FlightBridgeED Blog

FAST24 Day 1 Opening Keynote Speaker Announced – Scott Weingart… (yes, THAT Scott Weingart)
We are thrilled to announce that the Day 1 opening Keynote Speaker for the FlightBridgeED Air and Surface Transport Symposium 2024 (FAST24) is none other than Scott D. Weingart! As a renowned physician specializing in Resuscitation and Emergency Department Critical Care, Scott has dedicated his career to bringing “Upstairs Care” “Downstairs” – a mission to…

The STOP Card: Enhancing Patient Safety in Healthcare
by Matthew Sterling (additional edits by FlightBridgeED) In the fast-paced and high-stress world of air medical services, where every second counts, patient safety is paramount. However, a lingering challenge in this critical field is the reluctance of healthcare providers to voice their concerns or speak up when they notice safety issues. This reluctance can stem…

Learning From the Past
by FlightBridgeED September 11, 2001, and the Mental Health of First Responders The tragic events of September 11, 2001, have left an indelible mark on the world’s collective memory. The devastating terrorist attacks on the World Trade Center and the Pentagon resulted in the loss of thousands of innocent lives and left countless others traumatized….

Concerns, Controversies, and Considerations in the Management of Pelvic Trauma
Cody Winniford BA, EMT-P, CCP-C, FP-C While relatively straightforward, the management of pelvic trauma is not without its controversies and conversations. In the prehospital environment, new adjuncts and approaches are shaping the outcomes of these injuries. Numbers and Data How often do prehospital clinicians encounter these pelvic trauma? Pelvic injuries are actually more frequent than…

Undifferentiated Shock: A Pre-hospital Approach
by Cody Winniford BA, EMT-P, CCP-C, FP-C Shock is the final common pathway before death. No matter what the etiology or insult to the human body, we all will enter into a state of shock that reduces oxygen delivery to the point that cells die, then tissues die, organs become dysfunctional, then organ systems fail,…

Brief Resolved Unexplained Event
by Sara Moore Gruver The electricity had gone off on that hot July day. The mother’s phone kept dinging with texts from the power company with an estimated fix time, which kept growing longer and longer. Meanwhile, the temperature in the house kept climbing, and the three small children grew more upset. After an hour,…

The Remarkable Versatility of Ketamine: A Review of Pre-Hospital and Critical Care Use
by Jon Mohnkern Ketamine is a non-barbiturate dissociative anesthetic originally synthesized in the 1960s. In lower doses, ketamine acts as a potent analgesic, causing it to be adapted to manage pain during the Vietnam War.(1,2) Ketamine acts as an N-methyl-D-aspartate (NMDA) receptor antagonist. NMDA receptors are a type of glutamate receptor, which bind with glutamate,…

Traumatic Cardiac Arrest – The CAVE Checklist
by. Cody Winniford Of all the illnesses, diseases, and petulance that can befall a human being in the modern world, traumatic injury reigns supreme as the unbeatable, unpreventable source of morbidity and mortality. Since the 1960s, prehospital systems and trauma systems have been working on solutions to curb death and disability, and while it has…

The Intricacies of Pre-Hospital Trauma Triage: a Look into Special Considerations
Introduction A crew responds to a motor vehicle collision involving a passenger vehicle into a tree. The scene size-up illustrates moderate front-end damage and airbag deployment. Further analysis of the car shows no apparent signs of passenger compartment intrusion, steering wheel deformity, dash deformity, evidence of rollover, or window spidering. Your patient (75 male), a…

I Have a Crush on You!
Introduction Severe crush injuries have the power to shatter lives in an instant. Imagine the sheer force of an external crushing weight bearing down on the human body, inflicting direct tissue trauma and triggering a cascade of devastating consequences. From muscle necrosis to neurologic dysfunction, the aftermath of a severe crush injury can be a…

Is Change the Cause of My Bad Attitude?
by Bruce Hoffman I recently listened to a five-minute-ish Ted Talk given by Ric Elias on the “3 things I learned while my plane crashed”. If you haven’t had the pleasure of listening to it, just click the link and engage! I won’t spoil the storyline of his talk, but there were a few key…

2023 Enduring Impact Award Recipient
We are so excited to announce that Mr. Graham Pierce BS, MICP, FP-C, CCP-C, WP-C will receive this award first! Mr. Pierce’s contributions to the flight and critical care paramedic community go far beyond his work with the IBSC – He is the heart and soul of the Certified Flight Paramedic.

