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Medical Helicopter Tour ?911/CCT?

Medical Helicopter Tour ?911/CCT?
hey guys my name's sam and welcome to prepmedic in this week's video i'm giving you a full

tour

of our critical care

helicopter

all right guys so a little bit of background before we start the video i work for a critical care transport service out here in colorado so we actually operate three separate

helicopter

s and a multitude of ground units we do both the critical care interfacility transfers which means taking uh really acutely sick patients from the er to icu icu to icu and to other specialties so we do a lot of balloon pump transports we do impellas some ecmos uh high rob so high risk ob transports where they need fetal monitoring the whole time intubated patients uh that are on a ventilator or just patients that are very sick and have a lot of medications running at one time our cruise consists of a pilot a critical care nurse and a critical care paramedic so in this week's video i'm actually going to go through this entire helicopter we're going to start with the lead pilot giving a quick rundown of this aircraft and some of her controls up front and then we're going to go into more of the patient care compartment along with all of the exterior compartments of the helicopter so without further ado let's get into the video so we are going to look at the airframe that we fly this is the airbus as350 we also call it the a-star also known as the squirrel because it's kind of a handful to hover it's got a turbo mecha engine it's a three bladed helicopter has about a thousand horsepower it's one of the best helicopters for high altitude ems work for the fact that it leaves a smaller footprint in the mountains a lot of our lz's landing zones that we land in are tight in the mountains near rivers on a dirt road and we can't come in there with a huge helicopter as well as it is light very light airframe on the skids we have these things that are called bear paws and that allows us to land in the snow and keep the tail up out of the snow as well as this helicopter has a world record for landing on mount everest so the high altitude capabilities are phenomenal we were able to land in small areas and land at super high places a lot of the other helicopters that have dual engines are way too heavy and their power actually more power limited in the mountains all right so these are the gps modules this is the other gps on the other side they cross fill each other engine gauges backup artificial horizon everything you need to know about the helicopter and the panel of radios down here and these are the controls all right guys so coming into the patient care area of this aircraft both sides have the same door layout although the patient is actually loaded from the left side now this is a relatively small airframe so as you're going to see there's not a ton of room for the patient or even the attendants but in here we have this one sliding door now what's cool about this is that we can actually open the sliding door in flight as we're coming in for a landing if we're at an unsecured landing zone where we don't really know what the terrain is under us both the nurse and the medic can pop their doors we can guard the tail rotor make sure that's not going to come in contact with anything and then we can also look down and make sure that the skids are coming down on a level surface so kind of nice that we're able to do that now the second door here we can't open in flight but this actually allows us to get the cot in and out of the helicopter it can be opened while the rotors are spinning so we can do what's called a hot offload or hot on load if we do want to either take the patient or take the cot out while the rotors are still spinning we can do that and saying we can load the patient in which just makes our scene time a little bit faster if we don't have to shut the entire aircraft down so the name of the game for this helicopter is weight management we want everything as light as possible in fact for the crew members we all have to maintain a weight under 230 pounds with our helmet and anything else we have on us so fully loaded down any more than that and we actually get grounded till we can fix that so in here this cot is similar to an ambulance cop but doesn't have any wheels we can just unlock it right here and bring this out to allow for this to be taken out of the aircraft and then we can actually separate the sled from this and you'll see the sled is pretty light i can lift this on my own if a patient's on it we either need a bed to slide this onto or back into this or we need a bunch of people to carry the sled and actually lock it into the holder on here we have our what we call our first out bag or our scene bag this bag is meant to sustain a patient for the first five to ten minutes of any call uh and i do have a video going through this in detail so i'm not gonna spend a ton of time on it but i'll really quick run you through the pockets uh this top pocket here we have all our narcotics and our rapid sequence intubation medications so if a patient needs an airway if they need a breathing tube put in we can paralyze them and sedate them and we can actually insert that with these medications it also has all our pain management meds so all our narcotics and benzodiazepines live up here because these are things that we use relatively regularly in the top lid of this in this pocket here we've got two cat

