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Compliance Norms for Texas Air Ambulance Service Providers

Just because an aircraft is willing to transport a patient, it does not count as an air ambulance service, in any state of the US. Here, we discuss a few rules that have been laid down by Emergency Health Care Act. We discuss only such parts of the act that pertain to air ambulance service providers in the state of Texas. The rules may vary slightly for other states, but you would get the overall picture here.

Air Ambulance Service – What Constitutes Specialized Emergency Service

The vehicle must be specifically designed to carry the injured or sick by air. Also, all equipments necessary for transportation of the patient must be provided by the air ambulance service.

Any air ambulance service that claims to offer specialized transportation services must be licensed by the Department of State Health Services. This includes the aircraft as well as the staff involved. Even the air ambulance service providers flying into Texas from other states must be licensed by the Department of State Health Services and must be in compliance with the safety norms prescribed by it. Out of state providers must be accredited by Committee on Air Ambulance Medical Services. They would be considered to be in compliance with the Department’s norms if accredited.

The Location of the Air Ambulance Service

All advertisements of the air ambulance service provider must contain its physical address in the state. If the service operates from multiple locations, it is free to advertise them. If an out of state air ambulance service advertises within Texas, it must have at least one base in the state.

There is, however, one exclusion to state licensing. Any air transportation provider can offer voluntary service out of compassion without the expectation of remuneration and bear all the costs of transport. However, the company must be in compliance as a regular air transportation service provider.

Two US Passports

Overseas Help with Air Ambulances

Travelling overseas alone, or even as a couple, can be quite intimidating, especially if you encounter a medical emergency of serious nature. Even if you are covered for emergency medical evacuation and have good travel insurance, you would be better off returning to your home country for better treatment and aftercare. Air ambulances become a necessity in these cases. If you are a citizen of the United States, you can expect some help from the US Consulate in this regard.

How Can the Consulate Help You with Air Ambulances?

The consulate will assist you in locating an air ambulance that is best suited for your medical evacuation. You can even request that your friends and family be informed if doing that is tough for you given the circumstances. This will give your loved ones enough time to arrange for finances and take care of other aspects on your arrival.

You can always visit the US Passports and International Travel website to view the list of medical evacuation companies. The same website also lists the US as well as overseas travel and medical insurance companies.

Consulate does not Cover Cost of Air Ambulances

Keep in mind that the consulate merely acts as a facilitator and any expense will still have to be borne by you, your family, your insurance or any other type of coverage that you might have opted for. Keep in mind that your domestic insurance carrier will not cover you when you are abroad, if you have not purchased a cover that specifically states that a medical evacuation will be covered.

The website of the US Passports and International Travel specifically mentions that it assumes no liability or responsibility of any kind. The companies that provide air ambulances are merely listed for the convenience of international travellers. However, finding links to information about air ambulance companies and insurance providers becomes easy when you refer to this website.

Airambulance cabin filled with Medical Equipment

Structural Guidelines for Fixed Wing Airambulance Transport

All most all states in the United States have laid down certain minimum requirements that a fixed wing airambulance must satisfy. The guidelines given below have been issued by the state of Tennessee but the structural guidelines are, in general, similar in other states too.

Airambulance Doors

The doors of the airambulance must be wide enough that a stretcher can be passed through it without tilting it more than 30 degrees. This guideline ensures that the transit of the patient into the airambulance is safely done.

Vertical Height of the Airambulance

It is vital that there is enough headspace so that the medical personnel can function optimally and provide adequate care for the patient. For this reason, all airambulance vehicles must have a minimum vertical height of 30 inches.

The lighting of the Aircraft

The electrical capacity of the airambulance must be equipped to provide “sufficient” light inside, such that medical care is not hindered due to lack of it. The service providers are allowed to make use of portable lamps to achieve this.

Guidelines for Airambulance Equipments

To ensure stability of the patient while entering the aircraft and during the transport, the stretchers must be fitted with at least two restraining straps to keep the patient in place.

The suction devices must have a capacity to produce suction of at least 12 inches of mercury.

