All posts by airambulance

Air Ambulance Transport – A Dangerous Profession

Wanting to help the needy by being part of air ambulance transport is no doubt a noble intent. However, the profession is fraught with several dangers and is counted among the most dangerous professions in the world. People who aspire to join air ambulance transport sector must give due consideration to certain aspects of the sector. Apart from the fact that air ambulance transport services cater to people in war torn areas, natural disasters and global epidemics such as the recent Ebola threat, there are other factors too that must be considered. Here, we highlight a few of those.

Air Ambulance Transport Crews are More at Risk than Patients

One simple reason is the fact that more than one crew member accompanies a patient usually. The second reason could be that the crew usually has to make more flights, one to pick the patient, one to drop and another trip to return to the air base. All this while the crew, with the inadequate safety standards, is exposed to more danger.

There is also a sense of urgency that surrounds most air ambulance transport trips. For instance, if a patient has had a heart attack, the first priority is always to transport the patient to the nearest medical facility within the first hour.

Some air ambulance transport industry experts have also raised concerns about the competition that exists between air ambulance transport companies to make the maximum number of flights. Such a “race” naturally puts the air ambulance transport safety in the backseat.

Stricter Rules for Air Ambulance Transport in the US are on the Way

The need of the hour, therefore, is stricter regulations. American air ambulance transport sector can take a leaf out of the Canada which has stricter regulations. For instance, it is mandated that at least two pilots must be present in every air ambulance trip. That said, the FAA has now proposed new safety rules, which will be implemented by 2015. The regulations have come into place after many postponements and delays. On the positive side, however, we hope that the new rules make air ambulance transport safer for the crews.

“Appropriate Facility” for Medical Air Transportation According to Medicare

Among the many conditions Medicare lays down, ensuring that “the facility is appropriate” is vital. Failing this condition, the medical air transportation service might go uncovered and cause financial stress on you later. Here, we try and understand what makes a medical facility appropriate. The data has been collected from Department of Health and Human Resources, Centers for Medicare and Medicaid Services.

The Medical Air Transportation Must Carry the Patient to an Equipped Facility

The appropriate facility could be an acute care hospital. The facility must be adequately equipped to provide hospital care or skilled nursing services which are in accordance with the demands of the injury or illness that the patient comes with. A physician or specialist who is qualified to take care of the patient must also be available at the destination that the medical air transportation carries him or her to.

Situations that Allow Medical Air Transportation to a More Distant Facility

It is generally assumed that all licensed medical facilities would be able to care for the patient. If the nearest medical facility is not equipped enough to care for the patient, medical air transportation of the patient can be carried out to the next nearest facility. The circumstances that warrant such medical air transportation are as follows:

  • The patient’s condition demands a higher level speciality or trauma care, which can only be availed at a medical facility that is more distant.
  • There is a problem with the availability of beds in the nearest facility.

The medical air transportation to a facility solely for the purpose of availing the service of a particular doctor is not permissible and might not be covered. Also, Medicare might not cover medical air transportation to a distant hospital merely because the patient desires it, in spite of the medical facilities being available at the nearest hospital.

Unless you are ready to bear the cost of medical air transportation yourself or have other means to cover the cost, these facts must be borne in mind. Knowing such conditions beforehand keeps you insulated from monetary shocks at a later stage.

“Medical Necessity” for Air Ambulance Services According to Medicare

Medicare demands that certain criteria are met in order to get coverage for the air ambulance services. The information delineated below has been summarized from what has been published by the Department of Health and Human Services – Centers for Medicare and Medicaid Services. The Department has a few basic coverage requirements, perhaps the most important of these is the one that says, “the service is medically reasonable and necessary.” Here, we try to understand this requirement in greater detail.

Air Ambulance Services Transport Requirements

  • The patient’s medical condition demands rapid and immediate air ambulance services.
  • Air ambulance services are required because ALS or BLS can potentially adversely affect the patient’s health or can be a threat to patient’s survival.
  • The POP or point of pickup is inaccessible through ground transport. This can be especially true in areas such as Alaska and Hawaii.
  • The distance to the closest and medically appropriate facility is so much that it demands travel greater than 30 to 60 minutes via ground transport.
  • The instability of ground transport

Medical Conditions that Justify Air Ambulance Services

The list given below is a broad classification and can be further expanded depending on the location and other aspects.

