State of Alaska State of Alaska Aeromedical Physician Aeromedical Physician

Training CourseTraining Course

Welcome to the

Course ObjectivesCourse Objectives Understanding of air physiologyUnderstanding of air physiology Describe patient management in the Describe patient management in the

aeromedical settingaeromedical setting Recognize & anticipate problems Recognize & anticipate problems

common in the aeromedical settingcommon in the aeromedical setting Dispatching considerationsDispatching considerations Sending and receiving considerationsSending and receiving considerations

History of History of Aeromedical TransportsAeromedical Transports

InternationalUSAAlaska

120 hours of classroom training120 hours of classroom training Focused on aircraft environmentFocused on aircraft environment Three part examThree part exam

Practical Practical

WrittenWritten

OralOral

The first AlaskanThe first AlaskanAeromedical Transport Aeromedical Transport Training Course 1980Training Course 1980

Federal Aviation RegulationsFederal Aviation Regulations

They govern all civil aviation operations:They govern all civil aviation operations:

FAR Part 91 (general operating flight rules)FAR Part 91 (general operating flight rules)

FAR Part 135 (air taxi / commercial)FAR Part 135 (air taxi / commercial)

Violation may result in removal of certificationViolation may result in removal of certification

Effect of Altitude on Barometric PressureEffect of Altitude on Barometric Pressure

10, 000 feet

Sea Level760 mm Hg

523 mm Hg

Earth

The volume of a gas will varies The volume of a gas will varies inversely with pressure, given the inversely with pressure, given the temperature stays the same.temperature stays the same.

Aeromedical ConsiderationsAeromedical ConsiderationsAir splintsAir splints

Air mattress, mast suit, etc.Air mattress, mast suit, etc.

Air in IV tubing drip chambersAir in IV tubing drip chambers

Endotracheal tube cuffs?Endotracheal tube cuffs?

Boyles LawBoyles Law

Conditions in which barotrauma Conditions in which barotrauma may be dangerous:may be dangerous:

Pneumothorax, Mediastinal, pericardial airPneumothorax, Mediastinal, pericardial air

URI with sinusitis, otitis media, mastoiditisURI with sinusitis, otitis media, mastoiditis

Penetrating eye injury Penetrating eye injury

Diaphragmatic herniaDiaphragmatic hernia

Small bowel obstruction Small bowel obstruction

Recent SurgeryRecent Surgery

Gas-filled abscess or cyst, Gas gangreneGas-filled abscess or cyst, Gas gangrene

Following scuba divingFollowing scuba diving

Dalton’s LawDalton’s Law

The total pressure of a gas mixture is the The total pressure of a gas mixture is the sum of the individual partial pressures of sum of the individual partial pressures of all the gases in a mixture.all the gases in a mixture.

Aeromedical ConsiderationsAeromedical Considerations

Pa02 decreases Pa02 decreases

Another Look at Dalton’s LawAnother Look at Dalton’s Law

10, 000 ft.560 mm Hg

Sea Level760 mm Hg

Partial Pressure of oxygen = 11821% of 560 = 118

Partial Pressure of oxygen = 160 21% of 760 = 160

21%

21%

Charles’ LawCharles’ Law

The volume of a gas will vary directly The volume of a gas will vary directly with the absolute temperature, given with the absolute temperature, given the mass and pressure stay the same.the mass and pressure stay the same.

Aeromedical ConsiderationsAeromedical Considerations

Gas filled medical equipment Gas filled medical equipment increase size when warmed increase size when warmed

Henry’s LawHenry’s Law

The amount of gas dissolved in a solution The amount of gas dissolved in a solution is directly proportional to the pressure of is directly proportional to the pressure of the gas over the solution.the gas over the solution.

Aeromedical Considerations Aeromedical Considerations

Scuba Divers - Must fly sea levelScuba Divers - Must fly sea level

Other Gas LawsOther Gas Laws

Other Gas LawsOther Gas Laws

Graham’s Law -Graham’s Law - rate of diffusionrate of diffusion

Guy Lussac’s Law - pressure increaseGuy Lussac’s Law - pressure increase

Poiseulle’s Law - volume & pressure gradientPoiseulle’s Law - volume & pressure gradient

Altitude affects theAltitude affects theA-a GRADIENTA-a GRADIENT

DefinitionDefinition

The difference in partial pressure of oxygen in The difference in partial pressure of oxygen in the alveolar gas spaces and the pressure in the alveolar gas spaces and the pressure in the systemic arterial blood.the systemic arterial blood.

