camts blog

Commission on Accreditation of Medical Transport Systems

Urgent Safety Notice – Lifeport Clip Decks

CAMTS has received several calls on this safety issue.  We have been made aware of incidents as a result of the LifePort Clip Decks.  We have been told that not all parties have received the following notice from LifePort.  Please heed this urgent warning!

Re: LifePort, Inc.’s Clip Decks – All Models/Part Numbers

It has recently come to our attention that Life port’s Clip Deck may be subject to misues in the field.  Our records show that you purchased, received through an intermediary, or may be in possession of a Life port Clip Deck.  Accordingly, this is to inform you that Life Port’s Clip Deck is designed and to be used for the purposes of non-vehicular ground transfers only.

LifePort’s Clip Deck is not designed, approved and should not be used, under any circumstances, to secure or retain an AeroSled during ground vehicle travel of any kind, including ambulance travel.  LifePort’s Clip Deck is not, and has never been, intended to be used in ambulances or any type of ground vehicles, under any circumstances.  Any such usage will expose all persons using the equipment, including but not limited to patients, passengers and medical professionals, to possible injury or death and therefore should be ceased immediately.

Please immediately contact LifePort’s Customer Service Department at 360 225-1212 or via email at customerservice@lifeport.com to arrange for shipment of warning placards for affixation on all Clip Decks consistent with the above.  LifePort will provide all placards free of cost, including affixation instructions.

Sincerely

Patrick Ogle

Customer Service Manager

LifePort

The following was received from a CAMTS accredited program:

On 6-5-17, while traveling in a ground ambulance, the LifePort sled came out of its base when going around a curve.  This is the third occurrence of a sled coming out of the base at our program.   When the second occurred in 2010, we took a harder look at the pins and receptacle holes they go into.  We found two design flaws:  1) the metal where the pin went into was made of a softer metal, aluminum, versus steel like the one in our aircraft base 2) the hole is drilled on the edge of a bevel, facilitating its wear.  When we contacted Lifeport at that time with our findings and looking for help, they offered no solutions nor assistance.  We fixed the problem ourselves with our mechanic replacing the receiving metal receptacles with steel ones in all our stretchers as are in our aircraft base.

The current clip deck involved in the incident 6-5-17 was received six months ago with our new isolette.   We knew we should replace the receiving metal parts and had begun the process but unfortunately it was not high priority as the prior clip decks had been used for ~ 10 years before the incidents occurred.  Apparently, an even inferior metal is being used in current production for the degradation seen in the images to have occurred so rapidly.    The hole is no longer round, but oblong and by its being in the bevel, you can see in image looking top down, this allows for a more rapid loss of integrity.

Our program has yet to receive the attached Lifeport notice.  We know of at least 2 others that have not received this notice; we are all current customers.    We learned of the warning via AAMS Critical Care Ground Special Interest Group who had a member receive this notice. 

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Inadvertent Instrument Meteorological Condition (IIMC) training

In keeping with CAMT’s values of continuously improving accreditation standards to improve patient care and safety of transport, the next revision to the CAMTS Standards will encourage additional helicopter Instrument Flight Rules (IFR) training requirements.  The draft of the recommendation, to be incorporated into the 11th Edition of the CAMTS Standards, will require quarterly Inadvertent Instrument Meteorological Condition (IIMC) training and demonstration of the pilot’s ability to safely maneuver the helicopter into visual meteorological conditions (VMC) following an inadvertent encounter with IMC and completion of an IFR approach.

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For instrument proficiency training in non-IFR-certified rotorcraft, the pilot should perform such maneuvers as are appropriate to the rotorcraft’s installed equipment, the certificate holder’s operations specifications, and the operating environment.

A recent analysis of fatal accidents over a five- year period, conducted by the U.S. Helicopter Safety Team, revealed that the Helicopter Air Ambulance industry had the second most fatal accidents, second only to Personal/Private operations.  Fifty-two percent (52%) of these accidents involved:

  • Inflight Loss of Control
  • Inadvertent IMC
  • Low Altitude Operations

Increasing IFR training requirements is an attempt to reduce the historical accident rate in our industry while focusing on data driven causal factors and is in keeping with the CAMTS mission to continuously improve transport safety.

