Index

A

A-a (O2), 219

AAA Air Ambulance America, 455

AAMS. See Association of Air Medical

Services (AAMS)

AAP. See American Academy of Pediatrics (AAP)

AAPCC.

Control Centers (AAPCC)

Abandonment of patient, 115, 116

Abuse or neglect, 113-114

Academic journals, 449-451

Accidental hypothermia, 333-334

Accreditation, 15-16, 134, 319-330 accreditation standards, 322-324 accrediting bodies, 319-320 applying for, 328-329

CAMTS. See Commission on

Accreditation of Medical Transport Systems (CAMTS)

defined, 319 educational components, 326-327 financial incentives, 329 frequently cited deficiencies, 324-327 safety training checklist, 328t site surveyors, 329

Accreditation Council for Graduate Medical

Education (ACGME) residency training programs, 16 work-hour constraints, 16, 236 Acetaminophen ingestion, 334

ACGME. See Accreditation Council for

Graduate Medical Education

(ACGME)

ACSCOT. See American College of Surgeons

Committee on Trauma (ACSCOT)

Adenoidal hypertrophy, 225

Administrative liaison, 8-9

Administrative regulations, 93

Adult learning styles, 262-263

Advanced Cardiac Life Support (ACLS) course, 452

Advanced Pediatric Life Support (APLS), 452

Advanced Trauma Care for Nurses (ATCN) course, 452

AEA International/SOS, 456, 459

Aeromed 365 Ltd, 457

Aeromedical Services International, 455

Aerospace Medical Association (ASMA), 435 Agenda for Change, 144

AICD. See Automated internal cardiac defibrillator (AICD)

Aim statement, 142

Air ambulance. See also Fixed-wing aircraft; Helicopter

flight physiology. See Transport physiology and stresses of transport

ground ambulance, compared, 182-186, 298 instrument flight rules (IFRs), 164, 165 safety, 163-165

terrain-avoidance devices, 164

Air Ambulance Incorporated, 455

Air Ambulance International, 457

Air Ambulance Professionals, 455

Air and Surface Transport Nurses Association

(ASTNA), 436, 445

Air MD, 456

Air Medical Communication Specialist certification, 62

Air Medical Journal, 449

Air Medical Physician Association (AMPA),

78, 436

Air medical resource management (AMRM),

363

Air Medical Safety Advisory Council (AMSAC), 436

Airplane.

Airway management adjuncts, 85

Alcohol ingestion, 235

Altitude physiology. See Transport physiology and stresses of transport

Altitude-related effects, 217t

Altitude sickness, 222

Alveolar carbon dioxide, 219

Ambulance. See Air ambulance; Ground ambulance

American Academy of Pediatrics (AAP) benefits of PFCC, 240-241 bioterrorism/chemical hazards, 338 children with special health care needs,

335

Coding for Pediatrics, 271 disaster preparedness, 378 inhaled nitric oxide, 295 neonatal resuscitation program, 348 parental refusal, 310 patient participation in decision making, 306

Section on Transport Medicine, 437, 454 surfactant administration, 349 threshold of viability, 347 transport listserv, 437 transport newsletter, 437

American Ambulance Association (AAA), 437

American Association of Critical-Care Nurses

(AACN), 438

American Association of Poison Control

Centers (AAPCC), 334

American Association of Respiratory Care

(AARC), 438

American College of Emergency Physicians

(ACEP), 438-439

American College of Surgeons Committee on

Trauma (ACSCOT), 332, 333t American Journal of Critical Care, 438 AMPA. See Air Medical Physician Association

(AMPA)

Anencephaly, 426

Anesthesia and operating room experience, 51 ANSI/ASSE Z15.1 safety standard, 157, 159t, 192 Anti-dumping law, 101

Antibiotics, 88t Anticonvulsants, 88t

APLS: The Pediatric Emergency Medicine

Resource, 452

Appellate court, 94 Appropriate transfer, 108 Arrington v Wong, 103 Arterial oxygenation (PaO2), 219, 227 Aspirin intoxication, 334

Association of Air Medical Services (AAMS), 208, 439

Asthma and croup medications, 88t Asynchronous telemedicine, 353 Atlas and Database of Air Medical Services

(ADAMS), 439

Atmosphere, 216-218 Atmospheric pressure, 216-217. See also

Barometric pressure Attending physician. See Transport physician Audiovisual-assisted self-study program, 50 Australian Nursing Council (ANC), 447 Austrian Air Ambulance, 457

Automated internal cardiac defibrillator

(AICD), 343

Autonomy, 304

Aviation, Space and Environmental Medicine,

435

B

Barometric pressure, 216-217, 224-226 Base facility, 209-210

Basic decent minimum view of justice, 305

Basic Life Support (BLS) course, 451 Battery (legal concept), 96

Behavioral emergencies, 335-337 Benchmarking, 135

Bends (decompression sickness), 219-220, 341 Beneficence, 303, 306, 309, 311

“Best Practices for Protecting EMS

Responders during Treatment and

Transport of Victims of Hazardous

Substance Releases,” 338

Billing, coding, and reimbursement, 269-272 Billing regulations, 37

Bioterrorism, 338

Black, Nick, 282

Black box, 192

Blood gas analyzer, 87

Blood glucose monitoring strip, 87

Board of Certification of Emergency Nursing

(BCEN), 440

Bohlke Aviation International, 456

Boyle's law, 218

Brain death, 343

Branding, 252, 252f, 253t

Budgeting, 268

Burditt v U.S.

Human Services, 109

Burn center, 340-341, 341t

Business strategy, 250

C

CAAMS. See Commission on Accreditation of

Air Medical Services (CAAMS)

Cabin altitude, 221-222

Cabin lighting, 196-197

Cabin pressure, 207, 208

Cabin space, 193-194

California Perinatal Quality Care

Collaborative study, 350

Call-back process, 77

Call-park, 59

CAMTS. See Commission on Accreditation of

Medical Transport Systems (CAMTS) Capnography, 85-86

Captain's chair, 160

Car safety seat, 158, 160f

Carbon monoxide (CO) poisoning, 341, 342 Cardiorespiratory-BP-SaO2 monitor, 44t Cardiovascular and vital sign monitors, 86 Care Flight International, 455

Caregiver. See Parent

Carve-out arrangement, 275

Case-based discussions, 263

Case law, 93

Case studies, 262, 263

CCITT. See Critical care interfacility transport team (CCITT)

CCRN. See Certified critical care nurse

(CCRN)

Centers for Medicare and Medicaid Services (CMS)

EMTALA, 101

payer of services, as, 272

telemedicine, 359

Centralized hospital-based communications system, 57t

CERT. See Community emergency response team (CERT)

Certification courses, 14-15, 451-454

Certification examination, 38

Certified critical care nurse (CCRN), 38

Certified flight commander (CFC), 62

CFAI. See Commission on Fire Accreditation International (CFAI)

CFC. See Certified flight commander (CFC) Charge nurse, 431

Chemical, biological, and radiological hazards, 337-338

Child abuse or neglect, 113-114

Children. See also Patient

minors, 96

participation in decision making, 306 ward of the state, 21

Children with special health care needs,

334-335, 336f

CHSSDC. See Congenital Heart Surgeons Society Data Center (CHSSDC)

Circadian rhythm disruption, 169-171

Circuit courts of appeal, 94

Clinical research. See Transport research

Clothing, 162, 166-167, 324-325

CMS. See Centers for Medicare and Medicaid Services (CMS)

CO poisoning.

