Spring 2015 Surface & Air Transport Bulletin

Spring 2015 Surface & Air Transport Bulletin

Billy L. Hutchison, BA, RRT-NPS
Houston, TX
Tabatha Dragonberry, MEd, RRT-NPS, RRT-ACCS, AE-C, CPFT, EMT
Children’s National Medical Center
Washington, DC
(571) 264-5451
Steve Sittig, RRT-NPS, C-NPT, FAARC
Sanford Health
Sioux Falls, SD
Bryan Byrd, RRT-NPS
Hamilton Medical Center
Dalton, GA
CAMTS Representative
Steve Sittig, RRT-NPS, C-NPT, FAARC
Sanford Health
Sioux Falls, SD
In this issue:

Notes from the Editor

Steve Sittig, RRT-NPS, C-NPT, FAARC

As I sit at my computer to draft this edition of my Notes column, I pause to reflect on my tenure as the editor of our section Bulletin. I was first approached about becoming the next editor by then section chair Jerry Focht in 2000. I gladly took on the position, and in 2002 was elected as section chair as well.

Now in my 16th year as editor, however, I feel it is time to move on, so it is with a sad heart that I must let you know I have turned in my resignation. It has been an honor to serve the section as your editor over all these years. I have always tried to provide quality content in each issue. I will at times still contribute to the Bulletin, but with my duties on the CAMTS board and my new flight position at Sanford Health, it was time to focus on those commitments.

One of my last submissions is the article you will see at the end of this issue from George Phillips. George has been a member of the section since it was formed. I do not recall exactly when I met George at the AARC Congress, but it is safe to say it was a long time ago. I still can picture him sitting in on one of my lectures or at a section meeting. He has always been a resource for me over the years and a great friend. I hope you enjoy George’s reflections on his long career as a transport RT.

I can still be contacted on AARConnect or via my home email if you should ever need anything. Until next time, may all your transports end safely for you and your patients.

Notes from the Chair-Elect

Tabatha Dragonberry, MEd, RRT-NPS, RRT-ACCS, C-NPT, AE-C, CPFT, EMT

I hope everyone’s year is going well. It’s been a busy year thus far on my end. I am excited to say that I took the C-NPT during the first quarter and passed. For those who are thinking about taking the exam, I would go for it! I waited a little longer than I had originally intended, due to the unknown factor. I appreciate the guidance from those I reached out to who had previously taken the exam. It was a great help in preparing and it ended with a great success. This was on my to-do list for a while, and now I can check it off. If it’s on yours as well, go ahead and mark that check box also!

We are looking for contributors for our quarterly Bulletins. If your team is doing something you would like to share, or you have a topic you are interested in writing about, please contact me via email. The next deadline for articles is July 1. I will be reaching out to some of you to assist. Help us make our Bulletin relevant and interesting for our membership. Even if you aren’t the writing type, I would still love to hear your article ideas.

Lastly, it’s that time of year again — nominations for our 2015 Specialty Practitioner of the Year are due by July 31. So put your thinking cap on and nominate a deserving member of our section!

Family Centered Care in Transport

Tabatha Dragonberry, MEd, RRT-NPS, RRT-ACCS, C-NPT, AE-C, CPFT, EMT

In the medical field, many buzzwords and phrases are tossed around to describe what we do. One that has gained popularity is “family centered care” (FCC). When I think of FCC, I picture a team standing around the door of a patient’s room, discussing the diagnosis and planning how to address the issues they are being faced with. In addition to patients and parents, various disciplines are represented, including physicians, nurses, respiratory therapists, pharmacists, dieticians, and care managers. Medicine is no longer solely dictated by physicians but a collaborative effort of a health care team. We, as a health care team, are working with the family to meet the best needs of the patient.

FCC can take place in the transport setting as well. According to a 2001 article in Pediatric Emergency Care that surveyed pediatric transport team managers, 63% of teams permit parental accompaniment during ground transport for pediatric critical care. I was surprised to read this statistic, as I thought this was the norm for ground pediatric specialty care teams. On the teams I have been associated with, parental accompaniment has been standard. I never thought about transport as being the family’s first involvement with FCC, but in many cases transport is the family’s initial point of contact for their patient experience. This first encounter can set the tone for their patient’s whole hospital stay.

