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AMPA
Getting to Know You
AMTC in Minneapolis has come and gone, but the great memories are still fresh. Over 110 air medical physicians attended! Over 2500 air medical personnel gathered in Minneapolis. What a great turnout! AMPA and its Education Committee sponsored two preconferences: Core Curriculum I and a new session, Beyond Core Curriculum, The Medical Directors Forum. Members had made it quite clear that there was a need for networking and discussion, and AMPA responded appropriately.
AMPA honored two of its outstanding members with awards:
Congratulations to both award recipients!
I also want to congratulate PS Martin as being elected AMPA president-elect and Chris Fullagar as being elected secretary-treasurer. Chris is new to the AMPA board, so welcome. John Pakiela has taken over the as Education Committee Chairman, and of course congratulations also to Doug Floccare, a founding member of AMPA who was elected to the board as a member-at-large. I want to thank all the current members for their hard work on the many ongoing projects that AMPA has and to Steve Andrews, who left the board after his term ran out.
Thank you to Executive Director Pat Petersen for yet another tremendous year and AMTC.
Last and far from least, I want to say a special thank you to Mike Brunko, immediate past president and also a founding member of AMPA for all he has done for this organization and for the help he has offered to me personally. Thank you!
As I begin my 2-year term as president of AMPA, I have to look back at what the previous officers and members have accomplished and try to continue their fantastic efforts. AMPA is an international organization, 400 members strong, and has continued to work to promote its mission of “promoting safe and efficacious patient transportation through quality medical direction, research, education, leadership, and collaboration.” AMPA has some of the most well recognized names in the air medical community. AMPA has members from all over the world, maintains a unique relationship with other air medical organizations and their membership, and will continue to do so and play an important role in air medicine and critical care transport for many years to come.
AMTC was and always is an opportunity for all the air medical and critical care organizations to get to spend quality time together and plan for the future. This year was no different. It was my pleasure to meet the new officers from the various organizations, and I look forward to the next 2 years for a close, productive working relationship among all the organizations. AMPA will continue to work with all other members of the air medical and critical care transport communities to facilitate safe, quality transport of patients and to encourage the advancement of education of all those involved.
The Critical Care Transport Medicine Conference is coming up April 5-8, 2009, in San Antonio, Texas. The 2009 AMTC will be in San Jose October 26-28. Plan ahead so you can attend one or both! Be as active as possible with AMPA activities. If you feel as though you are being left out, please contact me.
I really enjoyed meeting with many of you at AMTC, and I look forward to seeing many of you at the next conference. However, if there is anything that you think AMPA or I can assist with, please do not hesitate to contact us ASAP. If you have colleagues that are involved in air medical transport and/or critical care transport, encourage them to join AMPA or the appropriate organization. Every person is unique and has something unique to offer. Let us all be safe and encourage safety among our colleagues and crews.
Jack B Davidoff, President
ASTNA
A Place at the Table
It was a distinct honor and privilege to be sworn in as the ASTNA president at AMTC. I began my nursing career 23 years ago; it seems like yesterday that I saw my first medical helicopter. Much like many events in my transport nursing career, this one has really stuck with me. I was an emergency nurse in a small rural ED in Moultrie, Georgia, when the crew from Tallahassee LifeFlight brought their brand new BO-105 aircraft to our facility for a PR visit. I was intrigued by the crew's professionalism and poise; from that moment on I knew what I was destined to do. Several years later I found myself at one of the leading academic medical centers in the US, Vanderbilt University Medical Center, vying for a flight nurse position. My career at Vanderbilt has spanned almost 20 years; I enjoyed 13 of them as a full-time flight nurse for LifeFlight.
As with most things in transport nursing, things have changed and evolved. However, the rate of change has increased dramatically. The issue on the forefront of everyone's mind is safety. Over the past year we have lost more than 30 professional colleagues. This topic has been thrust to the forefront and has the attention of the federal government, the media, and even the lay public.
Please rest assured that the leadership of ASTNA is heavily engaged with this issue. As an organization we have take the lead, as evidenced by the publication of a safety position paper, a membership survey, advocacy at a federal level, and plans to meet upcoming challenges head on.
The forthcoming NTSB hearings in February have the potential to be groundbreaking; many believe that the testimony and information presented there will shape the future for the air medical transport industry. ASTNA will be there. I have had dialogue with NTSB representatives and have offered our resources and the perspective of transport nurses.
My consistent message to everyone has focused on being engaged as an individual. Whether we are performing a rapid sequence intubation on a patient or performing a safety walkaround prior to a transport, it is vital that we be focused and have our head in the game. Being engaged means you are fighting the inertia that makes us all complacent. Being engaged means you speak up. Being engaged means you partake of positive action as a medical crewmember. Being engaged means you look outside your own organization to developments that may affect you or your organization. Our position at ASTNA has been to remain engaged, offer comment and guidance on specific safety issues within our area of expertise, and positively contribute to the ongoing process.