Cockpit resource management, 171

Code 99291, 270, 271t

Code 99292, 270, 271t

Code 99466, 270, 271t

Code 99467, 270, 271t

Code 99485, 270, 271t

Code 99486, 270, 271t

Code medications, 88t

Codingfor Pediatrics, 271

Collisions and crashes, 18-19, 188

Comcare Alliance, 440

Commission on Accreditation of Air Medical

Services (CAAMS), 330

Commission on Accreditation of Ambulance

Services (CAAS), 319-320. See also

Commission on Accreditation of

Medical Transport Systems (CAMTS)

Commission on Accreditation of Medical

Transport Systems (CAMTS), 440 board members, 321 climate control, 197 contact information, 330, 440 member organizations, 321-322 mission statement, 320 name change, 320 service information, 208 stress recognition and management, 363 vision statement, 320-321

Commission on Fire Accreditation

International (CFAI), 320

Common cause variation, 139

Common causes, 138

Common law, 93

Communication between facilities, 21-22, 264 Communication policies, 420

Communications and the dispatch center,

55-80

administrative protocols, 72-73

call-back process, 77 communications specialist, 62-70 cost/benefit analysis, 77-78

disasters, 79-80

documentation, 77

EMS, 78-79

ergonomics, 59

features of the communications center, 58 flow sheets, 75f

follow-up communication with referring provider, 78, 79f

high-volume times, 59

intake process, 73-76

integration of communications system into practice, 70-71

MCP, 71-72

models of communication systems, 56-57, 57t

“one call does it all” approach, 71 outsourcing of services, 77-78 phone system, 59

policies and procedures, 61 postaccident incident plan (PAIP), 61 radio system, 60

recording and storing conversations, 60-62 satellite-based communication, 80 security, 59

technical equipment costs, 58t Communications specialist, 62-70 Community emergency response team

(CERT), 379

Compagnie Generale de Secours, 457

Computer-assisted interactive self-study program, 50

Conduction system abnormalities, 342

Confidentiality, 111.

Information Portability and

Accountability Act (HIPAA)

Congenital abdominal wall defects, 421-424 Congenital Heart Surgeons Society, 281 Congenital Heart Surgeons Society Data

Center (CHSSDC), 281

Consent, 307-309

emergency exception rule, 308-309

implied, 97, 308

informed, 96-98, 107

Consequences, 304

Contagious diseases, 338-339 Continuing education, 38, 52-53 Continuous airway pressure (CPAP), 293-294 Continuous quality improvement. See Quality improvement (QI)

Contribution, 121

Control chart, 141

Controlled substances, 82, 89

Cooperation and collaboration

administrative staffs of referring and receiving hospitals, 10

communication between facilities, 21-22, 264

multiple neonatal-pediatric transport services, 5

relationships with referral personnel, 20 Costs, 11-12. See also Financial considerations

dedicated vehicle, 199

fixed-wing aircraft, 209

ground ambulance, 201

helicopter, 205-207

Course in Advanced Trauma Nursing

(CATN II), 453

Court of original jurisdiction, 94

Court system, 94

CPAP. See Continuous airway pressure (CPAP)

CPT transport codes, 270-271, 271t

Crash prevention device, 192 Credentialing, 123

Crew resource management (CRM), 171, 363 Criminal law, 99

Critical care interfacility transport team

(CCITT), 369. See also Transport team Critical Care Medicine, 455

Critical Care Medicine, 449

Critical care nurse, 26t, 38

Critical Care Nurse, 438

Critical care transport EMS provider, 371 Critical incident stress management model, 364 Critical transport decisions, 181

Criticizing referring hospital, 264

CRM. See Customer relationship management (CRM)

Crossing the Quality Chasm: A New Health System for the 21st Century, 133 Cuffed airway device, 85

Cultural and religious beliefs, 311, 312 Cultural sensitivity, 242

Current Procedural Terminology (CPT) codes, 270-271, 271t

Customer relationship management (CRM), 247

D

Dalton's law, 219-220

Dashboard, 137

Data storage, 286, 287f

Data validation, 284

Data warehouse, 286

Database, 279

Database development and application, 279-290

case scenario, 280

data acquisition, 282-285

data storage, 286, 287f

data validation, 284

data warehouse, 286 database query, 286, 287f

HIPAA privacy rule, 286-288

HIPAA security rule, 289

legal discovery of databases, 289-290 patient data to be included in database, 283t sample database fields, 285t, 407-412 types of databases, 281-282

Database field, 283, 285t, 407-412

Database query, 286, 287f

DEATH, 232

Debriefing, 366

Defibrillator/cardioverter/pacer system, 87

Decentralized hospital-based communications system, 57t

Decompression sickness, 220-221

Dedicated emergency department, 102

Dedicated transport team, 9, 328

Dedicated vehicle, 199

Dehydration, 230-231

Deidentified health information, 288 Deming, W.

Designated hospitals, 104-105

Diagnosis-based educational checklist, 39-40t Diagnosis-related group (DRG) payment, 267, 272

Directory of clinical databases (DoCDat), 282 Disaster medical assistance team (DMAT), 379 Disasters

AAP Web site, 378

CCITT, 377-378

communications system, 79-80 EMTALA, 105

Dispatch center. See Communications and the dispatch center

Dispatch intake record, 74f

Distress, 363

District court, 94

Diuretics, 88t

Diversion en route, 115-117

Diversionary status, 102

DMAT. See Disaster medical assistance team (DMAT)

DNR order. See Do-not-resuscitate (DNR) order

Do-not-resuscitate (DNR) order, 312-313 DoCDat. See Directory of clinical databases (DoCDat)

Doctrine of implied consent, 308

Documentation, 125-127 accusations/judgments, 130 communications system, 77 contents of the record, 126-127 details, 127 functions, 125, 126 medical narrative report, 126 policies and procedures, 420 record retention, 127-128 specifics vs generalizations, 127 users, 126

wrap-up narrative, 127

Documentation policies, 420

Documenting by exception, 126 Downstream revenue, 267, 272

DRG payment. See Diagnosis-related group (DRG) payment

Drug card, 90

Drug pack, 89, 90

Drugs. See Medications

Duty, breach, causation, damages, 95-96

Duty time, 235-236

Duty to act, 128-129

E

e-PHI. See Electronically transferred protected health information (e-PHI)

East West Rescue, 459

ECLS. See Extracorporeal life support (ECLS) ECMO. See Extracorporeal membrane oxy­genation (ECMO)