Does your team buy into the idea of parental accompaniment and FCC? What is the benefit to FCC beginning at the patient’s first encounter with hospital staff during transport?

Parental accompaniment can decrease parental anxiety. Parents who can stay with their children have the opportunity to be aware of the care their child receives en route to an advanced level of care. Parents are not left to wonder what is happening to their child but have the ability to observe and know exactly what is going on. In situations where parents do not have the opportunity to be present, they can create their own scenario as to what they believe is occurring. This allows their imaginations to run wild with “what ifs,” since they more likely than not do not have an understanding of what happens on transport other than what they have seen on the television screen.

Increased parental accompaniment allows for greater patient satisfaction and decreased stress on the patient and family. The idea of FCC beginning at transport can become a quality metric that can be measured, confirming the positive emotional benefits for those we serve. Transport teams may want to consider providing increased education to staff on FCC as a component of the transport experience. By having an open dialogue with staff regarding their concerns about parental accompaniment and addressing any barriers that are identified, a transport team can provide quality, safety, and FCC.


Jenn Watts, BS, RRT-NPS, C-NPT

Over the course of recent months, unmanned aerial vehicles (UAV)—more commonly known as drones—have increased in popularity. These aircraft have allowed us to see the winter wonderland of a frozen Chicago from a different view. We have been given a new look at the ghostly eeriness of Auschwitz from above. The potential of UAVs to benefit society is growing. But despite the beauty of the images UAVs have brought to the public eye, these vehicles present a potential danger to other occupants of the air.

Since June of 2014, 25 near misses of UAVs by other aircraft have been documented. These near misses hit close to home for those of us who are part of air medical transport teams. How do these vehicles affect us? How do the UAVs affect patient care? What do we need to know?

Currently, the UAV is given access to airspace by the Federal Aviation Administration (FAA). Last year the FAA published a plan to integrate regulations, procedures, and training requirements to allow for safe operation of UAVs within the National Airspace System. The snafu occurs within the uncontrolled airspace, which is usually lower than 700 feet above ground level, and in some cases, up to 1200 feet. Roto-wing ambulance services spend a considerable amount of time in this airspace. These aircraft frequently land, as well as fly, in areas inside the uncontrolled airspace…the same space being occupied by recreational drones.

Clearly, we need to be aware of the possibility of UAVs within our flight paths. Last August in Dayton, OH, a roto-wing medical team was forced to circle the hospital with their patient due to a drone within the airspace around the hospital. Since the drone was unmanned, and thus unable to communicate, the air medical team was delayed by four minutes during its mission. Thankfully, the patient was stable and care was not compromised as a result of the delay in landing; however, this outcome will not always be the case.

As of February 2015, the FAA and Department of Transportation have proposed a set of regulations to achieve safety rules for the use of UAVs. Transport teams will want to review these regulations to see how they may help protect our services. We need to be acutely aware of the potential of UAVs being out there while we are flying. We need to look for them and keep a vigilant watch while flying on transport.

Reaching Out

Alex Brendel, MBA, RRT-NPS, Outreach Education Coordinator, Carilion Clinic Children’s Hospital, Roanoke, VA

Although I work full time as the outreach education coordinator for Carilion Clinic Children’s Hospital, in my spare time I like to pick up a few shifts on our neonatal/pediatric specialty care transport team so I can keep up my skills and see what kind of education our region needs.

Prior to doing outreach full time I was the transport team manager and before that I was a transport therapist, starting in 2007. At our last AARC Congress I was talking with our chair-elect, Tabatha Dragonberry, and I offered to help with the section’s outreach and educational efforts. My first attempt at that will be this article, and if you all see fit to have me continue there will be more in the future.

The first thing I wanted to do was talk about a recent webcast we did on acute seizure management. One of our pediatric emergency medicine physicians and I reviewed some literature and a few scenarios you might find yourself in. I have uploaded the webcast to a non-searchable YouTube channel, which means you can try as hard as you like, but without the link you aren’t going to find it.

