Kris Abel’s Tech Life | A Look At Ornge’s Mobile Ambulances And A Preview Of Their Medical Simulation Truck

Kris Abel’s Tech Life | A Look At Ornge’s Mobile Ambulances And A Preview Of Their Medical Simulation TruckThis morning Ornge, a transport medicine company, held a little ceremony inside one of the hangars of Toronto Island Airport to announce that all of the air ambulances in Ontario would now be fully under their control and would bear their orange paint job as a result. I’ll let CTV’s Monica Matys handle the political side of the event, for myself it was a chance to check out their advanced telemetry system, virtual hospital concept, and grab a peek at their upcoming mobile patient simulation transport rig. The two air ambulances on display included a King Air 200 twin-turboprop aircraft and a Sikorsky S-76 helicopter, both representing a fleet of air ambulances that operate from 26 bases across Ontario in one of the largest networks in North America. The fleet can reach any community in the province and picks up an average of 17,000 critical patients every year. It requires round-the-clock teams including 244 flight paramedics (not counting the pilots) who are specially trained for emergency medical care. But long gone are the days when paramedics would simply pick up a patient and administer quick-fixes until they could reach a hospital, thanks to an impressive communications array installed in each air ambulance, one that operates on every known frequency – UHF, VHF, Satellite, cellular, GPS, etc. – every aircraft can always, always, always connect to a hospital in the province and reach a doctor on standby. An entire team of doctors, divided into 12-hour shifts, remain on stand-by in case of an Air Ambulance call. As soon as you are picked up by an Air Ambulance, the paramedics have the voice of your doctor in their headsets and they become his/her eyes and ears. Combined with the advanced medical equipment on board, the result is that your treatment begins immediately and the air ambulance becomes a Virtual Hospital. Dr. Chris Mazza, staff physician and Trauma Team Leader at Sunnybrook and Women’s College, explains “Before take-off, the flight paramedics give us a concise picture of the situation, we then give them a set of orders… ‘I want you to do this, this, and this, etc.” within these certain circumstances, so if the heart rate is at this level, if the blood pressure is this, then you can do this, etc.’ so they are all self-sustaining orders that the paramedics can use and that’s exactly the same way an ICU (Intensive Care Unit) nurse works. The doctor will give them written orders within certain circumstances and the nurse manages minute to minute to minute. The doctors only come in every so often. This then becomes a flying ICU, we’re doing the same level of intervention as we do in an ICU, I work in both. The flight paramedics, if something goes awry can connect to us through any channel, UHF, VHF, etc.”The idea is not entirely new, air ambulances have been using radio contact to get orders from doctors en route for many years, it’s just that today there are so many communication channels available and with such a wide range that an ambulance can now guarantee a connection with a hospital doctor regardless of the weather or remote location. Unfortunately the system has yet to evolve beyond simple voice communication, although web cam transmissions and data networks are growing stronger it seems every year, the quality is not yet reliable for an emergency service and so the doctors and paramedics maintain audio contact only. Where video and data transmissions are being used is in a new Mobile Simulation Trailer Unit, a transport truck loaded with interactive hospital rooms, a fake helicopter interior and a series of advanced patient dummies loaded with sensors to provide a realistic simulation of medical emergencies. The trailer is designed to provide training for students and physicians across the province such as Thunder Bay, Kenora, Moosenee,. With remote video and data connections, doctors here in major city centres can use the simulators to run students through the same scenarios and exactly the same kind of patients they would experience in a training program here in Toronto or Ottawa. The technological training dummy is called the METI Human Patient Simulator and is capable of dynamic cardiovascular, pulmonary, and pharmacological responses. A major disappointment, Ornge could only offer up a mock-up trailer with, admittedly a pretty cool paint job, as their first prototype is still in the construction phase, but they promise to contact me when it’s done for a visit. In the meantime, here’s Kevin King, Manager of the Simulation Program with a description of what’s to come:“It’s a mobile training platform, the first of its kind in the worldwide right now and we’re very proud of that, and a mobile configuration being one this size. Inside that trailer is a human patient simulator. If you think about where flight simulators, flight training period for the last forty years, they’ve been using flight simulators for a long, long time and we in the medical community think its about time we caught up to them.”“So we use a simulator that’s physiologically correct, anatomical model of a patient. It does things that real patients do, it reacts to drugs that you give it, it reacts to treatments that you do for it, and for a lot of our students it reacts to what you don’t do for it. If the patient has oxygen concerns for example, students will have to give it oxygen, it breathes in oxygen and uses carbon dioxide as a stimulus to breathe, just like you and I do and in the appropriate percentages.”“That’s part one, part two is creating the actual mobile platform, to get students inside and start training them, so to that end we have a fully functional Emergency Room set-up inside. Doctors and physician students will be part of our target market. There’s a fully functional helicopter interior and a fully functional land ambulance interior inside as well, again so we can get the students in their normal working environment, shut them in and allow the simulator to do its thing.”“Both from an evaluation perspective and an educational perspective, I believe simulation is changing the way medical education is delivered. It’s a much safer way to train.”