This proposed future revision of the CAMTS Standards is being recommended by the CAMTS Aviation & Safety Advisory Committee, comprised of industry safety experts including non-CAMTS Board members. Final verbiage for the 11th Edition of the CAMTS Standards will be approved by the CAMTS Board of Directors prior to incorporation.

 

AIR EMS awarded Conditional Accreditation

 

The Commission on Accreditation of Medical Transport Systems (CAMTS) awarded Conditional Accreditation to Air EMS today for fixed wing and medical escort services.  Air EMS is the first to be awarded this accreditation and is supported by two very experienced FAA Part 135 operators who are able to provide aircraft for both national and international transports.

Conditional Accreditation was created to verify that a new service (in business for at least 4 months but less than 1 year) is able to demonstrate that policies, practices and training of aviation, surface and medical staff under a dedicated medical director meet accreditation standards based on the mission and scope of service as advertised. The aircraft and/or surface vehicle and medical equipment must also meet compliance with the standards and all legal regulations must be satisfied.

A service receiving Conditional Accreditation is permitted to advertise as conditionally accredited and will receive a letter of conditional status which can be provided to regulators and to contracting agencies that require accreditation. There is no minimal number of transports required but staff must be hired and trained and the medical director must have developed protocols. Although new programs may not have a mature Quality, Utilization and Safety Management System, those systems must be developed and organized according to the criteria in the standards.

The program may submit a PIF for full accreditation at its one-year anniversary or when the Conditional Accreditation expires.

CAMTS feels strongly that this process will provide a robust review for a new medical transport service that regulators and contracting agencies can support rather than requiring accreditation as soon as an aviation company decides to transport patients without proper preparation.

PIF Process – online format

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Dear CAMTS Accredited Services:

We are in the process of moving the entire PIF process to an online format – including attachments and all forms. We are anticipating it to be ready by January 1, 2017. In preparation for the new process and in recognizing the need to streamline the reaccreditation process, we need your help to identify the areas of completing the reaccreditation process that seem especially labor intensive with little benefit.

We are holding a Town Hall Meeting on September 25 from 2-4 at the Charlotte Westin Hotel in the Queens Room to meet with those who want to express their suggestions about the accreditation process and discuss where we have seen some inconsistencies. All are invited to attend even if you have completed this survey. Many of our Board members will be present to speak with you individually or as a group. The following survey will provide us with a starting place for those discussions.

Please complete this survey and return by September 9, 2016

StartSurvey_Button          SURVEY

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ANNOUNCING   

PRE-CONFERENCE EVENTS

SUNDAY, SEPTEMBER 25, 2016

At the Westin Hotel Charlotte, NC  in the QUEENS Meeting Room

 REGISTER   

 

8:00 TO NOON PREPARING FOR ACCREDITATION

This half day class will review the process, polices and Standards of CAMTS and provide excellent information for both programs seeking accreditation for the first time or for those approach a reaccreditation.  Learn about the more common areas cited as deficiencies and ask questions directly with the CAMTS Executive Director.

Register by visiting the CAMTS website at www.camts.org

There is a cost for this conference and each person receives a copy of the current 10th Edition Standards.

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1:00 to 2:00 PM  CAMTS Standards Committee

Each year at the Air Medical Transport Conference, the CAMTS Standard Committee meets to hear your comments and suggestions for improving the Standards. All are welcome. Please contact us through the CAMTS web site at www.camts.org.if you plan to attend.

*2:00 – 4:00 PM   

OPEN FORUM  

Streamlining the Reaccreditation Process

This session will focus on your suggestions for streamlining the CAMTS reaccreditation process.  We encourage all site surveyors, Board members, member organizations, aviation and medical operators and accredited programs to participate in guiding us to a process that makes reaccreditation less labor intensive and more consistent for programs and for CAMTS, while assuring substantial compliance with the Standards.

The session is FREE and no registration is required.

Each accredited program will receive a survey by email within a few days regarding the reaccreditation process – please take a few moments to fill this out and send it in so that we have a starting point for our  discussions and so that we have your input if you cannot make the meeting!

