posted January 11, 2018

Several years ago, David Olvera, clinical education manager, awoke at night to find his fiancée convulsing in bed. She is a diabetic who had been working 80-hour weeks as a restaurant manager, and in her exhaustion, accidentally took the wrong medication.

She’s doing fine now, but the emergency led David to reflect: human error increases when people are tired or distracted. How could he improve the success rate of emergency procedures such as inserting tracheal tubes in unconscious patients, which is risky if done incorrectly?

“I said to myself, these distractions are things that can happen in a helicopter,” he said. “It doesn’t happen when everything’s calm and perfect.”

The scare with his fiancée added a personal impetus to David’s ongoing work. He, along with Dan Davis, medical director and scientific advisor, are using Air Methods’ extensive database to conduct university-style research and produce checklists to keep first responders from overlooking a step when they’re hurrying to save lives.

Despite a fast-moving environment, flying severely-injured patients from crashes and other emergencies, Air Methods has over a 90 percent success rate when inserting airway tubes, a procedure known as “rapid sequence intubation (RSI).” This is 20 percent better than the average pre-hospital rate, and compares favorably with in-hospital rates.

Much like a university or research hospital, Air Methods has established an Institutional Review Board (IRB) that approves research to make sure it applies ethical methodology. Air Methods is the first healthcare ambulance company to create its own IRB.

With a database of 8,500 procedures, Air Methods derives statistical research from its operations nationwide to scientifically establish best practices.

“It’s pretty incredible to see that data and the level of respect it receives not just from the United States, but Ireland, Latin America and South Africa,” David said. “We’ve had plenty of other people asking about this—what we’re doing and how we’re doing
it.”

The greatest improvements have come in airway management; Air Methods is boosting its success rate by implementing new checklists for its crews. Like pilots, healthcare workers and first responders have found that checklists decrease human-factor errors caused by fatigue, hunger and distractions. This gives company instructors confidence that the Air Methods RSI Checklist will help clinicians incorporate their education into completing the complex process of rapid sequence intubation. Because of research, Air Methods’ internal educators teach new teammates how to perform procedures based on evidence-based practice.

Like most researchers, David has coauthored studies, such as one slated for publication in early 2018 in the Air Medical Journal. His work has been cited in other journals as well. The company’s success will also be featured in EMS World. David plans to expand joint research with hospitals to determine outcomes after patients are admitted.

“If they can save one more patient because of something we know, then that’s an incredible thing,” he said. “And if we can do everything possible for those patients that
we’re taking care of, even if it’s a simple thing like raising the head of the bed up when we’re doing our work, it will help those patients have more tomorrows.”