Transport: Lifeflight Helicopter Guidelines

Transport: Lifeflight Helicopter Guidelines

In order to facilitate prompt and easy access of all neonates within the middle Tennessee and Southern Kentucky referral region to the new Vanderbilt Children’s Hospital, a neonatal LifeFlight transport program has been established as of May 2002.

While the renowned and experienced Angel ground transport team will remain the primary mode of transport for critically ill neonates to the Vanderbilt NICU, neonatal fellows and attendings dispatching transport should consider the LifeFlight Helicopter transport option under certain circumstances.

1. The referring hospital is located at a significant distance from Vanderbilt.

Target hospitals for LifeFlight transport include those in:

Cookeville

Livingston

Paris

Tullahoma

Winchester

and potentially

Crossville

Jackson

Lewisberg

2. The infant has an urgent life-threatening illness which cannot be stabilized at the referring hospital. For example,

An infant with cyanotic CHD needing balloon dilation of the atrial septum

An infant with CDH needing ECMO

3. The infant has an emergent life-threatening, reversible condition and the time required by ground transport is significantly longer than by air. This situation may exist if the referring hospital is located 60-100 miles from VUMC and arrival time by air is at least 20 minutes sooner than by ground (a list of ground vs air times is available) and the infant has, for example:

A tension pneumothorax unsuccessfully evacuated

Inability to be intubated, ventilated, or oxygenated

Refractory hypotension or need for blood products that are unavailable

Dispatch Protocol

The accepting physician should handle the request for transport as usual. The fellow or attending taking the van call should not promise the referring physician helicopter transport as multiple factors must be considered (see below.) Assure the referring physician that the Angel transport team will arrive ASAP by the most appropriate means available.

Does the patient meet selection criteria either based on distance or acuity?

Is there a LifeFlight-qualified NNP or MD (Dr. Walsh) available?

Is the Angel Ground transport team already out? If so, the call must be handled with regards to whether a second transport team needs to be organized.

Is the NNP on transport LifeFlight qualified? Check the transport schedule at the Medical Receptionist’s desk; LifeFlight NNPs names are shaded. The transport NNPs flight status should also be noted on the call board at the front desk.

Is the LifeFlight helicopter available?

Check with the LifeFlight dispatcher using the NICU base station radio or phone x23211 to see if a helicopter is available. The dispatcher will also check weather conditions both in Nashville and at the referring hospital to determine whether or not air transport is safe.

Now that all neonatal transport calls are being handled through the LifeFlight communications dispatcher, the LifeFlight dispatcher will be in constant communication with the NICU physician as the decision is made to transport a patient via either ground or air. The NICU physicians should remember that they are the ones most capable to decide the most desirable mode of transport for any given infant, not the dispatcher.

If all criteria are met and a LifeFlight transport is agreed upon and approved by the dispatcher, LifeFlight communications will notify the transport team by text paging to report to the helipad. The accepting NICU physician should still call the transport NNP to give her further information about the patient and the plan for stabilization and ongoing care.

Discussed and approved at the Regionalization and Transport meeting 5/15/02. Revisited at the Regionalization Meeting 3/19/03.