Document Sample
					      LifeNet of New York
Landing Zone Presentation
• Program Director – Dean Dow
• Medical Manager – John Fisher
• Medical Base Supervisors
  –   Jon Gryniuk
  –   Shannon Martin
  –   Mike Paulson
  –   Craig Castioni
• Medical Directors
  – Deb Funk MD, David Stuhlmiller MD
• Administrative Assistant – Desiree James
• All pilots hold a
  commercial certificate
  with instrument rating
• Have at least 2000
  hours of PIC time
• Completed specialized
  training in EMS flight
                               Medical Staff
• Available 24 hours a      • Provide advance
  day, 7 days/week, 365       medical procedures
  days/year                    – advanced airway
• Medically dedicated            management
                               – hemodynamic support
• Staffed by a
                               – advanced pharmacology
  Paramedic/RN team
                               – ability to act
  with equal training and        autonomously guided by
  responsibility                 “standards of practice”
Life Net 7-1 , Albany
• American Eurocopter
• Twin Pratt and Whitney 650 shp
• Rear load for ONE patient
• 187 gallons Jet A
• Range of 300 on full load of fuel
• Cruise speed of 168 mph
    Dimensions and Weight
• Total running length – 40 ft
• Main rotor diameter – 34 ft
• Main rotor height – 11 ft on level
• Tail rotor height – 2.2 ft
• Maximum gross weight – 6250 lbs.
• Can carry up to 350 lb. patient
Life Net 7-2, Glen
• American Eurocopter
• Twin 250hp Allison Engines
• Rear load for ONE patient
• 150 gallons of jet A fuel on underside of AC
  (similar properties to Kerosene)
• Range of 300 miles on a full load of fuel
• Cruising speed of 130-140 mph
     Dimensions and Weight
• Total running length – 39 feet
• Main rotor diameter – 32 feet
• Main rotor height – 10 feet (level
• Tail rotor height – 7 feet (level ground)
• Maximum gross weight – 5500 lbs.
• Can carry up to 350 lbs. patient.
Air 1 / Air 2 , Kobelt & Valhalla
• American Eurocopter
• Twin Lycoming 650 hp gas turbines
• Rear load for ONE or TWO patients
• 187 gallons of jet A fuel on underside of AC
  (similar properties to Kerosene)
• Range of 300 miles on a full load of fuel
• Cruising speed of 144-150 mph
       Dimensions and Weight
•   Total running length - 43 feet
•   Main rotor diameter - 36 feet
•   Main rotor height -10 feet (on level ground)
•   Tail rotor height - 6 feet (on level ground)
•   Maximum gross weight - 7055 lb
•   This aircraft has carried patients with
    combined weight of > 500 lbs.
        Scene Responses
• LifeNet NY can and has responded
  within a 100 mile radius of the
  respective bases
                        Equipment & Skills
•   ECG Monitoring
•   Biphasic Defibrillator
•   ETCO2 monitoring
•   Ventilator
•   IV pumps
•   IV warmer
•   Transvenous Pacer
•   EZ IO
•   Jet Insufflator
•   Needle & Surgical
•   Escharotomy
•   RSI Intubation
•   Neonatal Resuscitation Equipment
•   Over 70 medications
      Why Utilize Air Transport ?
• To “bring the Emergency Room to the
• To provide the patient with early, needed and
  advanced medical care
• To transport the patient to the “closest
  appropriate facility” therefore decreasing time
  to Definitive Care
   Transport Criteria: Physiologic
• GCS < 13                    • Burn patients—greater
• Head injured with altered     than >10% BSA 2nd and
  mental status                 3rd and >5% 3rd in any
• Confused/combative            population
• Unconscious/unresponsive
                                 – These patients will be
• Heart rate > 120                 transported directly to a
• Blood pressure < 90/p            burn facility @
                                   Westchester, Worcester,
• Pelvic fractures                 Syracuse University
• Limb paralysis                   Hospital and/or Boston
 Transport Criteria: Physiologic
• Chest trauma with      • Amputations
  respiratory distress     proximal to the hand
• Respiratory rate >       or foot, not to
  29                       include single digits
• Severe shortness of    • Penetrating trauma
  breath                   – Gunshots
• Difficulty speaking      – Stabbings
                           – Impailments
• CO poisoning
       Transport Criteria: Operational In
           Conjunction with Physiologic

