General Description

• Provide comprehensive, safe, effective medical care to patients transported by Duke Life Flight. All positions are 12-hour shifts, day/night rotation with weekends.
• After orientation to our ground transport units, newly hired employees will be transitioned to flight training as quickly as possible depending on the needs of the program.
• Strongly prefer experienced ground and/or air transport nurses.

Work Performed

• Plan, provide, supervise and document professional nursing care utilizing the nursing process for patients in accordance with physician orders and established policies and procedures
• Use professional nursing judgment to individualize the plan of care based on assessment of the patients’ baseline needs and response to care
• Delegate tasks and supervise the activities of other licensed and unlicensed clinical care providers
• Monitor and initiate corrective action to maintain the environment of care including equipment and material resources
• Participate in own professional development by maintaining required competencies, identifying learning needs, and seeking appropriate assistance or educational offerings
• Act as a preceptor and support the development of other staff and formal learners
• Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities.

Experience Requirements

• Minimum of 3 years critical care experience preferred with a strong preference for experienced ground and/or air transport nurses.
• Must have recent direct patient care experience within the last six months of application.
• Successful completion of BLS, ACLS, PALS, TNCC, and NRP will be required (ITLS or PHTLS preferred)
• Must have the ability to work in a diverse, autonomous environment.
• Physical requirements (height/weight restrictions)
  • No greater than 240 lbs in full uniform
  • No greater than 6’4” in height

Education

• Work requires graduation from an accredited Bachelor of Science in Nursing, Associate Degree or Nursing or Nursing Diploma program.

General Description

• The EMT Driver will perform a variety of activities associated with Duke Life Flight to include operation of the Life Flight Critical Care Transport ambulance and medical support systems, and assist with operations of associated satellite base and ongoing continuing education outreach programs.

Work Performed

• Responsible for minor repairs to the unit to include: changing light bulbs, replenishing fluids, tightening nuts and bolts, inspecting tires, etc.
• Responsible for daily maintenance including fueling and cleaning of vehicle.
• Responsible for reporting minor and major repairs needs to the site specific Clinical Operations Director.
• Responsible for assisting nursing staff with patient care as requested to include loading and unloading operation of commonly used equipment and providing family members with information about and directions to Duke.
• Responsible for replenishing air, oxygen, and medical supplies used during transport.
• Knowledge of streets and highways within the response area of the mobile intensive care unit.

Experience Requirements

• Two years’ experience operating an ambulance or fire truck equivalent to the Duke mobile intensive care unit.
• Two years EMT experience with an active EMT provider
• Current certification as a North Carolina EMT
• Current Class C driver’s license

Education

• Work requires a high school diploma or equivalent degree.

General Description

• The communications specialist will perform a variety of activities in the Duke Life Flight Communications Center database, mapping systems, and related systems and equipment in support of air medical and ground-based patient transport services.

Work Performed

• Operate communications center switchboard, two-way radio transmission and receiving console, weather radar system, computer database, mapping systems and related systems and equipment
• Respond to emergency transport calls and dispatch Duke Life Flight crew according to established procedures
• Receive incoming calls and set up teleconferences with attending physician(s), flight nurse, referral source and appropriate receiving units; provide information on aircraft or ground transport availability, weather projections, locations and time projections.
• Recommend appropriate utilization of Duke Life Flight services to medical control officer on duty; outline available options and recommend course of action based on assessment of all relevant factors.
• Maintain interface with Public Safety to ensure proper coordination of transport services in emergency and trauma-related transport activities.
• Monitor, read and interpret weather radar information as requested
• Maintain database on referrals and hospital locations; access, read and interpret county, state and specialized maps for determining locations of accident scenes or referral sites.
• Provide statistical information as requested to flight crew to include average flight distance, average time, latitudes and longitudes; provide directions for landing sites.
• Participate in Duke Life Flight educational outreach programs as directed.
• Enter and record a variety of data and maintain a file of reports, forms, records, and daily log.

Experience Requirements

• Two years of dispatching experience in 911 control line, fire or police dispatching, air traffic control, hospital-based health or related setting.

Education

• Work requires the ability to operate radio/console equipment and transmit information generally acquired through a high school education.
• Requires North Carolina EMT Licensure.

General Description

The Paramedic will perform a variety of activities associated with the Life Flight Critical Care Transport service to include operation of the Life Flight Ground Critical Care Transport ambulance and medical support systems, and assist with operations of associated satellite base and ongoing continuing education outreach program. The Paramedic will provide direct patient care within their scope of practice for ALS I, ALS II, or BLS patient care transports.

Duties and Responsibilities

Level I (Advanced Life Support Paramedic)

· Responsible for assisting with patient care as requested to include loading and unloading, operation of commonly used equipment and providing family members information/directions to Duke.

· Responsible for providing direct patient care on ALS I, ALS II or BLS transports, not to exceed beyond the scope of The Paramedic as defined by the NCOEMS and approved by local medical direction, and documenting in the electronic medical record.

· Responsible for replenishing oxygen and medical supplies used during transport.

· Demonstrates safe driving skills and ability to use technology to complete missions safely.

· Assist with continuing education outreach programs and public relations events as assigned.

· Provide staffing coverage to Code Teams. Assist units within Duke University Hospital when necessary.

· Other duties as assigned.

