Strong and Rural/Metro bring
state-of-the-art transport to region

As technology has increased the quantity and quality of life-saving techniques available to care for critically ill patients, so too have the challenges in transporting these extremely sick patients between hospitals. To decrease potential risks while continuing complicated care for critically ill cardiac, burn and trauma patients while en route, Strong Health is introducing a Critical Care Transport Service to the region.

At the heart of this service is a customized vehicle designed and created in partnership with Rural/Metro Medical Services. Strong Health's cardiac, trauma and burn physicians and nurses collaborated with specially trained Rural/Metro paramedics and engineers to custom-design all aspects of the vehicle, from its size, to its GPS navigation system, to the number of shelves in its interior cabin.

The result is a state-of-the-art vehicle that accommodates up to six health care professionals inside the cabin, and is equipped with specialized electrical power and multiple redundant systems needed to run advanced life support equipment that is typically available only at major hospitals. Rural/Metro estimates that there are only a handful of such vehicles nationwide, usually operating out of major metro areas, or in regions with an academic medical center.

According to Steven I. Goldstein, president of Strong Memorial Hospital, the need for such a vehicle grew dramatically over the last several years as the number of tertiary and quaternary services increased at Strong Memorial, such as the heart failure and transplantation program, solid organ transplant programs, and the expanded trauma and burn service. In addition, overall advances in care now allow regional physicians to stabilize acute trauma and burn patients so that they are able to be transported to Strong Memorial.

"Technology has rapidly advanced the ability of hospitals to provide care for critically ill patients," Goldstein said. "Our new Critical Care Transport allows us to safely transport the sickest of the sick patients, along with all of the extremely sophisticated equipment that is keeping them alive, in a manner that gives them the best chance of survival."

At 13 feet long and 8 feet wide, the interior cabin space is double that found in other ambulances, an important advantage when caring for patients on advanced life support equipment such as ventilators and various types of heart pumps, including ventricular assist devices (VADs) and intra-aortic balloon pumps. Where before only emergency medical technicians (EMTs) and perhaps a nurse could fit safely in a traditional ambulance along with the patient and equipment, now a cardiac care nurse, perfusionist, respiratory therapist, and a physician can travel with paramedics. The ability to transport these advanced life support professionals as a team to outlying hospital permits them to provide specialized care the moment they arrive, and continue that care while en route to Strong.

The Critical Care Transport contains a specialized electrical system that provides the "clean" energy necessary to run sophisticated equipment. In case of mechanical failure, a 7.5 kilowatt generator is available, along with a customized ventilator and compressed air systems. Another important element of the new transport is the custom-designed lift. Built eight inches longer than a traditional lift, the new system can simultaneously raise the patient, gurney and life support equipment. This is especially important when transferring a patient on a VAD, which relies on gravity to help pump the blood back through the heart, and therefore can never be positioned lower than the patient.

Rural/Metro paramedics underwent advanced intensive care training at Strong Memorial Hospital to better assist during transport. Twelve medics spent more than 120 hours each in the classroom and intensive care wing gaining a thorough understanding of the sensitive equipment that is now commonly used in such patient transports.