Transport Team Must Be Ready For Anything
from The Children's Hospital (TCH) News, July 2005
With every call the Flight For Life communication center receives, a team of nurses, EMTs and respiratory therapists is waiting to respond.
The communication center, based at St. Anthony Central Hospital, receives 20 to 30 calls a day for critically ill or injured adults and children.
Two separate teams respond to calls. The adult team, which waits at multiple bases throughout Colorado, responds to calls for adult patients and for children older than 3. The Newborn Young Child (NYC) Team, also known as The Children’s Hospital’s transport team, waits for calls at Children’s for neonates and children younger than 3.
Once the NYC Team is dispatched, they often use the Flight For Life ambulance, sometimes driving as far as 100 miles to a hospital to pick up a patient. Flight For Life EMTs operate the ambulances and assist with patient care. Inside the ambulance, care looks different. Instead of working at the bedside, flight nurses, respiratory therapists and an EMT must work in limited space with limited equipment.
“Basically we are a mobile ICU,” said Karen Percell, RN and NYC Team clinical coordinator. “We are able to take care of any patient, start any critical drip and provide any service they would do here at Children’s. It’s rewarding to bring patients here to Child-ren’s, where we can do procedures nobody else in the region can do.”
If a patient is too far away to send the ambulance, the communication center sends a Beechcraft King/Air fixed-wing plane, a Learjet or a helicopter to the referring hospital with a nurse and a respiratory therapist. Children’s employs seven flight nurses and seven respiratory therapists, who each work three 12-hour shifts and 16 on-call hours each week.
The helicopter, housed at St. Anthony North, can be at Children’s helipad within 4 minutes.
Either the ambulance or the helicopter is used to transport the team to Centennial Airport , where the fixed-wing planes are kept. Flight team members must be prepared for each patient’s situation. Prior to leaving for a transport, the team makes sure their two 50-pound bags are full of supplies and their 350-pound pram with an isolette and monitoring equipment is functioning properly.
Once the team lands at the airport nearest the patient, a local ambulance takes the team to the patient. Many patients are picked up at smaller hospitals that lack the specialized care provided at Children’s.
Before taking a patient back to Children’s, the team makes sure the patient is stable enough to be transported. Sometimes the team will be on the ground for up to five hours before leaving for Children’s. Critical thinking and advanced assessment skills are musts for flight nurses because they are the leaders of the team and do not have a physician standing by to assist, Percell said. The team relies on the NYC Team’s medical director, John Kinsella, MD, and his colleagues, she said.
“We always have a resource (at Children’s) we can call back to, but in an emergent situation you have to know the steps to take and then call the doctor and tell them what was done,” Percell said.
During flights, the team will coordinate a plan of action with the receiving physician at Children’s.
“We are given a lot of autonomy when it comes to taking care of the patient,” said Paula Lesmeister, RN. “Our physicians trust us and our clinical skills.”
The flight team specializes in emergent and critical-care management of neonatal and pediatric patients. They are trained extensively in providing assessment, intervention and care of the critically ill or injured patient. When the flight team is not out in the ambulance or in aircraft, they work at Children’s. Respiratory therapists work in the Emergency Department, the Pediatric Intensive Care Unit, the Newborn Center or the Cardiac Intensive Care Unit. Transport nurses are available to help with procedures in units and ICUs.
The NYC Team’s visibility in the community has piqued interest in the neonatal flight nursing profession, Lesmeister said. Flight For Life always has been able to recruit top talent, but becoming part of Children’s has increased the organization’s ability to recruit top neo-natal/pediatric nursing experts, Lesmeister said.
To become a NYC flight nurse, applicants must have three to five years of nursing experience with at least three years of experience in a neonatal, pediatric or cardiac intensive-care unit with a year or two of general pediatrics preferred.
Flight nurses’ specialized training includes airway management, including rapid-sequence intuba-tions and the maintenance of chemical sedation, umbilical line insertion and management and blood-product administration. Flight nurses also are required to maintain ACLS, PALS, NRP, PCEP and ENPC certifications.
Flight nurses and respiratory therapists are required to attend monthly skills training sessions, including survival and equipment training and helicopter and fixed-wing safety training.
Children’s Flight For Life team is the only neonatal/pediatric-specific transport team in the region. Flight For Life covers a nine-state region including Arizona , Colorado , Kansas , Montana , Nebraska , New Mexico , South Dakota , Utah and Wyoming . The NYC team has transported an average of 788 patients per year for the last four years.
