Forum| Volume 25, ISSUE 1, P12-15, January 2006

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        Safety above all else!

        Another successful AMTC has come and gone. More than 2,000 leaders in transport medicine gathered in Austin, Texas, to participate in “Raising the Bar,” the conference theme. Here are just a few of the ASTNA highlights:
        • More than 450 transport RNs attended.
        • 67 took the all-new, 1-day, ASTNA-sponsored CFRN Review Course.
        • 36 sat for the CFRN exam and 1 sat for the CEN exam.
        • 4 took the TNATC re-verification course.
        • More than 20 attended the military luncheon with an open forum led by Major Teresa Duquette on the needs of each military sector in regard to the Joint Medical EnRoute Care Program.
        • More than 70 attended the CFN luncheon and networking session with a lively discussion regarding unique challenges and innovative solutions in a changing transport community.
        • More than 80 attended the special interest group (SIG) dessert with networking sessions in the following areas:
          • Maternal/HROB
          • Neonatal/perinatal
          • Pediatric
          • Fixed-wing transport
          • Ground transporte
          • Research
          • Education
          • Safety
        • More than 100 people attended the ASTNA Member Luncheon and Annual Meeting, where Jodie Hignite, ASTNA President for 2004–2005, reviewed the activities of the association over the past 12 months, welcomed the new 2005–2006 ASTNA board, and honored the following award winners:
          • Elisabeth Henley—Katz-Mason Award
          • Laura Criddle—Jordan Award
          • Jon Genis—Ground Transport Award
          • Jill Johnson—Distinguished CFRN Award
        With the resurgence of an alarming industry crash rate and several recent tragic crashes, safety initiatives were at the forefront of many educational sessions and networking discussions. Merriam-Webster ( defines safety as “the condition of being safe from undergoing or causing hurt, injury, or loss.” At the AAMS spring conference in March 2005, the AAMS board of directors adopted Vision Zero as our community's safety program and requested each affiliate association to work together to support this initiative. The Vision Zero initiative was prominent at AMTC. Vision Zero is a concept that was originally developed in Sweden, with one outcome in mind: “…that eventually no one will be killed or seriously injured within the road transport system” (Ministry of Transport and Communications, 1997). In Sweden, models were developed to determine which tools would be most effective in attaining zero serious injuries or fatalities. Examples implemented include guardrail engineering controls, adjustment of speed limits to fit the safety standard of the road, seat belt reminders, and speed surveillance cameras (Swedish National Road Administration, ( A similar approach can be implemented to decrease the number of serious injuries or fatalities from medical transport crashes to zero.
        What does Vision Zero mean to you as a transport nurse, and what can you do to help?
        In addition to getting involved with safety initiatives, there are many ways to become or stay involved with ASTNA in the next year. Visit the ASTNA website ( for updates on calls for authors, reviewers, and committee members or send an email to any ASTNA board member. We look forward to collaborating with each and every one of you in the coming year!
        Last, but certainly not least, the Board of Certification for Emergency Nursing (BCEN) and the Air & Surface Transport Nurses Association (ASTNA) would like to recognize a CFRN who has demonstrated support for certification in flight nursing with the Distinguished CFRN Award. The recipient best represents the certification credential to his/her colleagues, other disciplines, or consumers. The award will be presented at the 2006 Critical Care Transport Medical Conference (CCTMC) in Las Vegas, Nevada, April 3–5, 2006. The recipient will receive airfare, one night hotel accommodations, and meeting registration paid for by ASTNA. The deadline for nominations is January 31, 2006. For more information, visit
        Here's to a SAFE New Year. I challenge each and every one of you to do your part to make it a reality!
        Jackie Stocking President


