The benefits of air ambulance services over ground ambulance have long been debated by people who have been concerned about the rising costs of patient evacuations. In fact, there was a fierce debate over the unnecessary use of air ambulance services when in 2013 two children were flown utilizing air ambulance services for minor injuries. While some in the EMS industry blamed it on bad decision by the medical staff on the ground, others blamed it on the air ambulance industry itself. Let’s take a look at both these modes of medical evacuation objectively.
What does the NCBI say about Air Ambulance Services?
National Center for Biotechnology Information had conducted a survey on the efficacy of air ambulance services that involved helicopters. A total of 45 patients were included in the study. It was definitively concluded that air ambulance services are much more efficient when it comes to saving time. The report also noted that the need to save time must be equated with the medical emergency before taking the decision. The study, however, was conducted way back in 2006 and the ground reality has changed considerably since then.
Report on Air Ambulance Services by Canadian Journal of Surgery
A more recent study was conducted by the Canadian Journal of Surgery. In fact, the study was conducted last year. The review was an extensive one and collected data over the past decade. The main objective was to compare outcomes between ground and air ambulance services with respect to interventions, injuries and outcomes. A total of 14,440 patients were taken into consideration.
The results left no doubt that the rate of death associated with air ambulance services was much less when compared to ground ambulance services. The reason for this was that the air ambulance services could reach speciality treatment centers within a shorter span of time when compared to ground ambulances.
It must be concluded that the efficacy of air ambulance services cannot be doubted. However, there is a need for careful medical deliberation before opting for an air ambulance.
Depending on the seriousness of the illness and the care requirements, a patient may be transported through any form of medical air transport. It could be through an air ambulance, commercial stretcher or medical escort. The point to be noted, however, is that all these forms of medical air transport invariably need the services of a flight nurse. It is one of those air ambulance careers that is seeing a high degree of demand currently and is slated to grow steadily. There is also a sense of adventurism that comes with the job as you are expected to be in the midst of challenging situations.
The Mindset of a Medical Air Transport Nurse
The salaries of air ambulance nurses are pretty high; however, it is also a high-pressure job. Often, flight nurses, especially critical care flight nurses, are expected to take calls that can mean the difference between life and death. Not every medical air transport vehicle carries a doctor on every rescue. So, remaining unflustered in tough situations is a quality that takes the front seat if you want to become a flight nurse. The ability to take calls independently and improvise to make the best of the situation is another welcome trait. It is always an on-call duty. If being available round the clock is too much for you, then this career is not for you.
Qualifications of a Medical Air Transport Critical Care Nurse
The foremost requirement is the license to practice in the state where you’re based. Most medical air transport companies demand an experience of at least 5 years, if you’re targeting critical care. The nurse might be required to attend Aviation Physiology courses once a decade. The course must meet the Department of Transportation specifications. The following certifications are deemed necessary:
- International Basic Trauma Life Support Provider
- Advanced Cardiac Life Support Provider
Most medical air transport companies prefer additional Advanced Pediatric Life Support Provider certification, although this is not compulsory.
Above all, a flight nurse needs to posses compassion and excellent interpersonal skills.
Imagine being in a situation where your loved one has a serious health condition that necessitates use of an air ambulance service and you are left worrying about the cost of utilizing it. No one would want to be in a situation like this. But what if the air ambulance service that you choose offers to help you with the insurance? Yes, there are air ambulance companies out there that will aid you in getting adequate insurance reimbursements. They even hire qualified personnel for this specific purpose. These experts can even give you an idea whether your claim is likely to be accepted or rejected.
Medical Necessity for Air Ambulance Service
There is no denying that the medical necessity for using air ambulance service needs to be established first. How do you achieve that? Well, frankly speaking, it is not in your hands. The physician treating the patient will determine whether the patient needs air ambulance service or not.
If the treating physician deems the use of air ambulance service a medical necessity, will that mean you will get insurance cover? Well, not always. There is the medical director of the insurance company that comes into picture. It is in the right of the medical director to dispute the claims of medical necessity by the treating doctor. If he or she does so, the insurance cover may be denied. However, if you are in good hands, the air ambulance service may try to pursue the insurance reimbursement until the end.
What if the Efforts of the Air Ambulance Company Fail?
That’s a very unfortunate circumstance but not unheard of. If your insurance provider refuses payment and you do not have an air ambulance membership, you might be asked to pay the amount out of pocket. However, most air ambulance service providers offer discounts in such circumstances. You need to be ready to negotiate hard so that you end up paying the minimum.
As far as neonates or newborns are concerned, medical air transportation is always considered a last resort, mainly due to the frailty of the infants. However, sometimes, medical air transportation becomes inevitable due to certain emergency treatments and diagnostics, which can mean the difference between life and death. Here are a few factors that need to be considered before availing medical air transportation.
Arranging Medical Air Transportation
Of course, if it’s an emergency, that demands an air ambulance, the treating physician would ask for it. Even if it’s not asked for and you wish to avail it so that the child gets the best care in the quickest possible time, you’d need to consult the treating physician. There are various parameters that the physician would check, before giving his consent for medical air transportation.
Altitude during Medical Air Transportation
There must be a clear understanding of what the change in altitude means for the clinical condition of the neonate. It must be noted that the barometric pressure goes down with the increase in altitude. If the infant has difficulty getting enough oxygen, arrangements must be made beforehand to tackle such situation.
Take off and Landing of the Air Ambulance
Reduced cerebral perfusion during take off and increased cerebral perfusion during landing can pose a health threat to the infant. There is also a possibility of intraventricular bleeding; however, it should be noted that such risks can be completely avoided by competent staff who are trained to handle infants on air ambulances.
Vibrations, Noise and Temperature
Vibrations as such do not pose a threat to the infant but can make securing IV lines and other such medical interventions a bit tedious. Noise can be an issue if any procedure is being performed onboard the medical air transportation vehicle. If the noise is going to increase beyond 125 decibels, special care must be taken to tackle this. There is a possibility of the infant experiencing cold stress. It must be ensured that the infant is in the right thermal environment.
A certified and experienced staff is always a safe bet when transferring a neonatal patient via medical air transportation.
The United States of America spends the highest amount of money on healthcare in the world. It was already at $2.9 trillion in 2013, which has only increased since. This is not necessarily a bad thing as patients invariably get excellent medical care throughout the country.
The insurance too, for the most part, covers the expenses well, although it’s a bit long-drawn sometimes. However, air ambulance service coverage has been a bone of contention for sometime with most of the blame going to the air ambulance service provider rather than the insurance companies. Take the instance of air ambulance services in Montana.
Air Ambulance Service in Montana
Montana is mostly comprised of rural areas, so speciality healthcare is not always available close by, necessitating use of air ambulance service for adequate treatment. The air ambulance services are not always covered by insurance companies in full and the reason given is that the service is not “in-network” and only the companies that are in the insurance network are covered.
Bargaining Power of Air Ambulance Service Providers Matters
To get to the core of the problem, one needs to understand the negotiations held between air ambulance service providers and insurance providers. In a place like Montana, there are a few insurance providers; in fact, there are just three. This gives the insurance companies huge bargaining power when fixing an amount that would be given to the air ambulance service provider. Most air ambulance companies are wary of settling for a low price as it doesn’t adequately cover the cost. As a result, they choose to stay out of the network. Insurance companies only cover air ambulance services in full if they are offered by companies “in network.”
Moreover, the patient rarely gets to choose an air ambulance service provider. Last year alone, Montana saw over 3,000 medical flights. There needs to be some consensus between all the insurance providers and air ambulance service providers if the patients are to benefit in the true sense.