ECMO center, 344-347

Economies of scale and scope, 275-276 ED. See Emergency department (ED) Educational initiatives. See Outreach education Efficient zone, 217

Egalitarian view of justice, 305

EHR. See Electronic health record (EHR) Electronic health record (EHR), 211, 282 Electronically transferred protected health information (e-PHI), 289

ELSO. See Extracorporeal Life Support Organization (ELSO)

ELSO registry. See Extracorporeal Life Support Organization (ELSO) Registry

Emancipated minor, 97

Emergencia Aera Nacional, 456

Emergency and survival training, 168

Emergency department (ED), 331

Emergency department experience, 51-52 Emergency department telemedicine, 357-358 Emergency exception rule, 308-309 Emergency lights and sirens, 433 Emergency medical communications system. See Communications and the dispatch center

Emergency Medical Journal, 449 Emergency medical services. See EMS and interfacility transport teams

Emergency Medical Services for Children, 441 Emergency medical technician (EMT). See Transport emergency medical techni­cian (EMT); Transport paramedic Emergency medical technician-basic

(EMT-B), 371

Emergency medical technician-intermediate (EMT-I), 371

Emergency medical technician paramedic (EMT-P), 371

Emergency Medical Treatment and Active Labor Act (EMTALA), 10, 101-111 administration of the law, 110-111 ambulances and helicopters, 102-104, 116 anti-dumping law, 101 appropriate transfer, 108 complaints of EMTALA violations, 110 dedicated emergency department, 102 designated hospitals, 104-105 disaster status exception, 105 helipad exemption, 103-104 hospital requirements, 101 informed consent, 107 minor can request treatment, 98 monetary penalties, 111 notice of termination from participation in federal insurance programs, 111 outpatient vs inpatient transfers, 110 “parking” patients, 103 patient transfer (stable vs. unstable condition), 105-110

qualified personnel and transportation equipment, 109, 179

referring physician, 16, 106-107 separate certification form, 107-108

Emergency Nurses Association (ENA), 441

Emergency Nursing Pediatric Course (ENPC), 453

Emergency plan, 419

Emergent consent, 97

Emotional intelligence, 365

EMS and interfacility transport teams, 369-380

disasters, 78-80, 377-378

environmental issues, 375-376 long-term entrapment, 376 patient handoff, 375

sharing expertise, 370-372 similarities/differences between CCITTs and EMS, 369-370

training opportunities, 379-380

triage, 376-377

unexpected medical encounters, 372-376 EMS Web site, 441

EMSC National Resource Center (NRC), 441 EMT. See Transport emergency medical technician (EMT)

EMT-B. See Emergency medical technician- basic (EMT-B)

EMT-I. See Emergency medical technician­intermediate (EMT-I)

EMT-P. See Emergency medical technician paramedic (EMT-P)

EMTALA. See Emergency Medical Treatment and Active Labor Act (EMTALA)

Encephalocele, 426

End-tidal CO2 monitors, 85-86

Endotracheal tube balloons, 226

Engine cycle, 206

Equipment. See Transport equipment Equipment review and competency checklist, 43-45t

Ergonomics, 192, 202

Ethics, 303-317 beneficence/nonmaleficence, 303, 306, 309,

311

commenting on perceived errors/deficient care, 314

consent. See Consent

cultural and religious beliefs, 311, 312

Ethics, continued

DNR order, 312-313

educational resources, 315

ethical obligations to patient, 305-306 ethical precepts, 303-305 hypothetical scenarios for discussion, 315-316

language barriers, 311

miscommunication, 311

parental refusal of care, 310, 311 privacy and confidentiality, 309-310 research, 307, 308f

resuscitation, 313

temporary protective custody, 310-311

Ethylene glycol ingestion, 334

Euro-Flite Ltd, 457

EuroAssistance, 459

Eustress, 363

External markets, 246

Extracorporeal life support (ECLS), 334

Extracorporeal Life Support Organization

(ELSO), 344, 345

Extracorporeal Life Support Organization (ELSO) Registry, 281, 345

Extracorporeal membrane oxygenation (ECMO), 294, 344-347

Extreme prematurity, 347-349

Eyewear, 167

F

FAA. See Federal Aviation Administration (FAA)

Family. See Parent

Family-centered care. See Patient- and family­centered care (PFCC)

FAR 91.17, 235

FAR Part 135, 235

FARs. See Federal aviation regulations (FARs)

Fatigue, 232, 235-236

Federal Aviation Administration (FAA), 93 investigation of aviation EMS crashes, 192 maximum duty hours, 235 personal medications, 234 pilots “preflight” themselves, 233 proposed rules, 190-191 use of oxygen, 228

Federal aviation regulations (FARs), 205, 228 Fellow, 15, 26t, 36

Fiduciary obligations, 303

FileMaker Pro, 282

Financial considerations, 267-277 billing, coding, and reimbursement, 269-272 budgeting, 268

carve-out arrangement, 275 CMS, 272 costs. See Costs

CPT codes, 270-271, 271t downstream revenue, 267, 272 economies of scale and scope, 275-276 fixed costs, 268-269, 268t goodwill, exposure, and branding, 274-275 hospital mergers/merging of units, 276 interfacility agreement, 269

Maclaran and McGowan research study, 274 nurse practitioners, 271-272 Sinay research study, 276 tertiary transport team, 269-270 value-based purchasing (VBP), 272 variable costs, 268t, 269 vendor contracts, 273-274

First responders, 371

Fixed costs, 206, 268-269, 268t

Fixed-wing aircraft, 207-209. See also Air ambulance; Transport vehicle cabin pressure, 207, 208 limitations/disadvantages, 209 maintenance, 208-209 number of caregivers, 4 operation costs, 209 purchase price, 209 range, 198 response time, 184 use of, for business ventures, 209

Fixed-wing delay, 184

Flattening of the hierarchy, 364 Flight Nurses of Australia, 447 Flight Nursing, 442

Flight physiology. See Transport physiology and stresses of transport

Flight Web, 442

Fluid dynamics, 232

Flying Doctors Society, 458

Follow-up notification system, 255

4 P's of marketing, 249

Free standing communications system, 57t Full-body immobilization device, 160

G

g-forces, 231

Gas expansion ratio, 218

Gastroschisis, 421, 422

General Practice Research Database (GPRD),

281

German Air Rescue, 457

Glucometer, 87

Good Samaritan laws, 372

Goodwill, exposure, and branding, 267,

274-275

Gravitational forces, 231

Ground ambulance, 199-203. See also

Transport vehicle

advantages, 199-201 after-market retrofitters, 156

air transport, compared, 182-186, 298 ANSI/ASSE Z15.1 safety standard, 157, 159t captain's chair, 160

car safety seat, 158, 160f

cost, 201

EMTALA, 102-104, 116

equipment review and competency checklist, 43t

exemption from oversight/standards, 156-157

full-body immobilization device, 160 identified risks and hazards, 163 in-vehicle telemetry monitoring, 163 limitations, 201-203

maintenance, 203

motion sickness, 201

neonatal transport incubators, 161 number of caregivers, 4 optimizing safety management, 158t range, 198

rear occupant hazards, 202

safety, 156-163

systems approach to safety and risk

management, 157

traditional box ambulance configuration,

202

types, 201

Guidelines for Air and Ground Transport of

Neonatal and Pediatric Patients, 437

H

Hackman v American Medical Response, 118 HALT, 365

Hazard warning device, 192

Hazardous Waste Operations and Emergency Response (Hazwoper) standard, 338

HBOT. See Hyperbaric oxygen therapy

(HBOT)