tour

niquets we've got chest seals some minor bandages we also have quick clot for our traumatic injuries that we need to stop bleeding quickly on coming into the side pockets here on this side we have uh blood tubing so we do carry blood products we've got a unit of liquid plasma and then we have two units of packed red blood cells we're not carrying whole blood yet and those are for our trauma resuscitations if somebody's bleeding externally or internally we can start administering uh this to them and the blood tubing is just a y so blood will go on one side of it saline will go on the other and then once the blood runs in we can flush the line with the saline and start running another unit or start pushing meds through that line if need be over here we've got an iv kit that's just in a welsh allen black bag and that iv kit has everything we need so it's got all the sizes of your ivs loops flush things like that and then down here we've got just a half bag of saline and normal drip tubing nothing super special about that we keep that on that side of the bag and then on this side here we have our i o so i o is interosseous i also have a video on interosseous access it's a needle that goes directly into the bone that allows us to get vascular access on somebody that's a really hard stick for ivs or that's unresponsive or in a really profound state of shock we've got a glucometer in here and then in here we just have o2 administration stuff so we carry nasal cannula and non-rebreather in that side of the pocket now coming into the main compartment here we have a number of different cells so these aren't the stat pack cells and i should mention this bag is the statpack g3 backup um it's a pretty nice pack the outside is really easy to wipe down and disinfect but in here we've got a bunch of these different cells these are made by cantera and this one has all our acls meds so epi atropine d50 narcan and amiodarone are in there and then in this guy we've got our backup airway so our backup adult airways our crycothyrotomy or eye gels for a supraglottic uh cricothyrotomy is cutting somebody's neck to establish that airway and then in here we've got our bvm with a peep valve and then our opas mpas things like that we do use a children's bvm because the tidal volume is still comparable to adults and we don't want to over inflate somebody's lungs down here we've got a video laryngoscope this is the glidescope it's a little bit older and i think we're getting a new one relatively soon and then these two packs are two glide scope covers and this last one is going to be our pediatric backup airways so we've got um our eye gels and then we also have stuff for needle crike if we end up having to and last but not least down here is a cantera airway roll that has everything for direct laryngoscopy all right so coming down to the lid of the pack here we've got a couple mesh pockets so up top we have our what we call a recess bag so this basically has our push-dose pressers we carry phenylephrine which is a pre-mixed stick and then we carry everything to make a push-dose epi uh for our patients are really hypotensive and then in here we've got a chest pain kit so this one has our heparin our adenosine and then our aspirin and nitro live in that one just meds that we need kind of at a moment's notice are going to be in this bag but this isn't the full amount of medications we carry on this helicopter so coming into the helicopter a little bit more you notice there's a left and a right seat both the nurse and paramedic will kind of trade off being in either one who's ever sitting right seat will be generally drawing up medications they're going to be doing the monitor they'll be looking at the vent while the person sitting left seat will be attending to the patient and making sure that the meds are being given making sure they're doing okay and then any procedures that needs to be done the left seat will do in addition the left seat also has the most flight responsibilities for clearing the tail and they'll generally be the ones under night vision goggles if you're doing a scene flight so behind me we have our med wall so this med wall mounts a couple pieces of our equipment the first one up here is our ventilator so patients that can't breathe um on their own or that have a breathing tube in will hook them up to this this is the revel ventilator we did get the hamiltons uh that we'll be replacing uh relatively soon however we haven't been trained on them yet so we're holding off uh this guy here allows us to select title volume so how much errors somebody's getting it allows us to change the breath rate give them peep which is pressure in the lungs change their fio2 which is how much o2 we're giving them and that has a lot of other features such as cpap and bipep it's a pretty advanced machine this guy has a cord here and you'll notice this oxygen tree to my uh right this guy can plug directly into that and that will feed this ventilator o2 so we don't have to hook up a nasal cannula or anything they'll just get oxygen straight into their tube these are all on aircraft rated mounts so if we were to get in a crash these would not fly around hit us and cause us further injury all right so coming down the med wall a little bit more we have two iv pumps now these iv pumps are the sapphire pumps if we are running a drip we don't want to be guessing at what the rate is which is traditionally what ems has done so we'll put this on special drip tubing that i'll talk about in a little bit and then this actually does our med math for us so i'll say we're doing this medication it comes up in the dr drug library i'll select the concentration it will calculate it and i'll tell it exactly what i want its dose to be pretty slick pretty easy to use the only issue with these is these are single channel so i wish these they had places for two uh because we'll routinely be transporting patients on up to eight drips at a time and it gets pretty tangled when every drip has its individual pump that is being used uh below that there is a little bit of an empty space down here when we transport patients on impellers or balloon pumps so a balloon pump is basically a balloon that goes up somebody's femoral artery sits right above their heart and then inflates and deflates and helps pump blood throughout the rest of the body if they're in cardiogenic shock an impeller is basically a propeller close to their heart that ejects blood throughout the body we take both of those machines they sit right here and then we can strap them to the floor using an aircraft rated uh webbing to make sure