Being a physician in fixed-wing medical flights is no small task. Being responsible for a patient in an intensive care unit setting, hundreds of feet above the ground while he battles for life can be quite daunting. What compound the gravity of the situation are the limited resources at the disposal of physicians manning the medical flights. It’s only the world- class training and a cool, professional head on the shoulders that comes to aid in situations like this, day in and day out. Here, we describe some of the training requirements that are typically needed.
Initial Training for Medical Flights
Well, the training starts even before one applies for the job. The training is a little different from the one that you receive in hospitals. You need to be adept in working with limited resources. Also, it is important to understand that problems that one can face up in high altitudes. Gas pockets within the body and limited oxygen are just some of those. Training is optional in some regions but in others, they are absolutely mandatory. The documentation of such training might needed to be vetted by organizations like National Accreditation Alliance for Medical Transport Applications. The training, however, can be obtained through organizations like European Aero-Medical Institute or Commission on Accreditation of Medical Transport Systems.
Keeping the Skills Current for Medical Flights is Vital
Some skills are more important than others, like the ability to intubate a patient quickly. Yearly ALS refresher courses are expected to be in place by most medical flight companies. Since, hospitals often see critical patients, experience handling them in emergency settings is considered an added advantage by most air ambulance companies.
Ongoing Training for Full-Time Professionals on Medical Flights
Most of the reputed air ambulance companies offer their medical staff ongoing training. While some of this training is conducted in-house, others may be outsourced to external agencies that are accredited. In all, these efforts and checks are put in place for the safety of both the medical flight professionals and the patients under their care.
When faced with an emergency situation concerning the life of a loved one, cost is the last thing that you want to worry about. However, it is always wise to have an idea of the costs involved in emergency situations and medical flight services are one of those. With the cost having doubled over the past decade, you must know what to expect if you’re opting for a medical flight. While most of the costs will be covered by your health insurance, you would still want to keep the costs low as you might be forced to pay the unapproved balance amount as it so often is seen happening.
The Cost of Ground Transportation
One cannot completely discount the fact that a ground ambulance may be required to transport the patient. It becomes an absolute necessity when it’s a fixed-wing medical flight, which can only take off from an airport. Even choppers can, at times, not reach the patients owing to the terrain and ground ambulance services may be needed.
The Destination of the Medical Flight
This is an obvious factor. The longer the medical flight, greater the cost. The nearest appropriate treating facility might be quite far and sometimes across borders – all this ultimately translates into higher cost.
Medical Flight Landing Fees
The landing fees depend on the duration that a medical flight uses the landing facility. This becomes a part of the final bill.
Type of Medical Flight and Number of Medical Staff
Long flights typically demand fixed-wing air ambulances. These can be more expensive than choppers. They are generally better equipped and considered more comfortable. The number of medical staff is also a criterion. Certain medical conditions demand that professionals in more than one field of medicine be present in the air ambulance and this can push the costs up.
While there may be other cost factors too, the ones discussed above are the major ones.
It might seem that the aviation and air ambulance companies have little in common. While one deals in the mechanics of aviation machines, the other primarily deals with biology and chemistry of the human body. However, when one looks closely, it is easy to spot several similarities between the two. It is these similarities that the air ambulance companies must be aware of and must work on, to improve the safety of medical flights. The risks involved in both industries are very similar to each other. This is why REVA, which is an international fixed-wing air ambulance company, has published a white paper on ‘Just Culture’
What is ‘Just Culture’ and How Does it Apply to Air Ambulance Companies?
This is a highly relevant question. Although one rarely gets to hear about fatal crashes and safety flaws concerning air ambulance companies, such incidents are not unheard of. Apart from this, there are obviously going to be some near misses. The logic behind the ‘Just Culture’ is to treat mistakes as learning opportunities to avoid them completely in the future. REVA released a white paper on the topic recently.
According to Emma Roberts who is the company’s Safety Director, the white paper meant for air ambulance companies, lays down the steps involved in implementation of just culture and explains how this culture increases the degree of safety.
‘Just Culture’ Fosters Transparency in the Way Air Ambulance Companies Function
‘Just Culture’ makes reporting easier for staff who constantly put their lives on the line to protect and serve the needy patients. The culture ensures that these front-line warriors are not punished for the mishaps but are rather encouraged to report them so that apt solutions can be found. The result is improved safety of medical flights and better compliance with medical as well as aviation norms.
The study of aviation physiology is quite extensive. On diving deep into this subject, it becomes apparent that air blocks are major factors that bring about physiological changes in relation to altitude. To say that principles of aviation physiology hold good for medical flights too is stating the obvious. In this guide, we highlight some of the very common air blocks. These must be considered every time a person opts for a flight, pressurize or unpressurized.
Ear Blocks on Medical Flights
The symptoms primarily start as a feeling of fullness; however, the symptom may take a slightly painful turn in higher altitudes and ultimately lead to vertigo. The solutions though are pretty simple: yawning, swallowing and Valsalva are quite effective.
Sinus Blocks on Medical Flights
There can be two types of sinus blocks. The first type is maxillary sinus block. This is characterized by sharp pain beneath the cheekbones as well as upper dentition. The second type is frontal and is characterized by severe pain under the eyebrow as well as eye corners. The best remedy for this is Valsalva maneuver.
Gastrointestinal Tract Blocks on Medical Flights
Our digestive system can hold a lot of trapped gas. When a person travels on a high-altitude medical flight, this collection of gas can lead to physiological changes in the gastrointestinal tract causing discomfort and sometimes, slight pain. Belching and flatus can provide instant relief.
Tooth Blocks on Medical Flights
This is not the most common air block on medical flights; however, these can be quite painful and irritating. Sometimes, the natural gaps within teeth and gaps that occur due to dental procedures can retain air and act like bubbles. These air blocks can cause pain at high altitude. There is no immediate remedy for this condition. It is advised that the patient visit a dentist upon landing.
It must be noted that any discomfort that does not go away even after the above-suggested techniques must be dealt with all seriousness. In extreme cases, descent or landing may be warranted.