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.
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.
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.
There are certain non-emergency situations which can warrant air ambulance transport as apposed to other means of medical transportation. This could even be for diagnostic purpose. If the insurance is to cover this amount, the statement delineating the necessity for air ambulance transport must come from the treating physician. The amount would then be covered by the insurance provider of the patient.
What if you don’t have insurance? This is when you really need to start thinking about the cost. Typically air ambulance transport utilizing a twin-engine airplane would cost about $2500 for a 55-mile flight. The amount can go up to $50,000 for longer distances within the country and international flights can cost above $200,000. The cost is most of the times unavoidable.
Having Air Ambulance Transport Membership Can Help
Air ambulance memberships come in various forms. Some memberships are specifically designed for international travel. They give you the security of travelling abroad without worrying about air ambulance transport costs to your home country in case of emergencies. There is usually a nominal annual fee involved.
Certain other type of memberships give you the liberty of paying only such amount that is not covered by the insurance company. For instance, if the cost of air ambulance transport was $100,000 and the insurance pays only $80,000, you would have to pay out of pocket in case you don’t have a membership. Having a membership rids you of this worry.
Things to Keep in Mind to Ensure Adequate Air Ambulance Transport Coverage
Most of the memberships are provided by individual air ambulance service providers. One needs to check out whether the provider you choose has a good network in your region. Checking whether your insurance provider has a tie up with any air ambulance transport company is also vital. If you are travelling abroad, check your travel insurance, and if need be, buy separate coverage, especially if you are going for a high-risk adventure-filled vacation.
It is natural that you only want the best for your loved ones. When an elderly relative has to travel from one place to another, you might face the dilemma of whether you should be hiring air ambulance services or not. In the absence of a directive from a qualified medical professional, air ambulance services might not be covered by your insurance or Medicare. Bearing the huge cost of air ambulance services is not something every individual can bear. In circumstances like these, you must consider medical escort services, which are cost effective. However, a medical escort is not best suited in all situations.
Can Medical Escorts Substitute Air Ambulance Services?
There cannot be a one-word answer to this question. First criterion to avail a medical escort service is that the patient should be deemed medically stable by a qualified medical professional. An unstable patient might need to be carried utilizing air ambulance services only.
If the patient needs only basic medical management such as administration of medicines, oxygen and monitoring, air ambulance services might not be warranted at all. Such services can be provided by a medical escort.
Are Air Ambulance Services and Medical Escort Services Similar?
Of course, you won’t have a fully equipped air ambulance at your disposal and the number of qualified personnel at your service would be limited. However, there are still a lot of similarities and this is one of the reasons why most air ambulance service providers also offer medical escort services. The coordination for bed to bed transfer is often taken care of. This involves coordinating with both sending and receiving hospitals as well as ground transport facilities.
Most medical escorts know the local language of the destination that you travel to. They also possess high level of experience having worked in emergency situations. So, even if you are travelling with a single medical escort, you are still in safe hands. Also, there is a huge cost difference when compared to air ambulance services. However, one needs to remember that in case of emergencies, medical escort services are never a substitute.
The call for medical flight services is usually left to the professionals who evaluate the situation and make a decision. However, the payment for the medical flight services almost always falls on your shoulders, and this can often turn out to be a huge burden.
What if the $10,000 call for medical flight services was totally unwarranted and you would have only incurred a few hundred dollars if you had opted for ground ambulance services? Here, we discuss a few factors that decide whether medical flight services should be pressed into service or not.
Is the Injury Life-Threatening to Warrant Medical Flight Services?
The concern for your loved ones is understandable but unless the patient is in a life-threatening situation and medical flight services can reduce the risk, there is no point calling for one. One must keep in mind that concern and fear are not the reasons to call medical flight services.
Discuss the extent of the injury with the qualified personnel who takes the call and voice your opinion. At the end of it, it is you who will have to make the payment and insurances won’t pay unless the reason for calling medical flight services is valid.
