"We Haven’t Seen Anything on This Scale"

Halldale Group Editor Marty Kauchak interviewed Cameron Curtis, CMM, CAE, President & CEO of Association of Air Medical Services & Medevac Foundation International, and Deborah Boudreaux, AAMS Board Chair, Chair and Director of Teddy Bear Transport, Cook Children's Medical Center in Fort Worth, Texas.

“This has been a team effort of the crews helping the pilots.” - Cameron Curtis (center) with Nathan Morreale (right) MBA, FP-C, NR-P, Chief Flight Paramedic, AirMed, University of Utah, and Trevor Ericksen (left), Metro Aviation pilot, assigned to AirMed, University of Utah. Image credit: AAMS.

CAT: Tell us how AAMS has been on thefrontline in the fight against Covid-19.

Cameron Curtis (CC): When Covid-19 first hit, we allunderestimated the impact of the pandemic. As an association, we have beenconducting weekly virtual town hall webinars, for anyone who wants to join, withsubject matter experts on topics from pilot safety to operational transportimpact. The initial town halls covered front-line response: a lack of personalprotective equipment (PPE) and other resources, how to keep pilots and crewssafe, and evolving practices as we learned more about the virus. Although ourmembers are trained to fly regardless of the situation, including infectiousdiseases – we haven’t seen anything on this scale.

CAT: Can you share any metrics on the numberof missions and such your members have completed during the pandemic?

CC: We have seen a 40% drop in volume, dueto the stay-at-home orders, as more people stay off the roads and away fromactivities that require emergency care. Hospitals are also showing a decreasein volume because people are afraid to go to these facilities – the emergencyroom, the doctor – when they are sick, for fear of Covid-19 exposure.

CAT: That 40% drop is a bit of a surprise. Ithought perhaps the number of C-19 related missions would have increased yourtotal flight numbers.

Deborah Boudreaux (DB): If you look at a hospital-basedprogram, and specifically, in a pediatric facility, we have a seen a drasticdrop in emergency room patients. Before the pandemic, typical ER admittance was350 children a day – now we’re seeing on average 120 a day. Hospitals haveprepared for this. We are trained to care for the sickest patients every day andprepare for situations like Covid-19 in simulation labs and annual competencies.We have the appropriate PPE and know how to use it. There was a global PPEshortage in the beginning, but we are now well prepared to care for allpatients.

CAT: Beyond the hospital teams justmentioned, air medical providers are also trained to respond to major events.

CC: Yes, air medical crews have beentrained to treat people with respiratory disorders and other emergencies.

CAT: From the perspective of the air crews,were this community’s previous exercises and other training events andinstruction adequate to meet the challenges of C-19?

CC: In most cases, our medical crews aretrained to remain calm and provide the critical care required based on thesituation. They are trained to avoid touching their face and wear theappropriate protective gear. Where we have seen some additional training iswith the pilot community. They are in the front of the aircraft and aren’tmedical professionals – what is second nature for the medical crew may not befor the pilots. In this case, the pilots are receiving additional training onPPE use and maintaining appropriate distance from a patient. This has been ateam effort of the crews helping the pilots. Their primary goal is to keep thecrew and the patient safe.

CAT: Is the community preparing C-19 lessons-learnedfor future training events and exercises, as well as classroom instruction?

CC: Yes, we plan to provide education on pandemicpreparedness at this November’s Air Medical Transport Conference https://aams.org/events/amtc/. We have a Safety Management Training Academyscheduled for late July and a Medical Transport Leadership Institute for lateAugust. We also have a Safety Committee, and once the response to the pandemichas settled, I’d like them to focus on guidelines and best practices forpandemic and emergency preparedness, beyond normal readiness. Our people arevery prepared for something like this. My goal is to provide white papers,standards, guidelines, and other resources in one place to be shared within thecritical care transport community.

DB: This is a part of the training for firstresponders – EMTs, paramedics, firefighters, nurses – we all take courses andthis is part of the curriculum. That may become more stringent but they are allwell prepared to deal with these cases. There will be benchmarking andevidence-based practices to guide us as we go forward. As an overallassociation and industry, we have done a very good job.

CAT: Are there supply and demand challengesin the air medical services community, much like we observe at the airlines andother civilian aviation organizations?

CC: There are shortages, but our crews haveadapted and created safe solutions for reusing PPE such as N95 masks.

CAT: And after the pandemic, in the nextseveral years, do you see your organizations having a shortage of fixed-wingand rotary aircraft pilots?

CC: That is very interesting. We had atownhall meeting on April 28 on pilot safety during Covid-19 and many of thesesame questions came up. No, we’re not seeing that on the scale the commercial airlineswere experiencing prior to the pandemic. If we do have a shortage, it would beour providers’ ability to get pilots to rural bases where the staff are flownin and out based on need.

CAT: Anything else to add?

CC:  Yes.In my leadership capacity at the Association of Air Medical Services &Medevac Foundation International, one concern is a high rate of substanceabuse, suicide, and PTSD that we see in the critical care transport industry,even prior to Covid-19. Our crews are trained to treat situations that wouldseem unimaginable to the public. This also includes pilots.

The MedEvac Foundationwill launch a wellness series in May as part of our Taking Care of Our Owninitiative. This initiative started last year with in-person events, but we’veadapted to virtual events during the pandemic. It’s an opportunity forindividuals who feel that despair to interact with other people who share thatexperience and have tools and solutions to help.

CAT: Of interest to your organizations may be the editorial content CAT has published on the  wellness topic and its inclusion on the agenda at an earlier  WATS conference.

FOR MORE on the aviation training community’s response to the pandemic, read Marty Kauchak’s features in the  new issue of CAT:

“… our members are trained to fly regardless of the situation, including infectious diseases …” - Cameron Curtis. Image credit: AAMS.

“There will be benchmarking and evidence-based practices to guide us as we go forward.” - Deborah Boudreaux. Image credit: Teddy Bear Transport, Cook Children's Medical Center