Name your top 10

CANMAN

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Another thread got me thinking about this. Name your top 10 air medical programs in the nation that you would consider working for. No right or wrong answers but just curious at how many people stay up on some of the top players who are really doing cool stuff. Mine would be in no particular order:
  1. University of Michigan Survival Flight
  2. Life Flight of Maine
  3. DHART
  4. STARFlight Austin Travis County
  5. STAT MedEvac
  6. Life Link III
  7. Vanderbilt
  8. Herman Memorial
  9. Nationwide Children’s
  10. UC Health Air Care
 

NPO

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Cox AirCare
Mercy Lifeline
(Both due to proximity)

STARFligjt
STAT Medevac
Vanderbilt
 

PotatoMedic

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Air St Luke's... (I'm biased lol)
MSP (yeah the helicopters break down all the time but I get to carry a gun and it isn't California)
Airlift Northwest.
Island air ambulance
 

DesertMedic66

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Not for the medical care because they are still in the backboard everyone phase but the members of the Los Angeles Sheriff Department Special Enforcement Bureau are pretty badass. Didnt even know they were a thing until we had to use one of their airships.
 

VentMonkey

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I don’t know that I can objectively conjure up a “Top 10” list, but I would find it safe to say that any Level 1, or program contracted to provide services to, or for/ from a Level 1 trauma center is almost always found to be providing cutting-edge EBM.

Vanderbilt does get props from me, not just for their seemingly top notch level of cutting-edge care, but also because they have a helpful YouTube channel. I find Kevin Highe’s 5 minute videos helpful.

Duke LifFlight seems pretty legit as well.

@E tank CalSTAR huh? Are you a Coastal California native? I don’t know much about them personally, but did admire their (former) RN/ RN staffing.
 

E tank

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@E tank CalSTAR huh? Are you a Coastal California native? I don’t know much about them personally, but did admire their (former) RN/ RN staffing.

Yeah. I got a hire letter from them as I was packing my bags for anesthesia school. Two helicopters and two RN staffing at the time. Out of their Hayward base. They were pretty bad *** back then. Quite the crew.
 
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CANMAN

CANMAN

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I don’t know that I can objectively conjure up a “Top 10” list, but I would find it safe to say that any Level 1, or program contracted to provide services to, or for/ from a Level 1 trauma center is almost always found to be providing cutting-edge EBM.

Vanderbilt does get props from me, not just for their seemingly top notch level of cutting-edge care, but also because they have a helpful YouTube channel. I find Kevin Highe’s 5 minute videos helpful.

Duke LifFlight seems pretty legit as well.

@E tank CalSTAR huh? Are you a Coastal California native? I don’t know much about them personally, but did admire their (former) RN/ RN staffing.

Yeah Vandy has a good program and has their hands in alot of things. I love that the staff there has alot of options for outreach and opportunities to work special events and such. Only downfall is they have like 3-4 different aircraft throughout the system, which doesn't make a ton of sense to me. I always forget about Duke!

I now work for a Level 1 trauma center and we are sadly far from cutting edge. Many of times I miss my old program (STAT MedEvac). Our hospital has a very old school medicine feel to it and unfortunately that transmits to the transport program as well. It pays the bills though, but if I didn't stay in my area I could be lured to one of the above programs. I have also looked at Intermountain Life Flight in UT. Seems like an awesome program and the only hospital based civi service that does hoist work.
 

VFlutter

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Hospital based services have a lot of advantages but can definitely leave much to be desired. Some don't maintain flight volumes enough to be on top of their game compared to a busy community based private. Usually great education and support from the hospital tho.
 
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CANMAN

CANMAN

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Hospital based services have a lot of advantages but can definitely leave much to be desired. Some don't maintain flight volumes enough to be on top of their game compared to a busy community based private. Usually great education and support from the hospital tho.
Totally agree. Luckily we have a huge volume inbound to our main hospital, as it serves as a trauma center but also tertiary center for cardiac services and ECMO, L&D, NICU, and burn. We also do stuff for other programs as backup and scene work. Our problem is our medical director has been here forever, is old and not progressive. We are hoping when he goes in the next few years we get someone more evidence based and aggressive.
 

