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Working Fire Training / Copyright 2004 / Volume 04-3 1 TRAINING Helicopter Transport Response Goals of Training Flight overview Flight Staff Reason to.

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Presentation on theme: "Working Fire Training / Copyright 2004 / Volume 04-3 1 TRAINING Helicopter Transport Response Goals of Training Flight overview Flight Staff Reason to."— Presentation transcript:

1 Working Fire Training / Copyright 2004 / Volume TRAINING Helicopter Transport Response Goals of Training Flight overview Flight Staff Reason to call How to initiate a call Aircraft walk-around Cabin Equipment Anatomy of a call GPS/Communications Training Classes Crew role Discussion Quiz Continuing Education Working Fire Training 04-3 Training Materials Click anywhere to view show in its entirety

2 Working Fire Training / Copyright 2004 / Volume I. Goals of Training Learning the issues of importance for helicopter transport crews Familiarity with the equipment and safety issues involved. Understanding the mindset of helicopter transport crews and the role they play.

3 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Inter-hospital flight; transferring of patients Scene flight; response to incident scene via calls from EMS dispatching. –ARCH Air Medical Service sometimes meets EMS at hospital for further transfer after initial stabilization. Flight Overview

4 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response A mapping system is used to convert location to GPS coordinates. –Range is about 150 miles from the base –Case load averages 3-5 per shift Flight Overview

5 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Staff Flight nurses usually have a hospital background. –Required to have five years' experience in a hospital ICU or ER.

6 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Staff Complimentary relationship between the flight nurse aloft and the paramedic on the ground. –Often, nurses have been paramedics and vice-versa. –On inter-hospital flights, the flight nurse is typically in control. These are often ICU transfer cases where the nurse may have more experience. –On scene responses, the paramedic directs the action. Click for live video FLOAT CLIP ABOUT COLLABORATION BETWEEN CREWS

7 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Staff HTR can provide: –a. just transportation if ALS has been administered on the ground, or –b. a full range of invasive, critical services.

8 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Reasons to call Incident is in a remote area from hospital services. Departments only have minimal life support services. Rough terrain and/or difficult access. Lengthy extrication that cuts into the Golden Hour.

9 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Reasons to call Injuries that may go downhill in a hurry or ones that will obviously need a specialist’s care quickly, such as a limb reattachment. Departments should develop protocols in advance; on-scene is not the time to argue as to whether a particular case is worthy. –Either you call or you don't. –If you're in doubt, call!

10 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response How to initiate a call HTR units usually have a toll-free number called by Dispatch when directed to do so. Give department name, nature of call or incident and a location (address with cross streets.

11 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response How to initiate a call If possible, call in advance if helicopter services might be needed. While on standby, the crew can check: –weather and flying conditions alternate hospitals, if necessary –exact location through latitude and longitude –safety checks of the aircraft which will save time

12 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter Walk-around The ARCH copter is a BK-117, a cabin class aircraft with single-patient capacity. Wire-strike protection kit Windshield wipers Main rotor system with two turbine engines

13 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter Walk-around Cockpit accessible from either side. Cabin area has an airway seat, bench seat, and room for a stretcher Cabin doors slide open for better access and can be jettisoned in case of an emergency Loading and unloading is done through the clamshell doors at the rear

14 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter Walk-around Note proximity to the tail rotor which is head-high: –Typically, the pilot will station himself in front of the rotor to keep a crew members from walking into it. –Because of the limited space in this area, only essential personnel should be there. exact location through latitude and longitude Click for live video FLOAT CLIP ABOUT TAIL ROTOR SAFETY

15 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter Walk-around The aircraft is powered with "shore power" when on the ground for starting the engines and powering and charging the on-board medical equipment. The aircraft has strips of electronic resistant heat to keep the gearboxes warm and the oil preheated in the event of a quick start and departure

16 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter cabin equipment Two IV pumps can manage six different drips simultaneously. On the stretcher, an MRL cardiac monitor and non-invasive blood pressure cuff. Pulse oximetry and CO2 monitoring; all patients receive cardiac monitoring and pulse oximetry as a minimum.