Make no mistake; things will change for everyone in the industry, perhaps not in the short term but definitely in the intermediate term.
As an organization we are committed to being engaged, to having a place and voice at the table, and representing and promoting the safety and well being of transport nurses.
Kevin High, President
IAFP
The Wheels of Progress
As my predecessor, Greg Winters, ends his presidential term for the IAFP, I reflect upon our growth, and I am elated with the progress that our association has accomplished over the past 5 years. The IAFP has been fortunate with leadership who have been true visionaries in expanding the role of paramedics in the critical care transport industry. I cannot recall a time in the critical care transport industry that has been as active as this year.
I am excited to take on this new leadership role and will continue with the same forward thinking as our forefathers of the critical care transport industry.
The IAFP continues to improve and enhance the role of paramedics in the critical care transport industry. We have created new educational opportunities with CEUs through the IAFP's education site (CentreLearn) at www.flightparamedic.org. In addition, the expansion of the State Delegate Program now provides local representation to current and new members in approximately 40 states. The IAFP continues to integrate the state delegates with the Government and Legislative Affairs Committee (GLAC) to address a multitude of issues as they relate to the critical care transport industry.
2009 has significant growth opportunities as we formally develop our Research Committee, which has several university institutions providing resources to the IAFP. We are also working to develop new critical care paramedic CEUs that will apply to current critical care certification renewal requirements. We are also in the final revision phase of our flight paramedic certification review book, as well as a few other projects that will give back more to our members in the future.
The IAFP has been working with all of our constituents to address the unprecedented number of critical care transport crashes in the rotor, fixed wing, and ground industry. We will continue to work toward options to mitigate these tragedies and engage the FAA and NTSB with recommendations from our association and through the Association of Air Medical Services (AAMS).
As some of you will recall, the “Safety Culture Topic” at AMTC 2008 was a very heated discussion, and much dialogue between the industries, the NTSB, and the FAA has provided subject material that, hopefully, will inject new concepts to enhance the safety culture. I believe we all have a duty and responsibility to represent what is in the best interest of our patients and members within the association and those who climb into aircraft or ground ambulances every day, providing the highest level of care to the ill and injured.
The display of selflessness that crewmembers possess is exactly the very concept that we as associations should embrace and employ for the very people we serve. We as associations must be vigilant in developing ourselves as servant leaders if we truly wish to represent what is best for our members in the critical care transport industry.
We all talk about the common themes of human safety for our crews and patients as well as clinical excellence. We all strive to stay on the cutting edge to provide the most advanced medical care possible to enhance the positive outcomes for our patients. We ultimately work toward the best interest of the patient. As health care providers we train, read, and perform research to continue to enhance better outcomes for our patients.
In final, I vow to place the IAFP on the forefront for patient advocacy, human safety, and clinical excellence for paramedics within the critical care transport industry. The IAFP wheels of progress are speeding up, so jump on board. We need to maintain our forward momentum, and I encourage all members to become more involved in shaping the future of paramedics in the critical care transport industry through the IAFP. You are all part of historical milestones within the critical care transport industry, so keep your passionate fires burning brightly!
My vision of the IAFP is defined best by Ralph Waldo Emerson, “Do not go where the path may lead, go instead where there is no path and leave a trail.”
Let us embrace the servant leaders within ourselves.
James P. Riley, President
NEMSPA
The Business We're In
I doubt there are many among us in the air medical industry who have not wondered, to some degree or another, why we have been plagued with so many accidents over a relatively short period. Ed MacDonald's recent article in this journal promotes a suggestion he has broached before, one that is hard to dispute. That is, there are no new causes to accidents, nor are there really new methods to minimize those accidents. If only we could abide by principles and practices that have been in place for years, we could likely make significant gains toward a safer industry.
While I am not a proponent of any “magic bullet” solution, and I generally agree with Ed's philosophy, I often wonder why air medical transportation is stricken with what appears to be an abnormally high accident rate. Is it possible that the combination of pilots, medical personnel, physicians, and communications specialists, all working together to achieve the common goal of “saving lives,” may have the tendency to produce an environment that results in a somewhat less than stellar model of preflight planning and cockpit discipline? Does the adage “we are in the transportation business, not the lifesaving business” apply to every pilot and medical flight crewmember whenever they are performing flight-related duties?
