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Do You Have what It Takes to Become a Critical Care Flight Nurse for Air Ambulances?

With the responsibility of providing specialized emergency care to patients, air ambulances need to be staffed with the most competent and professional medical personnel. A typical air ambulance crew comprises of an air ambulance pilot, an in-flight doctor, an in-flight nurse, and a paramedic. The number of people assigned for each task may differ according to the air ambulance company and its needs.

Among the most crucial positions in an air ambulance crew is that of a critical care flight nurse, but not everyone is capable of becoming one. So read on to find out more about becoming a critical care flight nurse and see if you have what it takes to become one.

Basic Requirements to become a Critical Care Flight Nurse for Air Ambulances

Although different organizations and charities have varying requirements and standards for recruiting a critical care flight nurse, most air ambulances have the same basic requirements. You will need to check about the specific requirement set by the company you’re planning to apply at. However, take a look at the basic necessities first and see if you can proceed with your application:

  • Licensed nurse with authorization to practice in that state you’re based in
  • Experience in critical care or emergency medicine ER (minimum years of experience may differ according to organizations)
  • High level of competency and proficiency with patient assessments
  • High level of proficiency, expertise, and knowledge in transporting and caring for critically ill patients
  • Ability to perform physical activities involved in performing aeromedical transport
  • Good problem-solving skills with the ability to combine judgment and experience in coming up with a solution

Possession of current certifications for Advanced Cardiac Life Support Provider and International Basic Trauma Life Support Provider. Some companies may also require that you possess a certification for Advanced Pediatric Life Support Provider

How to Become Certified as a Respiratory Therapist for Air Ambulances

When you’re in the medical field, there are a number of areas in which you may opt to specialize. If you’ve decided to become a respiratory therapist, there are a number of places in which you can work including in an air ambulance. You’ve met the necessary educational qualifications to pursue your licensure, but you’re not sure where to go from there. Just read on to find out more about how to obtain a license and operate as a respiratory therapist for air ambulances.

Meeting the Certification Requirements

The standard requirement for anyone to become a certified respiratory therapist is by obtaining a national license through the NBRC or National Board for Respiratory Care, Inc. It is the basis by which all other state boards will assess your qualification for a state licensure. So you will need to get through the Certified Respiratory Therapist or CRT examination.

Some respiratory therapists even pursue an advanced-level credential known as Registered Respiratory Therapist or RRT. While this may not be a prerequisite for licensure, it can boost your chances of being accepted as a certified respiratory therapist and provide your services at air ambulances. In fact, states like California and Ohio made it a mandate for respiratory therapists to obtain this license before gaining eligibility for a state license.

Meeting State Licensing Requirements and Working for Air Ambulances

Except for Alaska, every state within the U.S. requires that respiratory therapists also obtain state licensure. Although the process of gaining licensure may differ from state to state, the requirements are pretty much similar in all the states. This may include background checks, educational transcripts, and NBRC verifications in addition to application for licensure and application fees. It would do you well to study the requirements and procedures prescribed by the state licensing board in the state of your choice.

What You Need to Know about Medicare and Air Ambulance Transport

If you have Medicare coverage, you can get coverage for ambulance transportation to or from the hospital. The coverage also includes skilled nursing facility (SNF) or critical access hospital (CAH). It’s important to remember that Medicare will help you pay for ambulance services but only if other modes of transportation could be harmful for your health. This doesn’t necessarily mean you automatically quality for air ambulance transport either. First, let’s take a look at the medical necessity of availing ambulance transport.

