WEBVTT
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This week, the Valor Flight Crew Podcast welcomes Dr.
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Jens featuring from ADAC Luftertong to discuss HEMS in a different part of the world.
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So that means we should focus more and more to data-driven emergency medicine.
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We should focus more on to see what happens after we have seen the patient.
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So we should give we should have a feedback from the hospitals.
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We should have a feedback from register data and so on and so on.
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And that's part of the biggest uh one of the biggest discussions we are actually having in the healthcare service.
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Welcome back to the Valor Flight Crew Podcast, hosted by Echo and brought to you by Vertical Helicast and Valor Plus.
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Today, we go international with Dr.
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Jens Feathering from ADAC Luftertung to compare German and U.S.
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hems.
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From system design and training to pre-hospital care and operational efficiency, we explore what makes these systems different and what we can learn from each other.
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So strap in as we cross borders, challenge assumptions, and take a global look at improving hems.
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Thank you to our sponsors, Airbus, Metro Aviation Incorporated, and Global Medical Response Air.
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Welcome to the Valor Flight Crew Podcast.
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Brought to you by Vertical Helicast, produced in partnership with Echo, Every Coast Helicopter Operations.
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The Valor Flight Crew Podcast promotes the personnel and life-saving equipment behind helicopter air ambulance services.
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Join hosts, Mike Fidelic, and Flight Striker for in-depth interviews and expert insights from air medical personnel, pilots, communications specialists, and maintenance crews to play critical roles in airport emergency response.
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When there are three or four people suffering from the same problem like chest pain, you don't know if if it is different from the first to the second, the second to the third, and we start with our protocols and we use the same medications.
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Right.
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But are we really precise to find out if there is some chest pain and should we know using the ultrasound if the left ventricular if uh ejection fraction is 25% or 35%?
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Because we all know that no patient's gonna follow the textbook.
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So we have to figure this out some other way.
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Yeah, yeah.
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Yeah.
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That could be uh maybe in future one of our our efforts to concentrate on becoming more precise and to get more individual uh aspects in our treatment uh protocols.
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I think in 80%, but I d uh it's just guessing.
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Um in 80-85%, we all know if there's someone uh uh suffering from a pulmonary edema and you put some medication in and some nasal CPAP or uh uh non-invasive um uh ventilation on, and you bring him to the next hospital in uh 15 minutes and he is quite good.
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There's no difference if you put the same treatment on the first and the second and the third patient, so the outcome is the same, but nobody really knows.
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And then maybe this is something we should uh lay back on more and more scientific working, and therefore we have to have some more scientific working on pre-hospital condition.
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But that is really challenging because when you ask someone from the ethical committee uh to get the informed consent from the patient, it's quite different uh to get the informed consent from the patient with the GCS level of five.
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Right.
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Exactly.
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That's I think one of the challenges we we do have, but we shouldn't we should go for it because 'cause the result is uh important to know.
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Otherwise we can't answer the question in the future uh at which point, at which time we have this the right resource for the right patient.
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And this is at the end of a political debate how many resources we get because the the the the the idea in the constitutional law in my country is that every individual has the same right to get to get protected by the law, to get protected by the state, and at the end to get the same level of care it doesn't matter if you're living in rural, urban or whatever.
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But that is really if it is realistic or it is just I'd say uh a minimum requirement based on the constitutional law, but that doesn't mean that the the idea is good, the concept might be good, but if it is realistic, I'm not quite sure.
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You know, Mikey, you you brought up such a good point about like how we do things and and what kind of drives us on how we provide the care pre-hospital.
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And you talked about research and like so much of it is retrospective because be you know, we're not flying around and being like, you're gonna have a heart attack here in a little bit, or you know, you might rate have shortness of breath.
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Like someone asks for us to come to them, right?
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You know, and so much of that research is so retrospective.
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But but then I also wonder, and and and as I'm thinking in my head as we're having this discussion about like what business do I have being in the helicopter with my two years of school, two and a half, who am I to be qualified to take care of somebody as sick as they are?
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When when Jens, you've got what, 15 years of just education and and study, and like you said, the only way to learn medicine is to practice and provide and do medicine.
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Like, who the hell am I?
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You know, to do it.
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Like I've been doing this 20 years, but have I been doing it right?
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Have I been doing it wrong?
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Have I just been giving it the old try?
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You know, like uh it was you do all these things, and then when people I've worked with and they're like, ah, you have to worry about three things.
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If they're not breathing, you breathe for them.
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If they don't have a pulse, you know, you give them a pulse, and if they if they don't have an airway, you give them an airway and stop the bleeding.
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Like air goes in and out, blood goes round and round, and it's like, oh yeah, that just sounds so simple.
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But it's so much more obviously complex than that.
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But when I'm trying to assimilate, like, well, what business do I have being in the back of the helicopter providing this care uh to the patient?
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I I don't have a fraction of the the education that you have, the practice, the practicality of truly seeing what works and doesn't work for patients.
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And then I'm sitting right next to it.
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I I could essentially be sitting right next to you if I showed up tomorrow and you were sitting in my helicopter, like, hey, we're gonna go fly.
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Dude, my head would spin right off.
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I don't even know that I'd be able to be able to sit there and just like practically think that I'm would be the best resource for someone having uh, you know, their emergency.
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And and I think about this in my mind of like the education that I have, who am I to want to be able to do this, and then let alone to like become an educator to teach or train people?
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That I don't see myself as as that, as anybody qualified truly to retrospectively look back at that.
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But I feel like at least at some point we it's kind of that balance, right?
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Like, yes, I've been doing this for a while.
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I don't know that I've even been doing it right, but I've at least been maybe going in the right direction.
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And I think of like, how is like that best model to truly bring that to what model is it that we should follow to to bring that resource to the patient?
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Is it if we know that the physician doesn't have to go to every emergency, right?
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Then how do we and how do we get there?
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Like, how then do we really solve that?
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And then I then my other fear is it always comes down to money.
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I mean, it truly does.
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And and I think that's just the the the ugly truth to it is it it takes money to to get there.
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And whether it's should it be the government's responsibility, there then then the private sector comes along and says, Hey, I can also do the same thing, and I have money and I want to do this service, and people do, and they do it successfully all the time.
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So I just don't know, is there is there the way that like we can blend this all together?
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Like the three aspects of like how do we get this patient-centered care?
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And how do we standardize that?
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Like, how do we standardize that and really balance government authority, private sector influence, and all these things.
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So, how do we blend that to really say that this is going to be that best model and optimizing that HEMS model to get that to the patient?
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I think there there might be a few aspects uh when you would like to organize a highly efficient system.
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Starts with the with the incoming call, starts with a uh a good uh line of questions, so standardized questions to pick up the really emergency cases.
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And I think in general we should have uh two two things.
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When politics or other decision makers are trying to build up a system, they should talk to someone who's from the system.
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They should ask for someone who knows what happens when you just come and get confronted.
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I scratch my head at that and forgive our laugh because it's like you would think that that sounds so simple for people to be like, hey, why not talk to the people that do this?
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And I feel like at least here in the States, we just airball like just let me go ask someone that doesn't do the job on how we should do this job.
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I feel like that's just correct me if I'm wrong, Mike.
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I feel like this is dictated by those that don't.
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Oh, it's so frustrating.
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Yeah, because we maybe we're talking about ideal composition.
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So when we build up, and that's we we do have the same experience that when they started, there was a lot of a lot of influence from the from pioneers who who advised the politicians um to that there is a need for building up a systems like uh uh like uh ambulances and and all that.
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When they started at the end of the 60s, there was no structured system where you can call someone when you can send someone with an ambulance.
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So there was an influence.
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And nowadays everything is at the end of the day uh asked by someone who is uh responsible for money, and that's okay.
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So if we are all convinced about that we should deliver a high level of care, which means the context is is quite clear, which means that we know the the patient side.
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So if there's someone calling 112, which is 911, um we we do know people they call and they know which keywords they have to use to get an ambulance.
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So therefore uh that that's uh the efficiency of the system starts with uh with the beginning of the line that if there's an incoming call, there should be a standardized question so that the dispatcher is able to recognize what is really important.
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And that sounds very simple too.
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Um like if you would like to build up a house, you start talking to some people which are able to build up houses.
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And if you would like to have some new lamps in your house, you should talk to someone who knows which cable comes from the right to the left corner.
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If you would build up a system bus traveling from the eastern coast to the western coast, you should probably someone you should ask someone who is able to drive a bus and to know where you can buy a bus and what is needed to drive the bus and so on and so on.
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And uh maybe it's too I'm a little bit hard to say naive, yeah.
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So that I'm I'm uh in my mind and in my impression the world is sometimes the world is not only complicated, sometimes there are a few things that are really simple.
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And as you said, if there is someone suffering from a obstructed airway, we should open and secure the airway.
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I'm I'm not c I I think there maybe there is not the global solution for every region of the world.
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So I I think uh you should adapt this to every country, to the systems and to the people living in there.
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They um they are used to have support from EMS, from the hospitals, so the population is uh looking for someone who is answering their medical questions.
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And that in in some cases that could be someone from the hospital, that could be a general practitioner, and that could sometimes be someone from the EMS.
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When we would like to be precise and then we need more data, we should have this exchange between different countries.
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We should pick up not our own traditions and our own thoughts.
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What about the best way?
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It should based should be based on strong data and scientific working.
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And I think that that question is obviously a very hard one to answer because there's no there's one, no perfect system, but two, there's so many different systems that it's hard to pick what's going to work the best across the world, right?
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Right.
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And it seems in the US everything is much more privately funded.
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Uh there are some government agencies that are out there, but most things are privately funded and privately run, uh, whereas that may not be the case in every region or every part across the world.
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And so you run into different barriers or loopholes or uh whatever word you want to use to describe it, which I think makes it so difficult in each of those regions to really figure out what that best system is.
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You know, I and and I and that's why I I love hearing your perspective on this because I I feel as though we all at the end of the day often share the same frustrations uh and concerns and want the same things, but we we have different abilities.
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I'm not saying different um means to get there, but different abilities based off of the constructs that are in our particular areas.
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And so I find it very interesting to have those conversations because I don't, at the end of the day, I don't think your perspective is different than than Blake and I.
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It's just how we're able to deliver that.
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And I think back to there's been many conversations, you know, I'm sitting around the crew table and talking with my um with my partners, and we're like, okay, so we're either A, not happy or B thinks something needs to be changed.
