Hello, Sam. I am Dr. Felix Porras. I have been a flight surgeon for 28 years and I totally agree with the content of your video. In fact, I would consider flight medicine as the pinnacle not only of prehospital medicine but one of the most challenging of all medical activities. During critical patient transportation, you have to have the temper to solve difficult situations in a very reduced space with limited resources, with nobody to help you. You need proper training, experience, and the courage to do it. I know many brilliant ICU physicians who simply don´t dare to fly with unstable patients. And yes, the risk is always there. Many times you know where you take off from, but God knows the conditions of your landing spots. And the message of the video is true: Flight Medicine is not for everybody, but when you master it is really fascinating. God bless the journey of all flight medical crews. Congratulations and thanks for doing so much good for the community.
I have been watching your Channel since before I went to nursing school. I dreamt of being a flight nurse and after 3+ years critical care experience in the ICU got a gig in my home state with a flight program as a flight nurse.Thanks for all the content you make!
Accurate assessment! I fly rotor in Alaska and our extreme temperatures and weather are HUGE factors we have to contend with! Frozen IV lines are real, cracked vent tubing etc. Our flight times can be really long. If you like these extremes, we have a full compliment of fixed wing aircraft and are looking for qualified team members!!!
I'm a 40+ year, dual rated pilot, and with the exception of a one year period when I flew EMS, all of my flight time has been in various utility jobs. For me, EMS was just too boring. As for the air sickness, I've learned a couple tricks. 1. If you feel sick, let the pilot know ASAP so they can fly as smooth as possible. 2. Open a window. Get fresh air on you ASAP, this helps tremendously. 3. Try to look at the horizon, preferably straight ahead. This is also very helpful, and pretty easy in the Eurocopters/Airbuses, but can be impossible in the Bells. In my experience, those 3 things can prevent your sickness from getting worse, and often make it pass completely. There's a rumor that sniffing an isopropyl alcohol patch can alleviate nauseousness too. And you are 100% correct, it's another whole level of risk, for so many reasons. Thanks for the video, for informing potential medics of these things, and for all you and other medics do for those in need.
Risk is certainly real. I flew as a flight corpsman with the Marines in 73. I replaced a corpsman that went down in the mountains killing the whole crew at night. New him well.
While I have never flown as a medic, I am strict on making sure the ambulance doors stay shut as much as possible no matter the weather. Keeps weather and bugs out of the ambulance. I wouldn't know how the rotor wash affects the interior of the helicopter in a positive way during loading. I do know that in summer here in the South, bringing a patient to a chopper, it's like walking into a giant blow dryer.
I have a few funny stories on ambulance doors. Back in my really early days I had a truck where one of the rear doors would not latch properly. It popped open driving down the freeway. Same company, truck had a cracked manifold and the rear mod stunk of diesel exhaust when I was transporting a patient. I learned my lesson and just refused to drive their garbage.
Nice video Sam, lots of good information shared. This job is definitely not for everyone. I spent close to 30 years in EMS, (3+ years inflight) so I can relate. My advise is take training when you're able and stay proficient! The rest will generally work itself out! Fly Safe!!
I would add a couple other things: even with good fatigue policies as you mentioned, flying does take a toll on the body that I don't get working in ICU. Also, I think there's more of a disruption to your life outside of work: working late because you're on a call, waiting for a new crew for a return trip because your pilots have timed out...or there's a weather delay, etc. That may be fine for some, but something to be aware of as life and circumstances change.
Pro's & con's Sam. after years of medical nursing & rotated into ER. What an eye opener. Sadly the one thing that really bothered me was the level on violence people brought to the house of healing...
Great video. Might add the demanding continuing ed requirements, long and irregular shift schedules, and really awful ergonomics (protect your back and neck, that A-star medic seat is a class action suit waiting to happen!) I flew 7yrs in CO and 2 in Haiti and I was ready to move on. I miss the high performance medicine way more than the flying.
Hi Sam, love the video, biggest concern is forsure sickness for me, however i have never had sickness from an airplane so i’m still keen on trying. Definitely going to check out a helicopter tour, tell them to fly a bit sketchier.
Oh also was there any way you were able to do a video later on , on what you have on your EMERGENCY TO GO BELT. not for the job, as in for the house or self defense, also was wondering what kind of ifak i should invest into for my little belt.
@@levene_c098true, in my country you are at about 20k just for the ppl, then cpl, frozen atpl and most companies require 2000h flight hours which is basically impossible for me as an individual. And our military doesnt have a career path for helicopter pilot so, guess i'll keep dreaming
I flew as a nurse for over 10 years (past tense). Flew in mid Atlantic region in 135 and 145. Both were flying green houses in the summer. The Nomex is soaked in the summer and freezing in the winter. Number 5: 75% of HEMS is logistics, 25% medical. You need to be thinking two or three steps ahead. Fix it before you get into the air.On the ground you have better patient access, the environment is not vibrating, and you have more resources, than you do in a helicopter. Number 6: I have lost people flying HEMS. Those experiences caused me to become more vigilant and be proactive as a crew member, concerning operational safety. We cannot eliminate risk, but we can mitigate it. If you can’t live with that, you should not become a HEMS provider.
Ahh, good old imagetrend elite. We use the same program...Great video. Pretty good summary. I don't think it's possible to overstate the risk involved and the need for safety. I was once told that this is the most dangerous profession per capita, simply because there's so few who do it, yet not a year goes by where there aren't fatalities. Luckily, it seems safety has become more of a priority industry wide and this isn't the wild west anymore.
I am not the guy who was ever bothered by IFTs, and I do have a love for aircraft and aviation. But I know that while maybe I have a CCT cert in my future, that the helicopter is not for me. I prefer my medicine at ground level, tyvm Great video!
