The below article is a profile of Lesa Armstrong, Program Director of REVA Air Ambulance, by Airmed & Rescue Magazine published May 2016, Issue 76.
You’ve held several different roles with REVA over the years, from chief flight nurse, director of clinical operations and now program director; what does your current role involve and how do your previous jobs complement what you are doing now?
As the program director for REVA, it is my responsibility to manage all aspects of the medical department at all locations. Since I have held every position at some point within the medical department over the last 20 years. I am well versed in all functions performed by the medical crews and management. This allows me to anticipate future needs of the department and determine what changes are positive and necessary for us to be a world-class air ambulance provider. Each position I have held in the past was a building block to the position I currently hold. I started working for one of our founders, Stuart Hayman, prior to the inception of REVA. This was an invaluable experience as I have been able to grow and develop the medical department appropriately with the growth our company is experiencing.
What first attracted you to the air ambulance industry?
Years ago, my father told me a story about a woman he met whose daughter was a flight nurse. It sounded so great and exciting, and being that I was young, adventurous and not wanting “just a job’. I thought ‘this is the job for me’! So, I set out to become a critical-care nurse. I worked hard in the hospital setting and after a year got my first job as a per-diem flight nurse.
How has the industry moved on since you first started working in it in 1997?
When I first started as a flight nurse, almost everyone on the medical side of the business worked per diem. We all had pager/beepers in order to be contacted for a flight. If you were on the road, you had to find a pay phone and call in for dispatch information (ha-ha).
So many changes have taken place in the industry in the last 20 years. The air-ambulance industry has advanced by leaps and bounds. There are entities offering accreditation to those air ambulance services, like REVA, that meet high standards in safety, policy and procedure. The training and education requirements have become more robust as well. Flight crews are not just receiving the basic training required of their critical-care professions. They are trained in advanced medical procedures such as crichothyrotomy and needle-decompression techniques, to ensure that they are prepared to handle an emergency should one arise. The training must constantly evolve to meet the innovative and ever-changing world of medicine.
The equipment now available and used by REVA is smaller, lighter, and has more functionality. For example, instead of carrying a capnography monitor, a pulse oximeter, a blood pressure unit, a thermometer and defibrillator, like we did many years ago, our light-weight cardiac monitor holds all the capability in one unit.
There is also portable laboratory equipment that is handheld that allows for quick and accurate blood analysis right at the bedside or in flight. We can analyze cardiac enzymes, blood gases and blood chemistry in just a few minutes.
Medical training on simulators is something that REVA has focused on a lot in recent years. How important do you think such training is to air medical professionals, and can it ever match up to real-life experience?
REVA provides a human patient simulator at all its base locations to ensure that the training emulates realistic patient care and responses to treatment. Many of the advanced procedures are not possible to perform on an actual human for practice, naturally. The human patient simulator allows the practitioner to experience an ‘as close to real-life response’ as possible. Without the simulators, traditional training consisted of textbooks, PowerPoint presentations, and handouts. We can describe the responses, but nothing beats experiencing it first-hand. We have also incorporated the use of cadaver labs when possible. As the program director for REVA, Inc. it is my responsibility to make sure the quality of our medical department is world class.