Lifeguard and UNMH coordinated a flight of a patient that had been an in-patient at UNMH for approximately 10 months. The patient was well known to the hospital staff. The patient has a sensitive condition that can worsen if not careful. She was diagnosed with a chronic multi-focal dystonia. Her condition was sensitive to agitation where she can go into a "fit" and have uncontrolled movements that are difficult to reverse. Her father stated that the fits have been so bad that she nearly bit her tongue off on one occasion. She is also on a ventilator while sleeping and ventilator changes could stimulate her enough to agitate her, requiring careful intervention. She is also on chronic benzodiazepines for her condition.
In preparation, Dan Scribner visited the patient, as reports that her father would not allow any other ventilator on her and could disrupt the arrangements to transport the patient to her rehab facility in Arizona. After speaking to the respiratory therapist and father, Dan Scribner realized that her settings were not strange to our ventilator's capability but that the comfort level of her father and knowledge of the crew were important. He felt that the crew needed to know her and her tendencies and her of the crew. Dan was able to establish rapport with father and patient over the last week by visiting the patient in her room prior to the transport date.
On the day of the transport, Dan had obviously wanted to make sure all necessary steps were taken and all items potentially needed, were available to us. He decided that getting there with at least an hour and a half prior to transport was necessary to establish the comfort level of all involved. He considered everything from clinical management, logistical issues and making it a great experience for everyone. When we were leaving he had a plan A, B, and C.
We encountered a logistical problem when arriving at UNMH. Staff presented the crew with numerous items and boxes that need to accompany the patient to the destination, as most of the items were supplies needed at the receiving facility. Pictures and weights of the items were sent to our on duty rotor crew. They coordinated with one of the pilots and items were taken out the fixed wing in order to accommodate all items. The on duty rotor crew text us and stated that all items could be accommodated. While this was being completed, our Communications team arranged the ground transport to arrive at just the right time for packaging of the patient
During the transport, Dan was determined not to let his guard down and suctioned the patient of secretions from her trach. He then noticed her breathing had slowed down while she was sleeping. He wanted to be sure we were careful not to get too aggressive by placing the ventilator on the patient and cause irreversible agitation. He planned the movement and had a backup plan if things did not go as planned while placing the ventilator on the patient. Dan wanted to be sure he set up the ventilator as he was dedicated to living up to his promise to the patient and her family; without a doubt, she did great on the ventilator.
Dan went above and beyond to assure the patient and family that she would be well taken care of, and safe. She made it to Arizona without any trouble. We are grateful to have Dan on our team and representing lifeguard!