Im an up and coming fixed wing pilot but I've always been so fascinated (yet scared/timid) of helis, I love love love what they can do for people, and EMS especially heli ems have been so cool to me.
Great info. I can totally relate. I’m an ER nurse would love to do transportation air or ground. I never thought about it but get car sick and when I jumped in to ambulance 🚑 I thought. “Uh ooo”. I got so car sick in the back. So now I will just stay on the ground.
It’s something I’d kinda wanted to do, but had two things going against me. (1) there isn’t a flight operation near where I live (2) I’m 6’5”, so it would be extra hard to function in that space.
Expounding on your point about IFTs and having to do a shitload of work at the sending facility, folks should understand that the patient has to be stabilized before leaving. More so on international/fixed wing medevac flights because you can't drop the aircraft into a field and get help working a code. And for those long distance flights you have to be confident that you can handle them for up to an hour in your aircraft without moving them until you can find an airport. And there's also the consideration that just because there's an airport you can land at doesn't mean there's a hospital or an ambulance service to help you. Every L35 I've ever flown in had the stretcher against the starboard fuselage, so we have to move everything so it's accessible from the patient's right side, sometimes necessitating a new IV site or adjusting a chest tube. You can held up at the sending facility for days waiting for visas, payment arrangements between the patient and the hospital, or for them to be stable enough for transport. And getting stuck in Winnipeg in the winter for a week because weather won't let you out. So you have to trust your partner and your pilot(s) and be able to set your ego aside and be a team mate. I have rotor and fixed wing time in 5 different countries and I've worked with great people, but there's been some dicks too. You don't have to like them but you do have to get along. Not everyone can do that.
Do some ground CC transport to get an idea of CCT, and do some third rides with a service. That’s what I’ve done as a nurse. Still do ground CCT, same types of patients as aircraft in our area. Did third rides to check out the aircraft and make connections with crews for when I apply.
A good way to recruit, especially for a high-pressure profession, is to try to talk prospects out of joining. I've heard that some air ambulance services won't give the details of a mission until the pilot checks conditions and gives a go/no go call, in order to minimize pressure to launch. Is this standard?
Yes, that’s standard practice. None of us are told what we are being dispatched for until after a go/no-go decision has been made based on weather, fatigue, and aircraft readyness
@@PrepMedic Thanks. As a private citizen who understands that first aid is far more likely to be used than self defense, I really appreciate the information you provide!
There is a huge difference between Colorado and LA - In colorado they let Basic's do IV's and almost everything up to pushing meds - The hard core medics out here like PrepMedic are practically paramilitary verse the "Hollywood" medics in beach cities. Just keep that in mind.
Agreed with the other commenter, speaking from the Colorado perspective this opinion has nothing to do with anything when it comes to flights. Critical care medicine anywhere will always be light-years ahead because the people they are moving are so sick and need specialist hare hundreds of miles away If you disagree, OP, please explain what you mean
About risks... How much is it by numbers? For example, I know that the risk to make MVA (motor vehicle accident) with an ambulance is a tree fold than if I was driving a regular car. Are there any statistics about helicopters?
Good question, maybe an insurance assessor could give you a number. What I can tell you is that life insurance is nearly impossible, damn expensive if you don’t have it and try to get it and mention that you work on an EMS helicopter.
2:20 Wearing a what? When I look up Theraband, all I get are exercise gear. Is he talking about one of those wristband-thingies you see in pharmacies for motion sickness or something?
holy shit maybe it’s cus i haven’t started in the field yet even on the ambulance but IV lines freezing never occurred to me until u mentioned it. it seems like a given but i never thought of it.
I've been binging your video and as an avid motion sickness haver it humbles me that you guys deal with it so much as well. Good thing pianos don't need to be tuned in any helicopters LOL
Idk if you guys do this but VR stuff has urged my motion sickness that I don’t get that much anyways. I use to do a lot of sim racing and I like the graphical quality high that equates to fps drops. And that equates to vomit enduring scenarios. After being in VR for holy deeds of hours every few weeks I can say I “think” it helps train your head to Handel motion sickness.
Curious bc I think this is a neat idea, did you see any change in your motion sickness from before your VR hobby to after in a vehicle of any kind? Or is the only frame of reference your improvement within VR?
3:50 I had to laugh out loud at the "paint the side of the helicopter with vomit" comment. I am someone that loves being on boats and have never gotten seasick or carsick... but I have only been in a helicopter once in my life during my own emergency flight to an upstate hospital for treatment. I don't *think* I would be one to paint the side of a helicopter, but it still made me laugh knowing I could very well be doing that myself.
What about wearing your frozen ice plates under your flight suit? Since your dripping sweat anyways , what’s a little more water adding to a wet flight suit.
Weight is a huge issue. Most companies (depending on airframe) have a max crew weight if 215 lbsWITH gear on. Every pound of extra weight means less weight that a patient can weigh. Aircraft are grounded until weight can be sorted out
would go instead with a cooling vest that you dip in cold water, twist to wring out the water and put on under the flight suit. The gel in the vest stays cold. Tank crew used them for the same reason
It's just not worth it. I was a flight medic briefly. The pay was garbage and you can die by falling uncontrollably out of the sky. Loved the training and the people I worked with. At the end of the day, I'd rather be running calls safely on the ground.
Thank you for all the great information Sam. Do you have any videos or info on tourniquets and trams for children. I’m always trying to up my knowledge and now I gave two small kids 6 and three more specific advice from you would be greatly appreciated. Thanks again for all you do
What blows my mind is we continue private flight EMS when our tax dollars already pay for top-notch flight EMS in the form of the military medivac system. We could integrate military life flight operations into civilian EMS and keep training hours up and whatnot and knock down huge flight EMS costs to the civilian sector who are already paying money into military costs.
