EMT Lesson Plans

8.10 EMS Operations Station: Air Medical Lab Objectives: Properly set up an air medical landing zone and identify resources necessary to land a helicopter. Preparation: Deploy on the tabletop three cars in a simulated collision on a highway. Make sure the highway is clearly marked on the tabletop. Read to Students: You are called to the local highway where a 3 car collision has occurred. You are treating an unconscious shock patient with a suspected internal bleed. The plain is to fly him to the Trauma Center The ideal location will be free of power lines and other obstructions, be reasonably flat, and somewhat removed from the scene. Size is ideally 100’x100’ and ground should be hard or grassy. Objects that might fly due to wind from tubines should be removed (trash cans, EMS bags, pieces of debris). Goal 2: Summon the Fire Department The FD in many jurisdictions will want to be on scene to set up the landing zone and standby for problems that might arise. They will generally mark the LZ with lights or weighted cones. Goal 3: Stay outside the LZ until directed by the air crew Wait until directed to approach the helicopter. NEVER approach from the rear as the tail rotor is dangerous. Do not approach from a grade. Goal 4: Approach at a crouch Approach the helicopter at a crouch as the blades can come down to as low as 4’ off the ground. What Should Happen (you may need to coach them through this): Goal 1: Identify a safe location for landing the helicopter

Scenario 2: Medivac decisions

Read the following: “You are at a motor vehicle collision on the highway. Six patients are hurt. You have 4 BLS ambulances and 2 ALS intercept units on-scene and one helicopter available. Community hospital is 20 minutes out, trauma center is 40 minutes out. Please decide who is going to get transported and by what means:”

Patient 1: 4 year old, cardiac arrest

Patient 2: 2 3 year old, fx forearm, pregnant, no other complaint

HR 0, RR 0, BP 0/0

HR 96, RR 22, BP 104/72

Patient 3: 58 year old, alert, crepitus of hip

Patient 4: 48 year old, alert but confused, tourniquet on L Leg

HR 118, RR 18, BP 92/62

HR 128, RR 22, BP 96/60

Patient 5: 18 years old, femur fracture

Patient 6: 39 year old, unconscious, flail chest

HR 92, RR 22, BP 118/70

HR 124, RR 42 and shallow, BP 96/58

Patient 1 has a very poor prognosis even with ALS/Medivac and represents a poor triage decision for resources (BLS) also codes generally don’t fly in NJ Patient 2 is stable with minor injury (she can share a BLS unit with another patient) Patient 3 is shocky (BLS + ALS) - ALS might be able to buy him time with fluid Patient 4 is a critical hypovolemic shock patient with controlled bleeding (BLS + ALS) – ALS might be able to buy him time with fluid Patient 5 is a stable femur fracture (BLS shared with another patient) – although ALS would be ideal, they would mainly do pain relief and traction may help with that – under the limited circumstances, he could share a BLS unit with the pregnant patient Patient 6 is a critical injury with airway and breathing compromise (Medivac) – he needs to be intubated and ventilated