November 20, 2013

Safety first at 30,000 feet or at 60 mph

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UAB’s Critical Care Transport team practices regularly for what they hope never happens … a plane or ambulance crash.

A flight to Miami to pick up a critically ill patient bound for UAB Hospital is fairly routine for Ron Saladin, a pilot with the University of Alabama at Birmingham’s Critical Care Transport (CCT) team, but something has gone wrong today.

“We have a problem,” Saladin calls to the medical team in the back of the Cessna Citation Bravo — UAB’s flying intensive care unit. “I’ll try to make Crystal River Airport.”

Moments later, a chilling update.

“I don’t think we’re going to make it,” he says. “We’re going in about 2 miles west of the airport. We’ll crash-land in the swamp.”

The crew works to don life preservers as smoke begins to fill the dark cabin; but the smoke is coming from a theatrical fog machine, and the plane is not dropping through the sky somewhere off Crystal River. It is sitting in its hangar at the Birmingham-Shuttlesworth International Airport.

This is a drill.

“All of our team members are required to go through a safety drill at least once a year,” said Laura Lee Demmons, R.N., director of UAB CCT. “It’s fun, hands-on, practical training that we hope they will never need.”

The Oct. 30 drill reminded the team members — ICU nurses, respiratory therapists, nurse practitioners and physicians — about safety procedures in the event something goes wrong on a flight.

“Safety is one of the top things we focus on with our team members,” said Kevin Barlotta, M.D., the CCT medical director. “We do these drills to be sure that everyone is familiar with the emergency procedures.”

Team members get a refresher with on-board equipment that is needed infrequently and review the contents of the plane’s survival kit. They practice communication and teamwork skills.

In addition to the aircraft, UAB CCT has three ground vehicles — rolling intensive care units. Team members also review procedures for locating emergency gear and evacuating the vehicles in the event of a crash. They even put out a small fire.

“The premise is that, if you practice a skill, it’s a lot easier to perform that skill when a real emergency comes along,” said Demmons.

For new team member Wynn Glass, the training is invaluable.

“Especially to those of us who are new,” said Glass, a respiratory therapist who has not yet taken her first flight. “We don’t know what to expect, so getting in the plane, being engulfed in smoke and learning where we need to be is important.”

Saladin, a veteran pilot with Lifeguard Ambulance Service, which contracts with UAB CCT, stressed to the team that experience and familiarity with their surroundings is key.

“He reminded us that, yes, it’s an emergency situation, but we shouldn’t panic,” said Glass. “The more you can practice that and have hands-on experience, the better.”

“We’re a patient-care-oriented service, so that’s always priority No. 1,” said Barlotta. “But I think inherent to being able to meet that mission is always to make sure that we are being safe ourselves. We take a lot of care to ensure that, when we do deploy our team, we do so in the best way possible for our patient and for our service.”

Each new team member, like Glass, gets one other unique experience. While reviewing survival gear and techniques, each participant is encouraged to eat a cricket. If one is stranded in a remote corner of the world while awaiting rescue, insects might be the only easily obtainable food source. It is just one more skill to practice, and team members get a T-shirt if they join “the cricket club.”

“Cricket-eating is optional, but you’d be surprised what people will do for a T-shirt,” Demmons said. “I have done it, and my cricket was a lot bigger than the ones you see here today,” she said with a laugh.

Glass was game to give it a try.

“The cricket was awesome,” she said. “It was very earthy, actually. It had a pretty decent taste to it. I was pleasantly surprised.”