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If we had it our way and we could just tomorrow just poof build our own hem service, what would that look like?
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00:17:05.960 --> 00:17:15.160
And and I I think that there's a lot of wonderful ideas that we have about how we would make that that system there.
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But I think we always got into the weeds of it.
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And I think we need to kind of, this is also one of those things we need to simplify.
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So I guess my question to you is so you have a lot of insight on HEMS specifically and on the healthcare system in Germany.
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If you had to say, tomorrow I'm gonna have my perfect HEMS system in front of me, where would you start?
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What would that look like?
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It's a good question.
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Because when building up a system which should work and therefore for sure is there's money needed, where the money comes from, who cares?
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So we should define how much money is needed to build up a good system.
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But when talking about the good system, what means a good system?
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So we should um have the goal, we are we would like to deliver optimized level of care, which depends on on the time um you're living in, the time of development, and so on and so on.
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I'm sure that when at these days someone would like to build up a HEM system in my country, one of the most important barriers would be uh from the perspective as an authority, that uh it would be not allowed to land on an motor highway.
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So that would be one of the biggest challenges that someone was asking concerning the level of safety in when flying, that they would like to answer the question, are you sure you would like to land on a motorway?
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But this is not a medical point.
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I think creating an ideal rescue organization, uh rescue system using helicopters starts while picking up all these data from the country and starts on the green table.
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And that is the difference to what we have experienced the last five decades, because the pioneers started not having a a strong planning process.
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They started while they had been convened about the fact that there should be some kind of care on scene.
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We've recognized at the beginning of the seventies close to uh thirty thousand dead people f in in in in traffic and then they started to build up a system and they started very isolated in one or two areas just to see if it if they are able to deliver the the level of care using a helicopter with the with the knowledge from from these days we should start following a strong strong planning and then maybe the the the end of the the planning process would be not to have eighty helicopter bases, maybe there are only sixty bases needed.
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Maybe you don't have to have so much ambulance cars, maybe you d you would uh have different responsibilities in the different areas.
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So maybe when you when you start it nowadays with all the knowledge you have, it would be much more planning and it would be much more centralized.
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It's not a start uh a bottom up process, it it's much more a top-down process while you know how many people live in which area and uh uh with uh which kind of uh diseases, injuries you can expect in this area.
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So that is that would be big the difference, but it's unrealistic because we have the system we have and it's our it's our goal and it's our our effort to talk to all these decision makers to uh make the things better while having the system we have.
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But it starts from talking about having uh two hundred and thirty dispatch centers or using only fifty it starts with a with a national program and question if there is someone centralized and responsible for the system.
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It starts how many resources we should have.
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It starts from having a discussion, uh, what about the influence from the EMS to the to the final result from the patient and so on and so on.
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You know, I I think when when you're talking about like how do we we have the system we have, you know, like that's been brought up, we've got it.
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So how do we make that more efficient?
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And I want to kind of talk a little bit about how you you are set up throughout throughout Germany.
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And you said you have, I think when we spoke, you have 230 dispatch centers throughout Europe.
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And then you and for your for ADAC, you have 30.
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seven stations throughout Germany as a whole, correct?
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Correct.
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And and you're serving about eighty-four million people?
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Yeah, but uh there are two three other operators.
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So in in total we do have around about eighty helicopter bases and uh the population is about eighty eight four million people right in Germany.
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So I could only imagine uh like just using different type of measured data to see where you'd be most useful, right?
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So and I understand you you do have some aircraft that do like search, rescue, and hoist like and just and I think we kind of overlook that sometimes.
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Like I know for me I would want everything in one shot.
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I live in southern Florida of the United States it is flat and the only hills we have are overpasses for highways and you know we think about hoist and like mountain rescue but then out here in the the swamp land which is essentially Florida is just a peninsular swamp and we have a lot of adventurous people are Florida man you may have heard of them they uh they they like to go kayaking or do all kinds of random things at all hours of the night and they go get lost and so yeah we do send a helicopter and you're like why would you have a hoist there's not a mountain anywhere but well it's there's very difficult access right so and I think about that and I'm like oh I think we would really benefit from having that type of resource but then what if you actually look at the numbers and well if we did like two a year three a year well yeah obviously it wouldn't make sense and it's like well just stand up you're in the swamp like it just stand up and walk you could walk out of it right you know and you look at like providing that right resource and using that data to really optimize like that system.
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So I'm just kind of curious like what data do you guys use or those like how do you start to determine what bases are going to run either 247 versus just sunrise to sunset because I know that's a huge difference uh from how you operate in in in Germany and in Europe versus us here in the States.
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All of us here in the States are 24-7 as much as we don't like the 2 a.m calls but you know emergencies don't stop at sunset.
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But it also brings in the element of actually doing it safely and effectively and I've often wondered what those differences how they're measured and how we get to those abilities to say that this is the safest way to do it and deliver that.
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So are you able to elaborate a little bit on on on how you're able to kind of determine and strategize where you're going to put that resource and and how you're able to use it.
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I totally agree if you say emergency doesn't stop.
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At the end of the day it's a mix between ground and helicopter services and so if there's an emergency during the night in the in that region there is no helicopter available and the service should be done by the the ground ambulance and two things you stressed out.
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So the first thing is what about the hoisting hoist operation means traditionally it comes from the mountain areas where we pick up people from from the Alpine mountains but nowadays we think about using it more and more under different conditions.
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We do have some mountains which are only thousand five hundred and thousand and six hundred meters and we still use them inside some specific areas in the cities.
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So um uh as an example in Hamburg which is a large city from the German perspective it's about two million people it's not it's for Chinese it's just a small town but um for us it's a big city, the second second largest city in Germany after Berlin.
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So which where there is a big harbor where you have moving ships, big ships where you have uh different areas where you can't get enough access by ground ambulance.
00:26:53.960 --> 00:27:08.760
So there are still some advantages we uh we picked up uh the last three years when getting uh when having access to the to the patient and that in average there could be an advantage of ten minutes.
00:27:09.480 --> 00:27:16.040
So this could be part of a discussion if you would like to have a hoist on board or not.
00:27:16.280 --> 00:28:40.360
The decision how we run the service if it's 247 or just day by day if there's a hoist or if it's three or four people is not our own decision because the governmental authorities who are responsible for the EMS in that region they deliver a tender and then you can raise up the hand and say okay we are able to run that service and sometimes the decision if it is a 24-7 service or if it is just a day-by-day service um based on simulation data some uh governmental authorities ask for uh support from scientific institutes which starts uh using and and and uh retrospective data analysing retrospective data and uh doing some simulation stuff and then come to the recommendation that there is a need for a 24-7 helicopter or for some helicopter which um starts at six in the morning and ends up at uh ten in the evening because we do know that between two and five a m there are less uh emergencies and and then you come to the to the main and most important discussion if there's a need and if there's no need there's no need for spending money for having a service 247.
00:28:41.000 --> 00:28:53.400
Despite the fact that uh or on on on the other hand there's um the need for education, training people using IFR conditions or using NBG goggles and stuff like that.
00:28:53.560 --> 00:29:01.160
And all these the technical point is one point having an helicopter, having an hoist is one point.
00:29:01.320 --> 00:29:42.120
The other hand is uh how to train people and that's the most uh the most expensive part of the of the mission to to train these people so this is at the end one big uh big element of the discussion uh which you have to dis debate with the with the authorities but we do have a good experience while uh using a hoist in a city or in an urban area thank you to our sponsor Metro Aviation Metro Aviation the world's largest family owned aeromedical operator offers comprehensive aircraft services with 140 plus aircraft in over 25 states.
00:29:42.360 --> 00:30:02.280
The completion center installs medical and law enforcement kits in avionics serving diverse aviation needs including offshore utility VIP and corporate sectors I think people's minds would be blown here in the States if you were just like in the office building and you just see someone come over just you know we're not gonna yeah we're just gonna hoist them right out of there.
00:30:02.360 --> 00:30:03.160
We'll get you right out of there.
00:30:03.240 --> 00:30:06.040
I think people like that would just people here would be shocked by that.
00:30:06.200 --> 00:30:07.560
Just obviously not the everyday thing.
00:30:07.800 --> 00:30:12.040
Yeah usually for us it's we find somewhere to land and we go in and do our thing.
00:30:12.120 --> 00:30:17.240
That's something that I think people would just it would be totally different for us to see on the regular basis.
00:30:17.720 --> 00:30:26.440
And I guess so that kind of I I think this conversation easily leads into or this portion of it easily leads into the AirMed World Congress.
00:30:27.160 --> 00:30:29.720
Because we want to spend some time talking about that with you as well.
00:30:29.880 --> 00:30:43.720
I think that this is I didn't know a whole lot about this before we had kind of our our pre-recording conversation uh and it's certainly a like I said a Congress or a conference I would love to go to but uh the theme is beyond boundaries, right?
00:30:43.880 --> 00:31:01.800
And I was wondering if you can talk a little bit about the conference itself and what the overall goals are and if there's anything you're able to share maybe as a I guess it won't be a sneak peek uh since when this airs it will be after the conference itself but if you can kind of share a little bit about the AirMed World Congress coming up.
00:31:02.280 --> 00:31:27.240
So um the Amet Conference is um has a long tradition it started 40 years ago uh then when there's some where there have been some pioneers from Munich so we advertise a little bit the conference these days uh to bring the conference back home so coming back to the rules means that the Amet starts in Munich and it's for to today it's in Munich.
00:31:27.480 --> 00:32:03.240
The idea uh while we start with inside the program commission uh what we want to talk about is that we do have three sections like medicine, aviation techniques and management and the idea was to bring people from these different sections together not to have an isolated debate inside the medical community inside the technical community and uh gathering a few CEOs together and then they start talking about things they uh they have uh from their perspective.
00:32:03.400 --> 00:32:03.960
Yeah.
00:32:04.520 --> 00:32:14.520
So the idea was um to get the chance to to have a quick view all uh over your own comfort zone.
00:32:14.840 --> 00:32:41.320
So we managed to have some lectures, we managed to have some workshops uh where people uh typically working inside their aviation uh surroundings are able to follow someone uh who comes from the medical point and who can share some information what is the need when you're sitting back inside the cabin and and vice versa.
00:32:41.560 --> 00:33:02.600
So we bring uh someone from the medical crew and to see what happens in front of the helicopter while sitting in a simulator and uh we bring pilots to um uh how to say to uh to a meeting and to workshop where they can train uh to put some secure airway in.