•   Need for ALS otherwise unavailable
•   Extrication > 10 minutes
•   Fall of 20 feet or more
•   Patient ejected from a vehicle
•   Vehicle rollover with patient entrapped
•   High speed crash with significant intrusion
•   Motorcycle/Auto v. Pedestrian
Transport Criteria: Operational
•   Surviving patient of a MVC with a death
•   Age of < 5 or > 55 years old
•   Significant associated medical conditions
•   Pregnancy
•   ***These patients should be transported to a
    regional Trauma Center (Albany Medical
    Center, Bassett Health Care (Cooperstown),
    Robert Packer, St. Elizabeth’s, University
    Hospital, Wilson Memorial)***
             Special Circumstances
• Patients without        • A surviving patient
  vital signs:              will be transported
   – there is usually no    before one in arrest
     survival from        • LifeNet of New York
     traumatic death
                            can provide
   – Hypothermic patients
                            assistance to local
     being the exception
                            providers and
• No patient is too         transport by ground
  critical to transport
                      Who can request?
• Law enforcement       • RNs/MDs/Pas
• Firefighters          • Many of the regional
• Industrial safety       counties are on
  officers                automatic stand-by
• First responders        for “delta” calls:
• Paramedics            • Rensselaer,
                          Saratoga, Columbia,
• EMTs                    Washington, and
• First Responders        Schenectady
                        How To Request
                        1 800 525-6663
• Agency or comm.       • Ground frequency
  Center calling          with or without PL
                        • The AC can program
• Call back #
                          high/low and ultra
• State and county        high frequencies
• Lat/long or nearest   • Scene information
  roadway and cross     • Description of
  street                  landing area
                        • Hazards and their
                          position to the LZ
Delorme Street Atlas
                             STAND BY
• Automatic stand by/ launch currently
  instituted in Rensselaer, Columbia,
  Saratoga, Schenectady, and Washington
  counties for all “delta-level trauma”
• Readies AC and FC for mission
• Second call is needed to launch or cancel
• No charge if cancelled enroute
• Automatic launch for areas > 30 nautical
                                Early Call
• Lets YOU know if:
  – the AC is out on another call
  – unable to fly due to weather
  – is on a maintenance delay or out of service
  – may be a short delay only and still able to
    be utilized
  – an available AC will be found or we may be
    able to intercept
  Weather--Pilot’s Final Decision
• Minimum standards for
  ceiling and visibility
   – day versus night
• Weather based on
  satellite readings,
  current conditions, and
• Pilot knows only
  destination when
  making decisions
          Enroute Information

   Scene (LZ) information only
FC will obtain patient report when
           safely landed.
              Landing Zone Officer
• One person assigned, landing the AC safely
  the only responsibility
• AC will try to contact LZ officer ~ 5-10
  minutes out
• LZO may need to be on apparatus radio;
  portable may not transmit
• Focus all attention on managing
  communications, approach/departure, and
  landing site area
               Landing Zone Officer

• Directs the AC into the scene. May be
  required to use directions, “out your right
  door and/or clock method--nose of AC is
  1200, tail of AC 0600.
• Locating the scene in daylight is more
  difficult, even with overhead lighting.
• AC/pilot may circle LZ numerous times before
Slide of LZ officer, in turnout
      Choosing the Landing Zone

• Proximity to the
  accident, utmost        • Approach and
  importance                departure path clear
• 80’X70’                   of obstructions
• Level surface
• Clear of obstructions
• Secured by LZ officer
        Marking the Landing Zone
• DAY                        • NIGHT
  –   Flares (caution)         – Flares (caution)
  –   Cones                    – Chemical light sticks
  –   Rescue vehicles          – Battery powered
  –   Overhead lighting on       flash lights (secured
      rescue vehicles both       to ground)
      for day or night         – Headlights from two
                                 vehicles pointed at
                                 LZ to form an X
      Preparing Touchdown Area
• Secure loose debris (car   • Secure nearby activity
  doors, trunk lids,            – Moving traffic
  stretchers, linens,           – Rescue activity
  baseball hats etc.)           – Apparatus and
• Protect yourselves!             ambulance doors closed
  Wear turnout gear,            – Keep all spectators > 200
                                  feet from LZ. Only those
  goggles, protective eye         assigned to protect the
  shields                         AC allowed < 100feet
• LZ walk through
•   Fire Department
•   Pre-hospital providers
•   Police Department
•   Life Net of New York
•   All involved in the safe transfer of a
    critically ill or injured patient
           Take Off and Landing