A-a Gradient = [(Barometric Pressure - 47) A-a Gradient = [(Barometric Pressure - 47) times FIO2] - (PaCO2 /0.8) - PaO2times FIO2] - (PaCO2 /0.8) - PaO2

A-a Gradient A-a Gradient What is the Aeromedical significance?What is the Aeromedical significance?A-a Gradient A-a Gradient What is the Aeromedical significance?What is the Aeromedical significance?

Sea levelSea level

760 mmHg - 47 = 713760 mmHg - 47 = 713

(times the % of O2) (times the % of O2) 21% = 15021% = 150

minus COminus CO22 / Resp / Resp

quotient 50 quotient 50 mm Hgmm Hg = =

PaO2 100 (Predicted)PaO2 100 (Predicted)

Pulm Physiology

10,000 feet

560 mmHg - 47 = 513

(times the % of O2) 21% = 108

minus CO2 / Resp

quotient 50 mm Hg =

PaO2 58 (Predicted)

Hypoxic hypoxiaHypoxic hypoxia

Anemic hypoxiaAnemic hypoxia

Stagnant hypoxiaStagnant hypoxia

Histoxic hypoxiaHistoxic hypoxia

Four types of HypoxiaFour types of Hypoxia

DrugsDrugs

Prescriptive & recreationalPrescriptive & recreational

Alcohol Alcohol

one ounce = 2000 feetone ounce = 2000 feet

Cigarettes Cigarettes

Three consecutive = 8000 Three consecutive = 8000 feet feet

Causes ofCauses ofHystoxic HypoxiaHystoxic Hypoxia

REVIEW -CELLULAR RESPIRATIONREVIEW -CELLULAR RESPIRATIONREVIEW -CELLULAR RESPIRATIONREVIEW -CELLULAR RESPIRATION

2 PyruvateAcid

Protein, Fat, orGlucose (C6 H12 O2)

Electron Transport Chain

Kreb Cycle

CO2

1/2 O2 + 2 Hydrogen+ two electrons =

Makes Water

O2 function: discard electron waste after ATP synthesisCO2: this is the cell waste product.

ATP

ATP

Cell Mitochondria

CO2

ELECTRON TRANSPORT CHAINELECTRON TRANSPORT CHAINDrugs, alcohol, & Smoking affect the CytochromeDrugs, alcohol, & Smoking affect the CytochromeELECTRON TRANSPORT CHAINELECTRON TRANSPORT CHAINDrugs, alcohol, & Smoking affect the CytochromeDrugs, alcohol, & Smoking affect the Cytochrome

Located in the Cell MitochondriaLocated in the Cell MitochondriaFMN

QFe.S

Cyt b

Fe.S

Fe.SCyt c1

Cyt cCyt a

Cyt a3

Cytochromes

Cytochrome, is a proteinwith a heme group.

1/2 O2

Factors affecting hypoxia:Factors affecting hypoxia:AltitudeAltitude

Rate of AscentRate of Ascent

Physical FitnessPhysical Fitness

Physical ActivitiesPhysical Activities

Drug & MedicationsDrug & Medications

Individual VariationsIndividual Variations

AlcoholAlcohol

SmokingSmoking

Plane CharacteristicsPlane Characteristics

There are basic physical features similar to There are basic physical features similar to all planes.all planes.

Basic principles of flight similar in all planes:Basic principles of flight similar in all planes:

center of gravity, lift, drag, & propulsion.center of gravity, lift, drag, & propulsion.

There are several physical characteristics There are several physical characteristics that individualize planesthat individualize planes

Characteristics That Vary Among PlanesCharacteristics That Vary Among Planes

Pressurized?Pressurized?

Door dimensionsDoor dimensions

Passenger capability--including flight crewPassenger capability--including flight crew

RangeRange

Cabin length and heightCabin length and height

Cruise speedCruise speed

Electrical requirements--is it available?Electrical requirements--is it available?

Runway consideration--length & surface typeRunway consideration--length & surface type

PayloadPayload

Built in medical unitBuilt in medical unit

Disadvantages of Disadvantages of Pressurized AircraftPressurized Aircraft

Potential for rapid decompressionPotential for rapid decompression

(Typically commercial airlines fly at 30,000 (Typically commercial airlines fly at 30,000 to 36,000 feet. Cabin pressure typically to 36,000 feet. Cabin pressure typically 5,000 to 8,000).5,000 to 8,000).

