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The California Shock Trauma Air Rescue helicopter ambulance
arrived at the scene minutes after the car crash occurred
on the busy highway.
Bryan Pond, RN, CCRN, CFRN (certified flight registered
nurse), was one of two flight nurses dispatched to the
scene. He watched his partner confer with the firefighters
who had arrived first and were treating the driver.
His partner looked up and sadly shook his head, indicating
the woman had died.
Pond rushed to assist the sole passenger in the crash,
a young boy who had suffered leg injuries. After assessing
the boy's injuries, Pond gently lifted him into the
helicopter to transport him to the closest children's
hospital for further treatment.
"How is she?" the boy asked, looking back
at the woman lying on the ground.
"Please tell me she's all right," the boy
pleaded. "She's my foster mom and she's getting
ready to adopt me. If anything happens to her, it will
hurt much worse than my leg does."
Trained in virtually every emergency protocol and intervention,
Pond, for the first time in his career, found himself
at a loss for words.
The legions of flight nurses that care for patients
thousands of miles above the ground find that each day
brings a unique experience. Trained to think on their
feet, flight nurses are required to have extensive nursing
experience, including prehospital, emergency and intensive
care, as well as extensive training in caring for critically
ill patients in the airborne environment. Most flight
nurses are required to have a minimum of five years
critical care experience, and many retain their jobs
as trauma or emergency room nurses, rotating their work
in the hospital with their work in the air.
Pond has worked at CALSTAR for 3½ years, and
is based in South Lake Tahoe, Calif. A former emergency
room nurse from Texas, he transitioned to flight nursing
hoping to find additional challenges and more autonomy.
"When you're in the air, it's just you and your
nurse colleague caring for the patient," Pond said.
"You need to be motivated and confident in your
skills in order to be a successful flight nurse."
A typical day can yield cases that include ski accidents,
car crashes and treating hikers who have become injured
or lost in the mountains.
For trauma victims, medical treatment within one hour
can mean the difference between life and death. The
first hour after an accident or injury is commonly referred
to as the "Golden Hour," and statistics show
that treating trauma patients during this window of
opportunity can prevent 20 percent to 30 percent of
potential deaths and dramatically reduce hospital stays.
In the nearby mountains, Pond and his co-workers often
are the first emergency response team to arrive on the
scene. Their job is to stabilize and care for patients
while transporting them to either Washoe Medical Center
in Reno or Sutter Medical Center in Roseville, the area's
closest trauma centers.
Pond works 24-hour shifts, two days a week for CALSTAR,
and occasionally works shifts in the emergency department
of a local hospital. In addition, he is required to
do a clinical rotation each year in labor and delivery
and the ICU to keep his clinical skills current.
It's 9 a.m. in Concord, Calif., and Mario Palmieri,
MSN, RN, CFRN, is preparing to start his 24-hour shift
as a flight nurse for REACH Air Medical Services.
Palmieri works two-sometimes three-shifts a week, and
starts work each day never knowing what the day ahead
will hold.
"You have to begin each shift mentally and physically
prepared," he said. "On a typical day, we'll
do three or four flights."
REACH flight staff in Concord respond to 911 calls
in several local counties, handling everything from
shootings and stabbings to auto accidents.
They also conduct hospital transport for adults, pediatric
and neonatal patients.
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