An efficient, cost effective strategy for meeting the educational needs of aeromedical personnel

FACTORS INFLUENCING

PATIENT THERMOREGULATION

IN FLIGHT

Angela Fiege, William F. Rutherford, Dave Nelson; Life Line, Methodist Hospital, Indianapolis, IN Introduction: Endogenous control of core temperature (CT) is taxed during serious illness or injury Temperature extremes increase morbidity and mortality. This prospective study sought to identify risk factors associated with decreasesin patient CT during rotor wing (RW) transport. Methods: Rectal temperature probes were secured. Temperatures recorded on lift off (LO), at 15 minute intervals after LO, and on landing included patient, cabin, and ambient. Transport time, time subjects were uncovered, total IV fluid and blood infused, use of neuromuscular blockade (NMB), exposure to moisture, and any warming aids (WA) used during flight were also recorded. Results: Sixty-six of 75 patients had temperature changes (AT): Five (6.7%) had clinically significant -AT > -0.5 “C, the greatest -AT = -1.2 “C. Fifteen (20%) were hypothermic (<35 “C) on LO. Nine ot these had further -AT in flight, 4 with -AT 2 0.5 OC.No patient who was not initially hypothermic dropped below 3 5 “C. Spearman rank correlation indicated that inital hypothermia (p=O.O06),time uncovered (p=O.O2) and NMB (p=O.O5)were significantly correlated with -AT. WA were not significantly correlated with +AT. Conclusions: Factors associated with -AT in flight include initial hypothermia, NMB, and exposure. Clinically significant -AT were rare, but were associated with initially hypothermic patients. Nonhypothermic patients did not develop hypothermia during RW transport. Innovations

and Experience

Session

AN EFFICIENT, COST EFFECTIVE AEROMEDICAL PERSONNEL

Margie Inova

I, October

STRATEGY

Roche A.D.N., RN, CCRN, Jeannine Medical AirCare, Fairfax Hospitali

17

FOR MEETING

Kokiko M.S.N., 3300 Gallows

TEE

EDUCATIONAL

NEEDS

RN, CCRN, CEN Road, Falls Church,

OF

VA

22046 Introduction Meeting the diverse education needs of aeromedical personnel can be both costly and complex. Typically, aeromedical programs provide service to a wide variety of patients, and have multiple regulatory and certification requirements. With the current emphasis on cost containment, meeting educational needs becomes even more of a challenge. Methods In response, the staff education committee designed a strategy which contains the following elements: initial orientation (using a competency-based hpproach), skills verification, didactic continuing education, and clinical rotations. Results This approach has proved to be both cost effective and efficient for the following reasons: First, skills validation is completed on down-time every six months. Members of the education committee maintain responsibility for testing their peers to maintain quality control. Competency-based Orientation also has potential cost.savings because the orientation is geared towards the individual's specific needs. Clinical rotations have been modified because crew members must spend down time in the ICUs and ED. We have four rotation days per year to be spent in such areas as: OR, L&D, NICU, and PICU. Additionally, our education programs have been approved by the Virginia Department of EMS, so that much of the continuing education requirements for EMT-A (RN) and EMT-Ps are satisfied internally. Conclusion Budget management is one of the biggest concerns of any aeromedical service today. Fortunately, much can be done to contain educational costs without compromising quality.

162

14:3

July-September

1995 Air Medical Journal