It takes 5 hours for the guard to respond in Colorado and they are the only deployable asset in the state. They don’t fly with medics and their mission set is insanely controlled. Also the level of medicine practiced in civilian flight is far above a 68W and requires more repetition then a lot of military personnel see. That’s not to say the military is bad or completely not capable but there is a big disconnect from military medicine and civilian critical care.
The Military approach to combat medicine is battlefield triage based vs. The civilian approach which is deeply connected to liability and litigation. For example, all braches of the DOD are taught TCCC which actually trains you to NOT DO CPR or standard ALS/ACLS because it is a waste of resources in a combat environment because that person will probably be combat ineffective even if you somehow miraculously keep them alive with no defibrillator/monitor/ACLS meds. Your priority is to keep as many guns in the fight as possible NOT necessarilly save lives as soon as possible allthough keeping troops alive is a natural byproduct of fire superiority.
In California, the pay difference between flight and ground medics is like a couple dollars, it’s more dangerous, more training, more responsibility and not worth it. I’ll stay on the ground.
true, although most agencies that I know of wont take you with that weight. 230 is our cap and that includes all your on-body gear, flight suit, boots, helmet and night vision goggles.
Flying is inherently dangerous. I can count maybe a dozen people who I've known or my family has known who have died flying, at least 2 fatal ones in the same type/model I've flown occurring within the last several years. Still feels really distant to me even though I've witnessed a Class A loss of life mishap, and have had flights where I've been extremely, extremely sweaty.
It causes drowsiness, which makes it a no-no. Plus it takes a good 20-30 minutes to become effective, so you’re sick and flying before it has a chance to kick in.
@@PrepMedict least in Europe the paramedic or doctor in the back is classified as a medical crew member and responsible for communicating with the ambulance service on the ground not strictly flight crew it's only the front left seat paramedic or doctor who is classified as a technical crew member and their for subject to meny of the same rules as pilots regarding drugs and alcohol etc another difference between the us and Europe is in Europe we are almost exclusively emergency critical care teams to accidents as most of Europes Air ambulances are charities for critical care medicine rather than transfers except in rare cases like Scotland because it's very rural outside the the central belt
I flew a fixed wing air ambulance for nine years and would like to throw in a bit of the pilot's perspective if I may. 1. In addition to being a nurse, you are part of the FLIGHT CREW! That means you must assist the pilot when he/she needs help. For example, when doing a scene call, you have your head on a swivel looking, watching for obstacles the pilot can't see (especially around the tail rotor). On the ground, if you open an external door, close it and check that it is closed. We had a helicopter badly damaged, and minor crew injuries because one of the nurses left the door to an external storage area ajar. Just after liftoff, the door opened and some of the stored linens flew out fowling the tail rotor. The only good thing is that it happened when the aircraft was only a couple feet off the ground, and the pilot was able to get it back on the ground relatively safely. Had it happened at altitude, the results could have been much different. 2. Trust your captain's judgement. I flew with many NICU nurses who were not flight nurses. We flew to many places that did not have weather reporting or forecasts, so it was the pilot's judgement and experience that he used to decide if the flight could be made legally and safely. Sometimes the answer was "No." Most of the nurses understood, but on more than one occasion, a doctor or nurse would say that if I didn't fly, the kid would die. My response was always the same, "No matter what I do, that kid could die, but if I screw up, I could kill three healthy people." 3. Don't be obese. Every extra pound of weight reduces the aircraft's performance. This is a real problem when the pilot is forced to reduce fuel onboard to balance your fat and keep the aircraft under max weight. Also be strong enough that you and one other person can lift an isolette or 400 lb biker who just lost his leg. I've had nurses drop examples of both of those, 4. This is more of being part of the crew. When you fly on an airliner, there are Flight Attendants. Many people think they are there to serve drinks, but the real reason they are there is to assist passengers during emergencies. Guess what, you are flight attendants now in addition to being nurses. One of my old buddies took off at night in west Texas and launched into a thunderstorm (specifically a microburst). Long story short, they landed gear up about a mile off the end of the runway. A fire started near the right engine, and the pilot ordered the nurses to evacuate.... which they did. Only they left the 140 lb teen boy on the airplane. The pilot, by himself, extracted the patient and got the boy and himself to safety. Those nurses abandoned their patient. I know it sounds like I hated my job and the nurses, but I actually loved the work. It was a handful of individuals who I didn't like. I stayed with the company until a few months before the rotor side was sold off and the fixed wing side slowly pruned away.
Really? In Australia flight paramedics get paid more than RNs. Our Flight Nurses are generally on Flying Doctor (RFDS) fixed wing aircraft, whereas Flight Paramedics are used on ambulance service choppers and fixed wing aircraft. Ambulance aircraft are also generally the back up for road paramedics.
@@southerncalifornia8597 I think the biggest difference is both our paramedics and RNs require a university degree. Many here who do paramedicine also graduate with a Bachelor of Nursing. A Registered Paramedic and a Registered Nurse are on about the same rate, with rate increases for years of service and clinical rank in both professions.
Former US Army Flight Medic (11 years) with MEDEVAC/MAST. We used to call the civillians "Life Frights" due to the poor safety records ..most are single pilot, VFR only. No thanks.
Ironically enough the reason they had such appalling safety records was in-part due to GWOT as the government monopolized the purchasing of things like night vision goggles, terrain avoidance systems and certain navigation systems. Now, thankfully, the safety records are much much better with better equipment and more fatigue rules along with accrediting organizations like CAMTS that mandate things like minimum experience levels.
