Forum
2007; Elsevier BV; Volume: 26; Issue: 1 Linguagem: Inglês
10.1016/j.amj.2006.11.001
ISSN1532-6497
AutoresAnthony Pellicone, Gary Sizemore, Edward R. Eroe, Michael W. Brunko, Denise Treadwell,
ResumoIAFPLooking back, looking forwardIt is close to the end of another year as I write this, and I would like to acknowledge the events and accomplishments that have occurred this past year, as well as celebrate the upcoming year. AMTC in Phoenix was another spectacular event, drawing over 2,500 EMS and critical care professionals from around the world.2006 was a very exciting year for the International Association of Flight Paramedics, celebrating 20 years of representing the paramedic profession and critical care transport. As we celebrate this milestone, we look forward to not only the upcoming year but the following 20! In celebration of the 20th anniversary, the IAFP instituted the First Annual Leadership Precon at this year's AMTC. This interactive seminar was a tremendous success, offering members and all AMTC attendees an opportunity to share experiences and become enlightened by dynamic speaker, Kathy Gallo, chief learning officer for the North Shore-Long Island Jewish Health System, and by some of the top leaders in our industry. Plans are now underway for next year's Leadership Seminar.Since 1986, technology and communication have come a long way, especially the computer age and the advent of the Internet. No matter how big the world may really be, the Internet can shrink it down to a 20-inch screen. Like everything else, we adapt to change and anticipate outcomes for the future, so we have decided to roll out an entirely new website, www.flightparamedic.org. The new site will be informative, organized, and easy to navigate. We encourage each of you to visit the site and mark it as a favorite in your browser. We will use this new site as a catalyst for all communication to you, the members, and the industry. This is very exciting, and we ask for feedback after you visit.In addition to making the world an easier place to navigate with the new website, we have gone international! We are proud to announce our first international chapter in Germany. We welcome them and encourage all fellow EMS personnel across the globe to unite and join.In addition to the international chapter, we are encouraging the development of state chapters. This is a simple but responsible operation that integrates the representation and mission of the IAFP all the way down to the local level. We ask for representation at this level from state delegates. If you are interested in becoming a state delegate, please contact an IAFP board member. This is yet anther way to have a say in the direction of our profession and see the results in your state and across the nation.The state delegates and chapters work closely with another division of the association, the Government and Legislative Affairs Committee. This newly formed committee has individuals who work with other organizations and represent our profession across the country. These groups keep their fingers on the pulse of paramedicine across the nation and can work as a collective group to pass information to the membership and to government organizations and representatives.As progress and change for the future continues, the IAFP board of directors voted to restructure the IAFP board to a business model. Board positions and responsibilities with various committees and liaison positions will each be under an executive board member. Additionally, we have included a strong medical advisory team. We are very proud to have the medical direction support of Drs. Terri Hoffman and David Stuhlmiller. We are very excited to have dedicated individuals who will help us with dynamic and progressive ideas and support.Education is the foundation to all aspects of our profession. We need to continue growing and learning to ensure that our patients will get the care they need and deserve, as well as to keep us informed of current standards. Many paramedics do not have the funds or the time to attend continuing medical education (CME) on a regular basis. Some may have CME offerings twice a year, during their off shift, or in a neighboring state. We understand and have found a simple cost-effective way for each of you to stay current, get your CMEs, and pick the subjects you need, all from your home or work computer through CentreLearn, an IAFP member service. The Leadership Precon and other educational courses will be accessible through the IAFP website.I am very excited on the progress we have made as an industry, a profession, and especially as an association over the past 20 years. I am proud to be surrounded by such energetic individuals who dedicate so much of their time to their career. I ask each of you to celebrate these accomplishments and continue to support your profession.Be safe.Anthony J. Pellicone, PresidentNEMSPAPassing the baton and running the raceIt's hard to believe another year has passed. It seems only yesterday