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The holidays are a season of hope, a time to believe in the extraordinary. Remember the classic holiday film Miracle on 34th Street? Just when faith seems lost, a series of unexpected events brings about the impossible. This week on the Air Methods Prehospital Education Podcast, we share a real-life story that captures that same spirit—a tale of resilience, determination, and the power of preparation in the face of a life-threatening pediatric emergency. Picture this: a child in cardiac arrest, the festive joy overshadowed by an urgent fight to save a life. Our crew, confronted with a medical mystery and a young life in peril, refused to give up. Like Kris Kringle himself, they needed more than just skill—they needed a touch of magic, a glimmer of the extraordinary.
Join us as the AMPED crew—Medical Director Dr. Wilmas, Flight Nurse Nyssa Hattaway, and I—delve into this inspiring case. Together, we explore how preparation, quick thinking, and a series of fortunate events came together to save a child’s life. It’s a story that reminds us that even in the darkest moments, hope—like the spirit of the holidays—can shine through. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-47-miracle-in-the-desert. To join the conversation, use the hashtag #AMPEDpod on social media.
As the winter months set in, a surge in pediatric respiratory illnesses becomes an anticipated challenge for medical professionals. Rural, community hospitals often find themselves overwhelmed by the influx of pediatric patients needing specialized care they may not be equipped to provide. The rise in pediatric respiratory illness creates a demand for air medical transport that can safely and efficiently move young patients to facilities with more advanced pediatric capabilities. We’ll dive into how Air Methods manages these intricate transports, ensuring that critically ill children receive timely and appropriate care en route to specially equipped hospitals. We’ll also highlight the work our partners at Loma Linda University Health Center are doing to ease the burden at smaller community hospitals.
Pediatric respiratory viruses, including RSV, flu, COVID-19, and rhino enterovirus pose significant health challenges, particularly during the winter months when illnesses peak. Due to the anatomical characteristics of children’s airways which are smaller and more susceptible to obstruction, respiratory illnesses can escalate into severe distress more rapidly than adults.
“The 2022 tripledemic, characterized by surges in RSV, influenza, and COVID cases, overwhelmed pediatric healthcare systems nationwide, leading to a critical shortage of hospital beds, said Dr. Sonea Qureshi, medical director of pediatric critical care transport at Loma Linda University Children’s Hospital. “Fortunately, trends have normalized in 2023 and 2024, with a marked decline in COVID cases and a stabilization of RSV.”
However, a trend has emerged, as more children present with co-infections — experiencing two or three viral illnesses simultaneously. Theresa Doran, the PICU transport coordinator at Loma Linda University Children’s Hospital, highlighted this concerning development. “We are witnessing a significant increase in the number of pediatric patients who are battling multiple viral infections at once, which complicates both treatment and recovery,” said Doran. In response to these co-infections, many community hospitals have adopted high-flow nasal cannula devices to initiate oxygen therapy before transferring patients to higher-level care. This proactive approach, especially during peak respiratory illness season, has proven essential in managing care effectively.
When community hospitals need help treating severe pediatric cases, they turn to larger facilities that have pediatric-specific resources and advanced training. This is where air medical transport steps in as a vital bridge between initial diagnosis and comprehensive treatment at specialized centers.
Air Methods’ partnership with the pediatric medical team at Loma Linda University Children’s Hospital is one such collaboration. Serving a population of several million children across five counties, the PICU air medical transport team at Loma Linda is comprised of the Nurse, the Respiratory Therapist, and the resident. This specialized team initiates care at a referring community hospital to create seamless patient management and continuous monitoring from bedside to air transport. Pediatric patients and their families find comfort in an organized approach during what can be considered a high-stress air transfer. “With the aircraft, we are a traveling ICU for the patient, equipped with the best equipment and training,” says Respiratory Transport Manager Victor Bannis. “Onboard, the transport team is equipped with advanced life-support technologies, ranging from HFNC and conventional ventilators to advanced high-frequency ventilators and nitric oxide therapy.”