We do CPR. You just do it from the patients head area 🤷♂️. Not ideal but it works. You don’t get much smaller then an A-Star, what are your people flying that CPR can’t be done?
@PrepMedic they fly Bell 407s from what I can tell, the only reasons I've ever heard is that all that movement in the back causes problems for the pilot controlling the aircraft. Definitely could just be hearsay, I've only been in this field for about a month so I don't have a lot of knowledge about that at all.
@eastonkeeton5370 nah, movement doesn’t effect the pilot like that. They should be able to do CPR if the need arises. It’s not optimal but it sure beats watching someone die infront of you and doing nothing
No. You need to get your paramedic license, then a plethora of other certifications and spend at a minimum 5 years working a busy 911 ground ambulance before you even meet minimum requirements.
Great job explaining, and I have never considered this as a career option. Can i get training for this through the G.I. Bill? The only difficulty I see in the vid is your wrinkled ass ratchet shirt. With love.
You can get your EMT then go to paramedic school. You will need to spend 3-10 years running ground 911 and then get board certified as a flight paramedic.
Just watching now. Medical flyng is a joke now. Hardly any flight people are qualified to work in a hospital, let alone an ambulance. Has been like this for at least a decade. Recently retired 20 yr. Flight medic.
Because I’m SURE they required a minimum of 5 years experience in a busy system, a bachelor’s degree, FP-C, NRP, ACLS, PALS, PHTLS and TPATC when you got hired onto flights.
@PrepMedic it's actually the culture being taught to up and coming clinicians. The standards are in the toilet and the clinicians are more worried about image on social media than actually becoming competent. It's not the multiple cards that make the clinicians. Those are easy to pass now. The FP-C & CFRN used to be a benchmark of where your knowledge base was at. Now you can (15 years now) take a course to pass those benchmarks, without even knowing the material. It used to be a really cool profession. It's not any more. It's now an identity marker.
@@PrepMedic I see some of both sides. I think there’s a lot of turnover and more demand for the flight positions. I know when I switched to flight from ground I was surprised how inexperienced some people were. Like, on orientation if I had a triple pressor patient, it was just business as usual to me. But some of the experienced people precepting me were kind of uncomfortable with it. But they do have to fill those positions, and not everyone is going to get a high level ICU experience prior to it, depending on the area. This is mostly from my RN perspective though. The medics, of which I am also, seem to already be comfortable in the prehospital settings.
@@southerncalifornia8597 I would but im in the uk in the middle of getting my mechanical and electrical engineering degree so I can go to birmingham university in dubai to secure myself a job at the military making night vision
Glorified IFTs is all you are, and you typically run with RNs. So you do nothing but take direction from a higher care provider. Boring. Ground 911 EMS for life, we ain’t posers. 😝
@@PrepMedic aw did I hit a nerve? It was supposed to be a joke, but thanks for demonstrating that you flight guys are all the same. Sensitive and egomaniacal.
Hello, Sam. I am Dr. Felix Porras. I have been a flight surgeon for 28 years and I totally agree with the content of your video. In fact, I would consider flight medicine as the pinnacle not only of prehospital medicine but one of the most challenging of all medical activities.
During critical patient transportation, you have to have the temper to solve difficult situations in a very reduced space with limited resources, with nobody to help you.
You need proper training, experience, and the courage to do it.
I know many brilliant ICU physicians who simply don´t dare to fly with unstable patients.
And yes, the risk is always there.
Many times you know where you take off from, but God knows the conditions of your landing spots.
And the message of the video is true: Flight Medicine is not for everybody, but when you master it is really fascinating.
God bless the journey of all flight medical crews.
Congratulations and thanks for doing so much good for the community.
I have been watching your Channel since before I went to nursing school. I dreamt of being a flight nurse and after 3+ years critical care experience in the ICU got a gig in my home state with a flight program as a flight nurse.Thanks for all the content you make!
Congratulations on achieving one of your dreams! How do you like your job so far?
Massive congrats Naste510!!!! I wish you the best on your journey ✈️✈️
Congrats!
Please make some videos about it
I was waiting for the moment when you say you then realised you were terrified of flying 😅
Accurate assessment! I fly rotor in Alaska and our extreme temperatures and weather are HUGE factors we have to contend with! Frozen IV lines are real, cracked vent tubing etc. Our flight times can be really long. If you like these extremes, we have a full compliment of fixed wing aircraft and are looking for qualified team members!!!
are you with Guardian? I saw their job posting and thought it looked interesting
@@codyw4140 I am with LifeMed Alaska. Both are great companies. Very busy!!!
Could you post a contact please.
Hello sir
How may I get in touch with your agency?
I'm a 40+ year, dual rated pilot, and with the exception of a one year period when I flew EMS, all of my flight time has been in various utility jobs. For me, EMS was just too boring.
As for the air sickness, I've learned a couple tricks. 1. If you feel sick, let the pilot know ASAP so they can fly as smooth as possible. 2. Open a window. Get fresh air on you ASAP, this helps tremendously. 3. Try to look at the horizon, preferably straight ahead. This is also very helpful, and pretty easy in the Eurocopters/Airbuses, but can be impossible in the Bells. In my experience, those 3 things can prevent your sickness from getting worse, and often make it pass completely. There's a rumor that sniffing an isopropyl alcohol patch can alleviate nauseousness too.
And you are 100% correct, it's another whole level of risk, for so many reasons.
Thanks for the video, for informing potential medics of these things, and for all you and other medics do for those in need.
Risk is certainly real. I flew as a flight corpsman with the Marines in 73. I replaced a corpsman that went down in the mountains killing the whole crew at night. New him well.
