Department of Emergency Medicine

EMS ExpressCare

 
        University of Maryland ExpressCare Critical Care Transport
 
 
                                                                         
 


Through partnerships with Petroleum Helicopters International (PHI) and American Medical Response (AMR), the University of Maryland operates
a busy critical care and interfacility transport service. ExpressCare is comprised of critical care personnel, specialty care paramedics, transport
nurses, and communication staff. A primary mission of ExpressCare is to provide safe and effective transport for patients requiring a higher or
more sophisticated level of inhospital care. ExpressCare crews are capable of the following specialty transports:

  • Extracorporeal membrane oxygenation (ECMO)
  • Neonatal interfacility
  • Critical care / blood product administration / advanced modes of ventilation
  • Intra-aortic balloon pumps


Residents and students are encouraged to ride a long with transport crews and observe a shift in the communications center. Helicopter ride-
alongs are limited to the winter months when the EC-135 twin engine helicopter can accomodate additional observers. The most common crew
configuration consists of a registered transport nurse (RN) and specialty care paramedic (NRP). Crews are tasked with the transport of critically ill
and injured patients across the spectrum of age and acuity. Critical care transport exists to bring the definitive and specialty care resource of the
University of Maryland Medical System  to the patient's bedside. 

 

                                                                                                  Resident Rotation in Critical Care Transport

 

Goal:                      

The resident assigned to the Maryland ExpressCare (MEC) EMS rotation will become familiar with interfacility critical care transport operations.
The resident will interact with specialty transport crews and learn about how the standard of hospital based care is maintained throughout
transport.

Objectives:           

  • Understand how the scope of critical care transport (CCT)  practice differs from typical prehospital operations
  • Define the capabilities of CCT crews and discuss the specifics of training and education
  • Discuss how EMTALA factors into decisions about the level of transport care
  • Describe how patients in need of interfacility transport are matched to the appropriate level of transport care (BLS, ALS, CCT, flight)

Rotation description:

Residents assigned to rotations with MEC will check in with the CCT crew at the University of Maryland Medical Center. Residents will serve as
members of the critical care transport team. Residency policies about dress code and attendance shall remain in effect for the duration of the
MEC block.

  • Resident physicians will observe critical care crews and function under the auspices of the lead transport RN and MEC clinical guidelines
  • Residents will bring their own PPE (gloves, goggles, mask) the rotation. Additional supplies will be available to the resident in order to
    maintain a safe transport environment. Residents will report to the lead transport RN and participate in the formulation of a transport
    care plan. Procedures and patient care related activities will be performed at the discretion of the transport RN.
  • Examples of acceptable resident-performed procedures include: patient assessment, intravenous access, needle decompression, application
    of monitor leads, 12 lead electrocardiograph interpretation, and other tasks identified as appropriate by the transport crew
  • Senior residents who have completed base station training can serve as surrogate medical control physicians (upon request of the MEC crew)
    and can provide input on adjustments to the transport care plan. Advice or medical control provided by the senior resident physician will
    be in accordance with existing MEC clinical guidelines and documented on the prehospital / interhospital electronic medical record
  • The final authority for transport related decisions rests with the lead transport RN responsible for execution of the transport care plan. 
    Questions should be escalated to the Maryland ExpressCare medical director on duty. 

 

                                                                                                                Critical Care Transport Didactics 

The following articles provide the resident/student on rotation with a focus overview of operational considerations related to air medical
transportation. Selected articles discuss indications for HEMS, treatment guidelines, and clinically relevant scenarios 

 

HEMS Operations


HEMS Clinical 

HEMS Guidelines

 

 

 

ExpressCare Contact Information
 

Leigha McGuin, RN, BSN, CCRN
Nurse Manager, Maryland ExpressCare

Cody Winniford, NRP
Base Manager, PHI Air Medical (ExpressCare 1)

Benjamin Lawner, DO, MS, EMT-P
Medical Director, Maryland ExpressCare Critical Care Transport 

Jeff Nusbaum, MD, MBA
Assistant Medical Director, Maryland ExpressCare
 

Waiver of liability and confidentiality form 


University of Maryland ExpressCare Official Website 

       

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Maryland Institute for Emergency Medical Services Systems certifies that Maryland ExpressCare Critical Care Transport is a
licensed commercial service. MEC license #52 includes BLS, ALS, NEO, and SCT levels of service


ExpressCare 1 Hangar/Base:

 

Fly alongs and tours of the helicopter base take place at the Martin State Airport in Essex, MD. 

 

701 Wilson Point Road
Middle River, MD 21220
 

 

 

 
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