Will Medical Flight Services Actually Save Time?
Air ambulance cannot land just about anywhere. They need adequate landing facilities and if such a facility is too far, it is futile to transport the patient there. You are better off transporting the facility to the appropriate nearest medical center through land transport. Also, there must be a reasonable time difference between the land and air ambulance transport to the destination.
Are the Weather Conditions Congenial for Medical Flight Services?
FAA is already trying its very best to raise the safety standards of medical flight services. Bad weather and poor visibility are risky by themselves. A land ambulance would be a much safer choice in circumstances like these.
There are a lot of technicalities involved with air ambulance services and it is not always the quickest option. So, discuss the mode of transport with the decision-making authority on the scene, although you don’t have the real authority for making the decision when you are dependent on insurance for cost coverage.
Speak of flights and the first thing that comes to mind is the price tag; however, one needs to look at medical flights from a totally different perspective. While price can be a criterion, it can never be the only one. Here are certain factors that you must be taking into consideration to ensure the wellness of your loved ones while choosing medical flights.
The type of medical flights being used
Not all medical flights have the capability of running in tough weather conditions. Plus, the air ambulance needs to be cabin pressurized for patient safety. There are aircrafts that are often used part-time as chartered planes; you are advised to steer away from such medical flights as the chances of them being fully equipped medical emergencies is questionable.
Medical flights and safety compliance
Look for the accreditations. A company that complies with the rules laid down by the Federal Aviation Administration is the best one to choose. Violation of these norms is usually recorded and made public so that people have the choice to avoid them.
Medical flights with qualified crew
This one might come as a shock to you but providers of medical flights are not mandated by the government to maintain standards when it comes to qualified staff (apart from the pilot). The doctors and emergency medical personnel might not have great credentials. Medical flights don’t come cheap and you deserve the best. Ensure that you are knowledgeable about the credentials and experience of the crew members.
Experience of the pilot
Medical flights take to skies in tough weather conditions some times. It is essential that an experienced pilot is in control of the aircraft. FAA mandates that the pilot has at least 1500 flying hours under the belt. Some providers have their own standards that are better than the FAA standards.
The medical equipments onboard
Medical flights are often required to take care of midair emergency situations. To accomplish this, they need to have adequate equipments like oxygen, heart monitors, etc.
The communication and coordination
Medical flights need to be in constant touch with the receiving hospital so that all necessary arrangements are made beforehand. Also, the medical flights need to have good communication systems that constantly keep the pilot abreast of weather conditions in the destination. Having adequate communication infrastructure saves crucial minutes when time is of essence.
Of course, people must ensure that their insurance policies cover medical flights so that they are not burdened by huge costs during emergencies that warrant air ambulances.
Megan Gilbreath was a resident of Abilene, Texas. She was an 18-year-old student who was involved in a motor vehicle accident involving her pickup. She had a rollover accident where she sustained a head injury and a broken leg. A medical flight was quick to respond and she was all set to be transported to the nearest medical facility.
However, one major error was committed. The EMT that belonged to the medical flight service had intubated her wrongly. The tube that was supposed to carry oxygen was inserted into the esophagus instead of her windpipe. As a result she was declared brain dead by the time the medical flight took her to the treating facility. All the while oxygen was being pumped to her stomach instead of her lungs.
Are You Safe on a Medical Flight with Mere FAA Regulations?
It must be noted that FAA is a regulating body for flights of all types and not just medical flights. This means the medical flight service providers don’t really have regulations that govern them when it comes to ensuring adequate medical care on the flight. FAA only has the say when it comes to medical flight safety when flying. It concerns itself with issues such as crew safety in bad weather conditions and medical flight during bad visibility at night.
Who Regulates the Medical Flight when it Comes to Standard of Care?
The Airline Deregulation Act of 1978 that paved way for using air ambulances during medical emergencies had one major flaw. It exempted the medical flight service providers when it came to “routes, prices, and services.” This loophole allows the medical flight service providers to have their own standards when it comes to services.
