CAN YOU GET YOUR PATIENT A HELICOPTER? The art of the consult.

2. CAN YOU GET YOUR PATIENT A HELICOPTER? The art of the consult.

3. HOW TIMES HAVE CHANGED Presented by: Scott H. Wheatley BS, NRP, MICRB, CCEMT-P , FOIII Lieutenant Special Operations Queen Anne’s County Department of Emergency Services Contributing Author: H. Kevin Knussman NRP Caroline County Department of Emergency Services

4. A few video’s to get us warmed up:

5. Yet another one to capture the moment

6. Objectives • A little history about me. • Poll the room, provider level. • History of what changed. • Trauma Categories • Assessment skills

7. Objectives • Speak the talk, walk the walk. • Confidence when relaying information. • Paint a clear picture. • 60 seconds or less. Do not make the consulting base station loose their mind. • Review and wrap up.

8. Who knows these gentleman?

9. This is all I have ever wanted to do.

10. WHAT ABOUT YOU? • EMR’S • EMT’S • Paramedic’s • RN’S • PA’s • Physicians

11. THE GOAL • It is important for EMS providers to know the appropriate protocols and follow specific steps to ensure correct treatment and transport decisions are made to benefit the patient.   • The right patient must get to the right hospital in the right amount of time.

12. September 27th, 2008 • What happened? Do you remember?

13. Before September 27th, 2008 • Providers could activate EMS just on mechanism and injury presentation. • No consults were ever needed. • More patients ended up at trauma centers then needed it.

14. Now….THE TRAUMA DECISION TREE

15. CATEGORY A: What does this mean?

16. CATEGORY B:

17. CATEGORY C:

18. CATEGORY D:

19. Simple breakdown of the TDT

20. What about STEMI or Stroke • NO DECISION TREE CATEGORY IS NEEDED! • If your greater than 45 minutes by ground to your referral center, use aviation.

21. KNOW THE PROTOCOLS The Medevac Utilization protocol (Section 20, p 198-1) has specific directions on the medical decisions for transport by medevac helicopter.

22. ASSESSMENT OF YOUR PATIENT! Look, listen, execute Sick / Not sick? • Primary survey! What does this mean to you? • Sick or not sick? Listen to that small voice! • Always error on the side of the patient. • LAY YOUR HANDS ON THE PATIENT!

23. Really, head to toe means that! • Don’t forget to treat the elderly properly!

24. Preparing for your consult • Think before you speak. • Its okay to use a cheat sheet. • Don’t try to impress with big words. Especially if you don’t know them!

25. You have to sell the story • If it’s a “charlie” or “delta” patient, you have to sell the story. • Why do you feel they would benefit from a trauma center. • Be precise, clear, and concise.

26. REMEMBER THE MANDATORY FACTS • GCS • Priority • Category • These must be relayed in the consult per Maryland Medical Protocol’s for pre-hospital providers.

27. Remember categories can change • Update on your patient. • If you treat the patients appropriate, EUREKA, they can improve! • Explain the change to MSPAC upon arrival if needed. • COMMUNICATE!! • USE ALL YOUR TOOLS!

28. USE THE NEW AND ADVANCED TOOLS

29. STAY ON THE CUTTING EDGEALWAYS BETTER YOURSELF!

30. Assessment and tools: • By using your best assessment skills your patient will receive the best care and increase the survival outcome. • Your sole goal is to decrease morbidity and mortality. • Only you can make the difference!

31. Never stop learning!

32. What have we learned? • Reviewed the history of change. • Assessment skills and tips. • Communications. “CAN YOU HEAR ME NOW?” • Using the best tools possible.

33. SPECIAL THANKS TO: • TFC Sean Thistle MSPAC • MSPAC for shared pictures • QACDES • R Adams Cowley Shock Trauma • Diana Clapp RN, BSN, NRP • Dr. Joseph Ciotola • Zoll • Physio-Control • GE ultrasound • Autovent

34. QUESTIONS