00:33:02.840 --> 00:33:11.080
So uh just to make sure that uh each one who's working inside the system is able to understand what the other one is doing.
00:33:11.240 --> 00:34:59.320
For sure uh we we know that all people working on a daily basis uh together they they have the experience and I know that a lot of pilots have an imagination what happens inside the cabin they they they get an imagination uh what is uh what is uh a heart attack and what is a resource situation and vice versa uh all the medical crew members have an impression what about weather conditions what does it mean um to have uh the stick the pitch the collective and all the technical things and but to to increase the level of understanding from the different perspective that was one of the the ideas and the motto behind uh the next airmade I always have that longstanding joke with my pilots if the they let me fly I'll let them intubate no one no one's taking me up on that yet if you fail with intubation there's only one who is uh getting in trouble yeah if you stop flying maybe and then maybe guaranteed and then the steel is driving so well I probably don't want to fly wait a minute I didn't I have to throw a pitch at the pilots here because there are many pilots I would get in a helicopter with any day but getting in a car with them absolutely not the more technical systems in the helicopter where they are covered and and in the car it depends on how old is the car yeah I just I I looked at the how old is the pilot?
00:34:59.400 --> 00:35:17.800
We had one guy I was like every day you come in and you knew you saw how he parked I'm like man how do you fly a helicopter so well but you can't park in the line I think it's great though to to really have people come together to truly understand the perspective I guess of just what each aspect is going through.
00:35:17.960 --> 00:35:34.519
And it just highlights so much more how we are all an integral part for that success of that patient encounter like one can't perform without the other being there and being part of it to to to really be successful.
00:35:34.760 --> 00:36:02.440
And I think it's so great because and I'm the more that we talk we have the so many similarities of it's the same common goal and we and we we're wanting to provide the best patient care but there's so much that just goes into that and it's more than just the the the medicine that's just one aspect of it and that just has so many infinite characteristics that that we would always try to measure.
00:36:02.680 --> 00:36:18.039
But then there's so much more we could measure from the aviation side and then there's maintenance and then there's logistics it takes so much it takes a village right like that's our weird saying that we have it takes that village to to really have that really be successful.
00:36:18.280 --> 00:37:04.760
And I love that that you guys do that and and and Mike I know you can back me up on this I think it's only in recent years that we as clinicians that we have been able to prove that we are more than the the self-loading baggage as we've often been called right and you know we did a podcast with pilots before and he referred to pilots as meat servos which I thought was quite quite comical but we it but it just shows that we all have to work together cohesively and do it effectively and constantly reevaluate how we're doing things why we're doing things what's the outcome so Jens what would you say from for us in the States what could we take away from hems in Europe?
00:37:04.920 --> 00:37:19.880
Like what's something we could bring back that would help us in any one of those situations whether it be medical aviation the the technical aspects of it what's something we could learn from hems in Europe here in the States?
00:37:20.280 --> 00:37:37.480
I think we we all should and I I'm not quite sure if we have in Europe these common sense that means when talking about hEMs we mostly come up to very specific detailed different discussions but sometimes it's very simple.
00:37:37.640 --> 00:37:57.400
So the idea behind hems is we deliver medical care in a in a in a condition for a patient using the pl the technical platform helicopter that's the way where we come to the patient and we should have the same common sense what means HEMS.
00:37:57.960 --> 00:38:05.960
So the key product we have is we deliver medical care for someone who probably needs that.
00:38:06.200 --> 00:38:12.200
We don't know it at the beginning and we are able to transport if there is a need to transport the patient.
00:38:12.599 --> 00:38:26.440
So that is the common the common base and this understanding should be um the common base for all of us in Europe, in the US, in wherever you deliver HAMS or EMS.
00:38:27.400 --> 00:39:47.240
Sometimes we use the cars, sometimes we use the helicopter we know that there are a lot of regulations when I started my career in anesthesia we've learned a lot from the aviation area due to that they follow protocols that they do have checklists that they that they have strong debriefing that they look for what about data what they use close communication all these aspects we've learned from the aviation and in in Europe and in in Germany as well we try to understand if there are things to to we are able to make better and that is probably something what we can transfer to other countries to say okay that's our idea and sharing these ex experiences is something I I'm not sure if if you talk to to different providers, to different operators, if you have a common base all over the country because might be challenging due to that US is a large country and I know that when we start uh in ninety seconds after the uh incoming alert and be able to reach the patient in about 10 minutes, it's not comparable to what you're doing because uh you sometimes I can imagine use 30 minutes to come to the patient.
00:39:47.559 --> 00:40:04.840
So I I think to uh to be awake to be aware of what happens with these patients and to to share these expertise that is the mean goal to become better and that should be the common sense for all of us.
00:40:05.160 --> 00:40:15.800
I I love that and I think it's so important to bring everybody together just like you said and I I think that's also been what has always drawn me to the core values of Echo is bringing everybody together.
00:40:16.200 --> 00:40:23.160
It doesn't matter what color flight suit you wear it doesn't matter what your role is within the organization we can all learn from each other.
00:40:23.320 --> 00:40:29.000
We can all build upon things and we can all move forward as an industry and make it safer and better for ourselves and our patients.
00:40:29.240 --> 00:40:33.480
And I think that that's ultimately one of the most important goals.
00:40:33.960 --> 00:40:43.720
And I guess that kind of leads me into my next question for you of though like the so the the AirMed World Congress theme this year is Beyond Boundaries.
00:40:43.960 --> 00:40:56.440
What boundaries do you see in place for us and and where should we be looking as an industry whether that be you know locally or globally where should we be looking as an industry in moving forward?
00:40:56.680 --> 00:41:01.400
Like where do where where should we see ourselves in the next 10, 15, 20, 25 years?
00:41:02.360 --> 00:41:03.480
What's our our pathway?
00:41:03.960 --> 00:43:53.079
Then we'll talk about a lot of money how what I will get in about 10 years when I when I solve the problem and and and light up the the crystal ball right yeah so what we can learn from each other maybe we we can learn what what kind of uh which cases of emergency we can hand over to someone who's not really the highest uh qualified man on the scene and vice versa you you can think about how you innovate how you or how how you bring innovations to the system or in if there are cases where there is a a really profit from uh having a physician on board this could be something when you mixed up the systems and we know that uh due to some financing there is a difference between the systems because everything what we do is based on an insurance and and that is maybe quite different to the US but if you ask for uh how we we as an industry as a system uh move on forward I do expect that we should have much more and deeper understanding of of of data we should have in future much more ability to look onto how different industrial and industry partners um deliver their system and that's the chance we should that we should use because having the same goal and having the same common sense means that we should exchange these experiences and this is something to light at the crystal ball rotor wing pilots your experience is in demand your skills are indispensable now take your career vertical with global medical response find out about GMR's significant EMS pilot pay increases sign on bonuses and stay incentive plans for select areas visit gmr.net backslash pilots to learn more and earn more today and we we should have the the open mind to to understand that we are serving and we are delivering a good service but there are different people doing it differently and that doesn't mean that it is not it's not not a good service so that could be the same level of care and the final results so uh sounds a little bit uh simple but there are different ways to roam and um this open mind should always be a part of our thoughts and uh then uh I'm sure that we are able to to increase our service levels.
00:43:53.640 --> 00:44:10.440
As you're really elaborating on that I had this this thought of you know when we go to take care of a patient, especially in a helicopter we see so many different extremes I guess of of what we can bring to the patient, right?
00:44:10.599 --> 00:44:23.320
So I think of an ischemic stroke patient that's you know an hour and a half from that facility if we're called there as a flight crew for all of us together, uh you know we may get there.
00:44:23.800 --> 00:44:31.640
And the only thing that we're delivering to that patient is the fast ride, you know maybe You know, the supportive care, you know, a couple of things, but that's really what they need.
00:44:31.720 --> 00:44:33.160
They need the intervention.
00:44:33.480 --> 00:44:35.160
And then there's the other side of it too.
00:44:35.320 --> 00:44:45.480
We're talking about EPCR where you're cutting, inserting, slicing, medications, ventilating, doing so many things.
00:44:45.559 --> 00:45:17.320
And I think that that is what will always be probably that hardest challenge for us as the critical care or the higher level pre-hospital, whatever it is in the Hem's world, is trying to the the one flight of what we would call the the handhold or supportive care to the the uh just the most intense, the most invasive, and the most thought-provoking type of call you can run.
00:45:17.880 --> 00:45:30.440
And then at the end of that, that settles down, you have those moments of letdown and or you know that come down, I should say, and like you're you're trying to restore that clarity, and then we got to be ready for the next one.
00:45:30.760 --> 00:45:40.360
I think sometimes, and that's actually realistic, and it has been always realistic, is sometimes uh gas oil is the best medication you can give.
00:45:40.680 --> 00:45:58.519
So uh but uh the the the most important thing in that case is that you that you recognize that there's nothing or just a few things to do on scene, and then the patient profits from what has to be done inside the hospital.
00:45:58.920 --> 00:46:15.559
And that has something to do with good training, with experience, with uh an understanding of physiology, and that you know as a medical provider working in a pre-hospital setting, that you know what is happening behind the hospital door.
00:46:15.800 --> 00:46:31.079
So that that is, in my impression, that is the idea while bringing people working mainly inside the hospital to the outside, because they know what happens inside the hospital, and that has something to do with definite treatment.
00:46:31.240 --> 00:46:39.559
So sometimes what we do in the EMS is kind of a bridging therapy, sometimes it is definitive care.
00:46:39.800 --> 00:47:12.519
So I've seen a lot of patients suffering from from respiratory problems, and if you have the time for half an hour going by helicopter or by car to the hospital, um they are quite normal when you enter the uh the emergency department because they use the time, and that is some one of the one of the uh things we can do and offer outside to have an understanding of what is uh how to say uh what we are able to do and if there is a sense, or if you just skip it and just go.
00:47:12.680 --> 00:47:58.519
And that is I I think in in in my mind, if we talk about all these invasive and highly invasive procedures next time, the most important thing is that we understand in which time we are able to be on scene, and if we are able to to to manage these things in a quite short period, and if there is a need for for this specific patient and uh to to avoid some things uh once again, sometimes it is uh much much better for this individual just to let him go or just to do and see and that's it.
