The effect of an in-flight, emergency training program on crew confidence

A national survey of air medical infectious disease control practices

INTRODUCTION

Caring for an infectious patient in the air medical environment presents a special challenge to all air crew members (ACMs) involved. The purpose of this study was to survey the infectious disease control practices of air medical programs (AMPs) that are members of the Association of Air Medical Services.

METHODS

A structured telephone survey was designed to gather data. Using one interviewer (an undergraduate student) with no knowledge of the study's goal minimized experimental bias. AMPs from 151 geographically selected areas were called between June and August 1996. Only the programs' chief flight nurses (CFNs) were targeted as respondents.

RESULTS

The response rate was 91% (138 of 151). Although no program refused to participate, 13 CFNs were unavailable to be interviewed. Mission profile was 32% scene and 68% interhospital with an annual average of 950 patient transports per program. Transport type was 61% rotor-wing aircraft, 17% fixed-wing, and 22% both. Flight physicals for ACMs were required by 57% of the AMPs. Pre-employment screenings for rubella, tuberculosis (TB), and varicella were noted. Interestingly, 17% of the AMPs reported pre-employment HIV testing. Immunization was mandated by 57% of AMPs, including hepatitis B virus, measles, rubella, and tetanus. Nine percent of the respondents refused to accept a transport with specific contagious conditions, primarily TB. A formal decontamination policy was in effect at 88% of the AMPs, and OSHA-approved filter masks were available at 70%. Pathogen exposure reporting was required by 97%.

CONCLUSION

A current, comprehensive infection control program, continuing education, and 100% compliance with standard precautions will help reduce the possibility of accidental exposures. These strategies to reduce transmission also can be extended during training sessions to the prehospital and hospital personnel with whom the air medical program serves.

Evaluation of retention of safety and survival training content versus industry standard for training

INTRODUCTION

The accepted standard in the industry for survival and safety training is annual recurrent educational programs. The industry has never looked at nor tested content comprehension or retention on this subject. We decided to conduct a sample testing of crews' ability to understand and retain survival training material.

METHODS

This study solicited the participation of four program crews that had received previous training in safety and survival. A test on safety and survival training content was administrated to nurses and paramedics before a refresher course (test 1), then immediately after the course (test 2), and again 6 months later (test 3). Ninety-six crew members took tests 1 and 2, and 79 (82%) took test 3.

RESULTS

The average time since any crew member participating in this study had attended a survival course was 1 to 1.5 years. The pretraining test mean score was 60 (60%); the posttraining average score was 92 (92%); and the 6-month mean score was 65 (65%).

CONCLUSION

Flight crews do not retain a safe level of survival skill knowledge with annual recurrent training. Therefore the industry needs to reevaluate its position on this standard of annual recurrent training. Survival training is too important for flight crews to undertake only once per year. Rescuer care is as important as patient care.