One critical aspect of pediatric air transport during a rise in respiratory illness is the necessity for highly trained personnel who can handle the unique challenges posed by transporting sick children. The crew must be exceptionally skilled in clinical interventions and emotional intelligence to reassure worried and anxious families.
The Loma Linda medical transport team focuses on:
Looking ahead, our partnership with Loma Linda remains steadfast as we leverage advanced training through simulations to equip our teams with the skills necessary to handle real-life scenarios. We feel confident we are always prepared to meet the evolving needs of our young patients. With Air Methods’ comprehensive approach that emphasizes rigorous training and advanced equipment, pediatric respiratory transports function smoothly.
Extensive training and equipment mean:
Tom Crain, clinical director at Air Methods, emphasizes the importance of collaboration and communication between transport teams and receiving facilities. “Air Methods has established comprehensive policies that facilitate timely interactions with receiving physicians,” says Crain. “We ensure that the latest advancements in pediatric care are integrated into their practice and that the highest possible level of care is consistently achieved.” Air Methods is committed to delivering exceptional and responsive care in critical situations by working closely with pediatric specialty teams.
As the winter months usher in a surge of pediatric respiratory illnesses, air medical transport can be a vital resource, particularly within rural communities. The complexities of treating young patients, particularly those facing co-infections during peak illness season, underscore the urgent need for specialized care and rapid transport capabilities. By harnessing the advanced technologies of air medical transport and the dedicated expertise of a skilled multidisciplinary team, we ensure that critically ill children receive the timely interventions they need. Focusing on compassionate communication and trust-building, our air medical transport teams provide lifesaving medical care and support families’ emotional well-being.
Our commitment to enhancing patient outcomes and alleviating the burden on community hospitals remains steadfast. Together, we strive to transform the challenges posed by respiratory illness into opportunities for collaboration and healthcare access.
Learn more about clinical excellence at Air Methods and Loma Linda Children’s Hospital.
A motorcycle accident victim faces dire circumstances and our team has to execute a new procedure that is rarely done in the field and has a high degree of risk if not done correctly. They are one of the only teams in the region equipped to even do such a procedure, and our team is concerned about doing it correctly because a lot can go wrong. Could you do a procedure you don’t normally do with an audience? Because in addition to having to execute for the good of the patient, our team had the patient’s family, other first responders and more watching them. We’re joined by Veronica Huskey, RN, NREMT-P, CFRN, FP-C and Alaina Armstrong-Cain, NREMT-P, FP-C, listen in as our team tackles another fascinating case on this episode of AMPED.
Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-44-zen-and-the-art-of-treating-a-motorcycle-accident. To join the conversation, use the hashtag #AMPEDpod on social media.
Presented with a patient whose symptoms seem contradictory then flip, change and remain unclear, our team must continue to work to keep the patient alive. What’s causing the duress for our patient? Is it an aneurysm? Is it neoplastic process? Cardiac arrest? Some combination of these factors? Our team remains nimble, attentive, and diligent in their work. What lessons can we learn from this case? We’re joined by Liz Lashley RN, CFRN and Jorden Dick, OMS-1, NRP, FP-C.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-43-into-the-unknown. To join the conversation, use the hashtag #AMPEDpod on social media.
In the fast-paced world of air medical services, staying ahead of the curve is crucial. One way to ensure that we meet and exceed industry standards as an organization is through simulation education, a method that mirrors real-life medical scenarios for training purposes. Recently, Air Methods achieved a significant milestone by earning Simulation Center Accreditation from the Society for Simulation in Healthcare (SSH). Air Methods was the world’s first air medical program to earn this prestigious accreditation. In this blog post, we’ll talk about what simulation education entails, how we use it, and the importance of this accreditation for Air Methods and within the industry.
What is Simulation Education?