00:47:58.680 --> 00:48:29.960
And then I I think from the emotional point of perspective, uh maybe you have to have ten missions and there's only one where you can uh where you can pick up everything what you have learned, where you can decide using different medications, where you can give technical procedures, and that's the how to say common word, what what I've learned in anesthesia, these um hours of boring and seconds of thrill.
00:48:30.039 --> 00:49:05.240
And that is sometimes uh sometimes the impression you've got when you are on a weekend, uh on a Saturday and Sunday, um best weather conditions outside, and you're just waiting for the next mission, so you try to to wait and and to to make s uh things nothing to do with medicine, and then then there is the beep coming in and you start and then in in the in the short period you have to to manage everything what you have learned the last years and what you're able to do with your hands and what you have to think about.
00:49:05.880 --> 00:49:18.680
I think that is one of the challenges in medicine, in emergency medicine, and this is maybe one of the aspects we all love to do uh and what we started with this job.
00:49:19.079 --> 00:49:19.800
I love that.
00:49:19.880 --> 00:49:45.000
I I think it's it's been such a great discussion, kind of learning how honestly, I think at the end of the day, how many similarities we have and what our maybe our why or our how is in how in in in the hems industry, whether you're in Germany or in the United States, I think it's so incredibly important to have these discussions.
00:49:45.160 --> 00:49:48.920
And uh I I'm really grateful, Jens, that you were willing to come on and join us.
00:49:49.000 --> 00:49:57.000
I have had an absolute blast uh getting to talk about all of these concepts over the past uh almost hour or almost two hours.
00:49:57.240 --> 00:49:59.800
So uh thank you so much for joining us.
00:49:59.960 --> 00:50:02.039
I it this has been a great discussion.
00:50:02.119 --> 00:50:11.400
I feel like we could sit here and talk for days and uh just learn so much from each other and and how we maybe solve the world's problems, if you will.
00:50:11.800 --> 00:50:12.680
It would be endless.
00:50:12.760 --> 00:50:14.200
It would be an endless, I think, discussion.
00:50:14.360 --> 00:50:19.480
We could talk for a year, and I think we would still end up with more questions than answers.
00:50:19.559 --> 00:50:21.880
But I think we would at least answer that question.
00:50:21.960 --> 00:50:24.519
I think though, I think we're on the right track.
00:50:24.680 --> 00:50:25.960
Uh I truly do.
00:50:26.200 --> 00:50:26.519
Yeah.
00:50:26.760 --> 00:50:27.160
Yeah.
00:50:27.720 --> 00:50:39.640
Having a conference like the Aramate next week is uh is part of the discussion, is part of the development, is part of the making things better and um kind of movement.
00:50:40.360 --> 00:50:55.400
And I've seen I've lost my background picture, but I would like to just uh give a few numbers where you can see from the uh ambulance next week.
00:50:55.800 --> 00:51:09.720
So have been a three-year preparation for the conference and I'm happy to see and uh I'm eager to see a lot of uh uh colleagues from about 85 hands-on workshops.
00:51:11.880 --> 00:51:20.039
So different ones from medicine, um, aviation techniques, management discussions.
00:51:20.920 --> 00:51:23.720
I think the most important ones are the one with Manny.
00:51:24.200 --> 00:51:25.400
But uh yeah.
00:51:25.960 --> 00:51:30.200
We see maybe maybe someday I'll be able to join you.
00:51:30.280 --> 00:51:32.599
Uh but certainly appreciate you sharing all that.
00:51:32.680 --> 00:51:38.200
I I think it would be I I do actually know a couple people that are going to the the Congress.
00:51:38.360 --> 00:51:46.280
And I I think it's I I can't wait to hear from them their thoughts on your ability on a global level to bring everyone together.
00:51:46.519 --> 00:51:50.200
Because I do think that there is some really important discussions that are going to be happening.
00:51:50.440 --> 00:51:54.119
And uh I'm super stoked to someday hopefully be able to join you there.
00:51:54.680 --> 00:51:56.440
Would be a great opportunity.
00:51:56.599 --> 00:52:13.880
Um so I think um having a discussion like this or having a discussion next week uh while we're having the Yamet conference is the starting point for um having a longer discussions or um having the opportunity to e exchange um experiences in future.
00:52:14.119 --> 00:52:16.039
So that's the idea behind.
00:52:16.280 --> 00:52:44.840
And we see a lot of known people next week and we meet a lot of people we didn't had contact to uh the last year, so that's the mixed up we we we're gonna see, and that's why I'm really happy to have the conference next week and share all expertises and share informations and maybe we have the chance for having some fun, especially in the evening hours.
00:52:45.240 --> 00:52:46.280
Absolutely.
00:52:46.519 --> 00:52:55.880
That's probably the other reason why a lot of people love going to I've heard about uh there's a small festival activity in Munich uh from Saturday on.
00:52:56.200 --> 00:52:59.160
Uh when the conference ends, um Yeah.
00:52:59.559 --> 00:53:01.480
You may be having a little bit of a party there.
00:53:01.800 --> 00:53:02.599
No, that's okay.
00:53:02.840 --> 00:53:04.200
We'll be with you in spirit.
00:53:04.519 --> 00:53:05.079
Yes.
00:53:05.320 --> 00:53:06.119
That's good.
00:53:07.880 --> 00:53:09.160
Uh thank you again, Jensen.
00:53:09.320 --> 00:53:10.840
Really appreciate the conversation today.
00:53:10.920 --> 00:53:12.519
Uh, it's been an absolute blast.
00:53:12.599 --> 00:53:19.320
And uh I know that uh our listeners are gonna absolutely enjoy learning about everything uh and how you do everything over in Germany.
00:53:19.480 --> 00:53:23.480
So thank you again for joining us and for um sharing all of your insight with us.
00:53:23.559 --> 00:53:24.280
It's been a pleasure.
00:53:24.599 --> 00:53:26.280
Thank you for having me.
00:53:26.680 --> 00:53:37.800
And uh to our listeners out there, once you're all caught up on the Balor Flight Crew Podcast, make sure you head on over to verticalhelicast.com where you can check out the Hangers E podcast, helicopter podcasts, and the vertical MRO podcast.
00:53:38.039 --> 00:53:39.880
Really appreciate you joining us again, Yens.
00:53:40.280 --> 00:53:46.519
Uh, and a huge shout out to our listeners and thank you for your continued support of the Vertical Hellcast platform and the Valor Flight Crew Podcast.
00:53:46.599 --> 00:53:48.440
Take care and we'll see you next time.
00:53:49.240 --> 00:53:52.519
Thanks for joining us for this episode of the Valor Flight Crew Podcast.
00:53:52.680 --> 00:53:58.840
Don't forget to like and subscribe to hear more stories that promote the personnel and equipment behind the missions in public safety aviation.
00:53:59.000 --> 00:54:01.880
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Visit Airbus.com for more information.
00:00:28.039 --> 00:00:30.439
This week, the Valor Flight Crew Podcast welcomes Dr.
00:00:30.519 --> 00:00:35.079
Jens featuring from ADAC Luftertong to discuss HEMS in a different part of the world.
00:00:35.399 --> 00:00:40.359
So that means we should focus more and more to data-driven emergency medicine.
00:00:40.439 --> 00:00:44.840
We should focus more on to see what happens after we have seen the patient.
00:00:44.920 --> 00:00:48.840
So we should give we should have a feedback from the hospitals.
00:00:48.920 --> 00:00:53.239
We should have a feedback from register data and so on and so on.
00:00:53.320 --> 00:00:58.439
And that's part of the biggest uh one of the biggest discussions we are actually having in the healthcare service.
00:00:58.759 --> 00:01:04.200
Welcome back to the Valor Flight Crew Podcast, hosted by Echo and brought to you by Vertical Helicast and Valor Plus.
00:01:04.519 --> 00:01:06.840
Today, we go international with Dr.
00:01:06.920 --> 00:01:10.760
Jens Feathering from ADAC Luftertung to compare German and U.S.
00:01:10.920 --> 00:01:11.400
hems.
00:01:11.560 --> 00:01:19.719
From system design and training to pre-hospital care and operational efficiency, we explore what makes these systems different and what we can learn from each other.
00:01:19.879 --> 00:01:25.319
So strap in as we cross borders, challenge assumptions, and take a global look at improving hems.
00:01:25.560 --> 00:01:34.519
Thank you to our sponsors, Airbus, Metro Aviation Incorporated, and Global Medical Response Air.
00:01:35.879 --> 00:01:39.159
Welcome to the Valor Flight Crew Podcast.
00:01:39.319 --> 00:01:46.119
Brought to you by Vertical Helicast, produced in partnership with Echo, Every Coast Helicopter Operations.
00:01:46.280 --> 00:01:54.280
The Valor Flight Crew Podcast promotes the personnel and life-saving equipment behind helicopter air ambulance services.
00:01:54.599 --> 00:02:09.479
Join hosts, Mike Fidelic, and Flight Striker for in-depth interviews and expert insights from air medical personnel, pilots, communications specialists, and maintenance crews to play critical roles in airport emergency response.
00:02:16.920 --> 00:02:35.000
When there are three or four people suffering from the same problem like chest pain, you don't know if if it is different from the first to the second, the second to the third, and we start with our protocols and we use the same medications.
00:02:35.319 --> 00:02:35.800
Right.
00:02:36.280 --> 00:02:52.599
But are we really precise to find out if there is some chest pain and should we know using the ultrasound if the left ventricular if uh ejection fraction is 25% or 35%?
00:02:53.560 --> 00:02:56.439
Because we all know that no patient's gonna follow the textbook.
00:02:56.680 --> 00:03:00.120
So we have to figure this out some other way.
00:03:00.519 --> 00:03:01.159
Yeah, yeah.
00:03:01.400 --> 00:03:01.799
Yeah.
00:03:02.039 --> 00:03:18.199
That could be uh maybe in future one of our our efforts to concentrate on becoming more precise and to get more individual uh aspects in our treatment uh protocols.
00:03:19.240 --> 00:03:22.919
I think in 80%, but I d uh it's just guessing.
00:03:23.000 --> 00:03:45.319
Um in 80-85%, we all know if there's someone uh uh suffering from a pulmonary edema and you put some medication in and some nasal CPAP or uh uh non-invasive um uh ventilation on, and you bring him to the next hospital in uh 15 minutes and he is quite good.
00:03:45.400 --> 00:03:55.639
There's no difference if you put the same treatment on the first and the second and the third patient, so the outcome is the same, but nobody really knows.