While I have never flown as a medic, I am strict on making sure the ambulance doors stay shut as much as possible no matter the weather. Keeps weather and bugs out of the ambulance. I wouldn't know how the rotor wash affects the interior of the helicopter in a positive way during loading. I do know that in summer here in the South, bringing a patient to a chopper, it's like walking into a giant blow dryer.
I have a few funny stories on ambulance doors. Back in my really early days I had a truck where one of the rear doors would not latch properly. It popped open driving down the freeway. Same company, truck had a cracked manifold and the rear mod stunk of diesel exhaust when I was transporting a patient. I learned my lesson and just refused to drive their garbage.
Nice video Sam, lots of good information shared. This job is definitely not for everyone. I spent close to 30 years in EMS, (3+ years inflight) so I can relate. My advise is take training when you're able and stay proficient! The rest will generally work itself out! Fly Safe!!
I would add a couple other things: even with good fatigue policies as you mentioned, flying does take a toll on the body that I don't get working in ICU. Also, I think there's more of a disruption to your life outside of work: working late because you're on a call, waiting for a new crew for a return trip because your pilots have timed out...or there's a weather delay, etc. That may be fine for some, but something to be aware of as life and circumstances change.
Pro's & con's Sam. after years of medical nursing & rotated into ER. What an eye opener. Sadly the one thing that really bothered me was the level on violence people brought to the house of healing...
I'm not a pilot or med guy but this was a great video that gave me a lot of interesting perspective. Thank you. Nice work!
Wow. An extremely good perspective of what you do. Thank you!
I’m not a paramedic and I live in Scotland but I love your videos. Nice to just watch and learn.
Thank you for the detailed information. All paramedics and nurses considering a career in aeromedicine should see this video.
Great video. Might add the demanding continuing ed requirements, long and irregular shift schedules, and really awful ergonomics (protect your back and neck, that A-star medic seat is a class action suit waiting to happen!) I flew 7yrs in CO and 2 in Haiti and I was ready to move on. I miss the high performance medicine way more than the flying.
Glad you do what you do. Not many people want to become paramedics due to the requirements of the job.
Hi Sam, love the video, biggest concern is forsure sickness for me, however i have never had sickness from an airplane so i’m still keen on trying. Definitely going to check out a helicopter tour, tell them to fly a bit sketchier.
Oh also was there any way you were able to do a video later on , on what you have on your EMERGENCY TO GO BELT. not for the job, as in for the house or self defense, also was wondering what kind of ifak i should invest into for my little belt.
Me as a helicopter pilot: “Yeah, no. 100% agree not becoming a flight paramedic.”
Sitting here waiting on a call thinking the same thing.
@@Whitie02 Fire season has not been generous this year. Lol
im thinking about learning to fly once i finish nursing school but oh dear god its so expensive just to gain my PPL
@@levene_c098true, in my country you are at about 20k just for the ppl, then cpl, frozen atpl and most companies require 2000h flight hours which is basically impossible for me as an individual. And our military doesnt have a career path for helicopter pilot so, guess i'll keep dreaming
I flew as a nurse for over 10 years (past tense). Flew in mid Atlantic region in 135 and 145. Both were flying green houses in the summer. The Nomex is soaked in the summer and freezing in the winter.
Number 5: 75% of HEMS is logistics, 25% medical. You need to be thinking two or three steps ahead. Fix it before you get into the air.On the ground you have better patient access, the environment is not vibrating, and you have more resources, than you do in a helicopter.
Number 6: I have lost people flying HEMS. Those experiences caused me to become more vigilant and be proactive as a crew member, concerning operational safety. We cannot eliminate risk, but we can mitigate it. If you can’t live with that, you should not become a HEMS provider.
I'm not looking to change careers, but I very much appreciate your insight that I would not otherwise get access to. Thanks.
Ahh, good old imagetrend elite. We use the same program...Great video. Pretty good summary.
I don't think it's possible to overstate the risk involved and the need for safety. I was once told that this is the most dangerous profession per capita, simply because there's so few who do it, yet not a year goes by where there aren't fatalities. Luckily, it seems safety has become more of a priority industry wide and this isn't the wild west anymore.
Been watching you since the Lucas video! Love your work. Keep it up!
I am not the guy who was ever bothered by IFTs, and I do have a love for aircraft and aviation. But I know that while maybe I have a CCT cert in my future, that the helicopter is not for me. I prefer my medicine at ground level, tyvm
Great video!
Did it for 16 years. Back in the ER now but I'll probably return soon.
This was super informative and all your topics were very valid. Thank you for sharing this
Love the video, would like to see a video of flight paramedic reports vs ground medic reports
Im an up and coming fixed wing pilot but I've always been so fascinated (yet scared/timid) of helis, I love love love what they can do for people, and EMS especially heli ems have been so cool to me.
Great info. I can totally relate. I’m an ER nurse would love to do transportation air or ground. I never thought about it but get car sick and when I jumped in to ambulance 🚑 I thought. “Uh ooo”. I got so car sick in the back. So now I will just stay on the ground.
It’s something I’d kinda wanted to do, but had two things going against me. (1) there isn’t a flight operation near where I live (2) I’m 6’5”, so it would be extra hard to function in that space.
Expounding on your point about IFTs and having to do a shitload of work at the sending facility, folks should understand that the patient has to be stabilized before leaving. More so on international/fixed wing medevac flights because you can't drop the aircraft into a field and get help working a code. And for those long distance flights you have to be confident that you can handle them for up to an hour in your aircraft without moving them until you can find an airport. And there's also the consideration that just because there's an airport you can land at doesn't mean there's a hospital or an ambulance service to help you. Every L35 I've ever flown in had the stretcher against the starboard fuselage, so we have to move everything so it's accessible from the patient's right side, sometimes necessitating a new IV site or adjusting a chest tube. You can held up at the sending facility for days waiting for visas, payment arrangements between the patient and the hospital, or for them to be stable enough for transport. And getting stuck in Winnipeg in the winter for a week because weather won't let you out. So you have to trust your partner and your pilot(s) and be able to set your ego aside and be a team mate. I have rotor and fixed wing time in 5 different countries and I've worked with great people, but there's been some dicks too. You don't have to like them but you do have to get along. Not everyone can do that.