I am reminded of the movie Hoosiers, where Coach Norman Dale (Gene Hackman) takes his small town high school basketball team from relative obscurity to the Indiana state playoffs (where they eventually win). In 1952, when this story is set, all teams, regardless of high school size, competed for a single championship title. As the small town team first enters the empty auditorium where the games are to be held, it is obvious that the players are in awe and somewhat apprehensive about its sheer size and with what is sure to be the large attending crowd. In what I think is a moment of brilliance, Coach Dale takes a tape measure and verifies that the basketball hoop in this huge arena is still 10 feet above the ground and the foul line is still 15 feet from the backboard. As far as his team is concerned, they are still playing on that same court in Hickory, Indiana, where they have been successful all season long.
I think there could be a lesson learned from Coach Dale. As pilots, when we step into the cockpit of our “lifesaving” aircraft, we should pay special attention to the layout of all of the instrumentation, switches, and controls. My guess is the cockpit layout is pretty much the same way it was in the “non-lifesaving” aircraft that we used to fly. There won't be a heart monitor replacing the attitude indicator or a blood pressure readout gauge replacing the altimeter. The same principles of aerodynamics will hold true, the same regulations will apply, and the same basic rules of safety ought to be followed. This line of reasoning also applies to medical crewmembers, at least while performing any and all flight-related duties. When evaluating a flight that will traverse marginal weather conditions, you should not be considering whether or not this patient could wait a few hours. When clearing the tail for a scene landing, the concern should not be whether or not you brought the appropriate drug bag.
As difficult as it may be sometimes, as aviation professionals we must ignore the size of the building and roaring of the crowds or, in this case, the needs of the patient and become immersed in the flight-related tasks at hand, which include making unbiased decisions and performing our specific duties with precision and focus. As dull and unexciting as it may sound, and regardless of what our position is, when performing flight-related activities we are in the transportation business, pure and simple.
Kent Johnson, President
AAMS
The Search for Solutions
Happy New Year! I hope the holidays were a time spent with family and friends reflecting on 2008 and what the future holds ahead. 2008 will go down as the deadliest in our industry, and those lives lost will never be forgotten. With this high toll brings attention from all angles, and not just domestically. In my international travels, questions are frequently asked as to why the U.S. is suffering a higher accident rate in HEMS than anywhere else in the world. There is never a simple answer as there is never one cause, which is generally my answer. It never feels like enough, but who am I to respond to these kinds of questions while so many people are still working hard to put improvements into place to stop these tragedies?
As most of you are already aware, the NTSB has called for a public hearing the first week of February. A lot of preparation is already in full swing, and some industry experts have already been contacted by the NTSB to testify at the hearing. The FAA has recently issues several operational specification changes in response to the high accident rate. In addition, a congressional hearing has been requested for some time this year. The media continue to do follow-up reports and, unfortunately, often provide inaccurate information, either from a biased point of view or possibly an inadvertent interpretation of data provided. Either way, inaccurate reporting fuels the information pipeline and may be used as supporting data for the upcoming hearings.
AAMS has recently hired a full-time public relations manager to become proactive in sharing the good news stories that far outweigh the negative that have proliferated over recent months. This is not meant to make light of the losses of lives, as it has been heart-wrenching each and every time that phone call came. However, there are many positive life-altering stories that remain to be told, along with the strong research that is impacting the way prehospital medicine is provided. If you receive a call from Cindy Price, I hope you are willing to answer her questions or provide information necessary to get the word out about the kind of stories that should be shared.
In looking back to 2008 from a personal perspective, it has been a year of professional and personal growth. I'd like to thank the AAMS board and staff and all the professional association presidents I had the honor to serve with this year. With many issues coming to head during AMTC, it was impossible to thank many people in person. During one of the many meetings I participated in that week, an “outsider” to our industry mentioned she had never worked with a more passionate group in her career. She said normally a client gives her the project and walks away to wait on the results. This group is simply not like that and is one of the many traits that make us unique. It is this passion that can cloud judgment and may contribute to the decision-making challenges that seem to be a causal factor in too many of the accidents.
Several important decisions will be made in 2009 relative to the operations of providing safe and quality transport to our patients. I can only ask that the passion side of what makes us strive to be the best be put aside just long enough to look from a 50,000-foot level and make sure all consequences related to ensuring patient access to higher levels of care are considered. I am still doing a lot of research on my own to try and grasp what our future might look like and how best to evolve to help lead into the next chapter of transporting patients via air and ground.
Finally, thank you to the membership for the support and for many of you calling or e-mailing your thoughts, concerns, and even a few atta-boys during the year. I tried to follow up with everyone who reached out and will continue to do so. Please do not hesitate to contact me or any of the AAMS board of directors through the contact information provided at www.aams.org. Communication is the key to the success of an association as much as it is to ensure success of any relationship. There may be times we have to agree to disagree, but please know I have the utmost respect for that passion and professionalism that encompasses this industry.
Sandy Kinkade, President
PII: S1067-991X(08)00274-5
doi:10.1016/j.amj.2008.11.003