Simulation education at Air Methods uses realistic scenarios to train clinicians. It involves various methods, such as virtual reality (VR), didactic learning, cadaver labs, and physical manikins of varying fidelity. These simulations offer a risk-free environment where professionals can practice and hone their skills, preparing them for real-world clinical situations.
“Healthcare simulation is a vital tool that allows air medical programs to prepare for the complexities and high-stakes scenarios our clinical teammates face every day.” said William Belk, Director of Medical Simulation and Innovative Education, “By replicating real-world situations in a controlled environment, we can practice, refine, and master the skills needed to deliver critical care in the HEMS environment. This level of preparation is essential for ensuring that our teams are ready to respond effectively to any patient encounter.”
Simulation training is invaluable in healthcare because it provides hands-on experience without patient risk. Practitioners can make and learn from mistakes in a controlled setting, ensuring they are better prepared for clinical situations. This form of education enhances critical thinking, clinical decision-making, and procedural skills through deliberate practice and guided self-reflection.
Understanding SSH Accreditation
The Society for Simulation in Healthcare (SSH) accredits programs that adhere to the highest standards in simulation education. Accreditation ensures that a program follows best practices and maintains a high level of standardization, which is crucial for learner safety and ensures the program is delivering high quality education.
The accreditation process under SSH is rigorous. In 2020, we began revamping our simulation education program, rewriting policies and procedures to align with the Healthcare Simulation Standards of Best Practices published by the International Nursing Association of Clinical Simulation and Learning, as well as other published standards and industry best practices.
Now that we are fully accredited, Air Methods is committed to maintaining these high standards. The accreditation is valid for five years, but we must submit annual reports to SSH to ensure continuous improvement and adherence to best practices.
Significance of Accreditation with SSH
Air Methods is the first air medical program to receive SSH accreditation, aligning itself with experts across the healthcare field, including hospitals, and major universities. This accreditation signifies quality assurance and credibility, validating that Air Methods’ practices are on par with those of industry leaders.
A critical aspect of SSH accreditation is creating a psychologically safe learning environment. Air Methods encourages open communication, where learners can ask questions and acknowledge what they don’t know without fear of failure. This approach contrasts with traditional clinical training methods, fostering a more supportive and practical educational experience.
Air Methods’ achievement sets a new benchmark for the industry, encouraging others to follow suit. By raising the bar, we aim to create the best possible learning experiences for our students, ultimately leading to better-prepared healthcare professionals who can save lives.
“Our recent SSH accreditation is a testament to the collective effort and dedication of the entire clinical education team at Air Methods. Over the past several years, we’ve worked tirelessly to elevate our simulation-based education, refining our practices and enhancing the learning experiences for our employees and customers,” said William Belk, Director of Simulation and Innovative Education at Air Methods. “This achievement is not just a milestone but a reflection of our commitment to excellence in critical care transport education.”
To be the first air medical program to achieve Simulation Center Accreditation is more than just a badge of honor; it’s a commitment to excellence in clinical education. Our simulation training programs are designed to provide clinicians with the skills and confidence they need to excel in their field. By setting a high standard, we are enhancing our training programs and inspiring the entire industry to strive for better practices.
Our Simulation Facilities & Training Methods
Air Methods has established four state-of-the-art simulation education facilities in Georgia, New York, Colorado, and Arizona. Each facility offers comprehensive training programs for clinicians that include multi-day sessions. These programs cover various aspects, such as trauma care, invasive procedures, and advanced medical topics in critical care transport.
Air Methods brings out its clinicians at least once a year for an extensive training session, where they run through educational simulations and receive updated training. An annual needs assessment is also conducted to evaluate our training requirements and the industry’s needs. The assessment ensures that the training provided is relevant and updated to align with needs of our providers and patient population.
The facilities offer a wide range of training methods, including:
• Virtual Reality (VR): Immersive experiences that replicate real-world scenarios.
• Didactic Learning: Traditional classroom-based education.