Oxygen bags or masks must be available within the airambulance. There must be enough stock so that 95% fraction inspired oxygen is available at all times. The equipment must be capable of adjusting flow between 2 to 5 liters of oxygen per minute.

Adequate sanitary supplies like trash disposal bags, emesis bags, urinal, bedpan, towels, etc, must be available.

Basic tools like stethoscope, blood pressure cuff, dressing materials, and flashlights must be kept handy.

As a patient and a customer availing airambulance services, it is your right to have these facilities and being aware of such basic things about air ambulances can help.

Pic of hand holding money

Guide to Medical Flight Financial Considerations

Insurance is the foremost financial consideration when it comes to a medical flight; however, we’ve had enough discussion on the subject. There are also other factors that one must bear in mind. The cost of a medical flight largely depends on the aspects that we discuss below.

Does the Medical Flight Need Prepping for Special Equipment?

If the patient needs traction, cardiac monitors, ventilator and similar equipment, there is obviously going to be a cost attached to them. These factors will increase the price of the medical flight. If the medication is provided by the provider of the medical flight, the costs might even go higher.

The Destination and Duration of Medical Flight

It goes without saying that a longer medical flight costs more. However, the cost of flying from one country to another can push the costs even higher. As most health insurances do not cover overseas medical flight, the patient might have to bear a huge burden. Having a comprehensive travel insurance that covers such costs or being a part of medical flight membership programs is vital before overseas travel.

Distance between Transferring Facility and Receiving Facility from Airport/Helipad

Most of the medical flight service providers take care of all details including transportation of the patient from the transferring hospital to receiving hospital. One must understand that this demands considerable coordination. If the receiving facility is located in a foreign country, the service provider would have to take care of customs, visa, and other formalities too. The medical flight service providers charge for all their efforts. If it involves, ground transport, the patient will also be billed for that.

The costs might also depend on the type of aircraft used. Travelling through a long-range medical flight can be expensive but necessary. However, when it comes to medical transportation, all service providers are not equal. Some charge considerably more than others. It is for you to weigh the costs against the benefits and take a call, if at all possible.

Pill over a dollar bill

Guide: Air Medical Transport Cost Determination

With the cost of even a short air medical transport flight running into thousands of dollars, a little homework before zeroing on one is not a bad idea, especially if you have the liberty of doing so. Keep in mind that you would not have the liberty or time to choose an air medical transport operator during emergencies. However, if the situation is not life-threatening, it pays to look into certain aspects.

How Far is the Air Medical Transport Vehicle from You?

You might be paying for the distance covered by the air medical transport vehicle to reach you. So, it’s vital that you contact a local air ambulance company, which stations its vehicle close to you. This can save you several hundreds or even thousands.

Have you Got a Final Quote for the Air Ambulance Transport?

The quote that you receive from the company might not be all inclusive. This means you might have to shell out more money than what is mentioned in the quote. Contact your flight coordinator to know the exact details about the price quote.

Does your Insurance Cover Air Ambulance Transport?

There are several guidelines that one needs to follow to assure smooth coverage of air ambulance transport costs by the insurance provider. Look at aspects such as medical necessity, closest appropriate medical facility, and treating physician’s approval even before you start looking for an air ambulance.

Does the Air Ambulance Company offer Comprehensive Services?

There are several aspects that must be taken care of:

  • The transport of the patient from the hospital to the air ambulance
  • Transport from air ambulance to ground ambulance
  • Coordination with receiving facility
  • Medical repatriation beyond borders

Opt for an air ambulance company that covers these corners. Involving yourself in these matters can be time consuming and might cost you extra.

Finally, check whether you can substitute air ambulance for a commercial airline. Simple things like IV fluids, professional care, and stretchers can be accommodated in a commercial airline too, which cost far less than an air ambulance.

