Prep for flight is the 10th Core PFC Capability. Our working group had always deferred to subject matter experts
whenever available. This case is no different. Former SAR Corpsman and RN, Lieutenant Commander Nikki Selby has been has put an entire career’s worth of effort toward training Corpsmen and Medics all over the world. She is a wealth of knowledge who has recently been working on the Clinical Practice Guidelines from the Committee on En Route Combat Casualty Care. As she transitions out of the military her new job will find her doing more work with the Joint Trauma Service in Performance Improvement. Many CPGs have specific metrics in the back which can be tracked and measured. This allows us to identify what recommendations are being followed and if not, get to the root cause to improve compliance.
Planning for flight can include being aware of your intended flight path and time required to fly. Ensuring you have enough drugs, fluids and supplies is crucial. Reversals for any drugs the patient is currently being administered have also proven invaluable.
The preflight assessment can alert you to any potential issues which you may be able to address while still on the ground. This is your time to gather any critical information such as drugs administered, trends in vitals and any thing else not readily obvious. Once you have the information you an then ensure that the patient is properly packaged so as to not lose any lines or circuits which may be dangling out. Can you access injuries and iterventions while keeping the patient warm? Are there any other issues such as TBI which may make you consider a different patient position?
Handing over patients to another provider must be practiced! The MIST report is universally accepted and can get relay much information quickly. Ensure that you have copies of all documentation which you will be handing off. Ensure that you also relay the trends in vitals and over all co edition of the patient. Are they getting better or getting worse since you first layed hands on them? What else would you want to know?
Here are some additional resources from the Committee on En Route Care:
Standard Medical Operating Guidelines (SMOG) for Critcal Care Flight Paramedics Jan 2019
Interfacility Transport of Patients Theater MTF 24 Apr 2018