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Auckland HEMS

Auckland HEMS. Helicopter Emergency Medical Services Christopher Denny, MD, MSc, FRCPC, FACEP, FACEM SMO Emergency Medicine, Auckland City Hospital, ADHB. Senior Medical Officer in Emergency Medicine, Auckland City Hospital HEMS Medical Director, Auckland Rescue Helicopter Trust (ARHT)

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Auckland HEMS

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  1. Auckland HEMS Helicopter Emergency Medical Services Christopher Denny, MD, MSc, FRCPC, FACEP, FACEM SMO Emergency Medicine, Auckland City Hospital, ADHB

  2. Senior Medical Officer in Emergency Medicine, Auckland City Hospital • HEMS Medical Director, Auckland Rescue Helicopter Trust (ARHT) • Clinical Team Leader, New Zealand Medical Assistance Team (MOH NZMAT) Disclosure

  3. Objectives Increase awareness of Auckland HEMS Explore Pre-Hospital and Retrieval Medicine Compare patient care on the road with in hospital

  4. 1970: Auckland established the first civilian rescue helicopter service in the southern hemisphere • Rescue helicopter originally based on the west coast of Auckland @ Piha • Now the busiest rescue helicopter trust in New Zealand • The only service in NZ with a doctor as a core member of the flight crew Introduction

  5. Memorandum of Understanding established in 2011 • Specialists in Emergency Medicine, Critical Care and Anaesthetics • Purpose: to augment the clinical capabilities of the flight crew ADHB & ARHT

  6. HEMS Mission profiles

  7. BK-117 x 2 • Cruise speed 120 knots (222km/hr) • Cruise altitude ~1500 feet • Crew configuration: Pilot, crewman, paramedic & doctor • Instrument Flight Rules (IFR) capable • Winch capable • 600lb capacity Helicopters

  8. Why doctors?

  9. Airway: Rapid sequence intubation (RSI), video laryngoscopy (VL), surgical airway • Breathing: Mechanical ventilation, chest drains • Circulation: Tranexamic acid (TXA), Point-of-care ultrasound (POCUS), blood products • Disability: Reduction of dislocations and fractures; ultrasound-guided regional nerve blocks, field amputations, antidote therapies Critical interventions

  10. Time to critical intervention: • Airway management • CT • Operating theatre • Interventional radiology Accelerating time to definitive care

  11. Clinical governance

  12. Galvagno. JAMA 2012: HEMS and Survival after Major Trauma. • 223,475 patients in USA with age >15y & ISS>15 • HEMS Odds Ratio for survival 1.16, 95%CI 1.14-1.17 (ARR 1.5%) Evidence

  13. From roadside to bedside in definitive care • Standardized communications (METHANE, MIST, SBAR) Seamless care

  14. Coordinated Incident Management System (CIMS) • Inter-agency collaboration with St John Ambulance, NZ Fire Services, Police SAR • Aeromedical reconnaissance Disaster preparedness

  15. “To turn a team of experts into an expert team.” • Eduardo Salas High performing teams

  16. High task interdependency • Cooperation, coordination, communication, cognition, coaching and conflict Teamwork

  17. Integration • Coordination • Clinical networks The future

  18. Thank you. www.aucklandhems.com

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