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Guidelines1

Interpretation Guidelines of the CAMTS Standards….
Issue: # 001
Date: July 22, 2016
Reference: 10th Edition Standards

Fire Extinguishers
It has come to our attention that the following standard has been interpreted to mean that the fire extinguishers in the Bell 407 and Agusta aircraft, for example, must be moved, or another fire extinguisher must be placed in the medical crew quarters. The standard, however, speaks to accessibility as follows:

“02.03.07 Safety and Environment
2. Equipment and Operations Around the Transport Vehicle
l. A fire extinguisher must be accessible to medical transport personnel and vehicle operator while in motion.”

The purpose of the standard is to assist in extinguishing a fire on board in the event the pilot is incapacitated or otherwise occupied. The problem is fire extinguishers are understandably designed to be within the pilot’s reach and are considered part of aircraft as listed on the certificate. Adding another fire extinguisher is not possible without getting either an STC or a FAA field approval (337). The CAMTS Board of Directors understands this and does not base an accreditation decision on this type of compliance issue with one specific standard. It may be and remain an outlier to the standard but in terms of interpreting this standard – Site Surveyors should be asking crew members how they would reach the fire extinguisher during flight in an emergency situation. If it is possible – even though it may not be readily accessible – it meets the standard.
If it is not at all possible, it may remain an outlier without negatively impacting accreditation. Remember accreditation is based on substantial compliance with the standards – not 100% compliance.

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CAMTS EU Introduces Site Surveyors

CAMTS EU graduates its first class of Site Surveyors.  CAMTS conducted a three-day class for applicants to site surveyor positions for CAMTS EU in Zurich July 11-13.  Applicants were chosen for their expertise and experience, and all are currently employed by medical transport services outside of North America.

The CAMTS Board of Directors also met in Zurich, July 14-16 and welcomed the new site surveyors, who attended the first day of Board meetings.

During this time frame, the CAMTS EU Board of Directors held its first on-sight Board meeting since registering in Zurich in November of 2015. Currently, the CAMTS EU Board consists of: Stefan Becker, Chair, representing the European HEMS & Air Ambulance Committee (EHAC), Dr. Stephen Hancock, representing Air Medical Physicians Association (AMPA), and Dr. Vincent Feuillie, representing Aerospace Medical Association (AsMA). There are two CAMTS board members from the U.S. serving on the CAMTS EU Board: Jon Gryniuk, representing International Association of Flight and Critical Care Paramedics (IAFCCP)  and Ashley Smith, representing National Air Transport Association (NATA).

 

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In the picture from left to right – David Quayle, Clinical Services Manager for Air Alliance MedFlight UK; Stefan Becker, Chair of CAMTS EU Board of Directors; Dr. Alberto  Piacentini, Flying Doctor for S.Anna Hospital in Como, Italy; Dudley Smith, Assoc. Executive Director of CAMTS; Eileen Frazer, Executive Director;  Dr. Fatemah Rajah, Consultant for Embrace, Infant and Childrens Transport in the UK and Dr. Anyarit Sangcharaswichai, Medical Director for Bangkok Dusit Medical Services, PLC.

CAMTS lost a valuable friend & leader

CAMTS lost a valuable friend and leader yesterday. Ralph N. Rogers, MD, died after a courageous battle with an illness. Ralph was only 64 years old, leaving behind the people and the work he loved.

Ralph - Seattle July '15

Dr. Ralph Rogers and daughter, Madison

Ralph spent more than 25 years as a board-certified emergency physician at Spectrum Health in Grand Rapids, Michigan. His legacy includes initiatives in critical care, trauma and pain management. Ralph’s ability to clearly and succinctly provide situational analysis positively impacted physician and advanced practice provider engagement, clinical service lines, regional hospital clinical integration and the development and success of CAMTS.

Ralph spent the last 20 years on the CAMTS Board of Directors representing ACEP. He was the Chair of the Board since year 2000, re-elected unanimously by the Board every 2 years. Ralph was a major contributor to the success of CAMTS, setting the tone for our commitment to excellence in patient care and safety during transport. His ability to build consensus among 22 Board members, each with their own perspective, was a gift we cannot easily replace. Our thoughts and prayers are with Karen and his 4 children who were at his bedside when he passed. Madison, the 13 year-old youngest daughter, was a frequent visitor and spectator at Board meetings, sitting quietly with her books and crayons and interfacing with us during breaks. Karen was a member of the CAMTS Board as the NFNA representative from its inception and she was our Quality and Site Survey Coordinator for many years. CAMTS was actually the conduit for Karen and Ralph to meet and marry and they are like family to all of us.