we were in Austin, Cincinnati, Reno, and Kansas City—a sharp contrast to when we were young and it seemed to take forever for a birthday to get here. Our years are now spent busy at work, flying, and taking care of the people who place their trust in us to make their day better.At this time of year you hear things like, “The torch has been passed” and “New blood has taken over.” One of the few things that remain constant is that change will occur. While it is true that a change has occurred, I choose not to look at it as a torch being passed as I begin my tenure as president of NEMSPA, and I look forward to serving the pilots flying EMS aircraft for the next 2 years. My opinion is not that a torch has been passed, but rather a baton. NEMSPA has been extremely active for the past few years, and it will continue to be active for years to come. NEMSPA is in the race for the long run, not just for a dash or sprint. While we may not have the endurance to run the entire race, the race must be completed. For that reason I think a baton is more applicable than a torch. We are running a relay race, and many will carry the baton before we are finished. I am proud to be the one carrying the baton during this leg of the race.I look at the race NEMSPA is running as a relay race because we have been working together for a long time to address the concerns of EMS pilots. We continue to work together and help each other finish the more difficult legs of the race. We have a long history in the field of aviation and of EMS aviation, and this solid base makes us a source of valuable information. That source of information has been sought out and will continue to be sought for insight and solutions to problems that arise. Only true teamwork will allow us to be a true source of solutions to these problems.If you visited the NEMSPA booth at AMTC Phoenix, you noticed a new booth with a new theme. The pictorial history that adorns our booth projects the rich heritage of EMS aviation. From the Korean War-era pictures through Viet Nam “Hueys” and into the aircraft of today, it is obvious the race has taken us a great distance. As we looked at the pictures, many of us remembered fondly the time spent in those aircraft and the people we spent that time with.Many of the people present in the booth are familiar. Those people are still helping run the race. Not much more is evident of change, but we are constantly looking for new members and new runners to carry the baton. I strongly urge each and every pilot to join and take a leg in the race all of us run, member or not. I request your assistance in improving not only the organization but also the profession as a whole.Another change you may have noticed is the NEMSPA website. A great deal of improvement has occurred there, and we are dedicated to make it a top-notch, useable, and informative site. If you haven't visited lately, please take a look. If it doesn't serve your needs, please let us know so we can continue to improve that service.There are many issues that affect the way we complete our jobs, and these become the topic of the day for many of us. We are deeply involved in an era of change. As I mentioned earlier, change is a constant. I urge you when you look at the changes, look not only at the problems they cause but how they affect the EMS aviation community. If there is a problem, what needs to be done about it, and how does it need to be done?If you have input, please let the board of directors of NEMSPA know, and the full board will address the issue. If you really want to be involved, consider the possibility of seeking a position on the board of directors. Your involvement may be the positive change we need in the community.I eagerly accept the baton and will carry it to the best of my abilities, but I also know I have a terrific team to count on when the course gets tough. From the outside a change in leadership may be evident as I assume the duties of president; however, inside the team will continue to work together for each and every pilot flying EMS aircraft. Our mission, goals, and thrusts are the same. Our dedication is unwavering. We will be doing our best to serve you and welcome any opportunity to meet and talk about issues you feel are important and need our attention. I look forward to working for each of youGary Sizemore, PresidentAAMSAAMS presidencyIt is a pleasure again to be serving as the AAMS president for the upcoming year. While I joke that this position seems to add another full-time job to my busy schedule, it is also a very exciting job, and I enjoy working with everyone in our community. There continues to be a lot that needs to be done during these ever changing times, and we will need everyone, including the other associations, air operators, vendors, our board, and especially our great staff to accomplish everything. Thanks for entrusting me with the leadership of AAMS for another year!AMTC phoenixWow, the Air Medical Transport Conference in Phoenix this past September 25-27 was another