Peak

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I don’t know that I can objectively conjure up a “Top 10” list, but I would find it safe to say that any Level 1, or program contracted to provide services to, or for/ from a Level 1 trauma center is almost always found to be providing cutting-edge EBM.

I'm gonna have to disagree with that, at least locally.

DG is easy, I don't recall them ever having a HEMS program and they shut down their CCT program.
FFL's trauma care is decent, but they ability to care for specialties leave's much to be desired; and every time I encounter the CHCO transport team I think I loose a few IQ points.
AL doesn't know how to quickly package a patient, although their specialty teams are pretty dope.
UCH's program I see the least of, but I'd rather be transported by the majority of the ground services here.

I was impressed with the team out of Fort Carson the two times I worked with them, but they will only fly when a local group can't and I don't think are technically licensed for civilian transport; and EACH isn't a trauma center...

I honest think that the ground services in Colorado are in general doing much more to stay up to date than the flight programs. What's weird is that I think PSF's medical direction is great and yet FFL seems to lack so much. I know they come from different leadership/service lines but still...
 

Tigger

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I'm gonna have to disagree with that, at least locally.

DG is easy, I don't recall them ever having a HEMS program and they shut down their CCT program.
FFL's trauma care is decent, but they ability to care for specialties leave's much to be desired; and every time I encounter the CHCO transport team I think I loose a few IQ points.
AL doesn't know how to quickly package a patient, although their specialty teams are pretty dope.
UCH's program I see the least of, but I'd rather be transported by the majority of the ground services here.

I was impressed with the team out of Fort Carson the two times I worked with them, but they will only fly when a local group can't and I don't think are technically licensed for civilian transport; and EACH isn't a trauma center...

I honest think that the ground services in Colorado are in general doing much more to stay up to date than the flight programs. What's weird is that I think PSF's medical direction is great and yet FFL seems to lack so much. I know they come from different leadership/service lines but still...
Fort Carson also rarely if ever has paramedics aboard the aircraft and if they do it's Fort Carson Fire which most ground services can offer more care-wise.

The UCHealth helicopters are now REACH operations and the Colorado Springs ship seems to be pretty spot on. While they aren't hospital employees, they are based at the Level 1 and are well involved. Short scene times too. Their ground teams on the other hand...half the time it's pulling RNs from the ED or the unit and throwing them in the ambulance that's driven by AMR.

We share medical direction with Flight for Life in the Springs (Lifeguard 3) and it doesn't seem to matter. It's a super RN heavy program that has more than a little disdain for their own paramedics and ground services.

I would like to fly in Colorado someday, but I am not sure we necessarily have any "cutting edge" programs here.
 

Peak

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Fort Carson also rarely if ever has paramedics aboard the aircraft and if they do it's Fort Carson Fire which most ground services can offer more care-wise.

The UCHealth helicopters are now REACH operations and the Colorado Springs ship seems to be pretty spot on. While they aren't hospital employees, they are based at the Level 1 and are well involved. Short scene times too. Their ground teams on the other hand...half the time it's pulling RNs from the ED or the unit and throwing them in the ambulance that's driven by AMR.

We share medical direction with Flight for Life in the Springs (Lifeguard 3) and it doesn't seem to matter. It's a super RN heavy program that has more than a little disdain for their own paramedics and ground services.

I would like to fly in Colorado someday, but I am not sure we necessarily have any "cutting edge" programs here.

Both of the times they were staffed with uniformed military members so I'm guessing that they were 18 Deltas or 68 Whiskeys, but I didn't ask so I wouldn't know for sure. I know both the EACH ambulance medics and Fort Carson fire medics are federal non-military hires so I don't think it was them.