00:03:55.799 --> 00:04:06.840
And then maybe this is something we should uh lay back on more and more scientific working, and therefore we have to have some more scientific working on pre-hospital condition.
00:04:07.079 --> 00:04:21.639
But that is really challenging because when you ask someone from the ethical committee uh to get the informed consent from the patient, it's quite different uh to get the informed consent from the patient with the GCS level of five.
00:04:21.879 --> 00:04:22.040
Right.
00:04:22.680 --> 00:04:23.639
Exactly.
00:04:24.280 --> 00:04:33.240
That's I think one of the challenges we we do have, but we shouldn't we should go for it because 'cause the result is uh important to know.
00:04:33.400 --> 00:04:43.800
Otherwise we can't answer the question in the future uh at which point, at which time we have this the right resource for the right patient.
00:04:45.319 --> 00:05:15.800
And this is at the end of a political debate how many resources we get because the the the the the idea in the constitutional law in my country is that every individual has the same right to get to get protected by the law, to get protected by the state, and at the end to get the same level of care it doesn't matter if you're living in rural, urban or whatever.
00:05:17.240 --> 00:05:35.639
But that is really if it is realistic or it is just I'd say uh a minimum requirement based on the constitutional law, but that doesn't mean that the the idea is good, the concept might be good, but if it is realistic, I'm not quite sure.
00:05:37.000 --> 00:05:46.439
You know, Mikey, you you brought up such a good point about like how we do things and and what kind of drives us on how we provide the care pre-hospital.
00:05:46.680 --> 00:05:58.279
And you talked about research and like so much of it is retrospective because be you know, we're not flying around and being like, you're gonna have a heart attack here in a little bit, or you know, you might rate have shortness of breath.
00:05:58.439 --> 00:06:02.040
Like someone asks for us to come to them, right?
00:06:02.120 --> 00:06:06.680
You know, and so much of that research is so retrospective.
00:06:06.759 --> 00:06:28.519
But but then I also wonder, and and and as I'm thinking in my head as we're having this discussion about like what business do I have being in the helicopter with my two years of school, two and a half, who am I to be qualified to take care of somebody as sick as they are?
00:06:28.680 --> 00:06:43.959
When when Jens, you've got what, 15 years of just education and and study, and like you said, the only way to learn medicine is to practice and provide and do medicine.
00:06:44.199 --> 00:06:45.719
Like, who the hell am I?
00:06:45.959 --> 00:06:46.759
You know, to do it.
00:06:46.839 --> 00:06:50.040
Like I've been doing this 20 years, but have I been doing it right?
00:06:50.279 --> 00:06:51.480
Have I been doing it wrong?
00:06:51.719 --> 00:06:54.759
Have I just been giving it the old try?
00:06:54.920 --> 00:07:03.560
You know, like uh it was you do all these things, and then when people I've worked with and they're like, ah, you have to worry about three things.
00:07:03.639 --> 00:07:05.800
If they're not breathing, you breathe for them.
00:07:06.040 --> 00:07:12.920
If they don't have a pulse, you know, you give them a pulse, and if they if they don't have an airway, you give them an airway and stop the bleeding.
00:07:13.240 --> 00:07:18.360
Like air goes in and out, blood goes round and round, and it's like, oh yeah, that just sounds so simple.
00:07:18.920 --> 00:07:21.399
But it's so much more obviously complex than that.
00:07:21.480 --> 00:07:31.719
But when I'm trying to assimilate, like, well, what business do I have being in the back of the helicopter providing this care uh to the patient?
00:07:31.879 --> 00:07:43.560
I I don't have a fraction of the the education that you have, the practice, the practicality of truly seeing what works and doesn't work for patients.
00:07:43.639 --> 00:07:45.639
And then I'm sitting right next to it.
00:07:45.719 --> 00:07:51.159
I I could essentially be sitting right next to you if I showed up tomorrow and you were sitting in my helicopter, like, hey, we're gonna go fly.
00:07:51.240 --> 00:07:52.439
Dude, my head would spin right off.
00:07:52.519 --> 00:08:03.079
I don't even know that I'd be able to be able to sit there and just like practically think that I'm would be the best resource for someone having uh, you know, their emergency.
00:08:03.240 --> 00:08:17.319
And and I think about this in my mind of like the education that I have, who am I to want to be able to do this, and then let alone to like become an educator to teach or train people?
00:08:18.199 --> 00:08:25.319
That I don't see myself as as that, as anybody qualified truly to retrospectively look back at that.
00:08:25.399 --> 00:08:29.079
But I feel like at least at some point we it's kind of that balance, right?
00:08:29.159 --> 00:08:30.839
Like, yes, I've been doing this for a while.
00:08:30.920 --> 00:08:35.639
I don't know that I've even been doing it right, but I've at least been maybe going in the right direction.
00:08:35.960 --> 00:08:46.680
And I think of like, how is like that best model to truly bring that to what model is it that we should follow to to bring that resource to the patient?
00:08:46.840 --> 00:08:51.960
Is it if we know that the physician doesn't have to go to every emergency, right?
00:08:52.040 --> 00:08:54.120
Then how do we and how do we get there?
00:08:54.279 --> 00:08:57.240
Like, how then do we really solve that?
00:08:57.800 --> 00:09:01.720
And then I then my other fear is it always comes down to money.
00:09:01.960 --> 00:09:03.480
I mean, it truly does.
00:09:03.559 --> 00:09:09.559
And and I think that's just the the the ugly truth to it is it it takes money to to get there.
00:09:09.799 --> 00:09:25.799
And whether it's should it be the government's responsibility, there then then the private sector comes along and says, Hey, I can also do the same thing, and I have money and I want to do this service, and people do, and they do it successfully all the time.
00:09:26.120 --> 00:09:32.039
So I just don't know, is there is there the way that like we can blend this all together?
00:09:32.200 --> 00:09:35.879
Like the three aspects of like how do we get this patient-centered care?
00:09:36.120 --> 00:09:37.639
And how do we standardize that?
00:09:37.799 --> 00:09:45.080
Like, how do we standardize that and really balance government authority, private sector influence, and all these things.
00:09:45.159 --> 00:09:53.480
So, how do we blend that to really say that this is going to be that best model and optimizing that HEMS model to get that to the patient?
00:09:53.799 --> 00:10:00.279
I think there there might be a few aspects uh when you would like to organize a highly efficient system.
00:10:00.759 --> 00:10:13.559
Starts with the with the incoming call, starts with a uh a good uh line of questions, so standardized questions to pick up the really emergency cases.
00:10:14.679 --> 00:10:20.200
And I think in general we should have uh two two things.
00:10:20.919 --> 00:10:29.879
When politics or other decision makers are trying to build up a system, they should talk to someone who's from the system.
00:10:30.039 --> 00:10:41.159
They should ask for someone who knows what happens when you just come and get confronted.
00:10:41.639 --> 00:10:52.600
I scratch my head at that and forgive our laugh because it's like you would think that that sounds so simple for people to be like, hey, why not talk to the people that do this?
00:10:52.759 --> 00:11:01.960
And I feel like at least here in the States, we just airball like just let me go ask someone that doesn't do the job on how we should do this job.
00:11:02.120 --> 00:11:05.159
I feel like that's just correct me if I'm wrong, Mike.
00:11:05.320 --> 00:11:08.120
I feel like this is dictated by those that don't.
00:11:08.439 --> 00:11:10.360
Oh, it's so frustrating.
00:11:11.320 --> 00:11:15.559
Yeah, because we maybe we're talking about ideal composition.
00:11:15.720 --> 00:11:36.679
So when we build up, and that's we we do have the same experience that when they started, there was a lot of a lot of influence from the from pioneers who who advised the politicians um to that there is a need for building up a systems like uh uh like uh ambulances and and all that.
00:11:37.080 --> 00:11:45.639
When they started at the end of the 60s, there was no structured system where you can call someone when you can send someone with an ambulance.
00:11:45.799 --> 00:11:46.919
So there was an influence.
00:11:47.000 --> 00:11:55.879
And nowadays everything is at the end of the day uh asked by someone who is uh responsible for money, and that's okay.
00:11:56.200 --> 00:12:11.799
So if we are all convinced about that we should deliver a high level of care, which means the context is is quite clear, which means that we know the the patient side.
00:12:12.039 --> 00:12:23.320
So if there's someone calling 112, which is 911, um we we do know people they call and they know which keywords they have to use to get an ambulance.
00:12:24.039 --> 00:12:42.679
So therefore uh that that's uh the efficiency of the system starts with uh with the beginning of the line that if there's an incoming call, there should be a standardized question so that the dispatcher is able to recognize what is really important.
00:12:43.480 --> 00:12:46.279
And that sounds very simple too.
00:12:46.519 --> 00:12:54.600
Um like if you would like to build up a house, you start talking to some people which are able to build up houses.
00:12:54.840 --> 00:13:04.679
And if you would like to have some new lamps in your house, you should talk to someone who knows which cable comes from the right to the left corner.
00:13:04.919 --> 00:13:22.120
If you would build up a system bus traveling from the eastern coast to the western coast, you should probably someone you should ask someone who is able to drive a bus and to know where you can buy a bus and what is needed to drive the bus and so on and so on.
00:13:22.279 --> 00:13:27.080
And uh maybe it's too I'm a little bit hard to say naive, yeah.
00:13:27.240 --> 00:13:38.439
So that I'm I'm uh in my mind and in my impression the world is sometimes the world is not only complicated, sometimes there are a few things that are really simple.
00:13:38.679 --> 00:13:46.120
And as you said, if there is someone suffering from a obstructed airway, we should open and secure the airway.
00:13:46.360 --> 00:13:53.399
I'm I'm not c I I think there maybe there is not the global solution for every region of the world.
00:13:53.639 --> 00:14:02.600
So I I think uh you should adapt this to every country, to the systems and to the people living in there.
00:14:02.840 --> 00:14:17.080
They um they are used to have support from EMS, from the hospitals, so the population is uh looking for someone who is answering their medical questions.
00:14:17.480 --> 00:14:29.000
And that in in some cases that could be someone from the hospital, that could be a general practitioner, and that could sometimes be someone from the EMS.
00:14:29.720 --> 00:14:39.240
When we would like to be precise and then we need more data, we should have this exchange between different countries.
00:14:39.399 --> 00:14:44.840
We should pick up not our own traditions and our own thoughts.
00:14:45.320 --> 00:14:46.519
What about the best way?