huge success. Those who did not make it really missed out on another dynamic learning and networking opportunity, so plan on coming to Tampa in 2007! Although the staff is still finishing up the final attendance count for Phoenix, the official count as of this writing is 2,541, which makes the conference the second all time highest, with 2005 being the first at a little more than 2,600. For the Exhibit Hall, however, we had the highest number of exhibitors ever with 368 10'x10' booths and 142 exhibiting companies! We had 322 and 132, respectively, in 2005, so big thanks to all the exhibitors and especially to Blair Beggan for coordinating and recruiting! AMTC of course would not be possible with the great overall support from our sponsors and all the attendees.FAA operational control rule change & DOT economic authorityAs a follow up to the August 29, 2006, meeting in Alexandria, Virginia, the FAA held another meeting to a packed audience at the AMTC on September 25 to discuss the proposed changes to OpSpec A008 and how they effect air medical operations. Like the August meeting, the FAA is very concerned about the possible transfer of any element of operational control to a non-certificated person or entity by any Part 135 certificate holder. Included in their concern are program websites, PR materials, contracts between a Part 135 certificate holder and other entities that might impact operational control, communication/dispatching centers, billing operations, and any aspect of how a program holds itself out to the public. AAMS wrote a letter to the FAA stating our concerns, which can be found on the AAMS website under Member Services and then Government Affairs. Much thanks to the AAMS Government Relations Committee and especially Tom Judge, Dawn Mancuso, and Chris Eastlee in drafting our official response.I recently had the opportunity to meet with members of the Department of Transportation (DOT). The DOT has been focusing on how non-Part 135 certificate holders present themselves to the public on their website(s). In these instances, the DOT is responsible for making sure all air carriers are complying with the principles of economic authority. This issue of economic authority is different from the FAA's operational control issue noted above. During the meeting I reiterated the AAMS position that we outlined to the FAA in our letter and again asked that there be a meeting of the DOT, FAA, and our air medical community to help us craft some compliance guidelines for programs and operators. I know from the guidance we are providing to our MedServ Air Medical Transport programs, it is confusing, to say the least.On October 26, 2006, the FAA held another follow-up meeting in Washington, DC, and it appears they have listened to some of our concerns. See the AAMS website for more information, but the good thing is that the implementation of changes to OpSpec A008 was delayed until the end of November 2006 and enforcement will not start until April 2007.Get involved in your communityAAMS, in collaboration with all the associations in the critical care transport community, continues to add value to your individual programs. Be a part of things as we are always looking for volunteers for committees. Contact Dawn Mancuso at the AAMS office; we need your expertise and assistance.Thank you and remember Vision Zero!Edward R. Eroe, PresidentAMPAAMPA's new leadershipIt does not seem long ago that most of us were experiencing the 100-degree temperatures in Phoenix at another great AMTC meeting…until I look outside at my home west of Denver and see the 20+ inches of new snow we just received. Some changes can creep up on you quickly and force you to recognize where you have been and what may be in store for your near future.I am honored to now be the president of AMPA. I also would like to introduce some new faces to AMPA's leadership: Jack Davidoff, MD, medical director of Mercy Flight Central in Canandaigua, New York, and past board member of AMPA, is the new president-elect. P.S. Martin, MD, of LifeFlight in Pittsburgh takes over as secretary/treasurer. I am also happy to introduce three new board members: Steven Andrews, MD, of Flight for Life, Milwaukee; William Hinckley, MD, of University Air Care at the University of Cincinnati Medical Center; and John Pakiela, DO, of Cleveland Metro Life Flight.Ken Robinson, MD, program and medical director of Hartford LIFESTAR and past president, and Laurie Romig MD, executive medical director of LifeNet Florida and past secretary-treasurer, will be sorely missed as they have completed their dedicated terms of service. Ken and Laurie both contributed above and beyond their requested duties during their leadership terms with AMPA. I personally want to thank them both for all they have done for AMPA and its membership.Reed Brozen, MD, of DHART in New Hampshire, Kevin Hutton, MD, of Golden Hour Data Systems, and Eric Swanson, MD, of University of Utah AirMed will continue to serve as returning board members, as well