Health care law, 96-98. See also Legal issues

Health care professionals. See Neonatal trans­port team (NTT); Transport team Health care surrogate, 96

Health Information Portability and

Accountability Act (HIPAA), 111-115 abuse or neglect, 113-114 communicable diseases, 113 follow-up communication, 78

HIPAA compliance requirements, 115

HIPAA regulations in conflict with state laws, 113

monetary penalties/medical malpractice suits, 112

notice of privacy practices, 112 privacy notice forms, 112 privacy rule, 286-288 protected health information (PHI), 287-288

public health reporting, 113 security rule, 289 social media, 114

HEAR. See Hospital emergency and adminis­trative radio (HEAR)

Heart disease, 342-343

HEICS. See Hospital emergency incident command system (HEICS)

Helicopter, 203-207. See also Air ambulance;

Transport vehicle advantages/disadvantages, 204-205 costs, 205-207

EMTALA, 102-104

FAA proposed rules, 190-191 fixed/variable costs, 206-207 landing zone requirements, 204-205 maintenance, 206

number of caregivers, 4 purchase price, 206

safety, 168

service area, 204

speed, 204

VFRs/IFRs, 205

weather considerations, 205

Helicopter Association International (HAI), 442

Helicopter cycle, 206

Helipad exemption, 103-104

Heng-Gref Medical Services, 459

Henry's law, 220-221

Herzliya Medical Center, 458

HIE. See Hypoxic ischemic encephalopathy (HIE)

High-visibility clothing, 162, 193

HIPAA. See Health Information Portability and Accountability Act (HIPAA)

HIPAA privacy rule, 286-288

HIPAA security rule, 289

Hippocratic Oath, 111

Hospital emergency and administrative radio (HEAR), 60

Hospital emergency incident command sys­tem (HEICS), 377

Hospital mergers, 276

Human resources policies, 420

Humidity, 230-231

Hyperbaric oxygen therapy (HBOT), 341-342

Hyperthermia, 87

Hypothermia, 87, 333-334. See also

Therapeutic hypothermia

Hypoxia, 226-228

Hypoxic ischemic encephalopathy (HIE), 295, 350

I

Identifiable protected health information (PHI), 288

IFRs. See Instrument flight rules (IFRs)

“I'm safe” checklist, 233t

Implantable pacemaker, 342-343

Implied consent, 97, 308

In-Flight Nurses Association (IFNA), 447

In loco parentis, 96

In-vehicle telemetry monitoring, 163

Incident management, 125

Incubator, 83, 161

Indemnity, 121

Indigent patients, 101. See also Emergency Medical Treatment and Active Labor Act (EMTALA)

Infant simulator, 12

Infection control, 338-339

Informed consent, 96-98, 107, 307

Inhaled nitric oxide (iNO), 44t, 85, 294-295, 345-347

iNO. See Inhaled nitric oxide

Inotropic agents, 88t

Institutional review board (IRB), 307, 308f

Instrument flight rules (IFRs), 164, 165, 205 Insurance

patients, 19-20 transport team crashes, 18-19

Intake process, 73-76

Integrity, 306

Intelligent transportation system technolo­gies, 192

Intended variation, 138

Interactive telemedicine, 353

Interfacility agreements, 269

Interfacility transport team. See Transport team

Internal quality process, 128

International Association of Emergency Managers (IAEM), 442

International organizations, 447-448

International Society of Air Medical Services (ISAS), 447

International transport, 454-459

International Trauma Anesthesia and Critical

Care Society (ITACCS), 443

International travel electrical adapter, 82

Intracranial pressure medications, 88t

Intracranial pressure monitoring, 88

Intravenous fluids, 88t

Intravenous (IV) infusion pumps, 43-44t, 87 IRB. See Institutional review board (IRB) Isolette, 83

IV pumps. See Intravenous (IV) infusion pumps

J

Jet Flite, 457

Jet lag, 171

Joint liability, 121

journal of Accident and Emergency Medicine,

449

Journal of Pediatrics, 450

Journals, 449-451

JumpSTART, 377

Jury trial, 94-95

Just Culture, 364, 366

Justice, 304-305

K

Key driver diagram, 142

Key drivers, 142

L

Laboratory experience (facsimile training), 52 Language barriers, 311

Laryngeal mask airway, 85

Lean manufacturing, 144

Learning styles, 262-263

Lecture, 38, 50 Legal issues, 91-132

abandonment of patient, 115, 116 contribution, 121 court system, 94 delivery at receiving facility, 119-120 discovery of databases, 289-290 diversion en route, 115-117 documentation, 125-128 duty, breach, causation, damages, 95-96 duty to act, 128-129

EMTALA. See Emergency Medical Treatment and Active Labor Act (EMTALA)

Good Samaritan laws, 372

HIPAA. See Health Information Portability and Accountability Act (HIPAA)

incident management, 125

indemnity, 121 informed consent, 96-98, 107 jury trial, 94-95 licensure, 99-100 litigation support, 125 mission diversion, 115-117 negligence per se claim, 100 on-scene responses, 117-118 parent passengers, 130-131 prima facie case, 100 quality of care issues, 128-130 record retention, 127-128 risk management, 123-125 shared legal liability, 120-121 stacking, 117 standard of care, 95-96, 131 state vs federal law, 93 statute of limitations, 127 telemedicine, 358-359 transfer agreement, 122, 413-415 transfer of medical responsibility, 115-121 transporting nonpatients, 130-131 when duty to patient starts, 118 Legislative law, 93 Length-based tape, 89

Length-weight chart, 89

Libertarian view of justice, 305

Licensure, 15-16, 38, 99-100

Lobbying, 265

Long-term entrapment, 376

M

Maclaran and McGowan research study, 274 Magnetic patient tracking boards, 261 Managed care, 19

Managed care contracts, 20 Manager/management, 11

Market gap analysis, 248-249

Marketing, 245-256

branding, 252, 252f, 253t business strategy, 250

customer relationship management (CRM), 247

customer wants, 246-248

defined, 249

defining the customer, 246 demonstration of services, 253t educational initiatives. See Outreach education

evaluating effectiveness of marketing plan, 254-255

follow-up notification system, 255

4 P's, 249

implementation of marketing plan, 253­254, 254t

incentives (education), 253t market gap analysis, 248-249 marketing mix, 249

marketing plan, 251

media (written and Internet), 253t personal/social contact, 253t product life cycle, 249 program assessment, 250

social media, 248 surveys, 247, 247t

SWOT analysis, 250, 251t

Marketing mix, 249

Marketing plan, 251

M.A.R.M., 458

MAST, 226

Maternal and Child Health Bureau (MCHB), 239

Maximum duty hours, 235-236

MCHB. See Maternal and Child Health

Bureau (MCHB)