17 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter cabin equipment Two on-board suction units and two oxygen ports supplied by a LOX tank. A ventilator port and an air port for an isolette. A jump bag with airway and intubation equipment, first-line cardiac drugs, and IV drips

18 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter cabin equipment An infant/pediatric bag with the same equipment for those patients An RSI bag with rapid sequence induction medications for intubation and medications for sedation and chemically paralyzing patients to more easily intubate them An air-to-ground radio to the communications center

19 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter cabin equipment Drawers that hold medications Pouches for bandages and an OB kit should a birth delivery be necessary At the rear of the aircraft, a survival kit, extra headsets, portable suction, IV bags and tubing.

20 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Helicopter cabin equipment The helicopter has its own stretcher with collapsible wheels; some aircraft only has a litter. As a cabin-class aircraft, the cockpit is separate from the cabin area for safety and security reasons.

21 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Once a call has been initiated, the ARCH Dispatch center will alert the crew and provide ground locations via GPS. Those coordinates are programmed into the helicopter navigation system. The pilot, being constantly aware of the weather, will assign a level of "green" so the Dispatcher knows they can take a flight at any time. If the weather is "yellow," then weather will have to be checked specifically in the response..

22 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Radio frequencies are established with ground crew and advanced communications are begun regarding patient condition, hospital destination, landing zone obstacles, etc. Advanced notice allows the crew to be mentally and physically prepared. Usually the helicopter goes directly to the incident scene; sometimes they are forced to land some distance away with ground transport delivering the patient to the helicopter at that off-scene location.

23 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Upon landing, the ground crew should have control of the landing zone area; the air crew assists by looking out for obstructions. – Give the pilot landmarks he can see; buildings, rivers, etc. – Leave vehicle lights on, even in the daytime, but illuminate the landing zone; DON'T shine lights on the helicopter!

24 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Upon landing, the ground crew should have control of the landing zone area; the air crew assists by looking out for obstructions. –For landing, a 75-foot area is needed, perhaps a farmer's field or someone's yard that is relatively firm and flat. The helicopter can land on a 11- degree slope but prefers a flatter surface. –The pilot considers the wind in planning his approach and does a high-reconnaissance pass before descending.

25 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Once on the ground, the pilot idles the engine and then protects people from the tail rotor. The ground crew communicates where the patient is to go and transfers the patient physically.

26 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Anatomy of a call: step-by-step Assistance may be requested from the ground crew. If that occurs, ground crew members should remember to keep their arms close to their bodies, remove baseball caps, and restrain loose objects. Upon leaving, a radio transmission to the hospital is made, bringing its staff up to speed about the patient. ARCH Dispatch also calls the hospital security force to tell them a flight is coming in.

27 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response GPS/Ground communications GPS coordinates make finding the exact location much easier. Establishing ground communi- cations in advance of arrival is very helpful and increases the overall level of safety. Radio communications is one area that needs improvement. The standardizing of frequencies would be extremely helpful. Click for live video FLOAT CLIP ABOUT IMPORTANCE OF GROUND COMMUNICATIONS

28 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response GPS/Ground communications Rural areas often only have one dispatcher which makes communications difficult at times. Once on the ground, communications with ground crew members is difficult because of engine noise. Also, people sometimes confuse the front of the helicopter with the rear and can put themselves in harm's way. It's the pilot’s job to keep track of people on the ground.

29 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Training Classes ARCH Air Medical Service makes training available to ground departments who request it. Most air transports services offer will offer such training. Training will be given in: – landing zone setup – what's required by the flight crew landing zone setup – safety around the aircraft

30 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response Training Classes Most will offer a ride-along program to nurses, paramedics, firefighters, police, and emergency crew. ARCH gives a four-hour check ride and certification course.

31 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response HTR crew role The helicopter flight crew envisions its role as being an extension of the EMS ground crew. They realize that everyone involved has a role to play. It's the ground crew's incident; YOU'RE running the show! The air crew is there to provide assistance so tell them what you want them to do. Don't expect them to take over. Click for live video FLOAT CLIP ABOUT FLIGHT CREW ROLE

32 Working Fire Training / Copyright 2004 / Volume Helicopter Transport Response HTR crew role The helicopter crew is aware of and respects the good care that the ground crew provides. Without it, there would be no patient to deliver.

33 Working Fire Training / Copyright 2004 / Volume Department Discussion The departments involved in this month’s training pose some discussion questions that you can use as discussion-starters in your own department’s training sessions. How will your department handle these scenarios?