as Eytan Ish Tov, MD, of AirMed in Israel as the AMPA international board member.A positive change after the 2006 AMTC meeting is that AMPA's membership is growing. We now have 400 members—330 US members, 56 foreign members, and 14 Canadian members. If you are not a member and are considering it, read on and maybe you will reconsider.At the 2006 AMTC in Phoenix, two physicians were recognized by AMPA during our annual award presentations. Cathy Carruba, MD, medical director of Tampa General Hospital Aeromedical Transport, was named the 2006 Distinguished Physician by the AMPA board. Cathy was well deserving of this award, in view of her past service to AMPA as a founding member, past president of AMPA, and continued involvement in leadership of AMPA's and AAMS's education goals. Chuck Sheppard, MD, medical director of St. John's Lifeline Air Medical Service in Springfield, MO, was recognized as the 2006 Medical Director of the Year. This is a prestigious award that is given to an AMPA member after nomination by the member's own program's crew and administration. For those who know Chuck, he is well deserving of this award.The 2006 AMTC was also the official unveiling of AMPA's updated edition of its textbook, Principles and Direction of Air Medical Transport. This text is a compilation of the work of many authors and experts on numerous topics that should be of great value to any individual who has involvement in critical care transport—from medical direction to being a student interested in the area. The text is available in CD form and soft-bound copy and can be purchased from the AMPA.org website. As an AMPA member, you receive a copy of the CD as part of your membership benefits. (This is when you should reconsider becoming an AMPA member.) The text can be purchased, at a discounted rate, if you are a member. I personally feel that this resource should be readily available for access and use by every member of a transport program. All of the editors, especially Ira Blumen, deserve accolades for the final product that came together in this text.Finally, I would like to mention that the 2007 CCTMC meeting will be held in San Antonio, Texas, at the Sheraton Gunter Hotel from April 2-4, 2007. The planning and selection of courses and topics is in place, and the meeting should be a great opportunity to catch up on clinical and leadership issues in the critical care transport environment. Keep your eyes open for the brochures that will be arriving soon, and if you are unable to attend, please pass them on to members of your program who may have interest.Michael W. Brunko, PresidentASTNAPreventing talent dilutionAccording to the Association of Air Medical Services, since 2001 the number of medical helicopters has doubled. The number of air transport programs has risen to more than 2000.The typical medical transport team consists of a registered nurse, paramedic, and flight crew. Some programs may modify this approach by adding supplemental staff to their medical crew configuration to fit their missions, using teams comprising nurses and respiratory therapists with the occasional addition of physicians. Historically, the nursing positions have been regarded as an elite opportunity, held out to only the most seasoned professionals.We are experiencing a nursing shortage across the entire health care milieu; this is well known to both health care workers and the lay public. According to the Bureau of Labor Statistics, this is the third nursing shortage cycle in the past 50 years.1Bureau of Labor Statistics, U.S. Department of Labor Occupational Outlook Handbook, 2006-07 Edition, Registered Nurses.Available at: www.bls.gov/oco/ocos083.htmGoogle Scholar This cycle is plagued with several complex factors that were not witnessed with the previous two shortages. The Bureau reports that registered nurses are considered the largest health care discipline, with over 2.4 million nurses in the workforce in 2004 and anticipated employment growth increasing faster than the average occupation through 2014.1Bureau of Labor Statistics, U.S. Department of Labor Occupational Outlook Handbook, 2006-07 Edition, Registered Nurses.Available at: www.bls.gov/oco/ocos083.htmGoogle Scholar The reasons cited for this growth include technological advances in patient care and the increase in our aged population, which also impacts the workforce itself by creating a need to replace experienced nurses who leave the occupation by retiring.Further evaluation of these factors is as follows. The technological advances impact the demand for more experienced nurses by allowing us to treat medical problems once considered unmanageable or untreatable and escalating the ever-growing prominence of preventive care. Traditionally, health care reports reflect that older populations are more likely to need professional care than younger people. According to the U.S. Census Bureau, the population of individuals over the age generally recognized as “retirement age,” 65, has greatly exceeded the growth rate of the population of the country as a whole, increasing from 3 million in 1900 to 33 million in 1994, a ratio of 1 in 8 Americans.2Hobbs FB The Elderly Population. 