Module Nine Flashcards
What are the barriers to achieving coordinated retrievals? (12)
Aircraft on another task
Aircraft unavailable due to mechanical faults/service
Weather
Staffing shortfalls - duty hours, sick leave, fatigue
Wrong skill mix
Far distances
Number of simultaneous mission requests
Number of pts might make simultaneous transport impossible
Referrer stress and demands, tunnel vision
Critical care bed access
Difficulty contacting hospital personnel
Various processes to access hospitals
What factors should retrieval personnel be aware of to effectively prioritise? (8)
Good understanding of processes and potential barriers, plus:
Aircraft capability and capacity
Crew mix
Disposition decisions
Recognition of time/intervention dependent or both
Resource availability
Stakeholders involved
Local geography
What can aid prioritising?
Experience, local knowledge, info collection, and technology.
Telehealth is an adjunct to these things.
What can be used to improve safety and consistency?
Standards and guidelines
Scoring systems for assigning risk and resources
What can complicate asset management in SAR and disaster activities?
Rapidly changing/limited info
Ongoing conditions causing disaster
Continuation of daily activities
How should decisions be made in retrieval coordination?
Think through all implications including risks and benefits (risk-based approach)
Consult appropriately - evidence for skilled clinician being involved in dispatch process
Make a rational decision - may be time critical
How should AME be delivered?
In a coordinated manner as part of a systems-based approach to patient care.
Single point access to coordination/retrieval system (co-locate coordination and logistics)
What is the guiding principle of pt transport?
The right patient to the right place at the right time by the right means with the right level of escort and equipment.
What can impact the coordination and performance of a service?
Its oversight and funding arrangement.
List the tasks of the retrieval coordinator.
Provides referrer with advice, transport plan, and updates.
Provides retrieval team with tasking, urgency, and crew brief.
Provides receiving hospital with updates and time of arrival.
What are the five phases of coordination?
Open case: clinical details, location and on site resources, size and wt
Decision making: clinical management, urgency, complexity, crew-mix, platform, destination
Communication: crew, receiving facility, referrer
Case tracking: receive and provide updates
Case closure: receive and provide feedback
How can barriers to coordination be turned into enablers?
Referrer understanding of process and indications for retrieval
Common understanding of pt condition and needs (shared mental model)
Understanding of pt environment and referrer constraints
Anticipate logistic difficulties and delays
Understand local culture
How is the transport platform chosen?
Availability
Urgency - stability and complexity
Distance
Weather/terrain/day or night
Impact on competing tasks
Alternatives
Aircraft landing sites
Altitude restriction
Total out of hospital time
Crew and pilot duty hours and fatigue policy
Cost
List examples that require the highest possible skill set.
Severe sepsis
Multisystem disease
Pregnancy
Morbid obesity
Complex toxicology
Current/prior severe abnormalities in vital signs
High support requirements - vasopressors, o2, inotropes
What are causative factors of cognitive overload and how can they be managed?
Hungry, angry, late, tired, stressed - take a break
Task volume/complexity - list tasks in order of priority, use checklist
Task acuity - delegate to other clinical, logistical, and admin staff