34 Working Fire Training / Copyright 2004 / Volume Department Discussion “Does your EMS department or ambulance ground unit have access to helicopter transport response (HTR) unit and do you have protocols in place to work with them?” -Communications Supervisor Curtis Morice ARCH Air Medical service, St. Louis, MO

35 Working Fire Training / Copyright 2004 / Volume Department Discussion “Has your department or ground unit established communications frequencies and protocols that will enable smooth interaction between air and ground units?” -Communications Supervisor Curtis Morice ARCH Air Medical service, St. Louis, MO

36 Working Fire Training / Copyright 2004 / Volume Department Discussion “Is your EMS or ambulance unit trained in how to interface with an HTR unit? Do you understand the flight crew’s needs and considerations?” - Flight Paramedic Steve Harker ARCH Air Medical service, St. Louis, Missouri

37 Working Fire Training / Copyright 2004 / Volume Department Discussion “As an HTR pilot, my responsibilities after landing involve policing the activities of the EMS ground crew in and around the helicopter on the ground. Are you familiar with the safety procedures that must be followed around the rear end of the aircraft?” - Pilot Jeff Stackpole ARCH Air Medical service, St. Louis, Missouri

38 Working Fire Training / Copyright 2004 / Volume Department Discussion “Are you familiar with the assistance needed by an inbound HTR unit prior to landing that your ground response unit must render?” - Pilot Jeff Stackpole ARCH Air Medical service, St. Louis, Missouri

39 Working Fire Training / Copyright 2004 / Volume Department Discussion “Does your EMS department or ambulance unit train with the HTR unit serving your jurisdiction? Have your members tried to develop a training program or taken the HTR unit check-ride and certification program?” - Flight Nurse Andy Gucciardo ARCH Air Medical service, St. Louis, Missouri

40 Working Fire Training / Copyright 2004 / Volume Confined Space Rescue: Quiz Date__________________ Firefighter________________ Chief/T.O.______________ Education Credits _________ Select the best answer: 1. True or False: Upon landing, ground response units should gather as many members as possible to assist with the patient transfer.. 2. True or False: Even after a Helicopter Transport Response (HTR) unit arrives, the ground unit still controls the scene. 3. True or False: Ground responders should heed advice and safety warnings from the pilot.

41 Working Fire Training / Copyright 2004 / Volume Confined Space Rescue: Quiz Select the best answer: 4. Multiple Choice: Which of the following is NOT one of the reasons to call for HTR? a. Lengthy extrication that cuts into the Golden Hour. b. Departments only have minimal life support services. c. Incident is in a remote area from hospital services. d. Air transport helps to save gas usage by ground transport units. e. None of the above

42 Working Fire Training / Copyright 2004 / Volume Confined Space Rescue: Quiz Select the best answer: 5. Multiple Choice: Which of the following regarding HTR are in the right order? a. Call toll-free number - Give department name, nature of call, and a location - If possible, call for helicopter in advance - Provide person on ground to oversee landing b. Give department name, nature of call, and a location - Call toll- free number - Provide person on ground to oversee landing – If possible, call for helicopter in advance c. Provide person on ground to oversee landing - Give department name, nature of call, and a location - Call toll-free number – If possible, call for helicopter in advance d. If possible, call for helicopter in advance - Provide person on ground to oversee landing - Give department name, nature of call, and a location - Call toll-free number e. None of the above (Answers on Slide 45)

43 Working Fire Training / Copyright 2004 / Volume Continuing Education Kramer vs. Kramer: Confined Space Rescue Complete written responses to the following three essay questions: 1. List all the factors you consider important when deciding whether to transport patients by ground ambulance or by helicopter? 2. In your area, what are the advantages of transporting by ground? 3. In your area, what are the advantages of transporting by air? …CONT. If you’re enrolled in the Open Learning Fire Service Program at the University of Cincinnati, here’s your opportunity this month to earn one college credit hour for watching Working Fire Training.

44 Working Fire Training / Copyright 2004 / Volume Continuing Education ENROLLMENT INFORMATION: For more information on enrolling in the Open Learning program to gain college credit, call Fire at for a brochure or, to register directly, call the University of Cincinnati at Associates and Bachelors programs are available. Call to have your transcripts evaluated. Send your responses to: Mr. Bill Kramer University of Cincinnati College of Applied Science 2220 Victory Parkway, ML #103 Cincinnati, Ohio 45206

45 Working Fire Training / Copyright 2004 / Volume Training Materials TRAINING Thanks so much for viewing Working Fire Training! See you next month – stay safe! Answers to quiz on Slides 40-42: 1. False 2. True 3. True 4. d. 5. a.


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