In the past, the air ambulance industry has proved that it is an indispensable part of the health emergency services in the United States and beyond. The cost of availing the services has been a concern, but that apart, the utility of the air ambulance industry has never been questioned. Today, it plays an important role in repatriating COVID-19 patients from beyond the borders. It is also continuing to play a huge role in offering quality care to people in the rural parts of the United States. However, because of the COVID-19 situation, there needs to be a change in the way this industry functions.
Definition of Medical Necessity has Changed in the Air Ambulance Industry
Of course, we are not referring to medical necessity in the context of insurance coverage, approvals, etc. That remains the same. However, today, hospitals are encouraging people not to visit them unless it is important. The reason behind this is simple; people who already have a serious health condition must refrain from visiting spots that are hotbeds of COVID-19 infections, hospitals being one among these. The air ambulance industry is not completely prepared to handle this pandemic that is of epic proportions.
Recommending Air Ambulance Services Demands Careful Deliberation Today
Most of the helicopters in the air ambulance industry are not isolated enough to separate the patient from the rest of the crew. This poses a threat both to the healthcare workers and the patients. The problem of isolation does not exist in ground ambulances.
Besides, reaching the hospital early does not translate into immediate admissions today. Depending on the symptoms of the patient, he or she might need to be tested and isolated before being treated. The treatment protocols are still evolving. In essence, the physicians recommending air ambulance services should do so only after careful deliberation.
Amid thundering engines and pounding heartbeats, crews of medical flights set out on life-saving missions every day. The mission starts even before the takeoff. The planning begins with choosing the right crew, the right aircraft, ground coordination, specialists – the list goes on. On long-haul flights, it is also about accommodating the crew members of the medical flights once they land in far off places. Accounting for all the eventualities is what makes a mission successful.
Medical Flights beyond Borders
It takes anywhere between 12 hours to a day to get appropriate permissions for medical flights to cross borders. Failing to achieve this, can result in unnecessary delays and administrative hurdles. When the patient is critical, such a waste of time is can prove to be the difference between life and death. The degree of difficulty in obtaining these permits varies from one country to another. It can cost anywhere between USD 50 and USD 400.
Security of Medical Flights
All said and done, there are always those rare instances where air ambulances have to take off, and the ground staff then has to quickly work towards obtaining the permits. Security is a prime concern in such instances, especially if the travel destination is politically volatile. Experienced medical flight service providers are well aware of such issues and are always prepared for them. They know the process and the people in the right places to make it happen.
Planning the Duration
Typically, air ambulances can be prepared to take off within an hour but these are always short-haul. For longer distances, it can take twice this time. Fuel, medical supplies, landing permits, etc. are part of the preparation.
Medical flights are usually called for emergencies. It takes an experienced crew to smoothly handle the unexpected. This includes the pilot and also coordinators during long flights.
Medical flight professionals function in an atmosphere of uncertainty today where what seems like an unknown illness can be a highly infectious disease, especially with the flu season and infections like Novel Coronavirus making rounds. In this context, how can they ensure their safety while caring for the sick? The question beckons some thought and also a few precautions to remain safe. Difficulty breathing, fever, and cough can be reason enough to take the precautions that we discuss below. The idea is for medical flight personnel to remain prepared to avoid any unforeseen eventualities.
Precautions to be Taken by Medical Flight Professionals
The foremost thing to do is to handle bodily fluids such as blood, vomit, and diarrhea with utmost caution. In this regard, hand washing is very important. Washing hands often when in contact with patients with respiratory difficulty is advisable. Soap is effective, but alcohol-based cleaning agent, which contains at least 60% alcohol is also advised. Care must be taken to not touch the nose, eyes, or mouth with unwashed hands. Medical flight professionals must make ample use of disposable gloves while handling patients. These must be disposed of carefully in biohazard bags. It must be kept in mind that hands are washed even after removing the gloves.
