Flight Medic

rhan101277

rhan101277

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I didn't realize that these folks could so much. I guess it varies state to state, but they can do RSI, chest tubes, surgical cricothyroidotomy, Thrombolytic Therapy, etc.

http://en.wikipedia.org/wiki/Flight_medic
 
What is the difference between critical care ground medics and regular medics.
 
I replied to this earlier but it flew the coop? It really depends on the service, region, medical direction, misison profile, personal certification level, level of comfort, and equipment. Could go on and on but in a nutshell think extensive pharmacy, wider protocols, vent, increase airway management skills and equipment, and nearly 99% transer. Critical care patients from point A to B. ICU patient going to higher level. Must have experience and be comfortable with critically ill patients.

Plugging another current thread - just because you are certified to the CCEMT-P level doesn't necessarily mean you are now a critical care ambulance.

That help?
 
Here's the thread that FF894 plugged if you want to read

http://www.emtlife.com/showthread.php?t=10117

Flight Medics are the same as Critical Care Ground medics with a different mode of transportation. Some flight medics have also taken flight paramedic training and I'm not really sure what is taught there but it's not a requirement for flight crews in my area. The difference between the two is mostly driven by the different types of patients they see that requires slightly modified skill sets. Our flight crews also have a different medical director than the ground pounders so that accounts for a portion of the different protocols.
 
rhan101277 said:
I didn't realize that these folks could so much. I guess it varies state to state, but they can do RSI, chest tubes, surgical cricothyroidotomy, Thrombolytic Therapy, etc.

http://en.wikipedia.org/wiki/Flight_medic
Click to expand...

It really does depend on the state, region, service, and medical direction.

As a Ground Medic, not flight or CC, based on my protocols I can also do the following:

RSI
Surgical Crich
Thrombolytics

Our medical director requires us to attend his airway lecture and then do some training with him on the Advanced Airway procedures though.
 
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marineman said:
Flight Medics are the same as Critical Care Ground medics with a different mode of transportation. Some flight medics have also taken flight paramedic training and I'm not really sure what is taught there but it's not a requirement for flight crews in my area. The difference between the two is mostly driven by the different types of patients they see that requires slightly modified skill sets. Our flight crews also have a different medical director than the ground pounders so that accounts for a portion of the different protocols.
Click to expand...


Very broad statement. But, you may be correct if the state and the medical director have a very broad or a very narrow scope for the Paramedic.

Flight medics do have their own nationally recognized certification.

http://www.certifiedflightparamedic.org/cfp/index.htm


Just like ground CCT Paramedics, the scope for flight medics can vary widely. There are some that fly HEMS (helicopter EMS) which may be the same as the regular EMS Paramedics on the ground with just a little extra helicopter safety training. Some may be allowed a broader scope of practice for meds, equipment and procedures depending on what their state will allow for. Some helicopters (including HEMS) also utilize an RN (or both are RNs) to broaden the knowledge base, what can be done and the type of patient the helicopter can fly.

Some on the gound may be thought of as CCT Paramedics if they can use 3 different medications that a ground EMS crew can not. Some are allowed ventilators and some are not. Some are restrictel only to ATVs. Many Flight programs have ventilators if they do Interfacility but may not if they only do HEMS.

The Paramedics that are afforded a broad scope and a good medical director may be able to do everything listed in the CCEMTP thread.

It just depends on the state, type of service, medical director and type of patients they will be seeing (interfacility and/or EMS). There are also a few Paramedics that work for Specialty teams such as Pedi Transport for Childrens' Hospitals. They may have the option of driving or flying depending on the distance.

More reading:

Flight care vs ground care
http://www.emtlife.com/showthread.php?t=6896&highlight=LVAD

And this might be some of the patients you would expect on some interfacility transports of both types.
http://www.emtlife.com/showthread.php?t=8948&highlight=flight+scenarios
 
JPINFV said:
How does paralytics use differ from RSI?
Click to expand...

I don't know what he was referring to but some ground Paramedics can do RSI but can not maintain a paralytic for the duration of the transport.

That has also been a controversey with the ROSC Hypothermia protocol which may require continous paralytics to prevent shivering. The other problem being seen with a few hypothermia patients is the inability to fully stabilize and correct a few things effectively before cold is introduced. Thus the patient codes again at the ED and it may be more difficult to resuscitate a cold patient.
 
the pilot.
 
piggy16 said:
Who is in charge during flights? The RN's or Medics?
Click to expand...

Kev hit it spot on. I did one ride-along with our helicopter service a few years ago just to see what it was like and I guess technically the RN would be responsible for patient care but by the time you get on a flight crew you have enough experience that both the RN and the Paramedic knew exactly what had to be done and were able to do it efficiently with minimal communication.

Just like on a ground ambulance some who have been partners for a while don't even need to talk to know what the other is thinking and they work very effectively.
 
KEVD18 said:
the pilot.
Click to expand...

Thought I'd answer as being someone who actually does HEMS.

KEVD18, Yes... and no.

Who's in charge of flight operations? The pilot. The pilot is ultimately responsible for the operations of the aircraft.

Who's in charge of pt care? The RN... sort of. The RN is the higher level of care, and, therefore, ultimately responsible for the care of the pt. No nurse can do it alone. No medic can either. I'm talking about critical care HEMS, not ALS. Some aircraft are ALS, and they still will pull a second crew person and a real bad pt. Why? No one person can care for a critical pt alone.

Now if you have a true "crew" and true "partners", who's in charge? Everyone.
 
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piggy16 said:
Who is in charge during flights? The RN's or Medics?
Click to expand...

I fly in a RN/MEDIC system and we typically trade off on Pt care. Our system doesn't have a policy as to "who's in charge" or who will make the Pt care decisions--there is no dictator and we both sign the chart.

Some crews have developed their own systems as to what works best for them. Many crews will have the medics "attend" during scene flights and have the nurses run the interfacility transfers. Alot of it depends on the experience of the nurse or the medic. Many nurses I work with aren't medics but they are as good as any medics I've ever worked with. The same is true with some medics being able to function like any other nurse on a difficult critical care transfer. Alot of it depends on your experience and willingness to improve your knowledge base and overall patient care capabilities--you have to light this fire under your own butt though!

I will say that I would rather deal with an airway from hell than have to take a report and chart an ICU train wreck. On the other hand, some flight nurses want nothing to do with an intubation that looks difficult before we've even had a chance to take a peek.

The bottom line is this--You will lean on each other and utilize the strengths and skill sets that each has developed in regard to the different types of care we've generally provided throughout our careers. It's in the best interest of the patient, your service, and the medical field as a whole.

When I am "attending", I make it common practice to communicate in a professional and respectful manner. I will always ask my partner's opinion before giveing medications (perfuseing patients) as they may be aware of a situation that I may have overlooked or flat out missed. I expect the same with the nurses I fly with. It's a team effort and you will both save each others butts.

The pilot is in charge of the aircraft and flight decisions. The aircraft goes nowhere without their approval.
 
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