Medical Requirement for Availing Ambulance Transport Under Medicare

Medicare will pay for the cost of emergency ambulance transportation in case of sudden medical emergencies with your health being in serious danger, provided that other modes of transportation like cars and taxi could endanger your health. You can get coverage for ambulance transportation if:

  • You’re unconscious
  • You’re bleeding heavily
  • You’re in shock
  • You require skilled medical treatment throughout the transportation

Requirements to Qualify for Air Ambulance Transport Under Medicare

The above-mentioned examples don’t necessarily qualify you fir air ambulance transport that is covered by Medicare. To be eligible for medical transport by air, your condition must require immediate and fast transportation that cannot be done through ground transportation. Medicare will cover for your expenses only if your condition fulfills the following requirements:

  • Ground transportation can’t easily reach your location
  • Obstacles like heavy traffic, long distances, etc. could prevent you from getting the immediate care that you require if you’re traveling by ground ambulance

There may even be a few but special instances wherein Medicare will cover for the cost of ambulance transport even in non-emergency cases. This is provided in case you have a doctor’s letter stating that your medical condition requires transportation with an ambulance.

What Air Medical Transport Providers Need to Know about Pediatric Airway Management

As someone who provides air medical transport, you’re probably aware of how scary and challenging it can be to provide airway management. The task is especially daunting when you’re dealing with babies and children. Their smaller and delicate bodies make it extremely difficult for medical care providers to manage their airways effectively.

Important Facts and Tips about Pediatric Airway Management for Air Medical Transport Providers

Even when you’re a trained professional and have the necessary skills to carry out airway management, you may still make a mistake. This could be because of poor assessment, poor decision-making, fixation error, poor planning, or delayed fibreoptic incubation. Here are some useful facts you could make use of to help you carry out excellent pediatric airway management:

  • Truly difficult laryngoscopy occurs rarely but the main issue is that you can’t intubate when the patient is awake. This can make your job especially daunting if the patient requires immediate airway management.
  • In children, difficult laryngoscopy normally occurs if the child is younger than a year old with low BMI. It can also occur due to faciomaxillary and cardiac surgery, so it would be crucial for respiratory medical care providers to be aware of such incidences.
  • In case of infants who are chubbier than normal, it may be tricky to determine the right IV access location during a gas induction. If it’s difficult to find IV access or to administer anesthetic for such infants, it would be ideal to have two experienced hands.
  • Some infants may even experience laryngospasm, which is a common cause of hypoxia. It can occur due to various factors including secretions or blood in the airway, ENT and airway surgery, multiple attempts at airway instrumentation, and inexperienced anesthetist. It’s important for air medical transport providers to be aware of such incidents and avoid irritant volatiles.

Basic Airway Management Tips for Medical Air Transport Providers

Even the most experienced healthcare professionals can find airway management quite challenging. While it’s a fundamental skill for all EMS professionals, it’s an extremely daunting task that requires precision, skill, and expertise. As medical air transport providers, you may also come across patients who need airway management and depend on your competence for their future.

Important Tips for Medical Air Transport Providers in Airway Management

When providing medical care to patients who need airway management, make use of the following tips to help make your job easier:

  1. Remember the good airway management hallmarks – oxygenate, ventilate, and protect the airway. You will be attempting to accomplish two physiological tasks that are equally important. For proper oxygenation and ventilation, you need to ensure that the airway is clear from blood or secretions.
  2. Don’t forget to conduct a thorough assessment and remain vigilant for any early signs of respiratory issues. Measure airway patency by determining the patient’s level of consciousness. Ideally, you will need to be more aggressive with patients that have a Glasgow Coma Scale (GCS) that is lower than 8.Your assessment should include measuring the adequacy of the patient’s breathing, whether it’s too fast or too slow, whether their breathing is shallow or deep, etc. Try to listen for abnormal sounds like snoring, grunting, stridor, or wheezing. All of these factors can have a huge impact on the success or failure of your airway management efforts when providing medical air transport.
  3. As someone who provides medical care, you need to master the use of whatever equipment you need. Your equipment usage should be true to the principles of airway management mentioned in point #1. Ensure that your suction devices, BVMS, and oral and nasal airways are working properly and of the right size for the patient.

Air Ambulance Transport for People with Altitude Sickness

High altitude can leave people with a certain type of sickness and edema, which may result in a call for air ambulance transport in many cases. Altitude sickness normally occurs at elevations higher than 8,000 feet. It is a combined result of genetic build-up, underlying conditions, and fitness level. The most common form of this condition is acute mountain sickness.