A commercial airline stretcher

Guide: Medical Flight or Commercial Airline Stretcher

A medical flight is not always necessary to fly a patient domestically or even internationally, and commercial airline stretcher can be a great alternative. However, it must be noted that the stretcher cannot always substitute a medical flight that is equipped with advanced patient care systems. But what if a patient doesn’t need an advanced patient care system? For a patient to fly using commercial airline stretcher, the foremost concern is stability and the suitability to fly, which is determined by the treating physician.

More about Commercial Airline Stretcher

Unlike the medical flight where the patient has the entire flight to himself, commercial airline stretcher uses a part of a regular flight. A few seats are usually taken off to accommodate the patient in a sleeping position on the stretcher, and also to have all necessary medical equipment. The relatives or loved ones of the patient can easily travel along with the patient as there is no constraint for space.

Scheduling a commercial airline stretcher is much easier as the flight would anyway be heading to the destination. However, the patient might need a longer ground transport as the aircraft would only land in the designated area. The cost of the commercial airline stretcher is much lower than a medical flight as it is not a dedicated medical flight for the patient.

Similarities between Medical Flight and Commercial Airline Stretcher

For one, the patient is required to obtain clearance before opting for the stretcher, just the way one does with a medical flight. The provider who offers you the stretcher service will most likely arrange for ground transport as well and coordinate with the receiving facility. The medical team and necessary supplies such as medications and medical equipments too would be arranged.

At the end of the day, making the choice between a medical flight and commercial airline stretcher largely depends on the condition of the patient and the decision of the treating doctor.

Patient on a stretcher with paramedics

Preparing the Patient for a Medical Flight

It is important that the medical flight taken by a patient is both safe and comfortable. Following certain guidelines ensures that the medical flight transport is carried out smoothly and quickly. Here, we discuss the vital considerations that must top your mind.

Proper Documentation for Medical Flight

Laws specify that transfer orders by the treating physician and acceptance documents by the receiving facility must be in order before the patient boards a medical flight. Also, the patient’s medical chart, discharge summary, lab results and other medical information must be carried. A photo ID is vital and must be kept handy. Consent for medical flight transport must be sent to the air ambulance operator beforehand.

Medications and Equipments during the Medical Flight

An IV access must be ready. If the patient does not need IV access on a continuing basis, it can be capped. All medications that are necessary and those that are meant for comfort must be administered. These meds must also be provided to the crew in case the need arises midair. This also includes IV medications.

Casts, Traction, and Diapers

If the patient is being treated with a circumferential cast, it must be bivalved beforehand. Hanging weights for traction are not suited for a medical flight. Appropriate traction device must be used instead. An unconscious patient must be diapered prior to transfer to the medical flight and any tube feeding must be discontinued about 7 to 8 hours in advance.

Accompanying the Patient in Medical Flight

The passenger accompanying the patient must have prior approval. If the condition of the patient demands that no one accompanies him or her during the medical flight, the passenger must comply. Most fixed wing aircrafts have limited space and one must understand that it is essential for the medical staff to have enough space to function efficiently. Even when accompanying the patient, the passenger must occupy minimum space possible.

Knowing these guidelines well in advance helps make the medical flight travel a comfortable one.

A neonate being transferred from ground ambulance to air ambulance

Fixed-Wing Air Medical Transport Precautions

When you accompany a patient to a fixed wing air medical transport vehicle, you would be accompanied by qualified professionals belonging to both ground ambulance and air ambulance. However, knowing certain protocols can always come handy, and ensure a safe and swift transfer of the patient to the air medical transport vehicle.

Getting to the Air Medical Transport Vehicle

First and foremost, the ground ambulance needs to wait for the aircraft to shut down its engines completely before approaching it. Even when the ambulance approaches the air medical transport vehicle, it has to stop at least 25 feet away. All flashing lights must be switched off and only the headlights must be used in case of poor visibility.

You must wait for the crew to arrive to the ground ambulance to take the patient away. Switch off the ground ambulance immediately after reaching the destination to avoid the exhaust fumes getting into the aircraft. Keep in mind that the aircraft might be pressurized to a certain degree and the exhaust fumes can be quite a disturbance.