MCP. See Medical control physician (MCP) Medicaid reimbursement, 19

MEDIC'AIR International, 457

Medical Air Rescue Service, Ltd, 459

Medical control physician (MCP), 35t, 403-406 communications system, 71-72 educational duties, 405 leadership duties, 405 patient care activities, 404-405 position description, 403-404 professional accountability, 406 reporting relationship, 404 requirements, 404 research duties, 406 special assignments/project responsibili­ties, 405

specific capabilities, 406 transport capabilities, 405 Medical director

quality improvement, 146 roles and responsibilities, 34t safety, 172

Medical malpractice, 95-96. See also Legal issues

Medical narrative report, 126

Medical protocols and policies, 421

Medical record keeping. See Documentation Medical Rescue International, 459

Medical simulation center, 12-13

Medical Team Training, 363 Medication bag, 45t

Medications

basic groups, 88t

controlled substances, 82, 89 drug card, 90 drug pack, 89, 90 surfactant, 82, 89

Meningocele, 427

Mental health emergencies, 335-337

Merging of units/hospitals, 276

Metabolic acidosis, 423

Methicillin-resistant Staphylococcus aureus (MRSA), 339

Microsoft Access, 282

Minor parents, 97

Minors, 96, 97

MINT. See Mortality index for neonatal transportation (MINT)

Mission diversion, 115-117

Mission statement, 8

Mode of transport, 3

Model for Improvement, 142

Mortality index for neonatal transportation (MINT), 292

Motion sickness, 169, 201

MRSA. See Methicillin-resistant

Staphylococcus aureus (MRSA)

Multiple neonatal-pediatric transport services, 5

Myelomeningocele, 427

N

Nasopharyngeal airway, 85

National Air Ambulance, 455

National Air Transportation Association (NATA), 443

National Association of Air Medical Communication Specialists (NAACS), 443-444

National Association of EMS Physicians (NAEMSP), 444

National Association of Neonatal Nurses (NANN), 444

National Association of State EMS Directors (NASEMSD), 445

National Certification Corporation (NCC), 38

National EMS Pilots Association (NEMSPA), 445

National EMSC Data Analysis Resource

Center (NEDARC), 441

National Flight Nurses Association (NFNA), 445

National Flight Paramedic Association

(NFPA), 446

National Incident mMnagement System (NIMS), 377

National Transportation Safety Board (NTSB) safety recommendations (2008), 189-190 special investigation report (2006), 188-189

NCC. See National Certification Corporation (NCC)

Negligence per se claim, 100

Neonatal ICU, 344

Neonatal intensive care and delivery room experience, 52

Neonatal-pediatric transport

administration. See Transport program administration

background and principles, 1-2 components, 2

critical transport decisions, 181 dedicated transport team, 9, 328 mode of transport, 3 multiple neonatal-pediatric transport services, 5

outside transport service, 210

overview (flowchart), 461

patient condition for transfer, 20-21 personnel. See Transport team primary medical provider participating in neonatal transport, 425, 430 professional associations, 435-448 resources. See Transport resources roles and responsibilities of transport, 430-432

specialized neonatal-pediatric transport service, 5

transport vehicle. See Transport vehicle vehicle selection. See Vehicle selection

Neonatal resuscitation program, 348 Neonatal Resuscitation Program (NRP), 451 Neonatal transport incubators, 161

Neonatal transport team (NTT), 296-297. See also Transport team

Neural tube defect (NTD), 425-430 New Zealand Nurses Organization, 448

NIMS. See National Incident Management

System (NIMS)

911 dispatch center, 56, 57t

Nitric oxide transport ventilator and delivery system, 44t, 85

Noise, 228

Nonmaleficence, 303, 306, 309, 311 Notice of privacy practices, 112 NTD. See Neural tube defect (NTD) NTSB. See National Transportation Safety Board (NTSB)

NTT. See Neonatal transport team (NTT) Nurse, 26t, 35t, 381-386

additional training, 13 communications specialist, as, 62 educational duties, 384 environmental conditions, 386 leadership duties, 385

licensure, 38

multiple positions (transport nurse/nurse in hospital), 9

operation of transport equipment, 384 patient care activities, 383-384 physical capabilities, 385-386 position description, 381-382 professional accountability, 385 reporting relationship, 382 requirements, 382-383 research duties, 385 roles and responsibilities, 431 special assignments/project responsibili­ties, 384-385

Nurse practitioner, 271-272

NurseScribe, 448

O

Obligations, 303

Occult spinal dysraphism, 427 Occupant restraint devices, 325 Occupational Safety and Health

Administration (OSHA), 337 Omphalocele, 421, 422

On scene response. See EMS and interfacility transport teams

“One call does it all” approach, 71

One-way patient transfer, 180

Operational database, 282

Organ procurement and transplantation, 343-344

Organization chart (flowchart), 461

Organizational critical incident management policy, 364

Orientation program, 41-42

departmental overview, 48 departmental policies/procedures, 49 job responsibilities, 49 safety responsibilities, 49

Oropharyngeal airway, 85

OSHA. See Occupational Safety and Health

Administration (OSHA)

Otitis media, 225

Out-of-hospital time, 186

Outpatient vs inpatient transfers, 110

Outreach education, 257-266

case-based discussions, 263

case studies, 262, 263

certification courses, 451-454 communication with referring facility personnel, 264

criticizing referring hospital, 264 education content, 263-264

EMS continuing education courses, 265 frequently asked questions, 258-259t instructors, 261, 262

learning styles, 262-263

lobbying, 265

objectives, 257t

promotional items, 261 regional/state-wide initiatives, 264-265 ride-along programs, 263 sample topic list, 260

simulation-based training, 263

social media, 260

Outside transport service, 210

Outsourcing, 77-78. See also Vendor contracts

Oxygen and air, 195

Oxygen and air cylinders, 86

P

PAIP. See Postaccident incident plan (PAIP)

PaO2, 219, 227

Paramedic. See Transport paramedic Parent

cultural and religious beliefs, 311, 312 lack of health literacy, 311 presence of, during provision of care, 241-242

refusal of care, 310, 311

surrogate decision maker, as, 304 transporting nonpatients, 130-131 where parent is a minor, 97

