Literally translated, hypoxia means diminished availability of oxygen to the body, something that is quite common in medical air transport scenarios. However, a pre-existing condition that already has made the patient struggle for oxygen can further exacerbate while on the flight. Here, we discuss the reasons and also the different types of hypoxia. The intent is to create a quick reference for medical air transport personnel.
Why Worry About Hypoxia Onboard a Medical Air Transport Vehicle
The biggest risk of hypoxia is when the medical air transport flies over 12,000 square feet above the sea level in an unpressurized air craft. It must be noted that medical flights are pressurized at high altitudes. However, if not, and if no supplemental oxygen is available immediately, it can lead to hypoxia. This kind of hypoxia usually affects the lungs as is caused by partial pressure reduction of O2.
Histotoxic Hypoxia Could be a Danger
Histotoxic hypoxia is diminished ability to filter oxygen owing to narcotic or any other toxic substance. The patient loses the ability to get adequate oxygen. In situations like these, the medical air transport crew must take special care to avoid exacerbating the situation. The combination of histotoxic hypoxia and lack of oxygen pressure due to altitude can prove to be a deadly situation.
Understanding Stagnant Hypoxia
This is another form of hypoxia and is caused by exertion of positive G force in the Z axis. Other causes are heart failures and shock. All these interfere with the blood circulation for the worse and deprive the human body of adequate oxygen. However, medical air transport services always carry oxygen onboard and these conditions are easily taken care of.
Hypemic Hypoxia is Another Cause
This type of hypoxia is caused by health conditions that affect the oxygen levels in the blood. Prime examples for this are anemia and carbon monoxide positioning, both of which affect blood oxygen levels.
Not all medical travels warrant a medical flight. When time is in your hand but the treatment for the ailment demands that you travel long distances, medical flight stretchers can be quite useful and economical. The cost of this service would be a fraction of what an air ambulance would cost you. However, there are certain points that one must keep in mind before booking a medical stretcher and we discuss those in some detail here.
How Isolated is the Patient in the Medical Flight Stretcher?
Medical stretchers naturally occupy more space than a normal seat would. Plus there might be the need of space for some basic medical equipment. All this space translates into higher cost. The agency you have hired might cut corners by trying to make do with minimum space. It is wise to clarify this beforehand. Isolation from the rest of the fight is extremely necessary.
Does the Air Ambulance Company take Care of the Logistics?
You do not want to risk taking the patient in your car to the airport. It is always wise to have an ambulance for this purpose. Does the agency take care of this? Also, the on-boarding and off-boarding of the patient must be a quick process. The agency needs to anticipate all possible hurdles to this and take care of it well in advance.
Booking the Hospital Bed on Arrival in Advance
You do not want to run around to book a bed in the hospital of your desire. While you standby the loved one with health issues, the agency must take care of booking the hospital bed in advance. It is vital that you ask about this beforehand and take confirmation of the booking. Of course, the ambulance too must be ready in the airport upon arrival to save time and get through the process quickly.
Lastly, one must not hesitate to clarify any doubts that they may have, with the coordinator.
We have mentioned in our guides earlier that the best thing to do is leave patient care to the paramedics or emergency medical professionals before the air ambulance arrives. However, there can be times when such help is not available on time. It is in instances like these that the knowledge of some basic facts and maneuvers come handy. We discuss such minimum interventions below.
Pre Air Ambulance Arrival First Aid starts with Calling 911
It is only prudent to first seek professional help and then proceed to offer help. Most times, our foremost instinct is to jump into helping the victim physically, but in the process that precious and live-saving call to 911 emergency services might be delayed significantly. If you strongly feel the need to intervene directly, ensure that you have someone nearby call 911 immediately. Your presence of mind in this matter is vital.
After You Call the Emergency Number
What you do after the emergency call, is entirely situational. Let’s explore some scenarios here:
- Commence cardiopulmonary resuscitation or CPR if you see that the patient is not breathing.
- If the patient is bleeding profusely, apply pressure to stop it. You can prepare a tourniquet by tying a rope to restrict the flow of blood towards the wound.
- If the patient has any amount of food, vomit or blood in the mouth, place the patient on his side with his arm or a pillow-like material under the head.
- If you see that the victim is unconscious while lying face down, turn him over so that he rests on his back.
If the victim is conscious, calm him down by reassuring that help is on the way. Remember, your reassurance to the patient is vital to eliminate anxiety. Bring in some positivity into the situation. Even simply holding the patient’s hand would suffice.
Over the past few years, the medical flight services have steadily risen in cost, so much so that the cost has gone up at a whopping 5% per annum since almost the past 7 years. There have been concerted efforts on the part of state governments and the federal government to bring the cost of medical flight services down, at least to a ‘reasonable’ level. However, the definition of what is reasonable has been rather loose. In the midst of all this, it is natural that people in general are concerned about workers’ compensation and how it deals with medical flight services.
Handling of Medical Flight Services by Workers’ Comp
The big concern of most people is naturally whether they have to pay out of pocket in the eventuality that medical flight services are utilized for a work-related injury. Many would simply ask whether there is a possibility of a balance payment being demanded.
Such worries, however, have no basis to them. The amount would be settled by the insurance carrier and if the amount being approved by the carrier is less than what the air ambulance company is claiming, the victim of the accident need not be concerned. It is up to the medical flight services company and the carrier to come to a settlement. In most cases, the air ambulance company gives the insurance carrier a discount.
The Clash of Two Laws and the Way Out
Most states have fee schedules that define the extent of medical flight services cost coverage. However, ADA or Airlines Deregulation Act of 1978 allows air ambulance service providers to charge what they feel is reasonable without any questions being raised. The two laws can be, sometimes, contradictory to each other. However, in spite of all this, it still boils down to the air ambulance company and the insurance provider coming to a common monitory agreement, in case there is a dispute.