Taking the Patient to the Air Medical Transport Vehicle

Walking in front of the wing of the airplane is a strict no. Also, refrain from opening the doors of the air ambulance. Assist in loading the patient only if help is requested. If the help is sought, do not stay inside the air medical transport vehicle unnecessarily after loading the patient, unless you are travelling along. Never hesitate to ask what you must and must not do once inside and when travelling with the patient.

Before Exiting the Airport

It is wise to leave the airport only after the air medical transport vehicle takes off. Inform the crew of any issues such as debris or animals in the vicinity that might hinder takeoff. Even when the ground ambulance moves away from the aircraft, the flashing lights must be switched off.

Finally, have all your questions relating to the medical travel answered before the transfer. Your questions at the last moment can unnecessarily waste valuable time.

Picture of Sikorsky S-76 chopper

Airambulance and Your Safety – Know a Little About the Choppers

It is remarkable to know that airambulance services or Helicopter Emergency Medical Services ferry over 400,000 people safely each year in the US. Most of these rescues are usually conducted in tough weather conditions and poor visibility. Landing is another concern as pilots have to land the airambulance in unfamiliar terrains.

The fact remains that airambulance services today are increasingly turning commercial and safety is sometimes put on the backburner. The FAA has been extremely active in regulating the airambulance market in recent times, laying down new rules for safety. In this realm, we look at certain facts. However, a good chopper can cut the risks to a huge extent. Here, we discuss a few of those briefly.

The Various Airambulance Choppers and their Capabilities

There are several airambulance helicopters that are used in emergency situations these days. As a person who might potentially be in need of these at some point, you must know a little about the popular helicopters out there.

Bell 206: The cost varies from $800 thousand to $3 million. It is a single engine airambulance that can host only one pilot. It has only limited weather capability. It also has limits when it comes to carrying load such as fuel and medical equipment.

Eurocopter EC135: The cost varies from $4 million to $6 million. It sports a twin engine and can host 2 pilots simultaneously. It has excellent weather capability and can run on autopilot. It can fly for longer distances. This airambulance can carry equipments such as balloon pumps and ventilators.

Sikorsky S76: The cost of this chopper varies between $7 and $12 million. It is a twin engine helicopter that can host two pilots at a time. It has instrument weather capability and can also run on autopilot. It has specialty transport capabilities such as onboard pediatric care. This airambulance has the highest distance range.

Considering the fact that helicopter airambulance operations accounted for the second highest commercial accidents in 2014 as reported by FAA, it becomes vital that you know a bit about these helicopters.

Concerned Woman Waiting for Air Ambulance

Guide to Speed up Medical Flight Services – What Can You Do?

Medical flight services are often called when there is an emergency, and time can be a critical factor and mean the difference between survival and death of your loved ones. Here, we discuss a few things you can do to ensure that medical air transportation is not delayed because of you.

Do you have Preferences when it comes to Medical Flight Services?

If your insurance has a tie-up with a particular provider or if you have membership with a particular medical flight services organization, make it known the moment the need for air ambulance arises. Letting it know later can mean unnecessary delays and rescheduling.

Deciding who will Accompany the Patient

Many a times, only one family member is allowed to accompany the patient while availing the medical flight services. Do not let emotions guide this decision. A person who is emotionally stable considering the circumstances is the right one. Just because you love the person most, you might not be the best person to accompany the patient.

The Belongings that Medical Flight Services will Carry

Keep in mind that the belongings can be transported through other means of transport. Medical flight services usually have a huge limitation when it comes to space. So, carry only such belongings that are very important. Don’t waste time deciding on what to carry.

Don’t Save Your Questions about Medical Flight Services to the End

Pick up the phone and call up the medical flight services to clarify any doubts as soon as they arise. Most air ambulance companies will dedicate personnel to interact with you while coordinating the services at the same time.

Keep in Mind that You can Only Provide Moral Support

It is natural for you to feel “responsible,” but when it comes to medical flight services, all you can do is provide moral support to the patient. Everything ranging from the decision to call for air ambulance services to the receiving hospital is decided by qualified professionals. You imposing yourself could result in insurance carriers denying coverage.