2001 January 18.Available at: www.census.gov/population/www/pop-profile/elderpop.htmlGoogle Scholar Attributed to the aging Baby Boomers, by these reports, approximately 1 in 5 Americans will be within this age group by 2030.2Hobbs FB The Elderly Population. 2001 January 18.Available at: www.census.gov/population/www/pop-profile/elderpop.htmlGoogle Scholar Compounding these statistics, while enrollment in nursing programs at all levels have increased more rapidly over the past 2 years, many qualified applicants are being denied entry due to the shortage of nursing faculty.Predictably, these shortages will result in more overtime, night and weekend shifts, and work demands, i.e. doing more with less. The intensity of the nurse's skill level will increase to compensate for the increased number of seriously ill and injured patients for which they are expected to care. We have already witnessed how this results in burnout and premature departure of nurses from the critical care units and emergency departments, the very place from which the typical transport nurse evolves. With the nursing shortage and the growing number of air ambulance programs, what challenges will programs face to recruit and retain competent transport nurses?ASTNA recognizes the value of these experiences as the foundation for transport nurse qualifications and affirms that the minimum qualifications for the transport nurse should be 2 years of critical care and/or emergency department experience in our “Qualifications, Orientation, Competencies, and Continuing Education for Transport Nurses” position paper. This paper expounds on the need for continued education and advanced training to provide skills, knowledge, and expertise that might not have been attained from those clinical work experiences, including those needed to complete certification commensurate with transport nursing and advanced skill-set training as provided by advanced trauma courses.ASTNA is committed to meeting the demands of the current workforce and minimizing the talent dilution that our profession may experience with the present nursing shortage and the predicted deterioration of the experienced workforce by expanding the provision of the Transport Nurse Advanced Trauma Course to more locations with increased frequency. ASTNA also promotes professional development for all transport nurses by offering more review courses this year for nurses preparing for the Certified Flight Registered Nurse (CFRN) and Certified Transport Registered Nurse (CTRN) exams. Additionally, we have negotiated special discounts for all ASTNA members taking the exams, and persons achieving this certification are recognized nationally on the BCEN website at www.ena.org/bcen.New this year, ASTNA is offering a competency-based orientation curriculum for programs to use to prepare new transport nurses for positions within their organization. The program outlines the entire orientation process and provides a template for transport nursing orientation.And finally, ASTNA membership is your link to an expanded network of colleagues, contacts, education, and advocacy of professional issues. ASTNA is your professional organization, and together we are the unified voice of transport nurses around the globe.Denise Treadwell, President IAFPLooking back, looking forwardIt is close to the end of another year as I write this, and I would like to acknowledge the events and accomplishments that have occurred this past year, as well as celebrate the upcoming year. AMTC in Phoenix was another spectacular event, drawing over 2,500 EMS and critical care professionals from around the world.2006 was a very exciting year for the International Association of Flight Paramedics, celebrating 20 years of representing the paramedic profession and critical care transport. As we celebrate this milestone, we look forward to not only the upcoming year but the following 20! In celebration of the 20th anniversary, the IAFP instituted the First Annual Leadership Precon at this year's AMTC. This interactive seminar was a tremendous success, offering members and all AMTC attendees an opportunity to share experiences and become enlightened by dynamic speaker, Kathy Gallo, chief learning officer for the North Shore-Long Island Jewish Health System, and by some of the top leaders in our industry. Plans are now underway for next year's Leadership Seminar.Since 1986, technology and communication have come a long way, especially the computer age and the advent of the Internet. No matter how big the world may really be, the Internet can shrink it down to a 20-inch screen. Like everything else, we adapt to change and anticipate outcomes for the future, so we have decided to roll out an entirely new website, www.flightparamedic.org. The new site will be informative, organized, and easy to navigate. We encourage each