• Cadaver Labs: Hands-on anatomical training on human tissue.
• Manikin-Based Simulation: Realistic practice on task trainers and high-fidelity patient simulators.
Through the Air Methods Ascend program, we extend these training opportunities to not only our partners but also clinicians outside our network. This inclusivity allows a broader range of healthcare professionals to benefit from our advanced training methods.
“By setting a high standard of care and continuously striving for excellence, we not only benefit our organization but also set an example for the entire industry,” said Air Methods VP of Clinical Services, Stephanie Queen. “Through our dedication to innovation, collaboration, and patient-centered care, we push the boundaries and help drive the industry forward towards a brighter future.”
Sometimes the hardest part is the waiting. When our team is dispatched to a scene where a man who does not speak English is trapped inside a confined space with possible crush injuries, hypothermia and hyperkalemia, they must wait for him to be extricated. How do you stand that interminable time? How do you stay ready? And then how do you switch from inaction to action once it’s time? Our team tackles yet another unique case in this month’s episode. We’re joined by Nissa Hattaway, Flight Nurse BA, BSN, RN, CEN, CPEN, CFRN and Justin Brown, Flight Paramedic NREMT-P.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-41-the-calm-before-the-storm. To join the conversation, use the hashtag #AMPEDpod on social media.
Any pediatric case comes with a higher degree of tension due to a variety of factors, including compensatory efforts to distress leading to a precarious “cliff” when those efforts cease. When our team is called to assist a 5-year-old child struggling to breathe but still exhibiting strong vital signs, how will the AMPED team react? This episode emphasizes the importance of acknowledging that while we aim for perfection in our actions, sometimes achieving “good” outcomes is sufficient. Recovery is a journey, and there are skilled and compassionate teams ready to take over patient care as we transition. We’re joined by Robert Pringle, MD; Jamie Hogue, MSN, RN, TCRN, CEN, CFRN; and Greg Denz, NRP, FP-C, BS.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-40-macgyver-and-medicine. To join the conversation, use the hashtag #AMPEDpod on social media.
Any pediatric case comes with a higher degree of tension due to a variety of factors, including compensatory efforts to distress leading to a precarious “cliff” when those efforts cease. When our team is called to assist a 5-year-old child struggling to breathe but still exhibiting strong vital signs, how will the AMPED team react? This episode emphasizes the importance of acknowledging that while we aim for perfection in our actions, sometimes achieving “good” outcomes is sufficient. Recovery is a journey, and there are skilled and compassionate teams ready to take over patient care as we transition. We’re joined by Danica Mainridge RN, BSN, CEN, CPEN, CFRN and Kevin Dominic NRP, FP-C.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-39-dont-let-the-perfect-be-the-enemy-of-the-good. To join the conversation, use the hashtag #AMPEDpod on social media.
Zachary T. Fica MD, MS; Amy Marquez MSN, CFRN; John Ehrhart FPC; Christian Sloane MD
We present the case of a 10-year-old previously healthy male who suffered an out-of-hospital cardiac arrest because of abdominal trauma and survived with excellent neurologic outcomes and near complete return to baseline functional status at hospital discharge. The rapid response and efficient mobilization of resources led to an excellent patient outcome despite the severity of injuries, including intra-abdominal injuries with expected mortality, out-of-hospital traumatic arrest, coagulopathy, and an extended pediatric intensive care unit stay. This case underscores the significance of timely advanced trauma life support interventions, especially early blood product administration, efficient transport, and airway management, while sharing a remarkable case of out-of-hospital pediatric traumatic arrest with near full recovery.
A 10-year-old previously healthy male called his mother on his smartwatch saying he had crashed his bicycle while riding in their neighborhood and felt unwell. His mother called 911 who activated emergency medical services, and the local advanced life support fire department arrived at the scene to find the patient pale and lethargic with right-sided abdominal pain. Recognizing the need for immediate transport to the nearest pediatric trauma facility approximately 35 miles away, helicopter emergency medical services (HEMS) was requested per county protocol because of a shorter transport time.