Parent passengers, 130-131

Parental involvement/family presence, 241-242

Parental refusal of care, 310, 311

“Parking” patients, 103

Partial pressure of gases, 219t

Partial pressure of oxygen (PO2), 218

Partial space equivalent zone, 217-218 Patient

anticipation of transfer, 20-21 stabilization of, before transfer, 20 stable condition, 106

temperature, 87

weight, 89

Patient- and family-centered care (PFCC), 239-244

arrival at receiving facility, 243

benefits, 240-241

core concepts, 240

cultural sensitivity, 242

defined, 239

parental involvement/family presence, 241-242

“point person,” 243

Patient autonomy, 96

Patient condition for transfer, 20-21

Patient Safety and Quality Improvement Act, 289

Patient tracer process, 16

Patient transfer (stable vs unstable condition), 105-110

Patient transport and admission records, 45t

PDSA cycle, 143

Pediatric Advanced Life Support (PALS) course, 453

Pediatric burn center, 340-341

Pediatric Critical Care, 450

Pediatric Critical Care Medicine, 446

Pediatric Education for Prehospital

Professionals (PEPP), 453

Pediatric Emergency Care, 450-451

Pediatric ICU, 339-340

Pediatric intensive care experience, 51

Pediatric risk of mortality (PRISM), 292

Pediatric Transport Listserv (PEDTPT-L), 446 Pediatrics, 449-450

PEDTPT-L, 446

PEEP. See Positive end-expiratory pressure

(PEEP)

Pem-Database.Org, 446

Personal autonomy, 304

Personal flotation devices, 168

Personal protective equipment (PPE), 157, 158t, 163, 192, 193, 338

Personnel. See Transport team

Personnel costs, 11

PFCC. See Patient- and family-centered care (PFCC)

PHI. See Protected health information (PHI)

Phone system, 59

Physical gas laws, 218-220

Physician. See Transport physician

Physician assistant, 26t Physician-credentialing files, 16

Physiologic deficient zone, 217

Physiologic zone, 217

PIF. See Program information form (PIF)

Pilot salaries, 206, 209

Plan, do, study, act (PDSA) cycle, 143

Pneumatic anti-shock garments, 226

Pneumatic splints, 226

Pneumatosis, 218

Pneumocephalus, 218

Pneumoperitoneum, 218

Pneumothorax, 225

PO2, 218

“Point person,” 243

Poison center, 334

Policies and procedures, 417-434 communication policies, 420 documentation policies, 420 general policies, guidelines, and informa­tion, 417-418

human resources policies, 420 medical protocols and policies, 421 policy examples. See Policy examples safety and travel policies, 418-419

Policy examples, 421-433 congenital abdominal wall defects, 421-424 emergency lights and sirens, 433 ground transport provider skills compe­tency, 432

neural tube defect (NTD), 425-430 primary medical provider participating in neonatal transport, 425

roles and responsibilities of transport, 430-432

Portable blood gas analyzer, 87

Portable glucometer, 87

Portable suction, 45t, 86

Position descriptions, 381-406. See also indi­vidual position descriptions

Positive end-expiratory pressure (PEEP), 227 Postaccident incident plan (PAIP), 61

PPE. See Personal protective equipment (PPE) Practice review sessions, 47-48

Prehospital Emergency Care, 451 Preponderance of the evidence, 94-95

Prerecorded lecture, 38

Preterm/premature infants, 347-349

Prima facie case, 100

Primary medical provider (MD), 425, 430 PRISM. See Pediatric risk of mortality (PRISM) Privacy. See Health Information Portability and Accountability Act (HIPAA)

Privacy notice forms, 112

Procedural decision making and implemen­tation, 30

Product life cycle, 249

Professional associations, 435-448

Program director, 34t

Program information form (PIF), 329 Prolonged entrapment, 376

Promotional items, 261

Prospective activities, 146

Prostaglandins, 82

Protected health information (PHI), 287-288

Protective clothing, 167

Protocols, 16. See also Policies and procedures

Providing Emergency Care Under Federal Law:

EMTALA, 131

Public health reporting, 113

Public relations skills, 31

Pulse oximeter, 44t, 86

Pulse oximetry, 227, 228

Pulse synchronization, 86

Q

QI. See Quality improvement (QI)

QI committee, 146

QI coordinator, 145, 145t

Qualified personnel and transportation equip­ment, 109

Quality improvement (QI), 13-14, 133-153 common cause variation, 139

control chart, 141 definitions, 133-134

elements of QI program, 144 end product of QI program, 152 example, 147-151t

IOM dimensions of quality, 134

Lean manufacturing, 144 medical director, 146

Model for Improvement, 142 multidisciplinary commitment, 152 objectives of QI program, 145

PDSA cycle, 143 prospective/retrospective activities, 146

QI committee, 146

QI coordinator, 145, 145t

report results through established organi­zational structure, 152 review of adverse events/certain types of transports, 40-41 run chart, 139-141 selecting quality indicators, 135

Six Sigma, 143 special cause variation, 139 targeted areas, 136-137t tracking quality indicators, 135-137 variation, 138-139

Quality of care issues, 128-130 Quality review, 124 questionpro.com, 247

R

Radio system, 60

Range, 198

Rapid decompression, 222 Rapid-sequence intubation medications, 88t RDS. See Respiratory distress syndrome (RDS) Rear occupant hazards, 202 Record of patient care, 420 Record retention, 127-128

Referring physician. See also Primary medical provider (MD)

EMTALA requirements, 16, 106-107 final responsibility, 16

follow-up communication with dispatch center, 78, 79f

inappropriate transport services, 109 resources needed during transport, 3 Refrigerated medications pouch, 45t Regional poison center, 334 Regional transport consortium, 5 Regionalization of services, 1, 331 Release of Information, 288 Remote monitoring telemedicine, 353 Request for proposal (RFP), 273 Research studies. See Transport research Residency training programs, 16-17 Resident, 16-17, 26t, 28-29, 37 Resident work rules, 18, 36 Resources. See Transport resources Respectable minority rule, 95

Respiratory distress syndrome (RDS), 89, 292, 349

Respiratory quotient fudge factor, 219

Respiratory therapist. See Transport respira­tory therapist

Response time, 183-185

Resuscitation, 313

Retrospective activities, 146

Reverse transport, 4

RFP. See Request for proposal (RFP)

Ride-along program, 263

Rights, 304

Risk management

credentialing, 123 incident management, 125

litigation support, 125

policies, procedures, and protocols, 124 quality reviews, 124

Royal Flying Doctor Service of Australia, 448

Run chart, 139-141

S

Safety, 155-177, 187-191 air ambulance, 163-165 circadian rhythm disruption, 169-171 clothing, 162, 166-167

collisions and crashes, 188 emergency and survival training, 168 environmental factors, 165

ergonomics, 192 ground ambulance, 156-163

jet lag, 171 medical director, 172 motion sickness, 169

NTSB safety recommendations (2008), 189-190

NTSB special investigation report (2006),

188-189

physical requirements, 169 policies and procedures, 165-166 program director, 172

rehearsal of evacuation procedures, 168 sleep deprivation, 169-171

team participation policy, 169, 170f

Safety, continued

teamwork, 171-172

vehicle orientation, 167-168

weather conditions, 165 www.objectivesafety.net, 193

Safety and travel policies, 418-419

Safety culture survey, 329

Safety training checklist, 328t

SARS. See Severe acute respiratory syndrome

(SARS)

