Monday, April 8, 2019

Learn How To Fail Brilliantly!

By: Josh Henke, RN, BSN, CEN, CFRN, CCRN, Georgetown University.


Image result for Intubation in a helicopter
Image courtesy Sydney HEMS. 

Aviation and medicine have long-complimented each other. Checklists are the first thing that comes to mind when thinking of this. The airline industry helped to revolutionize the medical industry with the system-wide adoption of checklists, and the acceptance of resource-management. I challenge you to find an O.R. that does not follow a checklist prior to making the first cut. (Hint: you won’t)

I was reminded of the similarities between aviation and medicine the other day while talking to a non-flying, never-intubated-anyone peer. He was asking me about RSI and all of the stuff that goes along with it. I could hear the tension in his voice as  he was thinking of himself in the hot-seat with a patient. Just the thought of dropping a difficult tube can get a medical provider in a tizzy, with or without a checklist. I found myself articulating something I have long held dear;

 Learn how to fail brilliantly. Be the best at failing.

This might sound odd, but hear me out. We are all going to miss tubes. Anyone that tells you they never missed a tube is lying. We all have or will miss that airway, and its how we fail that determines the patient's outcome. The planning for failure; being brilliant with your back-up plan assures that WHEN stuff DOES go south, you are the best at re-acclimating and implementing a solution. I also like the phrase “you can BLS someone all the way to Texas if you’re good at it!”

In the air medical world, failure carries a higher price. But, failures do happen. Engines quit, wheels don’t deploy, blades can go rapidly south. My advice is - even in this case - know how to fail brilliantly. You can have the best pilot in the world, but even he can’t make a helicopter NOT FAIL despite his many years of flying-experience.

I challenge you to think about this; how might your operation fail? And how can you be brilliant when it does?
Who is designated to make radio call outs in the event of an emergency?
Are you allowed to put the gear down?
Do you, in the left seat, spend time looking for appropriate LZs in case sh!t happens in a hurry?

Take some time and think about how you plan for failed-airways and apply that to your air operations. Checklists have pervaded the medical industry and made it a better place. Can we use the lessons learned in critical-care medicine to do the same for aviation?

Are you willing to be part of that success-story? As my pilot-friend Dan Foulds says, “You are not a passenger!  Learn as much as you can about aviation as fast as you can and be a contributing- member of your flight-team!"

Wednesday, January 30, 2019

It Can Happen to You Too...

It was bound to happen. As women entered the ranks of HEMS pilots, it was only a matter of time until misfortune struck one of them as it has so many men sitting at the controls.

It seems no one gets a pass. Take note, this could happen to you too. Are you doing everything possible to mitigate risk as you fly sick people?

For now, let's keep the families of these victims in our thoughts. As hard as it is, let's not speculate or say things that might make terrible pain even worse. Let's let the NTSB and the FAA do their jobs.

For now, let's consider these souls, and search our own.

Fly safely, friends...

HelicopterEMS.com








Monday, January 28, 2019

From our Facebook page: You! Incorporated!

Image courtesy Gary Christian





As we begin the annual misery known as tax preparation, we are again grateful to the friend who several years ago said,

"You do have an LLC, right?"

Maybe you are way ahead of us on this and have been enjoying the benefits of incorporating for awhile. If so, feel free to add to the discussion with a comment. Tax wizards we aren't - but we do like to save tax dollars.

Let's say you are a nurse or paramedic who occasionally teaches a class for an outside agency. Do you get a check made out to you as a contractor? If so you should incorporate.

Are you a pilot who does a bit of flying for a friend. Do you speak at AMTC or a regional conference? If you get paid in any regard for occasional work that you do and are not an employee of the payor - you should incorporate.

If you do two simple things you can enjoy many of the tax-saving benefits that large corporate entities do.

1. Go online and visit your secretary of state and create your corporation. Several years ago, we created a "sole-proprietor" limited liability company named AMRM Training Solutions. In Georgia it's cheap - and you do not need a lawyer or legal service. You can do it yourself. We pay $50.00 per year as a for-profit. That cost is tax deductible.

For Georgia visit

http://sos.ga.gov/index.php/corporations

If you happen to live in Michigan, you might start here

https://cofs.lara.state.mi.us/…/LoginS…/ListNewFilings.aspx…

2. File for a federal employer identification number. It's easy.
https://www.irs.gov/…/apply-for-an-employer-identification-….

If you do a gig that pays more than a few hundred dollars, the payor wants to deduct what they have paid you, so they will ask you to fill out a W-9 (it's online too). You will enter your EIN also known as your taxpayer ID number. At tax-filing time, your preparer will need the number for your return.

Of special note, when you start searching for these resources, lots of sites will present themselves as your go-to resource. They cost money. You don't need to pay money to a service to do these things. Make sure you are at the state or federal website and you can do it yourself. Those guys are trying to run a scam. They have official-looking websites and send official-looking letters designed to scam you.

So, what's the benefit of incorporation? Well, if you have a business and are out there generating revenue, lots of "household" costs are tax deductible. Do you have smartphones? Check. Internet service? Check. Do you drive your vehicle to a gig? Keep track of the miles because they are deductible. If you present at AMTC or ECHO, all the expenses are deductible because you are furthering the aims of your business. You are an industry expert sharing knowledge and looking for gigs. Right?
Notwithstanding the audit-scare from a few years back, the room in which you bang on your computer is deductible as a home-office. But don't take our word for it - ask your tax preparer.

From our perspective, this is purely for the purposes of reducing our tax burden. We write off the costs mentioned and others, and then "lose" another few thousand dollars each year. Do we "intend" to make a profit? Absolutely! And that means our corporation can continue to lose money (and allow us to pay fewer taxes) indefinitely.

Here's to You, Incorporated!