Click below to read the full case report and discussion published by ScienceDirect.
David J. Olvera MBA, NRP, FP-C, CMTE; Michael Lauria MD, NRP, FP-C; Jeremy Norman BAS, NRP, FP-C; David Gothard MS; Andrew D. Gothard BS; William Bradley Weir MD, FACEP, FAEMS, FAMPA
Rapid sequence intubation (RSI) is a critical skill commonly performed by air medical teams in the United States. To improve safety and reduce potential patient harm, checklists have been implemented by various institutions in intensive care units, emergency departments, and even prehospital air medical programs. However, the literature suggests that checklist use before RSI has not shown improvement in clinically important outcomes in the hospital. It is unclear if RSI checklist use by air medical crews in prehospital environments confers any clinically important benefit.
This institutional review board–approved project is a before-and-after observational study conducted within a large helicopter ambulance company. The RSI checklist was used by flight crewmembers (flight paramedic/nurse) for over 3 years. Data were evaluated for 8 quarters before and 8 quarters after checklist implementation, spanning December 2014 to March 2019. Data were collected, including the self-reported use of the checklist during intubation attempts, the reason for intubation, and correlation with difficult airway predictors (HEAVEN [Hypoxemia, Extremes of size, Anatomic disruption, Vomit, Exsanguination, Neck mobility/Neurologic injury] criteria), and compared with airway management before the implementation of the checklist. The primary outcome was improved first-pass success (FPS) when compared among those who received RSI before the checklist versus those who received RSI with the checklist. The secondary outcome was a definitive airway sans hypoxia improvement noted on the first pass among adult patients as measured before and after RSI checklist implementation. Post-RSI outcome scenarios were recorded to analyze and validate the effectiveness of the checklist.
Ten thousand four hundred five intubations were attempted during the study. FPS was achieved in 90.9% of patients before RSI checklist implementation, and 93.3% achieved FPS postimplementation of the RSI checklist (P ≤ .001). In the preimplementation epoch, 36.2% of patients had no HEAVEN predictors versus 31.5% after RSI checklist implementation. These data showed that before RSI checklist implementation, airways were defined as less difficult than after implementation.
The implementation of a standardized RSI checklist provided a better identification of deterring factors, affording efficient and accurate actions promoting FPS. Our data suggest that when a difficult airway is identified, using the RSI checklist improves FPS, thereby reducing adverse events.
Click below to read the full research paper published by ScienceDirect.
When an infant patient faces seemingly insurmountable odds over the course of several hours, one of our clinicians suffers a mental health breakdown over the ensuing shifts, days and weeks. Thankfully her team recognized changes in her behavior and mood and offered abundant help. This episode covers not only the case involving the infant patient, but the aftermath and care for our clinicians. If you, or someone you work with, is struggling with your mental health, please reach out to Shatterproof, part of FHE Health on the web or at (833) 591-1536.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-37-asking-for-help-isnt-giving-up. To join the conversation, use the hashtag #AMPEDpod on social media.
Our profession requires extensive and exhaustive training. Much of it can seem esoteric and possibly unnecessary at the time, but we train on all of these things for a reason. When our team comes upon a severely burned patient, they extent of the burns causes a melange of difficulties. Could an obscure, and rarely used, procedure ultimately help and provide the patient more time? The AMPED team discusses this little-used technique and we discuss the importance of remaining familiar with the abundance of techniques and treatments we learn during our training.
AMPED is available on Apple Podcast, Spotify, Google Podcasts, Stitcher, and more. To listen to the episode or catch up on past discussions, visit https://ampedpodcast.libsyn.com/air-methods-prehospital-education-podcast-ep-36-sometimes-the-solution-is-obscure. To join the conversation, use the hashtag #AMPEDpod on social media.