Nothing is quite as anxiety provoking as having to emergently manage a patient’s airway while in the back of helicopter…communication is different, access to the patient is different, the environment is loud and we have little experience intubating there! This is why we do in-situ simulation…a great session with one of our advanced paramedics.

Auckland HEMS

Recently at the base, we’ve been discussing the concept of improving our ergonomics and making our workspace (e.g. the helicopter) as functional as possible. We are continually looking to optimize our equipment to best serve our patients.  Any procedure in-flight will be considerably more difficult than if performed in a well controlled environment like the hospital so in-situ training within the helicopter is essential.

Today, Karl (one of our advanced paramedics) and I did some in-situ simulation of an RSI within the helicopter. We ran through a scenario with an unpredicted deterioration of a patient in flight that required an RSI. A review of the literature provides little guidance on the emergency airway management of patients while in-flight so approaches to such situations currently must be derived from simulation and retrospective reviews within your own program.

We discussed a few key concepts that should be considered as we move forward…

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