I’m still learning the fine art of video production, so if you are a webcast or recording expert please tell me everything you know so I can improve the quality of my productions.

I also do a weekly Pediatric Grand Rounds webcast that any of you are welcome to participate in live or watch via recordings as they become available. These discuss a wide range of topics, but are always a great learning opportunity for anyone in the neonatal or pediatric field. To get into my educational network I just need your email address, which you can send to this address.

Also I wanted to provide you with a copy of our Status Epilepticus Pathway, which our transport team follows. <<THIS PAGE IS CREATED BUT I CAN’T LINK TO IT UNTIL IT IS PUBLISHED>> If you have any differing treatment pathways or protocols, let’s discuss them on the section’s email discussion list. I think we, as a section, could help each other better understand our practices, and in many cases, help each other establish best practice guidelines by sharing these clinical tools.

All of our clinical guidelines are available to anyone who would like to see them. Use Google Chrome or Mozilla if you are trying to download them, as Internet Explorer doesn’t work well with our site.

I think that will do it for now. If you have any suggestions for educational topics, ideas to raise awareness of the Transport Section, or want to get involved in the effort to keep RTs on transport teams, please don’t be shy!

Reflections on a Transport Career

George Phillips, MHS, RRT-NPS, Mary Washington Hospital, Fredericksburg, VA

My interest in transport began back in the mid ‘70s. I was working as a technician in a small hospital in Battle Creek, MI. A preemie was delivered in our L&D. I’m not even sure how early the infant was, only that it was very small. They called the transport team from Bronson Hospital in Kalamazoo. When they arrived I was amazed by what they did; the therapist on that call would end up being my instructor when I went back to school.

I went to work at that hospital after I became a CRTT and started doing neonatal and pediatric transport in the early 1980s. Back then there were no transport ventilators available in our area, so you hand-ventilated everyone. Our isolettes was one of the old Ohio transport isolettes (which was a pretty small unit). Every transport was completed by ground ambulance, as air transport was not available at that time. Our hospital team covered southwest Michigan and northern Indiana, which often made for some very long transports, especially when you had to hand-ventilate for the whole transport.

In 1985, after I became a registered RT, I decided to move to Columbia, SC, to work as a neonatal respiratory therapist at Children’s Hospital at Richland Memorial. This is where I really learned my skills not only as a transport therapist but also as a neonatal RT. I learned so much under the guidance of some great respiratory therapists and nurses. I started doing transport around 1986 and would continue until 2002. We were not a full-time transport team so we worked full time as neonatal therapists and covered transport on call. That was true dedication. Again we hardly flew, and when we did fly we did it with an Army Medevac unit in the Huey, which was really fun. While I was in Columbia I had the opportunity to help develop our pediatric transport team. It eventually became a neonatal/pediatric RN/RT team and is still active to this day.

In 2002 I left and took a full time transport position at Children’s Hospital of the King’s Daughter’s in Norfolk, VA, where I worked until 2006. I went into education for a period of time, then moved back to staff over the next 4-5 years. I came back to Virginia in 2011 and eventually resumed my transport role.

But in December of 2014, at age 65, I thought it was time to step down. I have had a great time from the 1980s until now. One thing I am especially grateful for is that every team I was on consisted of an RN/RT/Paramedic. It is the best configuration I know. We learned teamwork because we had to rely on each other.

If memory serves, I think am a charter member of the AARC Transport Section, joining when it was first formed. Like many transport therapists, I have many stories of my experiences. But all in all, I can definitely say I’ve had a great career as a transport RT.

Section Connection

Specialty Practitioner of the Year: Nominations for this annual award are underway now through July 31. Visit the section website to access our online nominations form.

Recruit a new member: Know an AARC member who could benefit from section membership? Direct them to section sign-up. It’s the easiest way to add section membership to their overall membership package.

Section Discussion List: Go to the section website and click on “Discussion List” to start networking with your colleagues via the AARC’s social networking site, AARConnect.

Bulletin Deadlines: Winter Issue: January 1; Spring Issue: April 1; Summer Issue: July 1; Fall Issue: October 1.