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University
of Michigan Health System Survival Flight:
Air Medical Transport Nursing
 During
the Vietnam War, wounded soldiers were treated in the battlefield
by medics who would call for a helicopter to transport the
soldiers "behind the lines" to an aid station or
hospital staffed with doctors and nurses and to emergency
facilities capable of treating them. As a result, soldiers
wounded in the Vietnam War were more likely to survive their
injuries than soldiers in any previous war. While those soldiers'
survivability can be attributed to being transferred to a
tertiary care facility with clinicians and services not available
in the battlefield, it is clear that rapid transport accompanied
by trained medical staff played a major role in improving
the chances that a soldier would survive his injuries.
As
an outgrowth of the Vietnam experience, emergency medical
services in the United States began to grow, leading to the
first civilian air medical transport service being established
in Colorado more than 30 years ago. Today, there are over
300 air medical transport systems serving and transporting
hundreds of thousands of patients throughout the U.S. From
caring for the critically ill newborn to the critically injured
motorist, air medical transport programs have networked with
emergency medical services and hospitals to provide rapid
transport for patients across the globe. Staffed with specially
trained medical crews of doctors, nurses, paramedics and specialists
in respiratory care, patients are transported to tertiary
care facilities that can provide emergency medical services
that may not be available in rural areas, as well as specialty
services that are not available at all hospitals.
Survival
Flight, the University of Michigan Health System's air medical
transport service, was established in May 1983. To date, Survival
Flight has safely flown more than 26,000 patients. Staffed
with two nurse/paramedics or a nurse/paramedic and a physician
team, Survival Flight can transport patients on one of its
three Bell 430 helicopters or on its medically equipped Citation
V jet across Michigan and the continent. In addition, Survival
Flight contracts with local, experienced emergency medical
services for its ground transportation service.
All
nurse/paramedics with Survival Flight are required to meet
certain qualifications. They must be licensed registered nurses
with a minimum of five years' experience as a nurse. Plus,
their experience must include work in an adult intensive care
unit, an emergency department, and a pediatric emergency or
intensive care unit.
Survival
Flight nurse/paramedics must have a basic emergency medical
technician license with the state of Michigan and must actively
obtain their emergency medical technician paramedic license
within six months after being hired. In addition, all flight
nurses are required to be certified as an Emergency Nurse
(CEN), Critical Care Registered Nurse (CCRN), or Flight Nurse
(CFRN). Certifications as a provider of neonatal life support
(NALS), pediatric life support (PALS), and basic and advanced
cardiac life support (BLS, ACLS) are required as well. Subsequent
certification requirements include trauma nurse core curriculum
(TNCC).
Although
it may appear to be somewhat of a daunting task, becoming
a part of Survival Flight's medical transport crew is well
worth the effort. In fact, the majority of applicants for
the position as a Survival Flight nurse are very tenacious
in their pursuit of the position and are driven to be the
best in their field.
Being
a flight nurse means that the individual is first and foremost
a professional in his or her field. He or she has followed
a difficult course and has invested a great deal of time to
become the best at what her or she does professionally. By
training beyond the didactics, members of Survival Flight's
crew have evolved into independent, responsible clinicians
capable of providing emergency and critical care to the ill
and injured patient well past the standard stabilization phase.
Armed with training by, and under the direction of, board-certified
emergency physicians, the flight nurse is able to provide
advanced life-saving techniques, perform invasive procedures,
and evoke medical decision-making skills, all within the context
of rapid medical transport.
However,
flight nurses do not work alone. They are part of the larger
picture - they are a part of the team of medical professionals
at the outlying hospitals and accident scenes who work closely
together to provide the most advanced care available to the
patient. Flight nurses are able to quickly evaluate a patient's
condition and, based on their experience and knowledge, provide
care to that patient, stabilizing or improving the patient's
condition until his or her arrival at the receiving medical
facility.
The
rewards associated with being a flight nurse cannot be measured.
As an individual, the flight nurse must operate independently,
make decisions based on a solid base of knowledge, plan care
accordingly, act on those decisions, evaluate that care and
institute new measures if needed. Autonomous practice is the
norm; responsibility and accountability are the result. To
see only one patient benefit from your intervention and survive
to be discharged to their family in good, or even better,
condition is worth every moment of the effort that it takes
to become a flight nurse.
Kris Nelson, RN EMT-P CEN CMTE
Flight Nurse Survival Flight
University of Michigan Health Systems
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