00:14:46.679 --> 00:14:52.519
It should based should be based on strong data and scientific working.
00:14:53.399 --> 00:15:06.919
And I think that that question is obviously a very hard one to answer because there's no there's one, no perfect system, but two, there's so many different systems that it's hard to pick what's going to work the best across the world, right?
00:15:07.159 --> 00:15:07.320
Right.
00:15:07.720 --> 00:15:11.480
And it seems in the US everything is much more privately funded.
00:15:11.559 --> 00:15:23.320
Uh there are some government agencies that are out there, but most things are privately funded and privately run, uh, whereas that may not be the case in every region or every part across the world.
00:15:23.399 --> 00:15:37.559
And so you run into different barriers or loopholes or uh whatever word you want to use to describe it, which I think makes it so difficult in each of those regions to really figure out what that best system is.
00:15:38.120 --> 00:16:00.519
You know, I and and I and that's why I I love hearing your perspective on this because I I feel as though we all at the end of the day often share the same frustrations uh and concerns and want the same things, but we we have different abilities.
00:16:00.679 --> 00:16:08.279
I'm not saying different um means to get there, but different abilities based off of the constructs that are in our particular areas.
00:16:08.519 --> 00:16:17.080
And so I find it very interesting to have those conversations because I don't, at the end of the day, I don't think your perspective is different than than Blake and I.
00:16:17.320 --> 00:16:19.480
It's just how we're able to deliver that.
00:16:19.960 --> 00:16:31.639
And I think back to there's been many conversations, you know, I'm sitting around the crew table and talking with my um with my partners, and we're like, okay, so we're either A, not happy or B thinks something needs to be changed.
00:16:31.799 --> 00:16:40.840
If we had it our way and we could just tomorrow just poof build our own hem service, what would that look like?
00:16:43.960 --> 00:16:46.439
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00:16:46.600 --> 00:16:56.519
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00:17:05.960 --> 00:17:15.160
And and I I think that there's a lot of wonderful ideas that we have about how we would make that that system there.
00:17:15.559 --> 00:17:17.559
But I think we always got into the weeds of it.
00:17:17.640 --> 00:17:20.759
And I think we need to kind of, this is also one of those things we need to simplify.
00:17:20.920 --> 00:17:29.559
So I guess my question to you is so you have a lot of insight on HEMS specifically and on the healthcare system in Germany.
00:17:29.880 --> 00:17:37.400
If you had to say, tomorrow I'm gonna have my perfect HEMS system in front of me, where would you start?
00:17:38.120 --> 00:17:39.480
What would that look like?
00:17:39.800 --> 00:17:40.840
It's a good question.
00:17:41.000 --> 00:17:53.320
Because when building up a system which should work and therefore for sure is there's money needed, where the money comes from, who cares?
00:17:53.640 --> 00:17:57.560
So we should define how much money is needed to build up a good system.
00:17:57.800 --> 00:18:01.000
But when talking about the good system, what means a good system?
00:18:01.160 --> 00:18:18.760
So we should um have the goal, we are we would like to deliver optimized level of care, which depends on on the time um you're living in, the time of development, and so on and so on.
00:18:19.640 --> 00:18:40.680
I'm sure that when at these days someone would like to build up a HEM system in my country, one of the most important barriers would be uh from the perspective as an authority, that uh it would be not allowed to land on an motor highway.
00:18:40.920 --> 00:18:56.920
So that would be one of the biggest challenges that someone was asking concerning the level of safety in when flying, that they would like to answer the question, are you sure you would like to land on a motorway?
00:18:58.120 --> 00:19:00.040
But this is not a medical point.
00:19:00.280 --> 00:19:16.680
I think creating an ideal rescue organization, uh rescue system using helicopters starts while picking up all these data from the country and starts on the green table.
00:19:16.920 --> 00:19:29.560
And that is the difference to what we have experienced the last five decades, because the pioneers started not having a a strong planning process.
00:19:29.720 --> 00:19:37.080
They started while they had been convened about the fact that there should be some kind of care on scene.
00:19:37.480 --> 00:20:23.080
We've recognized at the beginning of the seventies close to uh thirty thousand dead people f in in in in traffic and then they started to build up a system and they started very isolated in one or two areas just to see if it if they are able to deliver the the level of care using a helicopter with the with the knowledge from from these days we should start following a strong strong planning and then maybe the the the end of the the planning process would be not to have eighty helicopter bases, maybe there are only sixty bases needed.
00:20:23.400 --> 00:20:33.720
Maybe you don't have to have so much ambulance cars, maybe you d you would uh have different responsibilities in the different areas.
00:20:33.960 --> 00:20:48.200
So maybe when you when you start it nowadays with all the knowledge you have, it would be much more planning and it would be much more centralized.
00:20:48.520 --> 00:21:04.760
It's not a start uh a bottom up process, it it's much more a top-down process while you know how many people live in which area and uh uh with uh which kind of uh diseases, injuries you can expect in this area.
00:21:04.920 --> 00:21:27.960
So that is that would be big the difference, but it's unrealistic because we have the system we have and it's our it's our goal and it's our our effort to talk to all these decision makers to uh make the things better while having the system we have.
00:21:28.280 --> 00:21:47.080
But it starts from talking about having uh two hundred and thirty dispatch centers or using only fifty it starts with a with a national program and question if there is someone centralized and responsible for the system.
00:21:47.560 --> 00:21:50.680
It starts how many resources we should have.
00:21:51.000 --> 00:22:00.360
It starts from having a discussion, uh, what about the influence from the EMS to the to the final result from the patient and so on and so on.
00:22:00.760 --> 00:22:08.760
You know, I I think when when you're talking about like how do we we have the system we have, you know, like that's been brought up, we've got it.
00:22:08.920 --> 00:22:10.360
So how do we make that more efficient?
00:22:10.440 --> 00:22:16.360
And I want to kind of talk a little bit about how you you are set up throughout throughout Germany.
00:22:16.440 --> 00:22:23.240
And you said you have, I think when we spoke, you have 230 dispatch centers throughout Europe.
00:22:23.480 --> 00:22:27.480
And then you and for your for ADAC, you have 30.
00:22:28.200 --> 00:22:32.360
seven stations throughout Germany as a whole, correct?
00:22:33.160 --> 00:22:33.480
Correct.
00:22:33.880 --> 00:22:37.320
And and you're serving about eighty-four million people?
00:22:37.880 --> 00:22:42.200
Yeah, but uh there are two three other operators.
00:22:42.280 --> 00:22:52.200
So in in total we do have around about eighty helicopter bases and uh the population is about eighty eight four million people right in Germany.
00:22:52.680 --> 00:23:02.600
So I could only imagine uh like just using different type of measured data to see where you'd be most useful, right?
00:23:02.680 --> 00:23:12.520
So and I understand you you do have some aircraft that do like search, rescue, and hoist like and just and I think we kind of overlook that sometimes.
00:23:12.600 --> 00:23:15.720
Like I know for me I would want everything in one shot.
00:23:16.040 --> 00:24:30.440
I live in southern Florida of the United States it is flat and the only hills we have are overpasses for highways and you know we think about hoist and like mountain rescue but then out here in the the swamp land which is essentially Florida is just a peninsular swamp and we have a lot of adventurous people are Florida man you may have heard of them they uh they they like to go kayaking or do all kinds of random things at all hours of the night and they go get lost and so yeah we do send a helicopter and you're like why would you have a hoist there's not a mountain anywhere but well it's there's very difficult access right so and I think about that and I'm like oh I think we would really benefit from having that type of resource but then what if you actually look at the numbers and well if we did like two a year three a year well yeah obviously it wouldn't make sense and it's like well just stand up you're in the swamp like it just stand up and walk you could walk out of it right you know and you look at like providing that right resource and using that data to really optimize like that system.
00:24:30.600 --> 00:24:54.200
So I'm just kind of curious like what data do you guys use or those like how do you start to determine what bases are going to run either 247 versus just sunrise to sunset because I know that's a huge difference uh from how you operate in in in Germany and in Europe versus us here in the States.
00:24:54.360 --> 00:25:03.320
All of us here in the States are 24-7 as much as we don't like the 2 a.m calls but you know emergencies don't stop at sunset.
00:25:03.480 --> 00:25:20.040
But it also brings in the element of actually doing it safely and effectively and I've often wondered what those differences how they're measured and how we get to those abilities to say that this is the safest way to do it and deliver that.
00:25:20.200 --> 00:25:29.400
So are you able to elaborate a little bit on on on how you're able to kind of determine and strategize where you're going to put that resource and and how you're able to use it.
00:25:29.800 --> 00:25:33.320
I totally agree if you say emergency doesn't stop.
00:25:33.640 --> 00:25:49.560
At the end of the day it's a mix between ground and helicopter services and so if there's an emergency during the night in the in that region there is no helicopter available and the service should be done by the the ground ambulance and two things you stressed out.
00:25:49.720 --> 00:26:07.880
So the first thing is what about the hoisting hoist operation means traditionally it comes from the mountain areas where we pick up people from from the Alpine mountains but nowadays we think about using it more and more under different conditions.
00:26:08.040 --> 00:26:21.480
We do have some mountains which are only thousand five hundred and thousand and six hundred meters and we still use them inside some specific areas in the cities.
00:26:21.800 --> 00:26:41.400
So um uh as an example in Hamburg which is a large city from the German perspective it's about two million people it's not it's for Chinese it's just a small town but um for us it's a big city, the second second largest city in Germany after Berlin.
00:26:41.560 --> 00:26:53.400
So which where there is a big harbor where you have moving ships, big ships where you have uh different areas where you can't get enough access by ground ambulance.
00:26:53.960 --> 00:27:08.760
So there are still some advantages we uh we picked up uh the last three years when getting uh when having access to the to the patient and that in average there could be an advantage of ten minutes.
00:27:09.480 --> 00:27:16.040
So this could be part of a discussion if you would like to have a hoist on board or not.
00:27:16.280 --> 00:28:40.360
The decision how we run the service if it's 247 or just day by day if there's a hoist or if it's three or four people is not our own decision because the governmental authorities who are responsible for the EMS in that region they deliver a tender and then you can raise up the hand and say okay we are able to run that service and sometimes the decision if it is a 24-7 service or if it is just a day-by-day service um based on simulation data some uh governmental authorities ask for uh support from scientific institutes which starts uh using and and and uh retrospective data analysing retrospective data and uh doing some simulation stuff and then come to the recommendation that there is a need for a 24-7 helicopter or for some helicopter which um starts at six in the morning and ends up at uh ten in the evening because we do know that between two and five a m there are less uh emergencies and and then you come to the to the main and most important discussion if there's a need and if there's no need there's no need for spending money for having a service 247.