As a ex Huey crew chief great information and as always fly safe
Do some ground CC transport to get an idea of CCT, and do some third rides with a service. That’s what I’ve done as a nurse. Still do ground CCT, same types of patients as aircraft in our area. Did third rides to check out the aircraft and make connections with crews for when I apply.
Honestly some of the ground programs I have worked for have higher acuity patients compared to air I do now
A good way to recruit, especially for a high-pressure profession, is to try to talk prospects out of joining.
I've heard that some air ambulance services won't give the details of a mission until the pilot checks conditions and gives a go/no go call, in order to minimize pressure to launch. Is this standard?
Yes, that’s standard practice. None of us are told what we are being dispatched for until after a go/no-go decision has been made based on weather, fatigue, and aircraft readyness
@@PrepMedic Thanks. As a private citizen who understands that first aid is far more likely to be used than self defense, I really appreciate the information you provide!
There is a huge difference between Colorado and LA - In colorado they let Basic's do IV's and almost everything up to pushing meds - The hard core medics out here like PrepMedic are practically paramilitary verse the "Hollywood" medics in beach cities. Just keep that in mind.
What does that have to do with anything?
Agreed with the other commenter, speaking from the Colorado perspective this opinion has nothing to do with anything when it comes to flights. Critical care medicine anywhere will always be light-years ahead because the people they are moving are so sick and need specialist hare hundreds of miles away
If you disagree, OP, please explain what you mean
About risks... How much is it by numbers? For example, I know that the risk to make MVA (motor vehicle accident) with an ambulance is a tree fold than if I was driving a regular car. Are there any statistics about helicopters?
Good question, maybe an insurance assessor could give you a number. What I can tell you is that life insurance is nearly impossible, damn expensive if you don’t have it and try to get it and mention that you work on an EMS helicopter.
2:20 Wearing a what? When I look up Theraband, all I get are exercise gear. Is he talking about one of those wristband-thingies you see in pharmacies for motion sickness or something?
holy shit maybe it’s cus i haven’t started in the field yet even on the ambulance but IV lines freezing never occurred to me until u mentioned it. it seems like a given but i never thought of it.
I've been binging your video and as an avid motion sickness haver it humbles me that you guys deal with it so much as well. Good thing pianos don't need to be tuned in any helicopters LOL
Great video! On reason #6 at 15:32 I feel there is also an amount of risk while riding emergency vehicles on the ground as well, no?
Pretty cool to see videos on this topic my fathers a flight medic for air evac on the strike team for them
Idk if you guys do this but VR stuff has urged my motion sickness that I don’t get that much anyways. I use to do a lot of sim racing and I like the graphical quality high that equates to fps drops. And that equates to vomit enduring scenarios. After being in VR for holy deeds of hours every few weeks I can say I “think” it helps train your head to Handel motion sickness.
Curious bc I think this is a neat idea, did you see any change in your motion sickness from before your VR hobby to after in a vehicle of any kind? Or is the only frame of reference your improvement within VR?
3:50 I had to laugh out loud at the "paint the side of the helicopter with vomit" comment. I am someone that loves being on boats and have never gotten seasick or carsick... but I have only been in a helicopter once in my life during my own emergency flight to an upstate hospital for treatment. I don't *think* I would be one to paint the side of a helicopter, but it still made me laugh knowing I could very well be doing that myself.
What about wearing your frozen ice plates under your flight suit? Since your dripping sweat anyways , what’s a little more water adding to a wet flight suit.
Weight is a huge issue. Most companies (depending on airframe) have a max crew weight if 215 lbsWITH gear on. Every pound of extra weight means less weight that a patient can weigh. Aircraft are grounded until weight can be sorted out
would go instead with a cooling vest that you dip in cold water, twist to wring out the water and put on under the flight suit. The gel in the vest stays cold. Tank crew used them for the same reason
It's just not worth it. I was a flight medic briefly. The pay was garbage and you can die by falling uncontrollably out of the sky. Loved the training and the people I worked with. At the end of the day, I'd rather be running calls safely on the ground.
Thank you for all the great information Sam.
Do you have any videos or info on tourniquets and trams for children. I’m always trying to up my knowledge and now I gave two small kids 6 and three more specific advice from you would be greatly appreciated.
Thanks again for all you do
107° in the aircraft? That’s insane. Why doesn’t it have better AC?
What blows my mind is we continue private flight EMS when our tax dollars already pay for top-notch flight EMS in the form of the military medivac system. We could integrate military life flight operations into civilian EMS and keep training hours up and whatnot and knock down huge flight EMS costs to the civilian sector who are already paying money into military costs.
It takes 5 hours for the guard to respond in Colorado and they are the only deployable asset in the state. They don’t fly with medics and their mission set is insanely controlled. Also the level of medicine practiced in civilian flight is far above a 68W and requires more repetition then a lot of military personnel see. That’s not to say the military is bad or completely not capable but there is a big disconnect from military medicine and civilian critical care.
What blows my mind is paying for an ambulance or air ambulance, in the UK we pay absolutely nothing
@@lorcan1091 you pay for it, just in a different way. Pay for what you use vs. societal obligation.