The entire CAMTS Board sends their thoughts and prayers to the Rogers family and we will gather to celebrate his life along with many hospital peers, family and friends on June 23rd in Grand Rapids.

 Celebration of Life

Following Ralph’s wishes, the family will host a “Celebration of Life”

Thursday, June 23, 2016 from 12pm to 4pm at

Frederick Meijer Gardens & Sculpture Park in the Grand Ballroom

1000 E. Beltline Ave. NE, Grand Rapids, MI

Please wear colorful spring/summer colors. NO black allowed.

In lieu of flowers, the family requests donations be made

“In Memory of Ralph N. Rogers, MD” to:

David’s House Ministries, 2390 Banner Dr. SW, Wyoming, MI 49509

or Spectrum Health Foundation: Aero Med Fund, 100 N Michigan St NE, MC004

Grand Rapids, MI 49503

Here is a link to Ralph’s obituary if you would like to learn more about our CAMTS Emeritus Chairman of the Board  Dr. Ralph Rogers

 

 

Salute to Excellence

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Airbus Helicopters Golden Hour Award

Eileen Frazer: Eileen Frazer is the executive director of the Commission on Accreditation of Medical Transport Systems (CAMTS) — an organization dedicated to improving the safety of both air- and ground-based medical transportation, which she both founded and has led for the past 25 years.

In the mid-1980s, Frazer was an emergency room nurse and chaired the safety committee of what is now the Association of Air Medical Services. The committee drafted criteria for peer review safety audits to address a growing number of air ambulance accidents. But Frazer and the committee felt the audits should be performed by an independent organization. So in 1988 and 1989, Frazer did a feasibility study, modelling her proposed organization on the Joint Commission on Accreditation of Health-Care Organizations, which accredits hospitals.

Today, there are 184 CAMTS-accredited air ambulance programs in six countries around the world. CAMTS completes, on average, 75 new or reaccreditation applications every year and processes approximately 100 progress reports as operations correct deficiencies found during audits.

video: https://www.youtube.com/watch?v=6pefsjPuLMg

The CAMTS organization is proud of Eileen’s dedication and accomplishments.  This award is so well deserved for her passion for improving patient safety and the air medical industry.

 

Crash Resistant Fuel Systems

In keeping with CAMT’s values of imposing standards to improve patient care and safety of transport, the 11th Edition of the CAMTS Standards will encourage all helicopters to have a Crash Resistant Fuel System (CRFS) that meet the crashworthiness requirements of 14 Code of Federal Regulations 27.952 or 29.952.

As an industry dedicated to continuously improving the level of safety for those that we transport, it is essential that we begin the process of incorporating the highest level of safety technology in the aircraft we operate. Incorporation of Crash Resistant Fuel Systems (CRFS) is a significant financial investment of a relatively simple technology that may have a profound impact on the patients we transport. Because of the significant financial impact of this requirement, it is strongly encouraged that any future helicopter introduced into service, whether purchased, leased or contracted, by a CAMTS program or vendor have a crashworthy fuel system meeting the requirements of 14 Code of Federal Regulations 27.952 or 29.952. As manufacturers make retrofit kits available, we should also begin the process of financial planning to retrofit existing helicopters.

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In recent years, there have been incidents of thermal fatalities due to post-crash fires in survivable accidents. In 1970, the U.S. Army required CRFS on all newly manufactured helicopters and began an extensive retrofit of all existing helicopters. The International Helicopter Safety Team’s Year 2000 report recommended “The use of helicopters with a CRFS should be encouraged and a requirement on contracted efforts.”  More recently, the National Transportation Safety Board recommended the FAA Require, for all newly manufactured rotorcraft regardless of the design’s original certification date, that the fuel systems meet the crashworthiness requirements of 14 Code of Federal Regulations 27.952 or 29.952, “Fuel System Crash Resistance.”.

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This proposed future revision of the CAMTS Standards was unanimously approved by the CAMTS Aviation & Safety Advisory Committee, comprised of industry safety experts including non-CAMTS Board members, and was approved by the CAMTS Board of Directors.