More money : Plane and fuelMore money : Plane and fuel

Requires a longer runwayRequires a longer runway

Usually requires a paved runwayUsually requires a paved runway

Disadvantages of Disadvantages of Unpressurized AircraftUnpressurized Aircraft

Air pressure fluctuates in: Air pressure fluctuates in:

Body cavitiesBody cavities

Air filled tubes (i.e. Mast pants)Air filled tubes (i.e. Mast pants)

ET Tubes?ET Tubes?

Increase patient discomfortIncrease patient discomfort

Altered effectiveness of medical equipmentAltered effectiveness of medical equipment

Typical AK Medevac AircraftTypical AK Medevac AircraftCessna 185, 206 or 207Cessna 185, 206 or 207

DeHavilland BeaverDeHavilland Beaver

DeHavilland OtterDeHavilland Otter

Grumman GooseGrumman Goose

Piper CubPiper Cub

Piper Chieftan (Navajo)Piper Chieftan (Navajo)

Cessna ConquestCessna Conquest

Boeing 737Boeing 737

Factors that Affect the Factors that Affect the Decision to TransportDecision to Transport

Primary Principle--Primary Principle--Do no further harmDo no further harm Know indications for transferKnow indications for transfer Transfer agreementsTransfer agreements Transfer protocolsTransfer protocols Stabilize patientStabilize patient Transfer with skilled personnel and Transfer with skilled personnel and

adequate adjunctive equipmentadequate adjunctive equipment

Overview of the Process of Overview of the Process of initiating a Medevacinitiating a Medevac

1) Planning1) Planning

2) Inventory of resources & equipment2) Inventory of resources & equipment

3) Medical control3) Medical control

4) Decision to transfer4) Decision to transfer

5) Factors affecting transport5) Factors affecting transport

6) Communication -- Dispatch / Hospital6) Communication -- Dispatch / Hospital

7) Communication -- Pilot7) Communication -- Pilot

Planning StepsPlanning StepsAssess patientAssess patient

Escorts availableEscorts available

Escorts levelEscorts level

Required equipmentRequired equipment

Types of AircraftTypes of Aircraft

Landing conditionsLanding conditions

Number of patientsNumber of patients

Condition of patientsCondition of patients

NotificationNotification

Receiving communityReceiving community

AircarrierAircarrier

Family membersFamily members

Pre-Transport RecordsPre-Transport Records

Clinic or ambulanceClinic or ambulance

Insurance infoInsurance info

Family contact numberFamily contact number

AASuccessful Successful

Medevac startsMedevac startsbefore the patient gets ill.before the patient gets ill.

Medical Control Establish protocols, Educate

Clinic / Medevac PersonnelPrepare, Practice, Educate

Dispatch / PilotKnow what to anticipate

Pilot Weather ConcernsPilot Weather Concerns

IcingIcing

TurbulenceTurbulence

Wind direction & intensity for take-offWind direction & intensity for take-off

Weather at landing communityWeather at landing community

Extra fuel needed due to strong windsExtra fuel needed due to strong winds

The Pilot has the final word on weather.

Inventory YourInventory Your Community Resources Community Resources

AirfieldsAirfields

Air carriersAir carriers

Types of aircraftTypes of aircraft

Escort qualificationsEscort qualifications

Medical equipment availableMedical equipment available

Rescue vs MedevacRescue vs Medevac

State of Alaska:State of Alaska:Resources Available for Resources Available for

Rescue OperationsRescue Operations

Alaska State TroopersAlaska State Troopers U.S. Coast GuardU.S. Coast Guard MASTMAST Alaska Air National GuardAlaska Air National Guard Local Army GuardLocal Army Guard

Decision to Transfer Decision to Transfer Based on Matching:Based on Matching:

PATIENT

Medevac Aircraft Escort

1) ALS or BLS2) Critical Care 3) Specialty

Training level

Transport with CautionTransport with Caution

Diving Diving

Gas GangreneGas Gangrene

PneumothoraxPneumothorax

HypoxiaHypoxia

Cardiac Cardiac

Wired JawWired Jaw

AnemiaAnemia

Recent Abdominal SurgeryRecent Abdominal Surgery

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

Decision is made based onDecision is made based on

WeatherWeather

Plane availabilityPlane availability

Staff availability and skill levelStaff availability and skill level

Type of patient (pediatric, OB)Type of patient (pediatric, OB)

Remember: The rural physician is taking Remember: The rural physician is taking care of the patient with out the current care of the patient with out the current technological luxuries. Like CT scans, etctechnological luxuries. Like CT scans, etc

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

Conflicts arise when the “city” doctor Conflicts arise when the “city” doctor request you fix the problem. Not request you fix the problem. Not understanding the diagnostic, staffing, understanding the diagnostic, staffing, and equipment limitations of the rural and equipment limitations of the rural area.area.

