Our team is dispatched to a scene expecting to assist a pregnant woman in footling breech labor—but when they arrive, the baby has already been delivered and is receiving Basic Life Support (BLS). She’s in critical condition, and the team must act fast. How do they pivot in this high-stakes moment? What life-saving steps do they take as the baby goes into cardiac arrest? As is often the case, the key is going back to the basics. Tune in for this intense and emotional episode, featuring an unexpected twist you won’t see coming. We’re joined by Breanna Bingel RN, BSN, PHRN, TNS, CFRN, CEN, TCRN, CTRN. As always, thanks for listening and fly safe!
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-50-theres-no-place-like-home-or-the-basics. To join the conversation, use the hashtag #AMPEDpod on social media.
When two flight teams are dispatched to a scene, the first to arrive typically takes the sickest patient—but what happens when conditions on the ground shift that plan? How do teams seamlessly tag in and out to ensure the best care? In this episode of the AMPED Podcast, we break down a high-speed highway collision where multiple patients suffer severe trauma, including traumatic brain injuries, Beck’s triad, tension pneumothorax, and flail chest. With a special guest ride-along, our team navigates critical decisions and life-saving interventions in a fast-paced transport to the hospital. Tune in to hear how teamwork, adaptability, and expertise come together in the face of chaos. We’re joined by Breanna Bingel RN, BSN, PHRN, TNS, CFRN, CEN, TCRN, CTRN; Kayce Thompson, BSN, RN, Flight Nurse; Spenser Rich, RN-Paramedic, CFRN, FPC; Christopher Wright, BSN, RN, CFRN and Shawnee Trindle, ER RN. As always, thanks for listening and fly safe!
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-49-tag-youre-it. To join the conversation, use the hashtag #AMPEDpod on social media.
A pinkie promise is one you can’t break—and for our patient in this month’s episode, it was a lifeline. Stricken with a life-threatening COVID infection, he vowed to his wife that he would pull through. And he did—but not without countless obstacles along the way. Our team fought not only his severe COVID case but also a relentless pneumonia infection that ultimately led to ECMO, a last-resort intervention. Along the way, they faced unprecedented challenges: transporting him in a prone position for the first time in over 20 years, navigating an unexpected hailstorm mid-transport, and witnessing his incredible journey to recovery—including a life-changing lung transplant. Tune in to hear this extraordinary story of resilience, innovation, and the power of a promise. We’re joined by Jeff Dickson, NRP, FP-C and the Wilkins family. As always, thanks for listening and fly safe!
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-48-the-pinkie-promise To join the conversation, use the hashtag #AMPEDpod on social media.
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.
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.
In the aviation industry, safety is a priority. But it’s also a fundamental way of life, particularly in high-risk sectors like air medical services. Air Methods relies on its Safety Management System (SMS) program to establish a comprehensive systematic approach to safety, serving as the cornerstone of our company. It’s the backbone of our operations, ensuring that every flight is as safe as possible for patients and flight crew. With an unparalleled personal and financial commitment to our SMS, Air Methods has set the benchmark in air safety management.
What is a Safety Management System Program? A Safety Management System program is precisely what it sounds like — a method for proactively mitigating risk to operations. It involves structures, procedures, practices, and policies to handle safety risks. The Federal Aviation Administration (FAA) describes it as a “formal, top-down, organization-wide approach,” and having one ensures “the effectiveness of safety risk controls.”
Air Methods’ SMS program has several components, which include:
Until recently, the FAA did not require Part 135 operators (providing on-demand services like air ambulances) to have a safety program. Air Methods voluntarily implemented a safety management system to promote proactive safety practices. Following a federal ruling, most Part 135 operations will now adhere to the Department of Transportation and the FAA’s safety management system requirements, though not all. Operators impacted by the new rule are expected to comply by around May 2026, pending a final decision.
What the FAA’s New Requirement Means It is crucial that the FAA requires that most Part 135 operators follow safety procedures and have a formal Safety Management System program.
“Under the current voluntary program, it means that Air Methods has put into practice all relevant procedures required under the federal mandate,” says Caleb Luck, Safety Department. “To maintain acceptance, along with the active maintenance of our program and as part of the new standard, we must maintain a state of continuous improvement to our program.”
Part 135 operators rely on this program significantly. It allows us to maintain uniform standards while flexibly adapting to individual operational contexts. “This program also helps us navigate risks within our organization and foster collaboration using a shared approach,” explains Caleb.
The Key Components of an Effective Safety Management System To ensure a safe and secure working environment, organizations today need to have a robust SMS in place. An effective SMS program encompasses several key components that promote safety and minimize workplace risk.
These components include:
Safety Policy: Establishes senior management’s commitment to safety and defines methods and processes that will meet safety goals.
Safety Risk Management: Assessing acceptable risks helps determine the necessity and effectiveness of implementing new or updated risk management measures.
Safety Assurance: Assesses the ongoing efficiency of applied risk control tactics and aids in pinpointing fresh hazards.
Safety Promotion: Training, communication, and other efforts are essential for fostering a culture of safety across all levels of the workforce.
Specific Benefits of SMS-Certified Operations for Partners and Patients Our ongoing efforts to enhance our SMS program ensure the highest level of safety for all. We routinely monitor the program’s effectiveness and make sure it retains high standards for our employees, partners, and patients. This commitment is evident in our evolving platform, where employees can easily report concerns with the assurance that they will receive prompt action.
For Example, multiple reports were submitted by flight crews regarding the deficiency or absence of quality hazardous terrain and flight awareness systems across various aircraft within the fleet. These systems are essential for providing flight crews with information about nearby terrain and other aircraft. The safety management and aviation teams concluded that further discussion on this matter was necessary. As a result, immediate updates were implemented for aircraft with a critical need for these systems, accompanied by a phased-out plan to ensure the installation of new systems in other specified aircraft over time.
The Role of the SMS Program Within Air Methods The SMS program at Air Methods sets the stage for fostering a strong safety culture within the organization by setting clear expectations for all employees and outlining the two fundamental principles.
These are:
Upcoming Enhancements As we continue to evolve our safety culture, we are implementing new updates to our SMS program. In early June, we will see the release of a new tool for safety reporting that includes a Corrective/Preventative Action Plan (CAPA) tool. These tools will enable us to proactively identify hazards and unmanaged risk, respond more effectively, and ultimately decrease the risk of incidents and accidents from occurring.
We are confident that our SMS program will continue to evolve and adapt to meet the industry’s changing requirements. We will continue to work closely with the FAA to ensure we stay ahead of the curve and remain at the forefront of safety in the aviation industry. With the recent mandate for Part 135 operators, we have been working diligently to stay ahead of the changes that will impact the SMS landscape.
Learn more about safety practices at Air Methods.
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.