Satellite-based communication, 80

Scale economies, 275, 276

Scene telemedicine, 356-357

Schaefer's Air Service, 455

Scope economies, 275, 276

Scope of practice, 16, 28, 38

Securing equipment and supplies, 325

Self-imposed stresses, 232-236

alcohol ingestion, 235

DEATH, 232

duty time, 235-236 eating/diet, 236 fatigue, 235-236 illness, 233

“I'm safe” checklist, 233t

medication, 234 smoking, 235 stress, 234-235

Self-learning modules, 38

Service area, 199, 204

Several liability, 121

Severe acute respiratory syndrome (SARS), 339

Shared legal liability, 120-121

Shift work, 169-171

Shore line, 196

Simulation-based training, 263

Simulation education center, 12-13

Sinay research study, 276

Single universal equipment pack, 81

Site surveyors, 329

Six Sigma, 143

Skyservice Lifeguard, 455

Sleep deprivation, 169-171

Smoking, 235

Social media, 114, 248, 260

Solid organ transplantation, 343-344

SOS International, 456

Special cause variation, 139

Special causes, 138

Special considerations, 331-352

accidental hypothermia, 333-334

AICD, 343

behavioral emergencies, 335-337 burn center, 340-341, 341t chemical, biological, and radiological hazards, 337-338

children with special health care needs, 334-335, 336f

ECMO center, 344-347

extreme prematurity, 347-349 hyperbaric oxygen therapy (HBOT), 341-342

hypothermia, 333-334, 350 hypoxic ischemic encephalopathy (HIE), 350

implantable pacemaker, 342-343 infection control, 338-339 inhaled nitric oxide (iNO), 345-347 mental health emergencies, 335-337 neonatal ICU considerations, 344-350 organ procurement and transplantation, 343-344

pediatric ED considerations, 331-339 pediatric ICU considerations, 339-344 poison center, 334

premature infants, 347-349 surfactant replacement therapy, 349 therapeutic hypothermia, 350

trauma center, 332-333

“Special Investigation Report on Emergency Medical Services (EMS) Operations,” 188

SQL. See Structured query language (SQL) Stabilization and preparation time, 185-186 S.T.A.B.L.E., 452

Stable condition, 106

Stacking, 117

Staffing. See Transport team

Standard deviation, 138

Standard of care, 95-96, 131

State supreme court, 94

Statute of limitations, 127

Statutory law, 93

Stopping the line, 364

Storage pack, 81

Store and forward telemedicine, 353

Stress, 234-235

Stress management, 363-367

Stresses of flight and transport, 223-232. See also Transport physiology and stresses of transport

Structured query language (SQL), 286

Subcutaneous emphysema, 218

Suction, 45t, 86, 195

Supply box, 45t

Supply cabinets, 196

Supreme Court of the United States, 94

Surfactant, 82, 89

Surfactant administration, 292-294, 349 Surrogate decision makers, 304 surveymonkey.com, 247

Surveys, 247, 247t

Survival training, 168

Swiss Air Ambulance, 458

“Swoop and scoop” practice, 2

SWOT analysis, 250, 251t

Synchronous telemedicine, 353

T

Team coordinator, 34t

Team participation policy, 169, 170f

Team physician. See Transport physician

Team Steps, 363

Teamwork, 171-172

Telemedicine, 211, 353-362 credentialing and privileging, 359 defined, 353

delivery system, 354-355 emergency department, 357-358 equipment and telecommunications, 353-358

future of, 359-360

liability insurance, 358-359

purpose, 353

reimbursement, 359

scene, 356-357

during transport, 357

types, 353

Telephone system, 59

Temperature variation, 229-230 Template-only documentation, 126 Temporary protective custody, 310-311 Tertiary care center, 5, 36

Tertiary transport team, 269-270

The Joint Commission, 16, 82, 144, 145, 319

Therapeutic hypothermia, 295-296, 350

Thermal stress, 229-230

Thornton v Southwest Detroit Hospital, 110 Three-way patient transfer, 180

Toll-free number, 59

Torts, 93

Total space equivalent zone, 218

Toxic ingestions, 334

Tracheal mucosa damage, 85

Training, 3, 29-31, 37-38

accreditation standard (education specific to transport environment), 326-327 air ambulance, 164

alternative teaching methods, 38, 50 anesthesia and operating room experience,

51

certification courses, 14-15, 451-454

certification examination, 38 diagnosis-based educational checklist, 39-40t

emergency department experience, 51-52

EMS and interfacility transport teams, 379-380

evaluation methods, 47-48, 53

format of educational sessions, 38, 50

importance, 12, 13

instructors, 50

laboratory experience (facsimile training),

52

Training, continued

neonatal intensive care and delivery room experience, 52

orientation. See Orientation program pediatric intensive care experience, 51 potential sites of training experiences, 50, 51-52

practice review sessions, 47-48 required skills/competencies, 41-47, 51-52 residency training programs, 16-17 simulation education center, 12-13

Trans Care International, 458

Transfer agreement, 4, 10, 122, 413-415 Transfer form, 463

Transfer of medical responsibility, 115-121 Transport database collection fields, 407-412 Transport dispatch center. See

Communications and the dispatch center

Transport emergency medical technician (EMT), 26t, 36t, 395-398

educational duties, 397

environmental conditions, 398 leadership duties, 397-398 operation of transport equipment, 397 patient care activities, 396-397 physical capabilities, 398 position description, 395-396 professional accountability, 398 reporting relationship, 396 requirements, 396 research duties, 398 special assignments/project responsibilities, 397

Transport equipment, 81-90

airway management adjuncts, 85 ambulance, 43t cardiorespiratory-BP-SaO2 monitor, 44t cardiovascular and vital sign monitors, 86 compatibility of all mechanical equipment, 82

cuffed airway device, 85 defibrillator/cardioverter/pacer system, 87 end-tidal CO2 monitors, 85-86

equipment review and competency check­list, 43-45t

essential features of the equipment, 83t incubator, 83

inhaled nitric oxide, 44t, 85 intracranial pressure monitoring, 88

IV pumps, 43-44t, 87

life expectancy of equipment, 12 medication bag, 45t

nitric oxide transport ventilator system, 44t, 85

oxygen and air cylinders, 86

pulse oximeter, 44t, 86 refrigerated medications pouch, 45t single universal equipment pack, 81 specific equipment list, 84t

storage pack, 81

suction capability, 45t, 86 supply box, 45t transport incubator, 43t transport ventilator, 44t trauma supplies, 45t ventilator, 83-85 video-assisted intubation device, 85

Transport equipment review and competency checklist, 43-45t

Transport incubator, 43t, 83

Transport listserv, 437, 446

Transport medicine transfer agreement, 122, 413-415

Transport newsletter, 437

Transport nurse. See Nurse

Transport Nurse Advanced Trauma Course (TNATC), 454

Transport organizations and Web sites, 435-448

Transport outreach education. See Outreach education

Transport paramedic, 26t, 36t, 391-395 educational duties, 393 environmental conditions, 395 leadership duties, 394 operation of transport equipment, 393 patient care activities, 392-393 physical capabilities, 395 position description, 391 professional accountability, 394 reporting relationship, 391-392 requirements, 392 research duties, 394-395 special assignments/ project responsibili­ties, 394