Education of referring physician may be Education of referring physician may be necessary to avoid conflict.necessary to avoid conflict.

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

At times the patient stops at another At times the patient stops at another community due to weather restrictions.community due to weather restrictions.

This new health care person may alter your This new health care person may alter your initial plan of care. Communication is the initial plan of care. Communication is the key to preventing a disaster.key to preventing a disaster.

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

How long would you keep a patient in a How long would you keep a patient in a remote area with out remote area with out

A surgeonA surgeon

Advanced lab capabilitiesAdvanced lab capabilities

CT scanCT scan

or Ultrasoundor Ultrasound

Knowing you only have two flights a weekKnowing you only have two flights a week..

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

Limitations in staff and supplies may force Limitations in staff and supplies may force medical triage decisions.medical triage decisions.

Triage Triage

Salvageable vs the non-salvageable.Salvageable vs the non-salvageable.

The sickest salvageable patient to town.The sickest salvageable patient to town.

Rural Physician Rural Physician Medical Decision to TransferMedical Decision to Transfer

Realize some people choose to stay in the Realize some people choose to stay in the rural area AMA.rural area AMA.

However, they may “change their mind”. However, they may “change their mind”.

Now, you have a sick person and may not Now, you have a sick person and may not have the supplies to take care of them.have the supplies to take care of them.

Example: Pre-eclampsia at a doorstep Example: Pre-eclampsia at a doorstep delivery.delivery.

Dispatch / HospitalDispatch / HospitalDispatchDispatch

Never pressure the pilot into a flight.Never pressure the pilot into a flight.

Inform pilot if patient weight excessive or Inform pilot if patient weight excessive or

sea-level cabin neededsea-level cabin needed

Never, never, never, tell the pilot the patient Never, never, never, tell the pilot the patient will die unless he flyswill die unless he flys

HospitalHospital

Know names of contact peopleKnow names of contact people

Ask for patient follow-upAsk for patient follow-up

Aircraft Orientation: Prior to a flightAircraft Orientation: Prior to a flighthave the pilot discuss the following:have the pilot discuss the following:

ELTELT (Not to be confused with a BLT) (Not to be confused with a BLT)

Survival GearSurvival Gear

Fire ExtinguisherFire Extinguisher

Flotation DevicesFlotation Devices

Emergency Exit OperationEmergency Exit Operation

Oxygen StorageOxygen Storage

Equipment / Patient Tie DownsEquipment / Patient Tie Downs

RadioRadio

Essential Communication Essential Communication with the Pilotwith the Pilot

Air-ground radio communications Air-ground radio communications

Flight maneuvers Flight maneuvers

(i.e. high G-force during take-off)(i.e. high G-force during take-off)

Altitude restrictions Altitude restrictions (prior to taking on fuel)(prior to taking on fuel)

CCabin temperature considerationsabin temperature considerations

Weight of the patient (esp. if excessive)Weight of the patient (esp. if excessive)

If electrical power availableIf electrical power available

DiscussDiscuss

Aeromedical ConcernsAeromedical Concerns

Gas expandsGas expands

HypoxiaHypoxia

Stresses of flightStresses of flight

Psychological status of patient & escortPsychological status of patient & escort

Equipment Equipment

AvailableAvailable

FunctioningFunctioning

SecuredSecured

Aeromedical Considerations ofAeromedical Considerations of

Eye and facial InjuriesEye and facial Injuries

Head (free air?)Head (free air?)

