View From Above: Managing the Elements

Waking up to a squawking doorbell in the middle of the night, a flight crew is about to walk out into the elements in an effort to save a life. From coast to coast, helicopter EMS (HEMS) crews are working long, tiring shifts in blistering heat and frigid cold to deliver lifesaving prehospital care to critical patients.

From the whining of the engine powering up to the preflight walkaround, a HEMS crew is about to lift and be en route to a horrific traffic accident or to your hospital to aid in the care of very ill patient. HEMS crew members are trained in a multitude of disciplines. We are trained in every aspect of airway management and how to keep our patient comfortable yet hemodynamically stable. However, one thing no one is trained on is how to decompress and how to cope with bad flights.

Critical care transport providers are trained how to manage the unmanageable. In some sense, we enter a "robot" mode and do whatever it takes to resuscitate the dying patient. But when the rotor wash settles, how do we come away from that horrific car fire or heart-wrenching pediatric arrest?

In my experience, managing the unstable patient is something we all do proficiently. But coping with the aftermath is something we could all use a lesson on. I am notorious for listening to critical care podcasts to keep myself current with changes in prehospital critical care. One particular podcast titled Staying Fit for Duty I listen to again and again. It discusses how to stay mentally fit and decompressing after difficult missions. This discussion applies to every aspect of public service—fire, EMS, law enforcement, HEMS, nurses, and others. I encourage you to give it a listen.

At the end of an exhausting 24-hour shift, I’m often running on pure adrenaline. On my drive home, I call my wife or my mother, and we talk about my day and mix in normal everyday life. With both in the healthcare field, they can relate to the feelings I may have. This helps me decompress. I feel it’s extremely important to express your thoughts, debrief the call more than once if needed, and express every emotion running through your mind. Perhaps your partner is having the same thoughts but is afraid they’ll seem "weak" for addressing it.

Every public service organization can do a better job of highlighting the importance of mental health. When the rotors stop spinning, never be afraid to express your emotions, good or bad, and always keep your mental health top of mind.

Drew Sharrer, RN, BSN, CEN, is a critical care transport provider by ground for a large community hospital in Zanesville, Ohio, and by rotor-wing aircraft out of Westerville, Ohio.