A Twist on Pre-Hospital and Critical Care Transport Medicine
Tourniquets: a simple, time-honored device with roots dating back to the battlefields of ancient civilizations. If you’re picturing a ragtag concoction of sticks and bandages, give your mental image a 21st-century makeover! Today, tourniquets are sophisticated, researched, and increasingly vital tools in pre-hospital and critical care transport. Recently, there’s been an influx of research examining…

Pediatrics: Integrating Telemedicine
Pediatric pre-hospital and critical care transport medicine is undergoing a revolutionary change due to the ongoing evolution and expansion of telemedicine. This trending topic is currently reshaping the nature of patient care, enabling healthcare professionals to provide quality care regardless of the distance between them and the child in need. Telemedicine in Pediatric Care Telemedicine…

FRATs Aren’t Just for Bruhs
Introduction: When you hear the term “FRAT,” you might think of wild parties, toxic masculinity, and college shenanigans (“Toga, Toga, Toga, Toga…”) But in the world of air medical and critical care transport medicine services, FRAT takes on a whole new meaning. Flight Risk Assessment Tools (FRAT) are the superheroes of safety, ensuring smooth and…

Unlocking Success: Empowering Flight Paramedics (FP-C) and Critical Care Paramedics (CCP-C) through Advanced Training
Introduction Welcome to EMS Week 2023 day 2, “EMS Education Day.” We celebrate your unwavering dedication and heroic efforts as flight paramedics or critical care paramedics. At FlightBridgeED, we understand the pivotal role advanced paramedic education plays in your success in the dynamic and high-stakes environments you operate in. Every decision you make can make…

Unmasking the Unsung Heroes
Challenges Faced by EMS Professionals and Solutions for Change by. Evan Claunch, BSB, FP-C, NRP, CCEMT-P Emergency Medical Services professionals, including paramedics (of all types) and emergency medical technicians, are critical in providing life-saving care during medical emergencies. Despite their invaluable contributions, EMS professionals often face challenges such as the lack of public awareness and…

Crashing the Vented Patient – A Critical Care Odyssey
by Cody Winniford The Case Your team has been requested for an interfacility transfer. You find a 35-year-old female writhing on the stretcher, kicking her feet, hands restrained, and a wide-eyed ED technician attempting to hold her legs down. The patient is intubated, and the ventilator has a near-constant high-pressure alarm. You notice the patient’s…

SUSPECTED INTERNAL INJURIES
You are the first responder dispatched to a multi-casualty incident (MCI) for a motor vehicle collision on the interstate, with multiple cars on fire and bodies strewn all over the highway. You arrive in the “controlled” chaos with the roadway barely shut down. You immediately smell smoke and see fire everywhere, seeing danger at every…

ASTNA HONORS THE 2023 CLASS OF THE ACADEMY OF AIR & SURFACE TRANSPORT NURSES
ASTNA HONORS THE 2023 CLASS OF THE ACADEMY OF AIR & SURFACE TRANSPORT NURSES NEWS FROM THE AIR & SURFACE TRANSPORT NURSES ASSOCIATIONFOR IMMEDIATE RELEASE Aurora, Colorado (April 16, 2023). It is with great honor and utmost respect that we present to you the 2023 class of the Academy of Air & Surface Transport Nurses….

Thoughts from a Clinician: DO YOU DRESS REHEARSE?
Too much training is still being done without simulation. The value-added component of simulation is nearly immeasurable, especially for the critical care provider. As commonplace as it has become, simulation still gets the hairy eyeball from some. Perhaps the pushback comes from the cost of simulation or simply the available resources to do simulation training.

