You're Trained, You're Ready, Panic Is Not in Your Vocabulary: When a Helicopter Becomes a Delivery Room

Purpose for the program:  Vaginal delivery in a helicopter is an unpredictable and uncommon emergency.  A health care provider’s ability to react prudently in an unexpected situation is one of the most critical factors in creating a positive outcome in an obstetrical emergency.  This Emergency Delivery pilot program prepares the Life Flight and Maternal Transport teams how to successfully manage this rare unpredictable obstetrical emergency together through simulated training experiences that pose no risk to mother and infant. 

Proposed change:  The Life Flight helicopter air-medical transport system was established at OSF Saint Francis Medical Center in June 1984.  A Maternal Transport Team dedicated to the care and transport of high-risk pregnant women was established in 1986. These two teams come together to transport mothers with perinatal complications or those at risk for premature delivery to a hospital that can provide a higher level of care.  The crew configuration for obstetric transports includes one obstetrically trained Registered Nurse and one primary Life Flight Registered Nurse or Paramedic. There has never been collaborative emergency delivery training between the Life Flight and Maternal Transport crews.  This inter-professional pilot program will provided this training. 

Implementation, outcomes and evaluation:  A pretest of 30 questions to document the learners’ knowledge of emergency delivery has been administered.  The average number of correct responses was 18.8 for Life Flight and 24.7 for Maternal Transport.  The reference population for this collaborative includes 21 Life Flight Nurses, one Paramedic and 15 Maternal Transport Nurses.

The didactic segment includes five e-Learning modules.  These modules review strategies for emergency vaginal delivery management, correct application of interventions to manage vaginal delivery complications, infant stabilization and relevant team communication tools.  Data will be collected for pre and post learning comparison.

Completion of the Emergency Delivery e-Learning will be a mandatory requirement prior to participation in a helicopter in-situ simulation.  Using a standardized patient and partial obstetrical task trainer, the aim of the simulation component will be to analyze the crews performance using real-life emergency delivery scenarios, detect areas of deficiency and initiate performance improvements that will transfer to applied clinical practice.

Implications for nursing practice:  Evidence based guidelines exist for safe vaginal delivery practices.  The challenge is to ensure that these guidelines are applied to every patient every time, regardless of whether this delivery occurs inside a hospital or en-route to a hospital.   

Keywords:  Emergency delivery training, simulation