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