        AMTC eliminates prejudice

        I want to start my first AMJ article as president of the IAFP by congratulating all of you for making 2005 AMTC in Austin the largest AMTC ever. We had more presentations, more labs, more vendors, and more air medical professionals attending than ever before. And for the Texas locals, including medical providers, service and hospitality professionals, and even the bats, southern hospitality truly lives and breathes in Austin!
        As eventful as Austin was, thankfully my travel to and fro was not. Imagine, from New York to Austin and back, with every flight on time and each piece of luggage intact and present! I'd like to chalk that up to expert planning, but I think “lucky” is far more accurate. The only even moderately interesting story from my flight is the inspiration for this article. I spent the week thinking about a quote from, of all places, the airline magazine. There it was, somewhere between turn-off-your-cell-phone and takeoff. I spent the week contemplating one page with a monochromatic landscape and three words: Travel eliminates prejudice.
        In the interest of commonality, and good publishing form, I did a little research. I looked up the definition of prejudice. First and foremost, prejudice is both a noun and a verb. The definitions for the noun include:
        • An adverse judgment or opinion formed beforehand or without knowledge or examination of the facts
        • The act or state of holding unreasonable preconceived judgments or convictions
        The verb prejudice is defined as:
        • To cause (someone) to judge prematurely and irrationally
        • To affect injuriously or detrimentally by a judgment or act
        With precise vocabulary intact, I continued to contemplate that single page. And throughout the week, I became more and more convinced of the following statement: AMTC eliminates prejudice.
        As important as the educational sessions, labs, and meetings are, perhaps the systematic eroding of prejudice is AMTC's most crucial function. AMTC and the excellence it promotes chip away at many of the prejudices that can cripple organizations and industries.
        Clinical prejudice begins with, “The only right way to do things is my way.” When asked, providers often respond that they do things a certain way because it is the best way. Be honest! In many cases, is it not more accurate to say, “I do it this way because it is the only way I know”? Thanks to the presenters who challenged us. I appreciate those of you who made us feel uncomfortable or uneasy. And to those of you who shared universal lessons from your own difficult, tragic, or challenging experiences, what courage!
        Program prejudice is pride gone awry. Like many of you, I began to fly full time with a program that was a local institution. That program itself had become a verb (“We need to LifeWatch this patient”). The program and my team members were proud of what we did and the professionalism with which we did it. You all know the feeling. But occasionally I hear providers for whom “excellent” is not good enough. To validate themselves, they need to be “better.” Unfortunately, “better” most often relegates someone else to “worse.” This judgment is most often prejudiced, made without complete knowledge or examination of the facts.
        Professional prejudice simply pits crewmembers against one another. Pilots, nurses, paramedics, respiratory therapists, communicators, managers, vendors, and administrators all make up the team. Each discipline has mission strengths and weaknesses. We approach problems differently. Each of us has a certain comfort zone. Therein lies the strength of your team! And if the team does not function safely and efficiently, we all stumble.
        I saw you Tuesday in Austin, resplendent in blue, black, maroon, yellow, and red flight suits. Initially you clustered together like flowers in a formal garden blues here, reds here, and greens over there, everyone with his or her own program. The others were “competitors.” By the end of the day, that formality gave way to multihued groups. “Competition” had yielded to “neighbors,” “collaborators,” and “friends.” I am impressed by each of you who took this opportunity to exchange ideas, reinforce best practice, and build up each other and our community.
        I hope you have returned to work inspired. I hope the only “better” you aspire to is “better than you were yesterday.” I hope you are encouraged to let go of unreasonable preconceived judgments or convictions. And I hope you share this excellence with your patients, your team members, and your community. I am sure that those most injuriously and detrimentally affected by a judgment or an act of prejudice are those of us who perpetuate unexamined opinions.
        We eliminate prejudice!
        Gloria Tavenner Dow President