With every call the Flight For Life communication center receives, a team of nurses, EMTs and respiratory therapists is waiting to respond.
The communication center, based at St. Anthony Central Hospital, receives 20 to 30 calls a day for critically ill or injured adults and children.
Two separate teams respond to calls. The adult team, which waits at multiple bases throughout Colorado , responds to calls for adult patients and for children older than 3. The Newborn Young Child (NYC) Team, also known as The Children’s Hospital’s transport team, waits for calls at Children’s for neonates and children younger than 3.
Once the NYC Team is dispatched, they often use the Flight For Life ambulance, sometimes driving as far as 100 miles to a hospital to pick up a patient. Flight For Life EMTs operate the ambulances and assist with patient care. Inside the ambulance, care looks different. Instead of working at the bedside, flight nurses, respiratory therapists and an EMT must work in limited space with limited equipment.
“Basically we are a mobile ICU,” said Karen Percell, RN and NYC Team clinical coordinator. “We are able to take care of any patient, start any critical drip and provide any service they would do here at Children’s. It’s rewarding to bring patients here to Child-ren’s, where we can do procedures nobody else in the region can do.”
If a patient is too far away to send the ambu-lance, the communication center sends a Beechcraft King/Air fixed-wing plane, a Learjet or a helicopter to the referring hospital with a nurse and a respiratory therapist. Children’s employs seven flight nurses and seven respiratory therapists, who each work three 12-hour shifts and 16 on-call hours each week.
The helicopter, housed at St. Anthony North, can be at Children’s helipad within 4 minutes.
Either the ambulance or the helicopter is used to transport the team to Centennial Airport , where the fixed-wing planes are kept. Flight team members must be prepared for each patient’s situation. Prior to leaving for a transport, the team makes sure their two 50-pound bags are full of supplies and their 350-pound pram with an isolette and monitoring equipment is functioning properly.
Once the team lands at the airport nearest the patient, a local ambulance takes the team to the patient. Many patients are picked up at smaller hospitals that lack the specialized care provided at Children’s.
Before taking a patient back to Children’s, the team makes sure the patient is stable enough to be transported. Sometimes the team will be on the ground for up to five hours before leaving for Children’s. Critical thinking and advanced assessment skills are musts for flight nurses because they are the leaders of the team and do not have a physician standing by to assist, Percell said. The team relies on the NYC Team’s medical director, John Kinsella, MD, and his colleagues, she said.
“We always have a resource (at Children’s) we can call back to, but in an emergent situation you have to know the steps to take and then call the doctor and tell them what was done,” Percell said.
During flights, the team will coordinate a plan of action with the receiving physician at Children’s.
“We are given a lot of autonomy when it comes to taking care of the patient,” said Paula Lesmeister, RN. “Our physicians trust us and our clinical skills.”
The flight team specializes in emergent and critical-care management of neonatal and pediatric patients. They are trained extensively in providing assessment, intervention and care of the critically ill or injured patient. When the flight team is not out in the ambulance or in aircraft, they work at Children’s. Respiratory therapists work in the Emergency Department, the Pediatric Intensive Care Unit, the Newborn Center or the Cardiac Intensive Care Unit. Transport nurses are available to help with procedures in units and ICUs.
The NYC Team’s visibility in the community has piqued interest in the neonatal flight nursing profession, Lesmeister said. Flight For Life always has been able to recruit top talent, but becoming part of Children’s has increased the organization’s ability to recruit top neo-natal/pediatric nursing experts, Lesmeister said.
To become a NYC flight nurse, applicants must have three to five years of nursing experience with at least three years of experience in a neonatal, pediatric or cardiac intensive-care unit with a year or two of general pediatrics preferred.
Flight nurses’ specialized training includes airway management, including rapid-sequence intuba-tions and the maintenance of chemical sedation, umbilical line insertion and management and blood-product administration. Flight nurses also are required to maintain ACLS, PALS, NRP, PCEP and ENPC certifications.
Flight nurses and respiratory therapists are required to attend monthly skills training sessions, including survival and equipment training and helicopter and fixed-wing safety training.
Children’s Flight For Life team is the only neonatal/pediatric-specific transport team in the region. Flight For Life covers a nine-state region including Arizona, Colorado, Kansas, Montana, Nebraska, New Mexico, South Dakota, Utah and Wyoming . The NYC team has transported an average of 788 patients per year for the last four years.