that is as safe as possible for us so looking forward in the helicopter we have our zoll x-series monitor so this is a cardiac monitor you've seen it in some of my other tours and basically this allows us to take a blood pressure obviously we can't take manuals in the helicopter we can do a doppler that hooks up into the communication system but it doesn't work super well uh so we're relying on this take our blood pressures it has a pulse oximeter on it it also has a four lead and 12 lead ekg capabilities and then on the other compartment we have defibrillation pads which allow us to defibrillate a patient if they're in a shockable cardiac rhythm or we can cardiovert them or pace them with this device the other cool thing about this x-series in particular is this has the ability to monitor invasive lines so if somebody's on a balloon pump they have an a-line in or they have like a swan guns catheter this will allow us to actually monitor that real time and change our treatment based on their hemodynamics below that and i know it's kind of hard to see we have a couple things we've got an o2 tree down here that's generally for the patient but we can also hook pilot o2 or crew o2 up to this if we're flying above 14 000 feet which we do uh periodically here we need to actually hook ourselves up to o2 to make sure that we're not getting depleted then we also have a suction module so if the patient has an obstructed airway they've vomited they can't control their own airway we'll stick that in their mouth and that will get whatever secretions uh are out of there and then behind that we have our quinflo blood warmer so coagulopathy so somebody stops being able to clot at about 95 degrees with their body temperature so even on a hot day like it is today we still always warm our blood products always warm our fluids and that sits down here it just has a puck that connects to it and then we connect the iv line directly into that so on the other side of the helicopter we got a couple things strapped into the side we have our transfer bag and once again i've got a video going through these in depth so i'm not going to spend a whole lot of time on them but this guy is just our critical care bag it's everything we need to manage the patient for basically the entire transport if they're really sick we've got a liter of saline here for balloon pump transfers or a-lines that need to be transduced in the main pocket here we've got everything for nebulizers and then in here we've got our quinflo package so this has the puck that actually allows us to warm the blood and then in this side we have everything for our bipap or a cpap for a severe chf patients anybody with a lot of pulmonary edema and and then like your asthmatics things like that that connects to the ventilator and allows us to give them ventilation without actually intubating them or putting in a uh breathing tube and then down below we've got vent tubing so this is the tube that connects the ventilator to the endotracheal tube the breathing tube and allows us to breathe for them down below we've got a cuff that will show us the pressure of an endotracheal tube cuff in the esophagus you don't want that too high because it will actually cause some necrosis and some other issues with blood flow and down below we have an o2 accessory kit that just has connectors if the facility we're going to doesn't use the same kind of o2 hookups that we do this is the same step pack as the scene bag it's the stat pack g3 backup it's just in the black color and then the side compartments so this side compartment has all of our half sets so if we're continuing a hospital's infusion we're going to hook the patient onto a half set this just hicks on the end and then allows them to go to our pumps not many hospital systems are using the sapphires just because they're not hospital pumps they're transport pumps and then we also have full set so if we were spiking our own med like leave a fed or something like that we'll spike the levafed with this and flow it into the patient the other side has all of the tubing to transduce an a-line so we've got our a-line tubing here and then we've got the cables to connect it to the monitor and allows us to monitor those advanced hemodynamics in the icu setting under the seat we've got a red quintara drug bag so once again this isn't all our meds but these are kind of everything that didn't fit in the scene bag originally so you can see we've got a lot of stuff in here it's not everything that's in the protocol but i'll leave a list on the screen for you guys to take a look at some of the stuff that we're doing and carrying we've got a lot of pressers so your levafed dopamine epinephrine drips we're carrying our beta blockers along with a bunch of seizure meds you name it we carry a little bit of everything and it's far too much to go through in this video i will dedicate an entire video to our medications uh at a later time that you can check out all right looking at this seat this is the pilot seat right here and here we have a bunch of different uh compartments with kind of miscellaneous items and things we need in a hurry so up here we've got a bunch of tape a lot of us will take the three inch tape put it on our thighs of our flight suit and then we'll take notes throughout the call for drip titrations or anything we're changing so we can document it in our reports later uh in here we have all our cheat sheets so on the back these are all the plates for different airports we might have to land at good in emergency situations and that at unfamiliar airports it gives you kind of how to enter the pattern how high you need to be things like that as the med crew we are also part of the flight crew so we help the pilot navigate and do what they need to do especially in emergency situations uh and then back here we've got all our cheat sheets for the radio channels that we might have to go to and different coordinates for landing zones that are predesignated in the mountains so as you can see there are hundreds and hundreds of them so we can't memorize them we keep them on here all right so that tucks behind that seat neater than i did it there uh in this top pocket we've got a radio for ground contact extra batteries for the zoll and the ventilator in case they run out a thermometer in this pocket back here we've got syringes and everything we need for med admin down here we've got restraints so if a patient is uh has an altered mental status we don't want to risk them coming up off the cot and um hitting the pilot or touching controls or anything so we'll put them in these soft uh