LEVEL II (Adavance Life Support Paramedic Ground)

• Complete vehicle inspection and documentation each shift and complete a road test of assigned ambulance(s). Responsible for minor repairs to the unit to include but not limited to: changing light bulbs, replenishing fluids, tightening nuts and bolts, inspecting tires, etc. Responsible for daily maintenance including fueling and cleaning of vehicle. Responsible for reporting minor and major repair needs to the site specific Fleet Safety Coordinator, Clinical Team Lead, and/or Program Manager.
• Responsible for providing direct patient care in accordance with the Paramedic scope of practice as defined by the North Carolina Medical Board under the medical oversight of the Medical Director of the practice setting where the individual will function.
• Assists clinical staff in the evaluation, treatment and care of patients. Obtains pertinent history and performs a physical examination. Performs technical procedures as delegated.
• Monitors patients and maintains records using patient monitoring system and electronic health records. Documents patients' status, delivery of care and evaluation of the patients' response to care according to specific procedures and established protocols.
• Documents and maintains an informative and accurate medical record to initiate charges for each patient treated.
• Communicates in a professional manner essential information to all appropriate members of the healthcare team to promote sharing of information throughout the continuum of care.
• Operates extensive medical and mechanical equipment in the hospital and transport environment. Ensures all medical equipment is functioning; restocks medical supplies as needed.
• Provides and maintains a safe and therapeutic environment for the patients, visitors, and staff. Properly disposes of and handles as applicable, sharps, soiled materials, and linens and disinfects area in accordance with policy and policy as applicable. Properly uses PPE when in contact with patients, soiled utility, hazardous materials in accordance with policy.
• Act as preceptor and support the development of other staff and formal learners.
• Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Supports an environment of evidence-based practice/research/quality improvement initiatives
• Maintain certifications and clinical skills.
• Performs other related duties incidental to the work described herein.
• Complete vehicle inspection and documentation each shift and complete a road test of assigned ambulance(s).
• Responsible for minor repairs to the unit to include but not limited to: changing light bulbs, replenishing fluids, tightening nuts and bolts, inspecting tires, etc. Responsible for daily maintenance including fueling and cleaning of vehicle. Responsible for reporting minor and major repair needs to the site specific Fleet Safety Coordinator, Clinical Team Lead, and/or Program Manager.
• Responsible for assisting with patient care as requested to include loading and unloading, operation of commonly used equipment and providing family members information/directions to Duke.
• Responsible for providing direct patient care on ALS I, ALS II or BLS transports, not to exceed beyond the scope of The Paramedic as defined by the NCOEMS and approved by local medical direction, and documenting in the electronic medical record.
• Responsible for replenishing oxygen and medical supplies used during transport.
• Demonstrates safe driving skills and ability to use technology to complete missions safely.
• Assist with continuing education outreach programs and public relations events as assigned.
• Provide staffing coverage to all bases as needed. Assist units within Duke University Hospital when necessary.

LEVEL III (Critical Care Paramedic)

· Perform all responsibilities specified in Level II.

· Obtain pertinent history and perform a physical examination based on comprehensive knowledge, advanced skills and sound professional judgement. Obtain historical data from an environmental survey, attending medical personnel, patient or significant other, and existing documentation.

· Complete a systematic, rapid primary assessment and a prioritized secondary survey. Analyze and assess available diagnostic data. Revise plan of care as new information becomes available.

· Provide care in a critical care environment utilizing appropriate, timely interventions, per program protocols, in a priority sequence within scope of practice not to exceed standards set by the North Carolina office of EMS (NCOEMS) and local medical direction.

· Utilize Advanced Skills prioritizing the patient???s needs based on potential or actual needs. (I.e. intubation, Rapid Sequence Intubation, needle decompression of tension pneumothoraces, percutaneous cricothryoidotomy, placement of intraosseous and central line).

· Demonstrates proficient use of advanced and basic life support equipment and maintains contact with Medical Control when necessary for protocol deviation.

· Communicate essential information to all appropriate members of the healthcare team. Evaluate patient progress, analyze data, and modify the planning and implementation of care based on patient response throughout the transfer process.

· Communicate between referring and receiving healthcare professionals to ensure continuity of care. Act as a liaison between patients, families, referring healthcare professionals and DUHS staff.

· Plan, organize and maintain equipment and supplies for use before, during and after transport. Perform inventory of transport vehicle every shift with restocking after each transport. Plan for special equipment needs for each transport. (I.e. external pacemaker, intravenous infusion pumps, intra-aortic balloon pump, isolette, baby pod). Maintain equipment repair as needed.

· Provide and maintain a safe environment for fellow crewmembers, the patients, assisting agencies, and ancillary personnel.

· Maintain certifications and advanced skills.

· ADVANCED SKILLS: Intubations (nasal, endotracheal), RSI, and needle decompression of tension pneumothoraces, percutaneous cricothyroidotomy, central line placement (EJ), and intraosseous line placement.

· Mandatory attendance in Surgical Skills Lab, Skills Blitz and Safety Day. When identified to maintain competencies, participation in patient care in clinical areas to include the Operating Room, ICU???s, Labor and Delivery and Emergency Department to maintain advanced skills.

· Identify, develop, implement and evaluate clinical and operational protocols, policies and procedures. Participation in Performance Improvement. Mandatory review (75% attendance per year required) of clinical cases, policies, protocols and procedures in Monthly Peer Review with Medical Director.

· Develop, implement and evaluate educational offerings related to Life Flight for internal and external groups.

· Develop, implement and evaluate research studies. Collect, compile and evaluate clinical and demographic data. Complete required transport paperwork. Participate in multi-institutional research studies. Formulate research studies as needed.

Experience

Level I

• Preferred three years prehospital experience with a moderate volume (15,000-20,000 calls/year) 911 agency.

Level II

• One year ALS Paramedic experience required, preferred two to three years prehospital experience with a moderate call volume (>15,000 calls/year) 911 agency.

Level III

• Minimum of three years (4 years preferred) current ALS experience as a Paramedic in emergency setting with a moderate to high call volume 911 agency (20,000 to 35,000 calls/year) Obtain FP-C within 2 years of hire. If previous Critical Care Transport experience, FP-C required upon hire.