WHOLE BLOOD: READY FOR PRIMETIME?
If you’ve been reading about trauma care in the last few years, you have undoubtedlyseen something about the use of whole blood in trauma resuscitation. Born out ofmilitary medicine experience, we are starting to see civilian EMS programs in both airand ground using this treatment to save lives from traumatic injury and massivehemorrhage. But what…

Diabetic Ketoacidosis: The Right Ingredients for Recovery
This article is the first of a series of three articles about managing adult patients with diabetic ketoacidosis (DKA). This patient population can be quite challenging for even the most seasoned provider. Indeed, DKA is characterized by unique physiology that includes, amongst other things, severe fluid deficit and mild to severe metabolic acidosis. This patient…

Updated CAMTS standards for nurses
The Commission on Accreditation of Medical Transport Systems (CAMTS) is a non-profit organization that accredits air and ground medical transport programs in the United States and Canada. One of the recent changes to the 12th edition standards specifies that nursing certification will become transport specific (such as the Certified Flight Registered Nurse [CFRN] or Certified…

TikTok Toxicology
Since its North American debut in 2018, TikTok has dominated the teenage social media market. In 2022, a survey reported that 67% of American teenagers have used TikTok and 16% report use multiple times a day.[1] With its 60 to 120 second videos, TikTok allows users to record and upload video clips on almost any…

The Fallacy of “GCS <8 Intubate” and the Decision to Intubate
On the surface, these are not bad triggers for airway management, but they do not engage clinicians to evaluate the situation in its entirety. The astute clinician can recognize that there are obviously more than 4 notable triggers and that these decisions are made along a spectrum of “forced to act” to “elective.” The decision…

Dialysis Disequilibrium Syndrome
Clinical Scenario: You respond as an ALS ambulance to a local dialysis center for a middle-aged male with altered mental status. Upon arrival, you find a conscious male being gently held in his dialysis chair by staff members. They report the patient was partially through his dialysis treatment when he developed acute delirium. Medical History…

The 3P’s of Airway Management
Introduction It is not enough to merely be able to intubate; that is, perform the physical skill of instrumenting the airway and placing an endotracheal tube. Too often, prehospital and emergency clinicians find themselves in situations where mere intubation is not necessarily the most effective and important intervention being performed, and by ignoring the possibility…

Do We Understand Oxygenation?
The Oxyhemoglobin Dissociation Curve can be confusing… However, it’s essential to understand oxygen physiology in critical care. Think of it as a “Manual for Dating.” In a healthy relationship, you have a good date, and really like that person, but don’t mind dropping them off after an evening out because you know you’ll see them again….

EDS in the ED
Overview A 27-year-old woman arrived at the emergency room late at night, her face crumpled in pain. She reported feeling sick this morning and vomiting, but that didn’t strike her as unusual as her young children have had stomach flu the last few days. Since then, she has had severe and acute neck and head…

Alternative uses of EtCO2 in the pre-hospital and critical care settings
End-tidal capnography in clinical practice originated in the field of anesthesia around the 1950s but has also become established in the pre-hospital setting. EMS providers commonly use end-tidal CO2 values as an adjunct to cardiac arrest and airway management. Continuing to learn about end-tidal CO2 is critical because this device is easily applied, readily available,…

Flight Paramedic OR Critical Care Paramedic?
OVERVIEW The Flight Paramedic (FP-C) exam tests the knowledge of experienced, master-level paramedics working as part of a medical flight crew. The Critical Care Paramedic (CCP-C) exam is a bit broader in scope. It is designed to test the knowledge of adept paramedics working in critical care environments, from transport to in-hospital. Which exam should…

What It Takes to Become a Certified Flight Nurse
A flight nurse is a registered nurse with the training and experience to provide critical care in transport environments. This can be either rotor (helicopter) or fixed-wing, typically working alongside other medical providers such as paramedics, other nurses, respiratory therapists, nurse practitioners, or physicians; they’re essential for providing top-level patient care when it matters most!

How To Become a Certified Flight Paramedic
Flight Paramedic Career Overview Helicopter EMS (HEMS), also known as air ambulance services, are critical in saving lives. Air medical transport teams must have the right experience, skills, and training. A certified flight paramedic is a pre-hospital, critical care, and emergency healthcare professional. If you’re ready to take your career in this direction, read on…