medical

restraints there just to keep them um from harming themselves or us during flight sharps container and then down here is everything we need for crew o2 so if we are flying really high we need to throw oxygen on ourselves or on the pilot more importantly uh we can do that there and then down here we've got a satellite phone which just allows us to make contact with people if we're in the mountains uh we don't have cell service our radios aren't working we can always get out on that and i say always but anybody that's ever used a sat phone knows that they do not work 100 of the time we've got a bunch of sizes of gloves in there and then last but not least we have everything we need for suction so we have the ballard suction for down the endotracheal tube we also have hard tip suction in there for everybody else right here we've got a fire extinguisher just in case the helicopter did light on fire very unlikely occurrence but a lot of the safety equipment we carry is actually required by the faa and other accrediting bodies so the last thing to talk about is going to be our radio system so we have to be able to talk to pretty much every hospital in the area we talk to a lot of different ground units from a lot of different jurisdictions and then we need to talk to other aircraft our dispatch and basically anybody we have to be able to talk to them so the radio equipment on here is there's kind of a learning curve to it um but we also have the ability for the pilot to dial a sat phone if we have to come in contact with certain hospitals that we don't have their frequency we can do that as well all right last but not least we have our outdoor compartments and this one this is the largest one we have all of our ppe for infectious disease patients aka our covid patients at the moment uh in here we've got all our disinfection stuff for the helicopter and then we have survival equipment so we've got flares fire starting stuff water purification equipment and some food just in case we are forced to make an emergency landing or heaven forbid crash in the mountains we do have stuff to sustain ourselves for a couple days while help gets to us that is all for this cabinet it is a pretty shallow cabinet all right the last compartment on this aircraft i'm going to show you is the aft compartment now this is like the trunk of the helicopter we keep a lot of our extra stuff in here so in here we've got kind of our extra critical care bag this has extra vent circuits in it it's got some extra capnography everything that we need to run more than one call if we use it up front and we don't have time to get back to the hospital and restock we keep just an extra in here then we have a life blanket which is a big warm blanket it is 95 degrees out here so we only put it on the cot first trauma patients at the moment a lot of patients are very uncomfortable in this so we keep it in the aft during the summer and then we have our extra trauma bag in there this blue bag has our c collars our vacuum splint sam splints it also has a traction splint as well as extra tourniquets and packing gauze for a potential mass casualty and then last but not least in this very adorable bag we've got an ob kit it is near impossible to deliver a baby in the front of an a-star so hopefully you don't have to use this in flight and that's why we keep it in the aft but this has our ob kit and some extra supplies in addition to all of this stuff when we get a flight we actually pack our blood into a blood cooler and that generally goes back here unless we hear it as a trauma patient that's requiring blood a lot of our patients don't so it's not something that we routinely uh keep up front with us unless we absolutely need it and then once again if we have our eden monitor which is our fetal heart rate monitor we'll keep that back here for the portions of the flight we don't have a patient and then when we do have a patient we take the ventilator off and we put it on that med wall you saw earlier guys that is all i have for this week's video if you have any questions please leave them in the comments down below and i will see you next week you
medical helicopter tour 911 cct

Source : PrepMedic