Transport physician, 26t, 35t, 399-403 educational duties, 401 environmental conditions, 403 leadership duties, 402 operation of transport equipment, 401 patient care activities, 400-401 physical capabilities, 403 professional accountability, 402 program description, 399 reporting relationship, 400 requirements, 400 research duties, 402 special assignments/project responsibilities, 402

Transport physiology and stresses of transport, 215-237

altitude-related effects, 217t altitude sickness, 222 atmosphere, 216-218 barometric pressure, 224-226

Boyle's law, 218

cabin altitude, 221-222 cumulative nature of stresses, 223 Dalton's law, 219-220 decompression sickness, 220-221 dehydration, 230-231 effects of altitude on oxygenation, 220t fatigue, 232 fluid dynamics, 232 gravitational forces, 231 Henry's law, 220-221 humidity, 230-231 hypoxia, 226-228 noise, 228

partial pressure of gases, 219t physical gas laws, 218-220 physiologic zones, 216-218 prevention of complications, 223t rapid decompression, 222 self-imposed stresses, 232-236 temperature variation, 229-230 vibration, 229

Transport program administration, 7-23 administrative liaison, 8-9 billing regulations, 37

costs, 11-12 manager/management, 11 mission statement, 8

skill requirements. See Transport team

Transport research, 291-302 air versus ground transport, 298

ECMO, 294

inhaled nitric oxide (iNO), 294-295 IRB, 307, 308f

neonatal transport team (NTT), 296-297 possible topics for future research, 298, 299t

research funding, 299-300

research training, 300 specialized vs nonspecialized teams, 297-298

surfactant administration, 292-294 therapeutic hypothermia, 295-296 transport risk scores, 292

Transport resources, 435-459 certification courses, 451-454 disaster preparedness, 378 international transport, 454-459 journals, 449-451 transport organizations and Web sites, 435-448

www.callcorder.com, 62 www.objectivesafety.net, 193 www.pemfellows.com, 29

Transport respiratory therapist, 26t, 36, 386-390

educational duties, 388 environmental conditions, 390 leadership duties, 389

operation of transport equipment, 389 Transport respiratory therapist, continued patient care activities, 387-388 physical capabilities, 390 position description, 386 professional accountability, 390 reporting relationship, 387 requirements, 387 research duties, 390 roles and responsibilities, 432 special assignment/project responsibilities, 389

Transport restocking policy, 45t

Transport risk index of physiologic stability (TRIPS), 292

Transport risk scores, 292

Transport team, 25-31. See also individual team members

communication during transport, 31 contagious diseases, 338 continuing education, 38, 52-53 emergency medical technician (EMT), 26t, 36t, 395-398

fellow, 26t

medical control physician, 35t, 403-406 medical director, 34t

most common team compositions, 27t number of team members dispatched, 4 nurse. See Nurse

overview, 26t, 34-36t, 381-406 paramedic, 26t, 36t, 391-395 personality traits, 29 personnel selection, 29 physician assistant/critical care nurse, 26t procedural decision making and imple­mentation, 30

program director, 34t public relations skills, 31

required skills/competencies, 41-47, 51-52 resident, 16-17, 26t, 28-29

respiratory therapist, 26t, 36, 386-390, 432 scope of practice, 16, 28

self-imposed stresses, 232-236 self-interests, 305 skills competency, 432 stress management, 363-367 team configuration, 3, 33 team coordinator, 34t team physician. See Transport physician training. See Training

Transport team coordinator, 34t Transport team dispatcher. See also

Communications specialist

job description, 63-64f performance evaluation, 64-69f

Transport team log sheet, 76

Transport team medical director, 34t. See also Medical director

Transport team QI coordinator, 145, 145t Transport times, 183-186

Transport vehicle

airplane. See Fixed-wing aircraft ambulance. See Ground ambulance appropriate mode of transport. See Vehicle selection

base facility, 209-210 cabin lighting, 196-197 cabin space, 193-194 climate control, 197 collisions and crashes, 18-19, 188 communications equipment, 197-198 costs. See Costs dedicated vehicle, 199 electrical outlets, power/demand inverters, 196

future technologies, 211 helicopter. See Helicopter ideal transport vehicle, 187 medical configuration, 194-195 medical equipment, 196 occupant restraint devices, 325 oxygen and air, 195 range, 198 securing equipment and supplies, 325 service area, 199 speed, 198 suction, 195 supply cabinets, 196

Transport ventilator, 44t “Transporting Children With Special Health

Care Needs,” 335

Transporting nonpatients, 130-131 Trauma Care Journal, 451

Trauma center, 332-333

Trauma Nursing Core Curriculum (TNCC),

454

Trauma supplies, 45t

Travel advisories, 165

Travel Care International, Inc, 456

Triage, 376-377

TRIPS. See Transport risk index of physiologic stability (TRIPS)

2-challenge rule, 172

Two-way patient transfer, 180

2-way radio, 60 250-yard rule, 102 Type I ambulance, 201 Type II ambulance, 201 Type III ambulance, 201

U

UK London Heathrow, 458 Unintended variation, 138 Unit-based communications center, 56, 57t Unit secretary, 431

US Air Ambulance, 456

US Census database, 282

US Circuit courts of appeal, 94

US Constitution, 93

US district court, 94

US Supreme Court, 94

V

Valsalva maneuver, 225

Value-based purchasing (VBP), 272

Vancomycin-resistant enterococci (VRE), 339 Variable costs, 206-207, 268t, 269

Variation, 138-139

VBP. See Value-based purchasing (VBP) Vehicle orientation, 167-168

Vehicle selection. See also Transport vehicle

ideal transport vehicle, 187

logistic indicators, 182-183 out-of-hospital time, 186

response time, 183-185 stabilization and preparation time,

185-186

time and distance indicators, 182 transport times, 183-186

Vehicle stabilization technology, 192

Vendor contracts, 273-274 Ventilator, 83-85

Vermont Oxford Network (VON) database,

281

VFRs. See Visual flight rules (VFRs)

Vibration, 229

Video-assisted intubation device, 85 Videoconferencing. See Telemedicine Virtual PICU Systems, 281

Virtual private network (VPN), 354

Virtues, 304

Visual flight rules (VFRs), 165, 205

VPN. See Virtual private network (VPN)

VRE. See Vancomycin-resistant enterococci

(VRE)

Vuelo de Vida (Life Flight), 456

W

Ward of the state, 21

Water egress survival training, 327 Weather conditions, 165, 205

Weight-drug-dose table, 90 Weight-for-age chart, 89

Wings Medical Group of Companies, 458

Work-hour constraints, 16

Wrap-up narrative, 127

Wright v City of Los Angeles, 118 www.callcorder.com, 62 www.objectivesafety.net, 193 www.pemfellows.com, 29

Z

Z15.1 safety standard, 157, 159t, 192 Zepeda v City of Los Angeles, 118 zoomerang.com, 247