The Military approach to combat medicine is battlefield triage based vs. The civilian approach which is deeply connected to liability and litigation. For example, all braches of the DOD are taught TCCC which actually trains you to NOT DO CPR or standard ALS/ACLS because it is a waste of resources in a combat environment because that person will probably be combat ineffective even if you somehow miraculously keep them alive with no defibrillator/monitor/ACLS meds. Your priority is to keep as many guns in the fight as possible NOT necessarilly save lives as soon as possible allthough keeping troops alive is a natural byproduct of fire superiority.
3 years already?? Can't believe ive been watching for that long. Keep up the great work on and off the channel and good luck in future plans
Hey Sam can you do a video for additional education for ems, like Tccc, and W-Emt courses ?
In California, the pay difference between flight and ground medics is like a couple dollars, it’s more dangerous, more training, more responsibility and not worth it. I’ll stay on the ground.
I’d add, if your 6’ 4” 225 it’s going to be even more uncomfortable.
true, although most agencies that I know of wont take you with that weight. 230 is our cap and that includes all your on-body gear, flight suit, boots, helmet and night vision goggles.
@@PrepMedicHow many pounds would you say your total gear is?
In speaking of accidents let us not forget the HEMS companies that are using rotorcraft daily that have airframes approaching 50 years old....
Luckily ours is 4 years old
Flying is inherently dangerous. I can count maybe a dozen people who I've known or my family has known who have died flying, at least 2 fatal ones in the same type/model I've flown occurring within the last several years. Still feels really distant to me even though I've witnessed a Class A loss of life mishap, and have had flights where I've been extremely, extremely sweaty.
Am I the only person that can vomit violenty and then get right back to what Im doing?
Great career info. Thanks.
Start as an Army or Navy flight medic
Try a job with Aeromed at Tampa General Hospital
At night I am good with motion sickness but during the day.!! Mid day with late afternoon thunder showers Namibia Africa.. not fun.
Do any of your teammates use Dramamine to help with motion sickness?
Dramamine is not permitted for flight crew.
It causes drowsiness, which makes it a no-no. Plus it takes a good 20-30 minutes to become effective, so you’re sick and flying before it has a chance to kick in.
@@PrepMedict least in Europe the paramedic or doctor in the back is classified as a medical crew member and responsible for communicating with the ambulance service on the ground not strictly flight crew it's only the front left seat paramedic or doctor who is classified as a technical crew member and their for subject to meny of the same rules as pilots regarding drugs and alcohol etc another difference between the us and Europe is in Europe we are almost exclusively emergency critical care teams to accidents as most of Europes Air ambulances are charities for critical care medicine rather than transfers except in rare cases like Scotland because it's very rural outside the the central belt
This is my absolute dream job.
Great advice.
I flew a fixed wing air ambulance for nine years and would like to throw in a bit of the pilot's perspective if I may.
1. In addition to being a nurse, you are part of the FLIGHT CREW! That means you must assist the pilot when he/she needs help. For example, when doing a scene call, you have your head on a swivel looking, watching for obstacles the pilot can't see (especially around the tail rotor). On the ground, if you open an external door, close it and check that it is closed. We had a helicopter badly damaged, and minor crew injuries because one of the nurses left the door to an external storage area ajar. Just after liftoff, the door opened and some of the stored linens flew out fowling the tail rotor. The only good thing is that it happened when the aircraft was only a couple feet off the ground, and the pilot was able to get it back on the ground relatively safely. Had it happened at altitude, the results could have been much different.
2. Trust your captain's judgement. I flew with many NICU nurses who were not flight nurses. We flew to many places that did not have weather reporting or forecasts, so it was the pilot's judgement and experience that he used to decide if the flight could be made legally and safely. Sometimes the answer was "No." Most of the nurses understood, but on more than one occasion, a doctor or nurse would say that if I didn't fly, the kid would die. My response was always the same, "No matter what I do, that kid could die, but if I screw up, I could kill three healthy people."
3. Don't be obese. Every extra pound of weight reduces the aircraft's performance. This is a real problem when the pilot is forced to reduce fuel onboard to balance your fat and keep the aircraft under max weight. Also be strong enough that you and one other person can lift an isolette or 400 lb biker who just lost his leg. I've had nurses drop examples of both of those,
4. This is more of being part of the crew. When you fly on an airliner, there are Flight Attendants. Many people think they are there to serve drinks, but the real reason they are there is to assist passengers during emergencies. Guess what, you are flight attendants now in addition to being nurses. One of my old buddies took off at night in west Texas and launched into a thunderstorm (specifically a microburst). Long story short, they landed gear up about a mile off the end of the runway. A fire started near the right engine, and the pilot ordered the nurses to evacuate.... which they did. Only they left the 140 lb teen boy on the airplane. The pilot, by himself, extracted the patient and got the boy and himself to safety. Those nurses abandoned their patient.
I know it sounds like I hated my job and the nurses, but I actually loved the work. It was a handful of individuals who I didn't like. I stayed with the company until a few months before the rotor side was sold off and the fixed wing side slowly pruned away.
7- Doing the exact same thing as your nurse partner for half the pay!
Really? In Australia flight paramedics get paid more than RNs. Our Flight Nurses are generally on Flying Doctor (RFDS) fixed wing aircraft, whereas Flight Paramedics are used on ambulance service choppers and fixed wing aircraft. Ambulance aircraft are also generally the back up for road paramedics.
@@coover65I am in California. Average RN pay is $45-$50+/HR. Average Paramedic pay $30-$35/HR.
@@southerncalifornia8597 I think the biggest difference is both our paramedics and RNs require a university degree. Many here who do paramedicine also graduate with a Bachelor of Nursing. A Registered Paramedic and a Registered Nurse are on about the same rate, with rate increases for years of service and clinical rank in both professions.