        Kudos for jobs well done

        It is with great pleasure and humility that I take over as the president of the Association of Air Medical Services. This is both an incredible honor and a responsibility, especially with all that lies ahead in addressing safety and keeping our medical transport community strong and viable.
        I would like to first congratulate and thank Tom Judge for the outstanding job that he has done in leading our association over the past 2 years. Tom is one of those rare individuals who has both a strong depth and breadth of knowledge in EMS, medical transport, safety, and association leadership. Fortunately for our association, our community, and for me, Tom will be staying on as the chair of the AAMS Safety Committee and as a member of our executive committee as past president. He also continues to serve in his term as a regional director.
        What a great Air Medical Transport Conference in Austin this past October! While we only have preliminary results as of this writing, it looks like for the fourth year in a row we have set attendance records and had the largest exhibitor hall in the history of the conference. AMTC is a shared effort of all the associations, so I would like to thank their boards and staff for their hard work throughout the past year. A special thanks to the chair of the AMTC Education Committee, Jill Johnson, with the Kentucky Aeromedical Team; Vice Chair, Angie Golden, with Northern Arizona University; and the host programs, StarFlight in Austin and San Antonio LifeFlight in San Antonio.
        As we all know, the conference would not be a reality without the AAMS staff under the direction of Dawn Mancuso. The AMTC is a big part of their time throughout the year, and they have already started on the work for Phoenix in 2006! The AMTC has truly become the centerpiece of our community for education, planning, meetings, and networking. Thanks also to the many exhibitors and corporate sponsors, because, without their support, AMTC would not be possible.
        I have served on the AAMS board of directors for over 8 years, both as a regional director while in Michigan and North Carolina and now in my second term as an at-large director. For the past 2 years I have served on the executive committee as treasurer and vice president. For over 18 years I have been affiliated with a transport program that has been an AAMS member. I have seen the benefit of AAMS firsthand through many changes that our community has faced, which have included reimbursement, FAA regulations, government relations, and now the task of addressing safety head-on as a result of the number of crashes we have experienced over the past several years.
        During my presidency I will be actively continuing the work that both Greg Powell and Tom Judge so wonderfully started in bringing our entire community together. We cannot be successful without this cooperation! Safety has to be job 1, and through our reorganized AAMS Safety Committee, which has representatives from our entire community, we will move forward Vision Zero or zero errors of consequence. As a symbol of that effort, the Foundation of Air Medical Research and Education is selling Vision Zero bracelets, which we ask all members of our community to wear proudly as a visible reminder of everyone's role in ensuring safety of all of our operations.
        In my opening remarks to the new AAMS board when I assumed the presidency in Austin was the statement that we will further develop our AAMS committee structure, which was one of the tasks that I took on as vice president this past year. While we have active communications and public relations, government relations, safety, and research committees, we must further develop our standards and membership committees and our special interest groups. Please contact the AAMS office if you are interested in serving on a committee; we need your assistance.
        Thank you and remember Vision Zero!
        Edward R. Eroe President


        Can it be done?

        Discussion as to whether a zero accident rate is achievable, or sustainable if achieved, has been going on for a long, long time. Like most people, I do not know whether we can get there. I have had some discussion with friends who seem to think we should focus on reducing accidents and incidents and stop trying to reach an unattainable goal. I believe their arguments are valid. When I hear about those things that cannot be done, however, I tend to look back at other things that also could not be done.
        Imagine where we would be if there had not been someone who tried to do what could not be done? I will just throw in a few examples:
        • There was a kid from Portugal who believed a theory that the earth was round and that he could find shorter trade routes. Of course he was told that he was nuts. His cousin Edgar (not known to many) was among those who said he would sail off the end of the earth. Chris took three boats and sailed away. OK, he did not find the shorter trade routes to the Indies, but he did discover a few things.
        • Then there were those two brothers from Ohio who claimed they could make a flying machine. Wow! What a couple of boneheads those guys were. They were followed by a long list of other kooks who built on their contraption with more contraptions whose functions were absolutely impossible. A guy named Sikorski was the one of the wildest.
        • One of our youngest presidents (there were two about the same age) decided we should put a man on the moon by the end of the 1960s. Throughout history discussion about the moon and the solar system actually got some folks killed in very ugly ways. Fortunately, we had moved beyond that by the time Kennedy made his announcement.
        I could go on with a bunch of other examples, but I think you get my point. Where would we be if we just accepted what is believed to be impossible? I do not know the answer to that question, but I am certain we would not be as far ahead as we are right now. My examples are just a couple of the obvious ones. Pick an area of study and you will find people who refused to accept the norm, and because of that refusal, we moved on, for better or worse.
        None of the above-mentioned people said, “Well, let's just go as far as we can and call it good.” Columbus would be in a holding pattern in the middle of the ocean, the Wright brothers would still be screwing around with kites, and some of us might still be wondering whether the moon is made from cheese. The truth on that one was a heartbreaker.
        I do not know whether we can reach a zero accident rate, nor do I know whether we can sustain one if we reach it. I am certain that if we do not strive for it, we will never achieve it.
        Ron Fergie President