00:28:41.000 --> 00:28:53.400
Despite the fact that uh or on on on the other hand there's um the need for education, training people using IFR conditions or using NBG goggles and stuff like that.
00:28:53.560 --> 00:29:01.160
And all these the technical point is one point having an helicopter, having an hoist is one point.
00:29:01.320 --> 00:29:42.120
The other hand is uh how to train people and that's the most uh the most expensive part of the of the mission to to train these people so this is at the end one big uh big element of the discussion uh which you have to dis debate with the with the authorities but we do have a good experience while uh using a hoist in a city or in an urban area thank you to our sponsor Metro Aviation Metro Aviation the world's largest family owned aeromedical operator offers comprehensive aircraft services with 140 plus aircraft in over 25 states.
00:29:42.360 --> 00:30:02.280
The completion center installs medical and law enforcement kits in avionics serving diverse aviation needs including offshore utility VIP and corporate sectors I think people's minds would be blown here in the States if you were just like in the office building and you just see someone come over just you know we're not gonna yeah we're just gonna hoist them right out of there.
00:30:02.360 --> 00:30:03.160
We'll get you right out of there.
00:30:03.240 --> 00:30:06.040
I think people like that would just people here would be shocked by that.
00:30:06.200 --> 00:30:07.560
Just obviously not the everyday thing.
00:30:07.800 --> 00:30:12.040
Yeah usually for us it's we find somewhere to land and we go in and do our thing.
00:30:12.120 --> 00:30:17.240
That's something that I think people would just it would be totally different for us to see on the regular basis.
00:30:17.720 --> 00:30:26.440
And I guess so that kind of I I think this conversation easily leads into or this portion of it easily leads into the AirMed World Congress.
00:30:27.160 --> 00:30:29.720
Because we want to spend some time talking about that with you as well.
00:30:29.880 --> 00:30:43.720
I think that this is I didn't know a whole lot about this before we had kind of our our pre-recording conversation uh and it's certainly a like I said a Congress or a conference I would love to go to but uh the theme is beyond boundaries, right?
00:30:43.880 --> 00:31:01.800
And I was wondering if you can talk a little bit about the conference itself and what the overall goals are and if there's anything you're able to share maybe as a I guess it won't be a sneak peek uh since when this airs it will be after the conference itself but if you can kind of share a little bit about the AirMed World Congress coming up.
00:31:02.280 --> 00:31:27.240
So um the Amet Conference is um has a long tradition it started 40 years ago uh then when there's some where there have been some pioneers from Munich so we advertise a little bit the conference these days uh to bring the conference back home so coming back to the rules means that the Amet starts in Munich and it's for to today it's in Munich.
00:31:27.480 --> 00:32:03.240
The idea uh while we start with inside the program commission uh what we want to talk about is that we do have three sections like medicine, aviation techniques and management and the idea was to bring people from these different sections together not to have an isolated debate inside the medical community inside the technical community and uh gathering a few CEOs together and then they start talking about things they uh they have uh from their perspective.
00:32:03.400 --> 00:32:03.960
Yeah.
00:32:04.520 --> 00:32:14.520
So the idea was um to get the chance to to have a quick view all uh over your own comfort zone.
00:32:14.840 --> 00:32:41.320
So we managed to have some lectures, we managed to have some workshops uh where people uh typically working inside their aviation uh surroundings are able to follow someone uh who comes from the medical point and who can share some information what is the need when you're sitting back inside the cabin and and vice versa.
00:32:41.560 --> 00:33:02.600
So we bring uh someone from the medical crew and to see what happens in front of the helicopter while sitting in a simulator and uh we bring pilots to um uh how to say to uh to a meeting and to workshop where they can train uh to put some secure airway in.
00:33:02.840 --> 00:33:11.080
So uh just to make sure that uh each one who's working inside the system is able to understand what the other one is doing.
00:33:11.240 --> 00:34:59.320
For sure uh we we know that all people working on a daily basis uh together they they have the experience and I know that a lot of pilots have an imagination what happens inside the cabin they they they get an imagination uh what is uh what is uh a heart attack and what is a resource situation and vice versa uh all the medical crew members have an impression what about weather conditions what does it mean um to have uh the stick the pitch the collective and all the technical things and but to to increase the level of understanding from the different perspective that was one of the the ideas and the motto behind uh the next airmade I always have that longstanding joke with my pilots if the they let me fly I'll let them intubate no one no one's taking me up on that yet if you fail with intubation there's only one who is uh getting in trouble yeah if you stop flying maybe and then maybe guaranteed and then the steel is driving so well I probably don't want to fly wait a minute I didn't I have to throw a pitch at the pilots here because there are many pilots I would get in a helicopter with any day but getting in a car with them absolutely not the more technical systems in the helicopter where they are covered and and in the car it depends on how old is the car yeah I just I I looked at the how old is the pilot?
00:34:59.400 --> 00:35:17.800
We had one guy I was like every day you come in and you knew you saw how he parked I'm like man how do you fly a helicopter so well but you can't park in the line I think it's great though to to really have people come together to truly understand the perspective I guess of just what each aspect is going through.
00:35:17.960 --> 00:35:34.519
And it just highlights so much more how we are all an integral part for that success of that patient encounter like one can't perform without the other being there and being part of it to to to really be successful.
00:35:34.760 --> 00:36:02.440
And I think it's so great because and I'm the more that we talk we have the so many similarities of it's the same common goal and we and we we're wanting to provide the best patient care but there's so much that just goes into that and it's more than just the the the medicine that's just one aspect of it and that just has so many infinite characteristics that that we would always try to measure.
00:36:02.680 --> 00:36:18.039
But then there's so much more we could measure from the aviation side and then there's maintenance and then there's logistics it takes so much it takes a village right like that's our weird saying that we have it takes that village to to really have that really be successful.
00:36:18.280 --> 00:37:04.760
And I love that that you guys do that and and and Mike I know you can back me up on this I think it's only in recent years that we as clinicians that we have been able to prove that we are more than the the self-loading baggage as we've often been called right and you know we did a podcast with pilots before and he referred to pilots as meat servos which I thought was quite quite comical but we it but it just shows that we all have to work together cohesively and do it effectively and constantly reevaluate how we're doing things why we're doing things what's the outcome so Jens what would you say from for us in the States what could we take away from hems in Europe?
00:37:04.920 --> 00:37:19.880
Like what's something we could bring back that would help us in any one of those situations whether it be medical aviation the the technical aspects of it what's something we could learn from hems in Europe here in the States?
00:37:20.280 --> 00:37:37.480
I think we we all should and I I'm not quite sure if we have in Europe these common sense that means when talking about hEMs we mostly come up to very specific detailed different discussions but sometimes it's very simple.
00:37:37.640 --> 00:37:57.400
So the idea behind hems is we deliver medical care in a in a in a condition for a patient using the pl the technical platform helicopter that's the way where we come to the patient and we should have the same common sense what means HEMS.
00:37:57.960 --> 00:38:05.960
So the key product we have is we deliver medical care for someone who probably needs that.
00:38:06.200 --> 00:38:12.200
We don't know it at the beginning and we are able to transport if there is a need to transport the patient.
00:38:12.599 --> 00:38:26.440
So that is the common the common base and this understanding should be um the common base for all of us in Europe, in the US, in wherever you deliver HAMS or EMS.
00:38:27.400 --> 00:39:47.240
Sometimes we use the cars, sometimes we use the helicopter we know that there are a lot of regulations when I started my career in anesthesia we've learned a lot from the aviation area due to that they follow protocols that they do have checklists that they that they have strong debriefing that they look for what about data what they use close communication all these aspects we've learned from the aviation and in in Europe and in in Germany as well we try to understand if there are things to to we are able to make better and that is probably something what we can transfer to other countries to say okay that's our idea and sharing these ex experiences is something I I'm not sure if if you talk to to different providers, to different operators, if you have a common base all over the country because might be challenging due to that US is a large country and I know that when we start uh in ninety seconds after the uh incoming alert and be able to reach the patient in about 10 minutes, it's not comparable to what you're doing because uh you sometimes I can imagine use 30 minutes to come to the patient.
00:39:47.559 --> 00:40:04.840
So I I think to uh to be awake to be aware of what happens with these patients and to to share these expertise that is the mean goal to become better and that should be the common sense for all of us.
00:40:05.160 --> 00:40:15.800
I I love that and I think it's so important to bring everybody together just like you said and I I think that's also been what has always drawn me to the core values of Echo is bringing everybody together.
00:40:16.200 --> 00:40:23.160
It doesn't matter what color flight suit you wear it doesn't matter what your role is within the organization we can all learn from each other.
00:40:23.320 --> 00:40:29.000
We can all build upon things and we can all move forward as an industry and make it safer and better for ourselves and our patients.
00:40:29.240 --> 00:40:33.480
And I think that that's ultimately one of the most important goals.
00:40:33.960 --> 00:40:43.720
And I guess that kind of leads me into my next question for you of though like the so the the AirMed World Congress theme this year is Beyond Boundaries.
00:40:43.960 --> 00:40:56.440
What boundaries do you see in place for us and and where should we be looking as an industry whether that be you know locally or globally where should we be looking as an industry in moving forward?
00:40:56.680 --> 00:41:01.400
Like where do where where should we see ourselves in the next 10, 15, 20, 25 years?
00:41:02.360 --> 00:41:03.480
What's our our pathway?
00:41:03.960 --> 00:43:53.079
Then we'll talk about a lot of money how what I will get in about 10 years when I when I solve the problem and and and light up the the crystal ball right yeah so what we can learn from each other maybe we we can learn what what kind of uh which cases of emergency we can hand over to someone who's not really the highest uh qualified man on the scene and vice versa you you can think about how you innovate how you or how how you bring innovations to the system or in if there are cases where there is a a really profit from uh having a physician on board this could be something when you mixed up the systems and we know that uh due to some financing there is a difference between the systems because everything what we do is based on an insurance and and that is maybe quite different to the US but if you ask for uh how we we as an industry as a system uh move on forward I do expect that we should have much more and deeper understanding of of of data we should have in future much more ability to look onto how different industrial and industry partners um deliver their system and that's the chance we should that we should use because having the same goal and having the same common sense means that we should exchange these experiences and this is something to light at the crystal ball rotor wing pilots your experience is in demand your skills are indispensable now take your career vertical with global medical response find out about GMR's significant EMS pilot pay increases sign on bonuses and stay incentive plans for select areas visit gmr.net backslash pilots to learn more and earn more today and we we should have the the open mind to to understand that we are serving and we are delivering a good service but there are different people doing it differently and that doesn't mean that it is not it's not not a good service so that could be the same level of care and the final results so uh sounds a little bit uh simple but there are different ways to roam and um this open mind should always be a part of our thoughts and uh then uh I'm sure that we are able to to increase our service levels.
