The Critical Care Transport Medicine Conference was held this week in Charlotte, NC.  Physicians, nurses, paramedics, respiratory therapists, and allied health professionals gathered to explore evidence based best practice in the essentials of care during ground and air transport of the critically ill and injured.  Kudos to AMPA, ASTNA, and IAFCCP for a phenomenal conference!

Here’s a list of important learning points that I came away with:

• Miscommunication, or lack of communication, is the number one cause of errors in health care.  Effective teamwork and communication improve patient outcomes.
• Breathing is the only autonomic function that individuals have some control over. Taking time for a few slow deep breaths in highly charged, stressful situations is one way for medical personnel to improve their performance.
• Using an intubation checklist has shown to improve first attempt success rates.
• Half of all trauma patients that die will do so in the first hour, and half of those die from hemorrhage.  IV crystalloids contribute to acidosis, hypothermia, and coagulopathies.  If bleeding is compressible, then the first priority is to stop the bleeding. If the bleeding in non-compressible, the priority is to get to the hospital. The first priority should not be IV fluids.
• Once a patient’s SaO2 reaches 93%, giving more oxygen is detrimental.  Increasing oxygenation when patients are adequately saturated causes inflammation in the lungs, and the patient gradually decompensates.  More oxygen is not always better.
• UAV’s (unmanned aerial vehicles) otherwise known as drones, are an emerging threat to HEMS programs. 1,000,000 drones were sold at Christmas time last year and the market continues to grow. It is illegal to fly a drone higher than 400 feet or within 5 miles of an airport, but many operators don’t know, or follow the law. A collision with a helicopter, particularly during take off or landing, could be catastrophic.
• Simulations are a powerful way to troubleshoot the logistics of complex emergency transports. The more closely a simulation resembles an actual situation, the more effective it is.

One of the great things about NAAMTA is our focus on continual improvement.  In every individual and every program, there is room to learn, and grow, and improve the practice of transport medicine. When the focus is on daily attention to detail and improvement, then critical thinking, individual performance, and team success improve. 

Keep up the good work!