EMS ExpressCare

 

                                                                         

 

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Through partnerships with Petroleum Helicopters International (PHI) and Butler Medical Transport, the University of Maryland operates
a busy critical care and interfacility transport service. ExpressCare is comprised of critical care personnel, specialty care paramedics, transport
nurses, and communication staff. A primary mission of ExpressCare is to provide safe and effective transport for patients requiring a higher or
more sophisticated level of inhospital care. ExpressCare crews are capable of the following specialty transports:

• Extracorporeal membrane oxygenation (ECMO)
• Neonatal interfacility
• Critical care / blood product administration / advanced modes of ventilation
• Intra-aortic balloon pumps

Residents and students are encouraged to ride a long with transport crews and observe a shift in the communications center. Helicopter ride-
alongs are limited to the winter months when the EC-135 twin engine helicopter can accomodate additional observers. The most common crew
configuration consists of a registered transport nurse (RN) and specialty care paramedic (NRP). Crews are tasked with the transport of critically ill
and injured patients across the spectrum of age and acuity. Critical care transport exists to bring the definitive and specialty care resource of the
University of Maryland Medical System  to the patient's bedside. 

 

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                                                                                                  Resident Rotation in Critical Care Transport

 

Goal:                      

The resident assigned to the Maryland ExpressCare (MEC) EMS rotation will become familiar with interfacility critical care transport operations.
The resident will interact with specialty transport crews and learn about how the standard of hospital based care is maintained throughout
transport.

Objectives:           

• Understand how the scope of critical care transport (CCT)  practice differs from typical prehospital operations
• Define the capabilities of CCT crews and discuss the specifics of training and education
• Discuss how EMTALA factors into decisions about the level of transport care
• Describe how patients in need of interfacility transport are matched to the appropriate level of transport care (BLS, ALS, CCT, flight)

Rotation description:

Residents assigned to rotations with MEC will check in with the CCT crew at the University of Maryland Medical Center. Residents will serve as
members of the critical care transport team. Residency policies about dress code and attendance shall remain in effect for the duration of the
MEC block.

• Resident physicians will observe critical care crews and function under the auspices of the lead transport RN and MEC clinical guidelines
• Residents will bring their own PPE (gloves, goggles, mask) the rotation. Additional supplies will be available to the resident in order to
  maintain a safe transport environment. Residents will report to the lead transport RN and participate in the formulation of a transport
  care plan. Procedures and patient care related activities will be performed at the discretion of the transport RN.
• Examples of acceptable resident-performed procedures include: patient assessment, intravenous access, needle decompression,
• applicationof monitor leads, 12 lead electrocardiograph interpretation, and other tasks identified as appropriate by the transport
• crew.
• Senior residents who have completed base station training can serve as surrogate medical control physicians (upon request of the
• MEC crew) and can provide input on adjustments to the transport care plan. Advice or medical control provided by the senior resident
• physician will be in accordance with existing MEC clinical guidelines and documented on the prehospital / interhospital electronic
• medical record. The final authority for transport related decisions rests with the lead transport RN responsible for execution of the
• transport care plan. Questions should be escalated to the Maryland ExpressCare medical director on duty. 

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                                                                                                                Critical Care Transport Didactics 

The following articles provide the resident/student on rotation with a focus overview of operational considerations related to air medical
transportation. Selected articles discuss indications for HEMS, treatment guidelines, and clinically relevant scenarios 

 

HEMS Operations

• Activation / utilization of Helicopter Air Medical Services 
• Cost Effectiveness of Helicopter vs Ground EMS for Trauma Scene Transport in the United States
• FAA Review of recent HEMS Accidents

HEMS Clinical 

• Helicopter Emergency Medical Services for Adults with Major Trauma
• Association Between Helicopter vs Ground EMS and Survival for Adults with Major Trauma
• Hypoxia and Hypotension in patients Intubated by Physician Staffed HEMS 

HEMS Guidelines

• Evidence Based Guideline for the Air Medical Transportation of Prehospital Trauma Patients 
• Appropriate and Safe Utilization of Helicopter Emergency Medical Services
• Appropriate Air Medical Services Utilization and Recommendations for Integration of Air Medical Services 

 

ExpressCare Contact Information
 

Leigha McGuin, RN, BSN, CCRN
Nurse Manager

Mike McCabe, NRP, FP-C
Base Manager, PHI Air Medical (ExpressCare 1)

Benjamin Lawner, DO, MS, EMT-P
Medical Director

Jeff Nusbaum, MD, MBA
Assistant Medical Director

Ellen Souchak, RN
Senior Critical Care Transport Specialist and Scheduling Contact 
 

ExpressCare Documentation (Complete prior to ride along) 

• Waiver of liability
• Confidentiality form 

 

University of Maryland Medical System Maryland ExpressCare Official Website 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Maryland Institute for Emergency Medical Services Systems (MIEMSS) certifies that Maryland ExpressCare
Critical Care Transport is a licensed commercial service. MEC license #52 includes BLS, ALS, and SCT levels of service

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ExpressCare 1 Hangar/Base:

 

Fly alongs and tours of the helicopter base take place at the Martin State Airport in Essex, MD. 

 

701 Wilson Point Road
Middle River, MD 21220