00:43:53.640 --> 00:44:10.440
As you're really elaborating on that I had this this thought of you know when we go to take care of a patient, especially in a helicopter we see so many different extremes I guess of of what we can bring to the patient, right?
00:44:10.599 --> 00:44:23.320
So I think of an ischemic stroke patient that's you know an hour and a half from that facility if we're called there as a flight crew for all of us together, uh you know we may get there.
00:44:23.800 --> 00:44:31.640
And the only thing that we're delivering to that patient is the fast ride, you know maybe You know, the supportive care, you know, a couple of things, but that's really what they need.
00:44:31.720 --> 00:44:33.160
They need the intervention.
00:44:33.480 --> 00:44:35.160
And then there's the other side of it too.
00:44:35.320 --> 00:44:45.480
We're talking about EPCR where you're cutting, inserting, slicing, medications, ventilating, doing so many things.
00:44:45.559 --> 00:45:17.320
And I think that that is what will always be probably that hardest challenge for us as the critical care or the higher level pre-hospital, whatever it is in the Hem's world, is trying to the the one flight of what we would call the the handhold or supportive care to the the uh just the most intense, the most invasive, and the most thought-provoking type of call you can run.
00:45:17.880 --> 00:45:30.440
And then at the end of that, that settles down, you have those moments of letdown and or you know that come down, I should say, and like you're you're trying to restore that clarity, and then we got to be ready for the next one.
00:45:30.760 --> 00:45:40.360
I think sometimes, and that's actually realistic, and it has been always realistic, is sometimes uh gas oil is the best medication you can give.
00:45:40.680 --> 00:45:58.519
So uh but uh the the the most important thing in that case is that you that you recognize that there's nothing or just a few things to do on scene, and then the patient profits from what has to be done inside the hospital.
00:45:58.920 --> 00:46:15.559
And that has something to do with good training, with experience, with uh an understanding of physiology, and that you know as a medical provider working in a pre-hospital setting, that you know what is happening behind the hospital door.
00:46:15.800 --> 00:46:31.079
So that that is, in my impression, that is the idea while bringing people working mainly inside the hospital to the outside, because they know what happens inside the hospital, and that has something to do with definite treatment.
00:46:31.240 --> 00:46:39.559
So sometimes what we do in the EMS is kind of a bridging therapy, sometimes it is definitive care.
00:46:39.800 --> 00:47:12.519
So I've seen a lot of patients suffering from from respiratory problems, and if you have the time for half an hour going by helicopter or by car to the hospital, um they are quite normal when you enter the uh the emergency department because they use the time, and that is some one of the one of the uh things we can do and offer outside to have an understanding of what is uh how to say uh what we are able to do and if there is a sense, or if you just skip it and just go.
00:47:12.680 --> 00:47:58.519
And that is I I think in in in my mind, if we talk about all these invasive and highly invasive procedures next time, the most important thing is that we understand in which time we are able to be on scene, and if we are able to to to manage these things in a quite short period, and if there is a need for for this specific patient and uh to to avoid some things uh once again, sometimes it is uh much much better for this individual just to let him go or just to do and see and that's it.
00:47:58.680 --> 00:48:29.960
And then I I think from the emotional point of perspective, uh maybe you have to have ten missions and there's only one where you can uh where you can pick up everything what you have learned, where you can decide using different medications, where you can give technical procedures, and that's the how to say common word, what what I've learned in anesthesia, these um hours of boring and seconds of thrill.
00:48:30.039 --> 00:49:05.240
And that is sometimes uh sometimes the impression you've got when you are on a weekend, uh on a Saturday and Sunday, um best weather conditions outside, and you're just waiting for the next mission, so you try to to wait and and to to make s uh things nothing to do with medicine, and then then there is the beep coming in and you start and then in in the in the short period you have to to manage everything what you have learned the last years and what you're able to do with your hands and what you have to think about.
00:49:05.880 --> 00:49:18.680
I think that is one of the challenges in medicine, in emergency medicine, and this is maybe one of the aspects we all love to do uh and what we started with this job.
00:49:19.079 --> 00:49:19.800
I love that.
00:49:19.880 --> 00:49:45.000
I I think it's it's been such a great discussion, kind of learning how honestly, I think at the end of the day, how many similarities we have and what our maybe our why or our how is in how in in in the hems industry, whether you're in Germany or in the United States, I think it's so incredibly important to have these discussions.
00:49:45.160 --> 00:49:48.920
And uh I I'm really grateful, Jens, that you were willing to come on and join us.
00:49:49.000 --> 00:49:57.000
I have had an absolute blast uh getting to talk about all of these concepts over the past uh almost hour or almost two hours.
00:49:57.240 --> 00:49:59.800
So uh thank you so much for joining us.
00:49:59.960 --> 00:50:02.039
I it this has been a great discussion.
00:50:02.119 --> 00:50:11.400
I feel like we could sit here and talk for days and uh just learn so much from each other and and how we maybe solve the world's problems, if you will.
00:50:11.800 --> 00:50:12.680
It would be endless.
00:50:12.760 --> 00:50:14.200
It would be an endless, I think, discussion.
00:50:14.360 --> 00:50:19.480
We could talk for a year, and I think we would still end up with more questions than answers.
00:50:19.559 --> 00:50:21.880
But I think we would at least answer that question.
00:50:21.960 --> 00:50:24.519
I think though, I think we're on the right track.
00:50:24.680 --> 00:50:25.960
Uh I truly do.
00:50:26.200 --> 00:50:26.519
Yeah.
00:50:26.760 --> 00:50:27.160
Yeah.
00:50:27.720 --> 00:50:39.640
Having a conference like the Aramate next week is uh is part of the discussion, is part of the development, is part of the making things better and um kind of movement.
00:50:40.360 --> 00:50:55.400
And I've seen I've lost my background picture, but I would like to just uh give a few numbers where you can see from the uh ambulance next week.
00:50:55.800 --> 00:51:09.720
So have been a three-year preparation for the conference and I'm happy to see and uh I'm eager to see a lot of uh uh colleagues from about 85 hands-on workshops.
00:51:11.880 --> 00:51:20.039
So different ones from medicine, um, aviation techniques, management discussions.
00:51:20.920 --> 00:51:23.720
I think the most important ones are the one with Manny.
00:51:24.200 --> 00:51:25.400
But uh yeah.
00:51:25.960 --> 00:51:30.200
We see maybe maybe someday I'll be able to join you.
00:51:30.280 --> 00:51:32.599
Uh but certainly appreciate you sharing all that.
00:51:32.680 --> 00:51:38.200
I I think it would be I I do actually know a couple people that are going to the the Congress.
00:51:38.360 --> 00:51:46.280
And I I think it's I I can't wait to hear from them their thoughts on your ability on a global level to bring everyone together.
00:51:46.519 --> 00:51:50.200
Because I do think that there is some really important discussions that are going to be happening.
00:51:50.440 --> 00:51:54.119
And uh I'm super stoked to someday hopefully be able to join you there.
00:51:54.680 --> 00:51:56.440
Would be a great opportunity.
00:51:56.599 --> 00:52:13.880
Um so I think um having a discussion like this or having a discussion next week uh while we're having the Yamet conference is the starting point for um having a longer discussions or um having the opportunity to e exchange um experiences in future.
00:52:14.119 --> 00:52:16.039
So that's the idea behind.
00:52:16.280 --> 00:52:44.840
And we see a lot of known people next week and we meet a lot of people we didn't had contact to uh the last year, so that's the mixed up we we we're gonna see, and that's why I'm really happy to have the conference next week and share all expertises and share informations and maybe we have the chance for having some fun, especially in the evening hours.
00:52:45.240 --> 00:52:46.280
Absolutely.
00:52:46.519 --> 00:52:55.880
That's probably the other reason why a lot of people love going to I've heard about uh there's a small festival activity in Munich uh from Saturday on.
00:52:56.200 --> 00:52:59.160
Uh when the conference ends, um Yeah.
00:52:59.559 --> 00:53:01.480
You may be having a little bit of a party there.
00:53:01.800 --> 00:53:02.599
No, that's okay.
00:53:02.840 --> 00:53:04.200
We'll be with you in spirit.
00:53:04.519 --> 00:53:05.079
Yes.
00:53:05.320 --> 00:53:06.119
That's good.
00:53:07.880 --> 00:53:09.160
Uh thank you again, Jensen.
00:53:09.320 --> 00:53:10.840
Really appreciate the conversation today.
00:53:10.920 --> 00:53:12.519
Uh, it's been an absolute blast.
00:53:12.599 --> 00:53:19.320
And uh I know that uh our listeners are gonna absolutely enjoy learning about everything uh and how you do everything over in Germany.
00:53:19.480 --> 00:53:23.480
So thank you again for joining us and for um sharing all of your insight with us.
00:53:23.559 --> 00:53:24.280
It's been a pleasure.
00:53:24.599 --> 00:53:26.280
Thank you for having me.
00:53:26.680 --> 00:53:37.800
And uh to our listeners out there, once you're all caught up on the Balor Flight Crew Podcast, make sure you head on over to verticalhelicast.com where you can check out the Hangers E podcast, helicopter podcasts, and the vertical MRO podcast.
00:53:38.039 --> 00:53:39.880
Really appreciate you joining us again, Yens.
00:53:40.280 --> 00:53:46.519
Uh, and a huge shout out to our listeners and thank you for your continued support of the Vertical Hellcast platform and the Valor Flight Crew Podcast.
00:53:46.599 --> 00:53:48.440
Take care and we'll see you next time.
00:53:49.240 --> 00:53:52.519
Thanks for joining us for this episode of the Valor Flight Crew Podcast.
00:53:52.680 --> 00:53:58.840
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