Granted we receive mostly specialty transfers but most of the flight crews are here just don't seem to have a real understanding of the patient's disease process or immediate treatment plan. I get OB flights and the crew can't event tell me what tocolytics the patient has received prior to transfer, FHR, deep tendon reflexes when on a mag drip, or even when the patient has last had a contraction (this is one of my biggest CCT pet peeves, giving tocolytics and not monitoring contractions). I've had Peds transfers where the crew demands to pit stop in the ED because some kid's airway is failing and all they needed was a good suction; and I've had multiple crews freak out that they can't get a sat above 90% on a s/p norwood. We get a ton of BMT transfers and the most of the crews can't tell me if the patient was an allo or auto. On the outgoing side I've had multiple crews over sedate neurotrauma, and despite our medical providers giving orders for versed over ativan they still snocker them out for four plus hours.

I think that given the populations served and level of training that our ground crews are much more up to date in their practice than the flight crews are, though this varies hugely by service. Unfortunately there is little incentive for HEMS or ground services to be cutting edge, and everyone is constantly trying to cut cost regardless of service structure.
 
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CANMAN

CANMAN

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Both of the times they were staffed with uniformed military members so I'm guessing that they were 18 Deltas or 68 Whiskeys, but I didn't ask so I wouldn't know for sure. I know both the EACH ambulance medics and Fort Carson fire medics are federal non-military hires so I don't think it was them.

Granted we receive mostly specialty transfers but most of the flight crews are here just don't seem to have a real understanding of the patient's disease process or immediate treatment plan. I get OB flights and the crew can't event tell me what tocolytics the patient has received prior to transfer, FHR, deep tendon reflexes when on a mag drip, or even when the patient has last had a contraction (this is one of my biggest CCT pet peeves, giving tocolytics and not monitoring contractions). I've had Peds transfers where the crew demands to pit stop in the ED because some kid's airway is failing and all they needed was a good suction; and I've had multiple crews freak out that they can't get a sat above 90% on a s/p norwood. We get a ton of BMT transfers and the most of the crews can't tell me if the patient was an allo or auto. On the outgoing side I've had multiple crews over sedate neurotrauma, and despite our medical providers giving orders for versed over ativan they still snocker them out for four plus hours.

I think that given the populations served and level of training that our ground crews are much more up to date in their practice than the flight crews are, though this varies hugely by service. Unfortunately there is little incentive for HEMS or ground services to be cutting edge, and everyone is constantly trying to cut cost regardless of service structure.

Sounds like you just deal with some crappy services....

As far as sedation for neurotrauma, the patient is going to get as sedated as I need to complete the transfer safely and effectively.
If they’re a little over sedated and providers aren’t able to examine them as soon as we crest the door that’s the least of my concerns. This is where I prefer Propofol and Fentanyl in conjunction vs. benzo’s, but again you gotta do what you gotta do to get the patient to intervention first and some patients are difficult to get sedated adequately in a stimulus rich environment.
 

Peak

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Sounds like you just deal with some crappy services....

As far as sedation for neurotrauma, the patient is going to get as sedated as I need to complete the transfer safely and effectively.
If they’re a little over sedated and providers aren’t able to examine them as soon as we crest the door that’s the least of my concerns. This is where I prefer Propofol and Fentanyl in conjunction vs. benzo’s, but again you gotta do what you gotta do to get the patient to intervention first and some patients are difficult to get sedated adequately in a stimulus rich environment.

Don't get me wrong, I get sedating patients as needed especially as the patient's condition evolves during care. These particular patients are 20 minute ground transfers who are sleeping or resting comfortably and don't have a need for sedation but the crews sedate prior to transfer. If the patient had any need for sedation we would have already sedated and probably intubated the patient before they showed up.

We have multiple staff who either currently or previously worked HEMS or ground EMS so this isn't just the hospital staff looking to complain, but the local programs leave a lot to be desired. I only do specialty stuff to support our own high risk programs, I would advise others look at a different region if they wanted to do HEMS.
 

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