Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T00:30:20.978Z Has data issue: false hasContentIssue false

The Role of the Physician in a Helicopter Emergency Medical Service

Published online by Cambridge University Press:  28 June 2012

Robert J. Schwartz
Affiliation:
Research Director, Department of Emergency Medicine, Hartford Hospital; Assistant Professor of Surgery, University of Connecticut School of Medicine
Lenworth M. Jacobs
Affiliation:
Director, Trauma/Emergency Medicine, Hartford Hospital; Professor of Surgery, University of Connecticut Health Center
Margaret Lee
Affiliation:
Flight Nurse, Life Star, Hartford Hospital

Abstract

The purpose of this study was to measure the contributions of a physician crew member in a helicopter emergency medical service (HEMS) and to develop a method to utilize physician services more efficiently. A two-part study utilizing two independent sets of measurements of physician necessity was conducted. A post-flight questionnaire and the success rate for endotracheal intubation were used as measurement tools.

With the passage of time, the fight nurses perceived the physician crew member' contribution to clinical judgment decreased from 21% to 1% of the flights and that the physician's contribution of technical skills (intubation) declined from 11% to 3%. The contribution to clinical decisions seemed more important on interhospital transports than on scene responses. The technical skills (judged by the tracheal intubation success rates) of a physician seemed more cogent on responses to the scene. When in the capacity of a second crew member with an experienced flight nurse, the endotracheal intubation success rate increased from 71% to 90%. Therefore, it seems that physician services could be restricted primarily to scene response flights. This limited utilization of flight physicians should make these physicians available for other duties.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at: University Association for Emergency Medicine 18th Annual Meeting, May 25, 1988

References

1. Duke, JH, Clark, WP: A university-staffed, private hospital-based air transport service. Arch Surg 1981; 116:703708.CrossRefGoogle ScholarPubMed
2. Carraway, RP, Brewer, ME, Lewis, BR, Shaw, RA, Szymela, ZF: Why a physician? Aeromedical transport of the trauma victim. J Trauma (abst) 1984; 24:650.Google Scholar
3. Keyes, FN: National Flight Nurses Association. Liaison Committee Flight Programs Report. 1984.Google Scholar
4. Rhee, KJ, Strizeski, M, Burney, RE, et al: Is the flight physician needed for helicopter emergency services? Ann Emerg Med 1986; 15:174177.CrossRefGoogle Scholar
5. Baxt, WG, Moody, P: The impact of the physician as part of the aeromedical prehospital team in patients with blunt trauma. JAMA 1987; 257:32463250.CrossRefGoogle ScholarPubMed
6. Champion, HR, Frey, CF, Sacco, WJ: Determination of national normative outcomes of trauma. J Trauma (ABST) 1984; 24:651.Google Scholar
7. Snow, N, Hull, C, Severns, J: Physician staffing on a helicopter emergency service. ECQ 1986; 2:4045.Google Scholar
8. Snow, N, Hull, C, Severns, J: Physician presence on a helicopter emergency service: Necessary or desirable? Proceedings from International Aeromedical Evacuation Congress. September 10–13, 1985. Zurich, Switzerland, pp. 253254.Google Scholar
9. Soderstrom, CA, Cowley, RA: The physician's role in helicopter air evacuation support. Proceedings from International Aeromedical Evacuation Congress. September 10–13, 1985. Zurich, Switzerland, pp. 251252.Google Scholar