    “Most Critical Time of Flight”
AC will not land w/o first attempting to
    make contact with LZ command
  Arrival / Landing Information

• Obstructions: wires, power lines, light poles,
  smoke stacks, antennas, etc.
• Report all obstructions to the pilot as the AC
  is over the landing zone, never assume pilot
  has seen all obstructions.
• Winds: wind direction and intensity helps the
  pilot better plan the landing. Helicopter lands
  and takes off with nose into the wind.
Arrival / Landing Information

– Condition of the touchdown surface: be
  specific, ie: slope, surface (mud, packed snow,
– Security: assure crowd is secure and all traffic
  is stopped for landing and take-off.
– LZ officer will be notified of “final approach”. If
  any unsafe or potentially unsafe situation
  arises, contact pilot to make aware. Use short
  simple commands: “STOP! WIRES!”, etc.
       SIGNS, PLOW STAKES, etc...
High Hazards

  Do not assume the AC cannot land
   in the presence of wires near the
         Landing / Lift-off Safety

During night operations, NEVER allow
 white lights to shine into the cockpit.
 Night vision will be compromised
                      Final Approach

• As the AC is on “final approach” the
  pilot or FC may ask the LZ officer to
  have all white lights, shining toward the
  LZ, extinguished before touchdown.
• The AC can produce > 70 mile per hour
  winds with short final. Protect
                Ground Operations
– Always approach the   – Keep all personnel
  AC from the nose.       and others at least
– Never approach the      50 feet away from
  AC unless directed      the AC when
  by the FC or pilot.     running.
– If asked to get       – May post a safety
  equipment by FC in      officer 50 feet
  AC, never approach      behind the tail rotor
  w/o the getting       – NEVER APPROACH
  pilot’s attention.      OR GO NEAR THE
                          TAIL ROTOR OF THE
                Ground Operations
– Let the FC come to    – Nothing carried above
  you                     the waist level.
– FC does NOT require   – No smoking within 50
  assistance off-         feet of the AC
  loading equipment     – No sheets, blankets,
                          baseball hats near AC
– Keep apparatus and
                        – Firefighters should
  EMS vehicle doors
                          have turnout gear and
  and windows closed.     helmets with shields
– Leave patient in        down.
     Keep All vehicles > 50 feet
                        from AC
• Cartoon of pic of EMS vehicle damage by
  rotor blades.
                     Patient Preparation
• Flight Team will

  – patient assessment
  – required
  – transfer patient to FC
  – load into AC
                             Patient Loading
• Only FOUR people to
  carry patient/stretcher
  into the AC
• One person on each
• Follow the directions of
  the FC
• Load patient into AC
  feet first
Patient Loading
• Approach AC toward
  nose and watch pilot
  and FC for directions
• Stay close to body
  of AC
• After patient is
  loaded, FC and/or
  pilot will secure
  stretcher and
            After Loading Patient

Depart AC off the nose when directed by
                FC or Pilot
                  Departure Information
 Limit Communications to Hazards Only

– Assure AC and tail      – Maintain radio
  rotor is clear of any     communications with
  obstructions              the pilot until the AC
                            is safely in forward
– Maintain visual           flight
  contact with the AC
  until clear of LZ       – Immediately report
                            any safety concerns
                            to the pilot, again
                            using short, simple
                     Hazmat Situation
– Preparation and consideration for everyone’s
– Give AC and FC advance warning, if possible
– Land AC at least 1/2 mile from hazardous scene
– FC do not carry protective suits or breathing
  apparatus for protection. Early warning is
– Patients will be completely decontaminated prior
  to being placed in the AC
     Wind direction              Hazmat

                      1/2 mile
75 x 75
                             MCI Situation
• Consider utilizing LifeNet of New York as part of
  your MCI plan
• FC will be available to the transport officer
• Patients are able to be dispersed with available
  AC not overwhelming one facility
• If multiple patients are involved in a situation,
  multiple AC can be activated using the LifeComm
  dispatch center.
• Have separate LZ areas for each AC called to
  incident. Each LZ does not require separate FD
            Equipment Return

  Be sure all equipment is well
marked. LifeNet will make every
effort to return all equipment by
         ground or mail.
                 Post flight contact
• Any concerns should be addressed as
  soon as possible
• Please complete and return our
  customer survey to allow us to continue
  to improve our service
• (518) 262-8800

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