ZONE: DAY - AT LEAST 100’ X 100’ NIGHT AND HIGH WINDS - AT LEAST 150’ X 150’ MAKE SURE SITE IS CLEAR OF TREES, WIRES, EMERGENCY VEHICLES, SIGNS OR OTHER HAZARDS. MARKER FOR THE L.Z. PLACE RIG IN SHOULD STAND AT PLACE RIG IN CORNER WITH THE UPWIND SIDE CORNER WITH HEADLIGHTS OUTSIDE OF ZONE HEADLIGHTS FACING CENTER. FACING CENTER. HAVE FLASHING HAVE FLASHING LIGHTS ON 100’ LIGHTS ON 60-100’ WIND DIRECTION 100’ 100’ 100’ ANGLE OF ENTRY BY HELOCOPTER MARK CORNERS WITH SECURED FLAGS OR FLARES  IF INTERSECTION IS USED, MAKE SURE TRAFFIC IS STOPPED  USE ROPES, BARRACADES OR VEHICLES TO SECURE AREA  KEEP BYSTANDERS AT LEAST 150’ AWAY  ENGINE COMPANY TO STAND BY WITH (1) DRY-CHEM AND (1) CO2 EXTINGUISHER  WEAR PROTECTIVE EYE COVERING  LANDING SITE SHOULD BE AS SMOOTH AND FLAT AS POSSIBLE  ONCE THE HELICOPTER IS ON THE GROUND ESTABLISH A TAIL GUARD End of Document 5