What Happens When a Person Has Altitude Sickness?

In your job as an air ambulance specialist, you may have come across a patient experiencing this condition. But not everyone knows how to determine whether or not someone has altitude sickness. In case of acute mountain sickness, the patient may experience symptoms like headache, decreased appetite, nausea, fatigue, vomiting, and general malaise.

In some cases, the patient may experience periodic breathing, which can be identified by irregular breathing that is mostly noticeable while sleeping. Many forms of altitude sickness may not be life-threatening although they may limit the body’s abilities. However, air ambulance transport may be crucial for patients with high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE).

Providing Air Ambulance Transport for Patients with Altitude Sickness

Acute mountain sickness doesn’t require a specific treatment, but it’s important for people to stop ascent until the symptoms subside. If the symptoms worsen, ensure proper hydration, which can significantly improve symptoms like headache. Descent can normally alleviate most symptoms of altitude sickness.

HAPE treatment requires the treatment of underlying pulmonary hypertension through descent. You will need to administer oxygen and other necessary medications. Even for patients with HACE, descent and oxygen usually help alleviate symptoms like irritability and headache. Many people make the mistake of getting such patients to descend alone. Instead of this, having an air ambulance chopper transport them back to safety is the best choice.

A Guide for Air Ambulance Specialists on Caring for Burn Victims

More than 450,000 people in the United States require medical treatment for burns every year. Since burns are so common, it’s likely that air ambulance specialists will come across at least one burn victim. How you initially asses and treat the patient can have a huge impact on their outcome, meaning that you need to keep yourself updated on the latest norms and trends in the treatment process.

Different Types of Burns Air Ambulance Specialists May Encounter

While all burns cause damage to the skin and the underlying tissue, not all burns are the same. Different types of burns can influence the treatment decision you need to take:

  • Thermal burns – Thermal burns make up 80% of the burn cases treated within the United States. It’s caused by exposure of the skin to open flame, scalding water, or intense flame. The damage to the skin can result in changes to the thermoregulatory system. This means that patients can become hypothermic unless air ambulance specialists take care to prevent heat loss. Pain management, aggressive airway management, and fluid resuscitation are also important.
  • Chemical burns – This type of burns is caused by exposure to different types of chemical compounds like acids, alkalis, and organics. It’s crucial that you remove any contaminated jewelry or clothing so as to limit exposure. Make sure you also use proper protective equipment to prevent exposure. If there’s any powder left on the skin, brush it off and immediately start flushing the contaminated areas using plain water.

    When you’re transporting the victim, continue the irrigation process but take care to avoid causing hypothermia in cases when you’re flushing large skin surfaces. Try using warm water in place of cold water.

In addition to these, you may come across people with electrical burns. The severity of this type of burns may be difficult to determine as they may cause internal injuries despite showing minimal evidence on the surface of the skin.

What You Need to Know about Critical Care Medical Air Transport

Patients in critical condition require extensive care. This makes it crucial for providers of critical care medical air transport to maintain efficiency and compassion in administering care. You can find air ambulance operators who provide specialized medical transportation services for such patients. The flights are fully-equipped with the latest medical tools for providing intensive care. The patients are also overseen by top-notch medical care providers from critical care nurses to in-flight doctors.

Comprehensive Care for Critical care Patients

Operators providing air ambulance critical care transport aim to provide the highest level of care to trauma patients. So they offer comprehensive care that isn’t just limited to transporting the patient to a hospital. They assign flight coordinators who make arrangements to provide the following services:

  • They aim to guarantee a smooth transfer from departure facility to destination facility. This will include obtaining medical reports and providing them to the receiving facility efficiently.
  • They make arrangements for ground ambulance service that will ensure optimum care in transportation between the medical facilities and the airport.
  • They assign an appropriate medical team for all medical air transport flights to ensure that each patient receives the right level of medical care. The composition of the team is tailored according to the needs and condition of the patient.
  • They even provide regular updates to family members and other necessary parties throughout the medical transfer.