This however does not mean that all air ambulance service providers cut costs when it comes to standard of care. Most medical flight operators maintain high standards of medical care. However, in the highly competitive air ambulance sector, it is possible that there are medical flight service providers who cut corners through not-so-well trained or inadequately trained medical staff.
The Airline Deregulation Act of 1978 does have a provision where the states can regulate the medical aspect of air ambulances; the only condition is that such regulation should not impact the economics of operating a medical flight “significantly.” In essence, there is scope and hope for regulations in this regard.
Shauna Laswell recently suffered chest pains and was taken to a local hospital; however, she was diagnosed as having a heart attack. She had to be emergently flown via air ambulance to a Las Vegas hospital. Shauna did get great care and survived the medical emergency. When she received the bill, she was just short of having another heart attack – it was a whopping $38,800! Thanks to her insurance provider who did not cover the air ambulance cost, she got a reimbursement of only $6,200.
Why Was Shauna’s Air Ambulance Bill Not Covered?
Anyone would wonder why air ambulance bill was not covered, as heart attack is a life-threatening situation and definitely warrants an air ambulance flight. For one, the nearest medical facility was not the one she was taken to. Insurances only cover the distance to the appropriate nearest medical facilities. So, the vital question is, “What can I do to avoid a situation like this?”
Few Tips to Ensure Adequate Air Ambulance Insurance Coverage
Remember that only travel to the nearest medical facility is covered by insurance. Also, you are better off hiring the services of the air ambulance attached to the hospital, rather than hiring an independent medical flight service. The ones attached to the hospital are usually cheaper.
Look at the kind of coverage that your insurance provider provides. If there are clauses that keep you from getting full air ambulance cost coverage, steer away from such providers. Most air ambulance services have membership programs. Being a member of such a program gives you immunity against the amount not covered by insurance company. The air ambulance company itself would cover such amount.
Be prepared for eventualities. Air ambulances are being increasingly used these days. So, request for the air ambulance provider that you prefer. Know the air ambulance services that are affiliated with your insurance provider.
Most of the time, insurance companies do not cover 100% of the charges for air ambulance services. The Utah State Insurance Department has even issued a warning to the public in this regard.
The Federal Aviation Administration had laid down its groundbreaking safety rules for choppers in February of 2014, popularly known as the HAA (helicopter air ambulance) rule. It mandated that the choppers involved in emergency transport of the patient would have to meet requirements like:
- Inclusion of certain specific safety instruments
- Improved training and testing
- Establishment of control systems for air ambulance transport vehicles
These were only a few requirements that were laid down. Although the initial deadline to meet these requirements was April 22 of last year, it was then extended by a year owing to the difficulties of the air ambulance transport companies to comply with them at such short notice. Most air ambulance transport companies have already complied with the first set of rules, although there is some anxiety in the air ambulance transport industry as the deadline nears.
The Air Ambulance Transport Sector will have to Meet More Deadlines
Although the air ambulance transport companies will have to comply with several of the rules laid down this year, there are some for which the sector still has time. Here’s a breakdown.
Compliance by April 2016: Setting up of operations control center.
Compliance by April 2017:
- Installation of radio altimeters
- Incorporation of warning systems and terrain indicators for choppers
- Meeting qualification criteria for PIC instruments
Compliance by April 2018: Complying with mandated systems to monitor flight data.
Guidance is awaited by the Air Ambulance Transport Industry
The sources in the air ambulance transport industry revealed that it is not possible to comply with certain mandates unless there are clear guidelines by the FAA. Compliance with most of the rules will cost the air ambulance transport operators huge dollars, so obviously, they want to get it right and keep the expenses to a minimum.
For the pilots, crew and the people travelling in air ambulance transport vehicles, the rules will bring in more safety and efficiency. In general, the rules have been well accepted by the air ambulance transport industry so far.