ChestChest

RespiratoryRespiratory

AbdominalAbdominal

Anemia / Sickle cell Anemia / Sickle cell

Aeromedical Considerations ofAeromedical Considerations of

Hypothermia and frostbiteHypothermia and frostbite

Psychiatric emergenciesPsychiatric emergencies

MaternalMaternal

PediatricPediatric

BurnsBurns

Amputations Amputations

Effects of Altitude on PaO2 may Effects of Altitude on PaO2 may be Particularly Hazardous for:be Particularly Hazardous for:

ShockShock

Severe respiratory distress (ARDS, COPD)Severe respiratory distress (ARDS, COPD)

Decompensated cardiac disease (CHF, MI)Decompensated cardiac disease (CHF, MI)

Severe anemia (especially SS)Severe anemia (especially SS)

Glaucoma, eye injury, recent eye surgeryGlaucoma, eye injury, recent eye surgery

Cyanotic congenital heart diseaseCyanotic congenital heart disease

EpilepsyEpilepsy

CNS injury requiring 02CNS injury requiring 02

Things that will Things that will injureinjure or or killkill the patient: the patient:

IllnessIllness TraumaTrauma Too much careToo much care Too little careToo little care

Matching the Escort to PatientMatching the Escort to Patient

Skill level of:Skill level of:

EMT IEMT I

EMT IIEMT IIEMT IIIEMT III

ParamedicParamedic

NurseNurse

Critical Care Air-ambulanceCritical Care Air-ambulance

Match escort to worst pt case scenarioMatch escort to worst pt case scenario

You have a pt with a possible You have a pt with a possible Ruptured Appendix Ruptured Appendix Who do you use? Who do you use?

EMT IEMT I

EMT IIEMT II

EMT IIIEMT III

ParamedicParamedic

NurseNurse

Critical Care Air-ambulanceCritical Care Air-ambulance

Other Medical Escort & Other Medical Escort & Patient ConsiderationsPatient Considerations

Strength & fitnessStrength & fitness

WeightWeight

Motion sicknessMotion sickness

Pre-existing health problems Pre-existing health problems

Upper respiratory infectionsUpper respiratory infections

Matching escort to patient:Matching escort to patient:

Determine the potential problems Determine the potential problems

escort could encounter should the escort could encounter should the

patient deteriorate.....patient deteriorate.....

The escorts skill level and The escorts skill level and equipment equipment should match theshould match the WORSTWORST possible possible patient problem.patient problem.

Preflight & Postflight Preflight & Postflight check sheet check sheet

essential essential

Potential Adverse Effects of Potential Adverse Effects of Altitude on EscortAltitude on Escort

Reduced attention spanReduced attention span

Impaired judgmentImpaired judgment

Develop “What, me worry?” attitude Develop “What, me worry?” attitude

Effects of drugs & fatigue are potentiatedEffects of drugs & fatigue are potentiated

Air sickness & claustrophobiaAir sickness & claustrophobia

Decreased night vision, poor cabin lightingDecreased night vision, poor cabin lighting

Increased insensible water loss due toIncreased insensible water loss due to

decreased humiditydecreased humidity

Stages of FlightStages of Flight

EnplaningEnplaning

Don’t step on plane door step while holding ptDon’t step on plane door step while holding pt

Take-offTake-off

Secure yourself, pt, & equipmentSecure yourself, pt, & equipment

Descent & DeplaningDescent & Deplaning

Respect the pilots “sterile zone”Respect the pilots “sterile zone”

Transfer of CareTransfer of Care

Give report. Label all equipment.Give report. Label all equipment.

““G” loading for various patient positionsG” loading for various patient positions

G force

G force

G force

G force

Aircraft Moving

A.

D.

C.

B.

Remember: “G” force higher on takeoff

Safety ConsiderationsSafety Considerations

Airstrip -- AirportAirstrip -- Airport

Securing EquipmentSecuring Equipment

Securing PersonnelSecuring Personnel

Take-off and LandingTake-off and Landing

Inflight EmergencyInflight Emergency

Plane & HelicopterPlane & Helicopter

SafetySafety

Safety: Take-off & LandingSafety: Take-off & LandingArtificial light should not be used. If need Artificial light should not be used. If need

light--use a hand held flashlight with clear light--use a hand held flashlight with clear red filter.red filter.

Respect the “sterile” field, do not talk to the Respect the “sterile” field, do not talk to the pilot if below 10,000 feet. (This is a FAA pilot if below 10,000 feet. (This is a FAA regulation).regulation).

Don’t touch any cockpit controls unless the Don’t touch any cockpit controls unless the pilot instructs you to do so.pilot instructs you to do so.

SafetySafety

Safety: Plane & Helicopter SafetySafety: Plane & Helicopter SafetyGeneral: General:

Pilot is the Pilot is the finalfinal authority for continuing or authority for continuing or canceling a flight.canceling a flight.