Complete Equipment for Critical Care Medical Air Transport

Critical air ambulance aircrafts require a higher level of equipment than regular air ambulance aircrafts. So critical care aircrafts have to be equipped with the following:

  • Full mechanical ventilation including high-frequency oscillation ventilation and nitric oxide (NFOV)
  • Extracorporeal membrane oxygenation (ECMO)
  • Ventricular assist devices
  • Diagnostic imaging
  • Intra aortic balloon pump
  • Temporary pacemaker
  • Neonatal isolette transport
  • Point-of-care lab analysis capabilities
  • Invasive line insertion and monitoring

How to Become a Respiratory Therapist for Air Ambulances

Respiratory therapists form an integral part of any medical care team. They are especially important for air ambulances, as they normally deal with patients who have sustained critical injuries. Many times, such patients experience respiratory distress and require emergency help from a trained professional. If you’re trying to become a respiratory therapist to provide professional care for such patients, this article will give you a brief guide regarding the process.

Meeting the Educational Requirements

The standard requirement to become a respiratory therapist is a college education in the related field. Every state that gives out a license in respiratory therapy require candidates to completed a program in respiratory care at an accredited and recognized institution. To meet the minimum requirement for getting a license, you’ll need at least an associate’s degree with two complete academic years of study along with a clinical experience.

Regardless of whether you’re becoming a respiratory therapist for air ambulances or other emergency services, you’ll need to be proficient in the following:

  • Respiratory care
  • Oral and written communication
  • Social/behavioral sciences
  • Biomedical/natural sciences

What’s Next to Become an RT for Air Ambulances?

Once you’ve completed the relevant degree program approved by the CoARC or Commission on Accreditation for Respiratory Care, you can move forward to the licensing procedure. You will need to pass the Certified Respiratory Therapist examination. In some states, you will be allowed to begin working in the field with a temporary license before you take the CRT exam.

Some employers, however, may also require that you have a Registered Respiratory Therapist credential as well. Since January 2015, this credential became a standard requirement for licensure in states like California and Ohio. After getting certified, you can then apply for licensure from the state and become a licensed respiratory therapist.

What You Need to Know about IS-BAO Accreditation for Air Ambulance Specialists

When it comes to accreditations for an air ambulance company, CAMTS certification is one of the most popularly known. Big names in the industry have started to pile on their accreditation records with the IS-BAO certification. While this certification was already introduced in 2003, only several air ambulance specialists have successfully been accredited. Let’s take a look at some important information about the IS-BAO certification.

More about IS-BAO Accreditation

IS-BAO stands for International Standard for Business Aircraft Operations. It was developed by the International Business Aviation Council (IBAC) along with its member associations. As the name suggests, the certification proves that a certain service follows the recommended code of best practices for flight departments over the world. It was designed to ensure that these flight service companies maintain a high level of safety and professionalism.

The IS-BAO accreditation is recognized by the Federal Aviation Administration (FAA) in the U.S. and the Canadian Civil Aviation Authority (CAA) as meeting the ICAO standard. Additionally, it is also recognized as an industry standard for business aircraft operations by the European Committee for Standardization (CEN).

In 2012, the IS-BAO was amended so that it will facilitate the implementation by helicopter operators. It was a result of a joint effort made by the IBAC with helicopter associations like HAI, EHA, and BHA.

Benefits for Air Ambulance Specialists

The IS-BAO program can be beneficial to air ambulance specialists and the aviation community itself in a number of ways. Here are a few of those benefits:

  • The implementation of predictive and proactive methods enhance operational safety
  • The implementation of safety practices across teams promotes and improves safety culture
  • An integrated Safety Management System (SMS) helps in improving efficiency and effectiveness
  • Increased appreciation of aircraft operations at the executive level

Enhanced ability to carry out safety performance measurement

Air Ambulance and Medical Flight Transport Services: Everything you need to know!