Docstoc

Aeromedical Evacuation Past_ Present and Future

Document Sample
Aeromedical Evacuation Past_ Present and Future Powered By Docstoc
					                                  Aeromedical Evacuation
                                  Past, Present and Future

                                                                                              Sharon Walsh-Hart
                                                                                         Educational Coordinator
                                                                                                    of Simulation
                                                                                             CSTARS Cincinnati
                                                                                                     10 May 2010

As of: Distribution                      I n for g r i y - S e r v i c e - E x c e l e n c e
                      Statement A:  Approved t e public trelease; distribution is unlimited.  l311 ABG/PA No. 10-153, 28 Apr 2010   1
                                Integrity - Service - Excellence

         Critical Care Air Transport Teams
                      (CCATT)
          Improving Performance Through
                     Simulation




                                   Division of Trauma and Critical Care
                                          Department of Surgery
                                   The University Hospital of Cincinnati
                                              Cincinnati, Ohio



As of:            Integrity - Service - Excellence
                                                                  CCATT

            Operates an intensive care unit in an aircraft cabin during flight
            Supports combat casualties evacuated from combat zone
            Supports peacetime movement of critically ill beneficiaries of the
             military health care system
            Humanitarian assistance: Natural disasters and airplane crashes




As of:                     Integrity - Service - Excellence
                                    Key Concepts of CCATT

        Critical care in the air             Stresses of flight
             Ventilatory support                  Decreases in barometric
             Hemodynamic monitoring                pressure
             Intracranial monitoring              Decreases in partial
                                                    pressure of oxygen
                                                   Decreases in humidity
                                                   Temperature fluctuations
                                                   Vibration
                                                   Noise
                                                   Fatigue
                                                       Patient and caregiver



As of:                     Integrity - Service - Excellence
                                 Teaching Methodology at
                                      C-STARS Cincinnati
        Intense 12 day training program
        Military and civilian components
        Several different training adjuncts
           Clinical
              80 hours MD’s
              56 Hours RN’s/RT’s
           Didactic
           Cadaver lab
           Patient Movement Items (PMI) Skills Lab
           Simulation
              Human Patient Simulator
              Flight exercises



As of:                  Integrity - Service - Excellence
As of:   Integrity - Service - Excellence
As of:   Integrity - Service - Excellence
                                   Scenario Development

        Anecdotal reporting               Objectives
            Combat casualty care              Hypovolemic shock
        Reviewing raw data from               Respiratory distress/
         report forms                           failure
                                               Traumatic brain injury
        Complex missions selected
                                               Cardiac arrhythmia
                                               Thermal Injuries
                                               Obstructive shock
                                               Septic shock
                                               Team dynamics




As of:                  Integrity - Service - Excellence
                                                           Pre-Flight
        Patient Movement Request            Designed to replicate the
         (PMR)                                EMEDs environment
        Team will discuss and ask           Evaluate ability to critically
         about the current state of the       think and plan the patient’s
         patient such as:
                                              care during flight
           Updated diagnostic tests
           Vitals signs
           Interventions
           Equipment
           Medications




As of:                   Integrity - Service - Excellence
                                                            Flight

        Headsets for communication
        Acclimate to the environment
        Assess the patients and equipment
        Then first “emergency” or “fire drill” occurs




As of:                   Integrity - Service - Excellence
                                                           Flight

        “Fire Drills”
           Tension pneumothorax
           Hypotension
           Increasing intracranial pressure
           Endotracheal intubation
           Abdominal compartment pressure
           Ventilator malfunction
           Obtaining venous access
           Cardiac arrhythmias
           Cardiac arrest




As of:                  Integrity - Service - Excellence
                                  Post-Flight aka Debrief

        Major portion of learning takes place
        Guided by C-STARS cadre
              Vent their feelings
              Discuss technical aspects of the simulation scenario
              Reflect upon their actions, discussing what went well and
               what did not
              Relate to information presented during the didactic portion
               or even real-world experience




As of:                   Integrity - Service - Excellence
                      Two Part Evaluation Tool
                  Part One: Primary Objectives




As of:   Integrity - Service - Excellence
                 Two Part Evaluation Tool
                Part Two: Team Dynamics




As of:   Integrity - Service - Excellence
                                                     Future Plans

            Validation of evaluation tool
            Add a third “patient” to the simulation scenarios
            Create scenarios that will involve the other C-STAR sites
            Human Factor/Performance studies
              •   Task Saturation




As of:                     Integrity - Service - Excellence
                                                             Thanks!

                                  CSTARS cadre

         •   Col Warren Dorlac               •   Capt Derik Brumley
         •   Col Todd Carter                 •   Capt John Eggert
         •   Lt Col Dave Norton              •   SMSgt Dario Rodriguez
         •   Maj Phil Mason                  •   MSgt Angel Boshonek
         •   Maj Mike Petro                  •   MSgt Toni Garrett
         •   Maj Robert Peron                •   MSgt Mark Andresen
         •   Maj Heidi Stewart               •   Dan Donegan




As of:                   Integrity - Service - Excellence
                                      Questions?




As of:   Integrity - Service - Excellence          17

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:14
posted:8/26/2012
language:English
pages:17