Former US Army Flight Medic (11 years) with MEDEVAC/MAST. We used to call the civillians "Life Frights" due to the poor safety records ..most are single pilot, VFR only. No thanks.
Ironically enough the reason they had such appalling safety records was in-part due to GWOT as the government monopolized the purchasing of things like night vision goggles, terrain avoidance systems and certain navigation systems. Now, thankfully, the safety records are much much better with better equipment and more fatigue rules along with accrediting organizations like CAMTS that mandate things like minimum experience levels.
Would age be a problem? If someone enters EMS/Paramedic at 35-40 years old?
I can’t even ride passenger seat in a vehicle without getting sick. I have to be driving. If I’m driving, I can do anything.
unfortunately you probably wouldnt do well in a helicopter
@@PrepMedic lol I’d never get on one anyway 😂😂
@@PrepMedic god made me 6 foot because that’s as high as he wants me off the ground 😂😂
In Colorado you have to now what you are doing
Love your videos!
Thank you!
What does the fight crew do if a patient codes in-flight? I know for the service around here the birds are to small for compressions of any kind.
They have the pilot climb and descend really quickly to get blood flowing.
We do CPR. You just do it from the patients head area 🤷♂️. Not ideal but it works. You don’t get much smaller then an A-Star, what are your people flying that CPR can’t be done?
@PrepMedic they fly Bell 407s from what I can tell, the only reasons I've ever heard is that all that movement in the back causes problems for the pilot controlling the aircraft.
Definitely could just be hearsay, I've only been in this field for about a month so I don't have a lot of knowledge about that at all.
@eastonkeeton5370 nah, movement doesn’t effect the pilot like that. They should be able to do CPR if the need arises. It’s not optimal but it sure beats watching someone die infront of you and doing nothing
@@PrepMedicthat's what I always thought but I've never been on a bird before.
Cool mustache
@prepmedic Can you jump from EMT Basic to a flight paramedic?
No. You need to get your paramedic license, then a plethora of other certifications and spend at a minimum 5 years working a busy 911 ground ambulance before you even meet minimum requirements.
At 4:52 what kind of medics were they??
They work in Detroit.
@@lorcan1091 do you know what unit they are??
Why I should not be a flight medic? - that's easy to answer: I am scared of heights, can't stand blood and have basically no medical training...
All valid reasons 😂
while they stole from my family?
is/was/will mine
Great job explaining, and I have never considered this as a career option. Can i get training for this through the G.I. Bill? The only difficulty I see in the vid is your wrinkled ass ratchet shirt. With love.
You can get your EMT then go to paramedic school. You will need to spend 3-10 years running ground 911 and then get board certified as a flight paramedic.
Why not just simply store the fuel at the helipad and save the trip and valuable time?
expense, upkeep, refilling it on a roof.....
Living is already a risk.
Just watching now. Medical flyng is a joke now. Hardly any flight people are qualified to work in a hospital, let alone an ambulance. Has been like this for at least a decade.
Recently retired 20 yr. Flight medic.
Because I’m SURE they required a minimum of 5 years experience in a busy system, a bachelor’s degree, FP-C, NRP, ACLS, PALS, PHTLS and TPATC when you got hired onto flights.
@PrepMedic it's actually the culture being taught to up and coming clinicians. The standards are in the toilet and the clinicians are more worried about image on social media than actually becoming competent.
It's not the multiple cards that make the clinicians. Those are easy to pass now. The FP-C & CFRN used to be a benchmark of where your knowledge base was at. Now you can (15 years now) take a course to pass those benchmarks, without even knowing the material. It used to be a really cool profession. It's not any more. It's now an identity marker.
@@kevincollins6302you sir are F.O.S.
@@PrepMedic I see some of both sides. I think there’s a lot of turnover and more demand for the flight positions. I know when I switched to flight from ground I was surprised how inexperienced some people were. Like, on orientation if I had a triple pressor patient, it was just business as usual to me. But some of the experienced people precepting me were kind of uncomfortable with it. But they do have to fill those positions, and not everyone is going to get a high level ICU experience prior to it, depending on the area. This is mostly from my RN perspective though. The medics, of which I am also, seem to already be comfortable in the prehospital settings.
maybe you need to be an accountant.
You missed off not likeing hights, if God wanted me to go that high he would have given me wings, not stick a "glorified fan" on a tin box 😂😂😂
The doctors medic is awsome just sayijg check him out
This indeed is not for me. I wanna make night vision dammit
Buy some. They cost thousands but there is no restriction on buying your own in the USA.
@@southerncalifornia8597 I would but im in the uk in the middle of getting my mechanical and electrical engineering degree so I can go to birmingham university in dubai to secure myself a job at the military making night vision
All those moving parts all made by the lowest bidder.
Goggles just suck!
*Promo sm*
This guy just said they have extreme heat yeah right not in Colorado that’s bs lol
If cabin temps of 114 degrees isn’t extreme I’m not sure what is. Sitting in 100 degrees ambient today soooo 🤷♂️
It gets hot in Colorado In the summer.
Whoo Hoo !!!....the puke blender.....
Glorified IFTs is all you are, and you typically run with RNs. So you do nothing but take direction from a higher care provider. Boring. Ground 911 EMS for life, we ain’t posers. 😝
lol not how it works at all but believe what you want 😂🤷♂️
I know, just wanted to see who I’d bait first! Not surprised it was you! Bahahahahahaha
@michaelfuchs7115 not surprised it was the guy who made the video and gets a notification when there is a comment?
@@PrepMedic aw did I hit a nerve? It was supposed to be a joke, but thanks for demonstrating that you flight guys are all the same. Sensitive and egomaniacal.
@@michaelfuchs7115 bro what 😆
Hey Sam can you do a video for additional education for ems, like Tccc, and W-Emt courses ?