of you to visit the site and mark it as a favorite in your browser. We will use this new site as a catalyst for all communication to you, the members, and the industry. This is very exciting, and we ask for feedback after you visit.In addition to making the world an easier place to navigate with the new website, we have gone international! We are proud to announce our first international chapter in Germany. We welcome them and encourage all fellow EMS personnel across the globe to unite and join.In addition to the international chapter, we are encouraging the development of state chapters. This is a simple but responsible operation that integrates the representation and mission of the IAFP all the way down to the local level. We ask for representation at this level from state delegates. If you are interested in becoming a state delegate, please contact an IAFP board member. This is yet anther way to have a say in the direction of our profession and see the results in your state and across the nation.The state delegates and chapters work closely with another division of the association, the Government and Legislative Affairs Committee. This newly formed committee has individuals who work with other organizations and represent our profession across the country. These groups keep their fingers on the pulse of paramedicine across the nation and can work as a collective group to pass information to the membership and to government organizations and representatives.As progress and change for the future continues, the IAFP board of directors voted to restructure the IAFP board to a business model. Board positions and responsibilities with various committees and liaison positions will each be under an executive board member. Additionally, we have included a strong medical advisory team. We are very proud to have the medical direction support of Drs. Terri Hoffman and David Stuhlmiller. We are very excited to have dedicated individuals who will help us with dynamic and progressive ideas and support.Education is the foundation to all aspects of our profession. We need to continue growing and learning to ensure that our patients will get the care they need and deserve, as well as to keep us informed of current standards. Many paramedics do not have the funds or the time to attend continuing medical education (CME) on a regular basis. Some may have CME offerings twice a year, during their off shift, or in a neighboring state. We understand and have found a simple cost-effective way for each of you to stay current, get your CMEs, and pick the subjects you need, all from your home or work computer through CentreLearn, an IAFP member service. The Leadership Precon and other educational courses will be accessible through the IAFP website.I am very excited on the progress we have made as an industry, a profession, and especially as an association over the past 20 years. I am proud to be surrounded by such energetic individuals who dedicate so much of their time to their career. I ask each of you to celebrate these accomplishments and continue to support your profession.Be safe.Anthony J. Pellicone, President Looking back, looking forwardIt is close to the end of another year as I write this, and I would like to acknowledge the events and accomplishments that have occurred this past year, as well as celebrate the upcoming year. AMTC in Phoenix was another spectacular event, drawing over 2,500 EMS and critical care professionals from around the world.2006 was a very exciting year for the International Association of Flight Paramedics, celebrating 20 years of representing the paramedic profession and critical care transport. As we celebrate this milestone, we look forward to not only the upcoming year but the following 20! In celebration of the 20th anniversary, the IAFP instituted the First Annual Leadership Precon at this year's AMTC. This interactive seminar was a tremendous success, offering members and all AMTC attendees an opportunity to share experiences and become enlightened by dynamic speaker, Kathy Gallo, chief learning officer for the North Shore-Long Island Jewish Health System, and by some of the top leaders in our industry. Plans are now underway for next year's Leadership Seminar.Since 1986, technology and communication have come a long way, especially the computer age and the advent of the Internet. No matter how big the world may really be, the Internet can shrink it down to a 20-inch screen. Like everything else, we adapt to change and anticipate outcomes for the future, so we have decided to roll out an entirely new website, www.flightparamedic.org. The new site will be informative, organized, and easy to navigate. We encourage each of you to visit the site and mark it as a favorite in your browser. We will use this new site as a catalyst for all communication to you, the members, and the industry. This is very exciting, and we ask for feedback after you visit.In addition to making the world an ea
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