Medevac nurses need targeted training

CASE WESTERN (US) — The unstructured and at times chaotic environment on board a medevac helicopter calls for more specialized training, according to a new study.

Because flight nurses need to work in a cramped environment where it is often hard to reach the patient, some medications and practices of the emergency room can be in effective at best, and at worst, not  possible on board, so care often relies on visual cues and patient patterns.

Because flight nursing is a relatively new field of nursing, “The knowledge about what works is limited,” says Andrew Reimer, PhD graduate of the nursing school at Case Western Reserve University.

In 2003, there were 545 helicopters transporting patients from 472 bases.  By 2007, the number increased to 810 helicopters from 664 bases.  Currently, about 500,000 patient transports take place annually, according to the Atlas and Database of Air Medical Services,

Nurses need different skills from those used in a hospital to access a patient’s physical signs, Reimer says.  For example, the noisy environment may make it difficult to hear a patient’s heart beat or distinguish a pulse from the vibrations from the rotor blades.

Many flight nurses learn how to work around obstacles while on the job, but should know how before they become airborne, Reimer says. His recommendations are reported in the Journal of Advanced Nursing.

Advanced training would be advantageous during a major disaster, like the earthquake that shook Japan in March.  Because of the devastation, it was hard for people to get in and out of the stricken areas.

Christopher Manacci, director of the nursing school’s flight nurse program and also a practicing flight nurse, trains Japan’s flight nurses through a program at Aichi Medical University and traveled to Japan following the February earthquake and tsunami.

Making a fast assessment of a patient’s needs has to be second nature, Reimer says.

“You can take an ICU nurse with 20 years of experience and put them in the helicopter to care for a patient, and the learning curve will be similar to someone with only two years of experience.”

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