Our iconic red helicopters are highly visible in the sky, bringing life-saving tools, talented crews and hope to patients in need. Largely unseen, however, are the transport physicians who also fight for the life of every patient STARS carries.
Physicians are the voice of command for every mission, often without stepping into a helicopter. When a call for help is received, a transport doctor ascertains the level and type of care the patient needs, the time-sensitivity of their injury or illness, and the capacity of the sending facility. The physician triages the call with other requests and determines the best mode of transport, which could be ground ambulance, fixed-wing aircraft or helicopter.
“If the skills of STARS’ air medical crew or the speed of the helicopter offer a benefit to the patient, these are the missions we prioritize,” said Dr. Doug Martin, STARS medical director, Winnipeg. “This helps keep the team and the aircraft available when and where they are most needed.”
Transport physicians provide consultation to local health centres and EMS to stabilize patients for transport, and they brief tertiary care hospitals for the patient’s arrival. Throughout, they support the air medical crew’s patient care by phone or radio.
“Our role is to ensure the patient receives the right care at the right place at the right time,” said Dr. Eddie Chang, STARS medical director, Edmonton. “We are ready to go on missions, with STARS or with other providers, if it augments the ability to provide that care.”
When a transport physician attends in-person, it adds mental and physical capacity to the team.
“In complicated cases physicians bring an extra layer of expert skills, which enhances the critical care we provide,” said flight nurse and Calgary clinical operations manager, Janice Kirkham. “They also help take on the cognitive load, which accelerates decision-making.”
Flying missions enables transport doctors to visit rural hospitals and learn about their needs. “Meeting my rural colleagues has given me a better appreciation of their resources, the great work they do, and how STARS can help,” said Dr. Ryan Deedo, STARS medical communications lead.
Outside of missions, remote health-care professionals can also look to transport physicians for 24/7 virtual assistance. Recently, as rural practitioners have had to adapt to the unique requirements of COVID-19 patients, the need for virtual support has increased.
“STARS’ previous use of virtual care paved the way for its current explosion. The organization is recognized as an innovative partner to trial new technologies,” said Dr. John Froh, STARS medical director, Saskatoon.
An essential part of transport physicians’ role is to lead STARS’ medical control protocols, education, research, and quality assurance.
“They not only assist us with patient care, they teach us about the pathophysiology behind the trauma or disease,” said Kirkham. “This enables us to improve the care we provide based on the most recent research and best practices.”
Quality assurance starts with meticulous peer and physician analysis of every mission record which fuels an ongoing dialogue about safety and quality. Physicians regularly evaluate STARS’ performance against industry benchmarks.
“Very few organizations put their physicians and their decisions under this degree of review and assessment so we can continue to improve,” Dr. Deedo said.
Perhaps the greatest strength of STARS’ physician- driven approach is that it has helped raise the bar for critical care throughout the chain of survival.
“I worked in emergency rooms and critical care prior to our use of transport physicians, and I’ve seen the amazing impact this unique model of care has provided,” said Dr. Froh. “I sleep better knowing transport physicians are there for my family and friends if needed.”
Behind the scenes with STARS transport physicians
- More than 100 transport doctors work part-time for STARS as well as in emergency departments, intensive care units and operating rooms of busy hospitals.
- Some of the advanced procedures requiring a transport physician’s diagnosis/authorization or that benefit from their hands-on skills include blood transfusions, clot busting therapies, advanced resuscitative procedures, temporary transvenous pacer insertion, central venous line insertion, pericardiocentesis, and thoracostomies.
- During mass casualty incidents some transport physicians travel to the scene or remote hospitals to help bolster local resources, while others often assume leadership roles at centralized incident command posts.