  • Intracranial bleeding (bleeding inside the skull) that warrants the medical intervention of a neurosurgeon.
  • Shock caused by cardiac arrest (cardiogenic shock)
  • Burns that warrant admission of the patient to a burn unit or burn center
  • Medical condition that warrants treatment in a HOU or hyperbaric oxygen unit.
  • Severe and multiple injuries
  • A trauma that can be a threat to patient’s life

Also, facilities such as critical care, burn care, cardiac care and trauma care might not be available at the facility that the patient is first taken, and can be a reason for utilizing air ambulance services.

Understanding these conditions helps people gauge in advance whether Medicare would cover the cost of air ambulance services or not.

Understanding the Importance of Golden Hour in Air Ambulance World

“Golden hour” is a term that is often referred to in cases of medical emergencies, especially involving an air ambulance. However, if you try looking the term up on the internet, you will be confronted with a variety of conflicting definitions and opinions on it. Here, we try and impress upon you the importance of the term golden hour and tell you why the term needs to be viewed in a broader perspective.

What does the Term Mean for an Air Ambulance Service?

In short, golden hour is that short window of time by which a patient stands the maximum chance of full recovery if he or she receives medical attention. The term is most often referred to in critical cases and the window is usually 60 minutes. It is therefore always the ultimate aim of an air ambulance service to get help within this window of time, when dealing with emergencies. It must be understood that an air ambulance does not always get the full 60 minutes to transport a critical patient, since getting the logistics right can be quite a task. Getting the first-responders, qualified crew, and the staff of the receiving hospital in tandem can prove tough, although an air ambulance service would give it its best to get these aspects in sync.

An Air Ambulance may get a Larger Window of Time Sometimes

If one is to define the golden hour in a wider sense, it would be a time greater than one hour in some cases. Take for instance stroke victims. Here the air ambulance would have about 3 hours at its disposal to get the patient the help he or she needs. In essence, the golden hour need not be 60 minutes literally. It could be a case-by-case urgency, which would be best defined by the treating physician. The golden hour would also determine – in most cases – whether an air ambulance is a feasible option considering the time, accessibility, and costs involved. However, being knowledgeable about the golden hour can help you call for help in a timely manner and save a loved one.

Questions that Define the Necessity of Air Ambulance Service

As the kin of the patient or a patient, you might feel that you need only the best care possible in the quickest possible time. However, if one is to keep the emotions and fears aside and decide purely on necessity, the answers to the questions listed below determine whether you need air ambulance service or not. Let’s take a peek.

Does the condition of the patient warrant that he or she spends only a minimum amount of time outside the environment of a medical facility?
If the answer to this question is as little time as possible, then the patient might need the air ambulance service.

Is a particular test or evaluation urgent or time-sensitive?
If the patient needs a test done urgently and it is not possible to get to the testing facility on time through ground transport, an air ambulance service might need to come into play.

Is the weather condition suitable for air ambulance service to be availed?
Suitable weather conditions are of paramount importance when it comes to an air ambulance service. The wrong weather can put the life of the patient and the crew members in jeopardy.

Is there adequate landing facility near the hospital that the patient is being transported to?
Without proper helipad or air port near the hospital that the patient is being flown to, availing air ambulance service would make no sense. The overall time advantage might be negated after landing if the distance to the hospital is huge.

Is the patient’s condition right for air ambulance service?
There are certain ailments that can exacerbate or turn into critical ones if the patient travels by air. The treating physician would be in the knowhow of this.

Is the air ambulance service equipped enough to address the ailment?
Air ambulance service providers may have several aircrafts with varying medical facilities onboard. The patient can be transported using the medical aircraft only if the facilities onboard meet his or her requirements.

Are qualified crew members available at the moment?
In rare situations, when the mishap is of huge proportions, adequately qualified crew members might not be available. In such situations, depending on the patient’s condition, it might be wise to wait until the crew members are available.

These are the type of questions that treating facilities and air ambulance service providers ask themselves before suggesting or even considering an air ambulance service for a patient. Knowing these parameters beforehand helps the patients and their loved ones to understand the logic behind the medical transportation decisions being taken.