Located in Winston-Salem, North Carolina, AirCare Critical Care Transport Service provides both air and ground transport for Wake Forest University Baptist Medical Center.
Mission
AirCare's mission is to provide the highest standard of clinical and ethical care in the most expeditious manner available to those patients entering the Medical Center.
Goal
The key values of the Medical Center; excellence, compassion, innovation, integrity and collegiality, are incorporated into our everyday challenges of the critical care patient in the transport environment. Our goal is safety and to provide the best care possible to our patients.
Outreach
AirCare extends its services to the community through public relations activities involving schools, other healthcare facilities and other emergency medical service providers.
RACE-ER
RACE-ER=Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments-Emergency Response.
As an active member to the RACE-ER program we strife to meet the following guidelines. The new RACE-ER recommendations for Air Transport were just released in September 2008.
- Local EMS ambulance, staffed by a paramedic, should generally be used for the transport of hemodynamically stable STEMI patients if available and less than 30 minute transportation time to destination hospital.
- ST-elevation myocardial infarction patient for reperfusion("STEMI medical scene") has the same priority as 911 and trauma calls.
- Helicopter transport protocols should include EMS and ED Protocols capable of launching helicopters to medical scenes and establishment of helicopter landing zones(LZ). Patients transported to LZ's adjacent to hospitals should not require medical evaluation by that hospital unless deemed necessary by the EMS crew.
- 10-minute pick up time(of accessing, loading, and lift off)
- Streamlined transfer of care process.
- Transport directly to catheterization laboratory.
- When possible minimize or avoid IV infusions such as Nitroglycerin or Heparin drips.
- Transfer protocol should focus on rapid transport to catheterization laboratory rather than pain relief with medications.
- Helicopter capable of transporting patients on ten minutes notice 24 hours per day/ 7 days a week.
- Consider helicopter transport when alternate transport options unavailable.
- Immediately activate helicopter transport during initial communication with receiving hospital regarding the need for reperfusion.
- Transfer patient to Percutaneous Coronary Intervention(PCI) hospital with similar consideration to patient registration, bed availability, and accepting physician as trauma patients(use of dummy registration numbers, acceptance of all STEMI patients regardless of bed availability, and reliance on a single accepting physician that is on call 24 hours per day/7 days a week).
- When transporting a patient treated with fibrinolysis who has continued chest pain and/or less than 50% ST resolution 60-90 minutes after the initiation of fibrinolysis, notify the receiving hospital about the potential need for rescue angioplasty.
- Hospital records should be faxed to the receiving catheterization laboratory, so as not to delay patient transfer.
- EMTALA/COBRA/medical necessity of transfer form should be completed as soon as possible after the decision to transfer.
- Advance life support units serving a hospital should be willing to transfer patients to any available PCI facility in cases where another transport option is not immediately available.
For more RACE-ER information see: http://www.race-er.org/