Helicopter specific: Helicopter specific:

AlwaysAlways secure loose items. secure loose items.

Never hold IV poles or arms above your head. Never hold IV poles or arms above your head.

Stay lower than the person next to you.Stay lower than the person next to you.

SafetySafety

Safety: Securing Equipment Safety: Securing Equipment and Personneland Personnel

All equipment will be secured for flight (FAA All equipment will be secured for flight (FAA Regulation 91.203Regulation 91.203

All personnel must be secured for take-off All personnel must be secured for take-off and landing (FAA regulations 91.14, and landing (FAA regulations 91.14, paragraph 3)paragraph 3)

SafetySafety

Safety: Inflight EmergencySafety: Inflight EmergencyKnow the location & operation of:Know the location & operation of:

ExitsExits

Fire extinguishersFire extinguishers

Survival equipmentSurvival equipment

Flotation devicesFlotation devices

Rapid Decompression procedureRapid Decompression procedure

Secure patient, equipment & yourselfSecure patient, equipment & yourself

Stay calm & do not disturb the pilotStay calm & do not disturb the pilot

SafetySafety

Patient Problems in FlightPatient Problems in Flight

TurbulenceTurbulence

Positioning Positioning

LightingLighting

Motion SicknessMotion Sickness

Prolonged Immobility Prolonged Immobility

DisorientationDisorientation

Unable to ausc lung soundsUnable to ausc lung sounds

Other Patient Other Patient Problems in FlightProblems in Flight

ExerciseExercise

Oral HygieneOral Hygiene

SleepSleep

EliminationElimination

Ear & Sinus SqueezeEar & Sinus Squeeze

Tooth SqueezeTooth Squeeze

Electrical PowerElectrical Power

Do you have an in-plane power source?Do you have an in-plane power source?

Carry extra batteries.Carry extra batteries.

Have equipment inspected on a routine basis.Have equipment inspected on a routine basis.

Remember: Remember: There is a limit to the numberThere is a limit to the number

of cords you can plug into an outlet.of cords you can plug into an outlet.

Equipment Affected by AltitudeEquipment Affected by Altitude

OxygenOxygen

To Calculate number of tanks: To Calculate number of tanks: Flight time plus two hoursFlight time plus two hours

E cylinder lasts 1 hour at E cylinder lasts 1 hour at 10L/min10L/min

Actual flow rate is greater than Actual flow rate is greater than indicatedindicated

Must be secured wellMust be secured well

IV’sIV’sGlass Bottles (Nitroglycerin bottles)Glass Bottles (Nitroglycerin bottles)

Vent & tape glassVent & tape glass

Don’t hang above pt’s head Don’t hang above pt’s head

Plastic Plastic

Plastic preferred over glass when possiblePlastic preferred over glass when possible

Use pressure bag Use pressure bag

Vent air prior to using pressure bagVent air prior to using pressure bag

Equipment Affected by AltitudeEquipment Affected by Altitude

Cold Weather ConsiderationsCold Weather ConsiderationsAmbu: stiff plastic does NOT re-inflate well if it Ambu: stiff plastic does NOT re-inflate well if it

gets coldgets cold

IV lines will freezeIV lines will freeze

Patient’s head needs to be coveredPatient’s head needs to be covered

Battery life short Battery life short

Medical equipment batteriesMedical equipment batteries

Plane batteries (Don’t leave a light on!)Plane batteries (Don’t leave a light on!)

Plastic may break (i.e. O2 rings)Plastic may break (i.e. O2 rings)

Infection ControlInfection Control

Universal precautionsUniversal precautions

Cleaning equipmentCleaning equipment

Cleaning aircraft / vehicleCleaning aircraft / vehicle

Discard of contaminated materialDiscard of contaminated material

Seven Basic Survival StepsSeven Basic Survival Steps

1. Recognition1. Recognition

2. Inventory2. Inventory

3. Shelter3. Shelter

4. Water4. Water

5. Signals 5. Signals

6. Food6. Food

7. Survival / Spiritual activity7. Survival / Spiritual activity

Most Common Reasons for Failure to Most Common Reasons for Failure to Survive Emergencies Are:Survive Emergencies Are:

• Wrong attitude• Carelessness• Lack of equipment• Inability to use equipment• Inability to adapt to environment• No will to live

Safe Aeromedical patient care Safe Aeromedical patient care starts by educating yourself starts by educating yourself

and staff.and staff.

Community ResourcesCommunity Resources