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The Role of the Physician in a Helicopter Emergency Medical Service

Published online by Cambridge University Press:  28 June 2012

Robert J. Schwartz
Affiliation:
Research Director, Department of Emergency Medicine, Hartford Hospital; Assistant Professor of Surgery, University of Connecticut School of Medicine
Lenworth M. Jacobs
Affiliation:
Director, Trauma/Emergency Medicine, Hartford Hospital; Professor of Surgery, University of Connecticut Health Center
Margaret Lee
Affiliation:
Flight Nurse, Life Star, Hartford Hospital

Abstract

The purpose of this study was to measure the contributions of a physician crew member in a helicopter emergency medical service (HEMS) and to develop a method to utilize physician services more efficiently. A two-part study utilizing two independent sets of measurements of physician necessity was conducted. A post-flight questionnaire and the success rate for endotracheal intubation were used as measurement tools.

With the passage of time, the fight nurses perceived the physician crew member' contribution to clinical judgment decreased from 21% to 1% of the flights and that the physician's contribution of technical skills (intubation) declined from 11% to 3%. The contribution to clinical decisions seemed more important on interhospital transports than on scene responses. The technical skills (judged by the tracheal intubation success rates) of a physician seemed more cogent on responses to the scene. When in the capacity of a second crew member with an experienced flight nurse, the endotracheal intubation success rate increased from 71% to 90%. Therefore, it seems that physician services could be restricted primarily to scene response flights. This limited utilization of flight physicians should make these physicians available for other duties.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

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Footnotes

Presented at: University Association for Emergency Medicine 18th Annual Meeting, May 25, 1988

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