Life-Saving Research in the Sky November 8, 2007

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Almost everyone in Central Texas has spotted the distinctive yellow and blue Austin-Travis County EMS STAR Flight helicopter ambulance headed for the region's only adult and pediatric Trauma Centers at Brackenridge Hospital or Dell Children's Medical Center of Central Texas. The patients aboard may need life support following critical injuries or illness. Care in the air often includes giving medication, blood or volume expanding fluids to prevent life-threatening drops in blood pressure during the transfer to the hospital. But sometimes medical personnel have challenges getting IVs started.

STAR Flight and Seton Family of Hospitals facilities constantly work together to save lives. The Seton physicians speculated that patients would arrive at the Trauma centers in better condition if more IVs were successful. Now they are collaborating with STAR Flight personnel on a new study looking at the benefit of using an ultrasound machine to place IVs in patients during air medical transports. The study is the first of its kind and the only one underway in the country.

Improving 'Difficult Sticks'

Researchers are examining whether a portable Sonosite ultrasound machine makes it easier Austin-Travis County STAR Flight paramedics and nurses to place IVs successfully in very sick patients who are considered "difficult sticks" or are in shock.

"Getting IVs is a fundamental part of caring for patients. Often an IV can mean the difference between life and death. When patients come through the door of the Emergency Department, we are providing rapid treatment to stabilize them, but being able to do IVs during transport could make a huge difference and that's what we are looking at," says Patrick J. Crocker, DO, Principal Investigator of this study and Medical Chief of Staff at Dell Children's.

"Without good access to a vein, patients can't get large amounts of fluid, drugs or blood into their system. The only current option for patients when Austin-Travis County STAR Flight paramedics and nurses can't get an IV is using a needle that can be drilled into a bone. It works well for administration of drugs, but is not optimal for volume fluid administration," observes Howard Polden, Flight Nurse, Austin-Travis County EMS STAR Flight."

Many patients are considered 'difficult sticks' because of several conditions including obesity, shock and chronically illness. Using an ultrasound allows flight paramedics and nurses to 'see' through the skin and find deeper veins they might not be able to feel or see otherwise. They can then guide the catheter with the ultrasound into the vein so life-saving drugs and fluids can be administered.

"The procedure is fairly new. There are a handful of studies showing nurses and doctors are more successful in getting IVs using this technology in the Emergency Department," said Dr. TJ Milling, Emergency Services, Brackenridge Hospital. "We have been using it at Brackenridge for more than a year, but the idea to use it on the helicopter ambulance hasn't been studied before."

"Austin- Travis County EMS STAR Flight and Seton are proud to be on the forefront of technology and patient care during transport. Much of the innovative technology they use in their ambulances starts in STAR Flight pilot programs," said Dr. James Kempema, Associate Medical Director of Austin-Travis County EMS STAR Flight and Emergency Services at Brackenridge Hospital. "We're excited to be leaders in the field of emergency air transport with this first-of-its-kind study."

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