Other Precautions that are Necessary
In areas that are known to have even the smallest number of infected patients, medical flight professionals must make use of bodysuits that are certified to insulate from infections. Since it is suspected that Novel Coronavirus can be aerosolized, it is wise to wear a facemask as a form of protection. Also, the number of personnel coming in direct contact with the sick should be minimized, although it is impossible to completely eliminate this possibility. Most importantly, one should be well-versed with the precautions put forth by the CDC.
There is no disputing the fact that the most important consideration when acquiring an air ambulance is the aircraft itself. However, once this is zeroed down upon, other considerations come into play. The prime among these factors is the interior of the aircraft. In this context, it must be borne in mind that aircraft manufacturing companies do not usually build one specifically for the air ambulance industry. They are designed for business. Once acquired, these aerial vehicles are then customized for medical transport. The following become the basic considerations for effective customization:
- Crew comfort
- Ease of access
- Ease of loading and unloading the patients
- Medical equipment accommodation
What Makes a Good Structure for Air Ambulance?
The entry, in other words, the cargo door, plays a vital role. The bigger this aspect is the better, as it facilitates easy on-boarding and off-boarding of patients. Cabin room is another factor that holds high importance. Since medical equipment needs to be kept handy during flights, cabin room matters. Plus, leaving just a little space for the patients and the crew is not advisable as it poses an operational challenge when the situation is critical.
Cabin floor is among the important factors. It is quite possible that the floor gets dirty during the course of patient care. Blood, bodily fluids, and even spillage of medicines are sometimes unavoidable. However, all these must be easily cleanable later as they can pose a health risk. Electrical outlets, high ceilings, fresh air distribution, low vibration, sound proofing are some of the other considerations.
While most of these factors can be customized post purchase, some aspects like low vibration and sound proofing are inherent features of an aircraft. More and more aircraft manufacturers these days are developing aerial vehicles that are meant specifically for the air ambulance industry. The change has come about due to the increasing demand.
Spinal cord injuries unfortunately are among the most serious ones and can leave the patients in need of high level of medical care. Prolonged rehabilitation is almost always a requirement. However, getting to the hospital, especially if they are located a huge distance away, can be a challenge. This is where air ambulance services come into picture. Fixed wing air ambulances are best suited in the situation. They are quick, which means travel time is minimum and the patient does not have to go through hours of discomfort-filled travel. Moreover, the fixed wing air ambulances themselves are sans bumps, making it safe for the patient.
Air Ambulance and Patient Needs
Worsening of the current injury is a possibility during patient transport. The air ambulance must therefore have the right equipment and the right experts onboard to make this journey a smooth one. The care during the transit has a huge bearing on the ultimate outcome post recovery. Risks like pulmonary embolism and deep vein thrombosis are high. The crew must be cognizant of this fact. Many patients who develop spinal complications also suffer from bladder and bowel disorders. It is something that the staff must be ready to handle.
Why Medical Flights are the Best Choice
Most air ambulance companies facilitate seamless coordination between the ground ambulances and the air ambulance itself. The transition becomes flawless and the patient is assured of good care. Moreover, the fixed wing air ambulances these days are nothing less than highly sophisticated intensive care units. This means that any complications that can potentially occur en route can be efficiently handled. The cost of the air ambulance can be a concern for people. However, by doing the right research and proper negotiation keeping the insurance provider in mind, the issue can be solved efficiently. In the end, what matters most is the full recovery of the patient.
The huge air ambulance bills are a matter of concern no doubt for citizens of the United States. We present a few options through which this burden can be contained.
Community Partnership with Air Ambulance Companies
It was recently seen that Gulf Shores residents now have access to free air ambulance services. Thanks to the partnership between the county and a large medical flight service provider, they will not have to pay any balance bills going forward. It is an idea that is worth emulation for the rest of the country.
Individual Memberships for Air Ambulance Services
Almost all big air ambulance companies offer membership plans that insulate their customers from balance bills. However, not many people avail this as it is an addition to their medical insurance cost. More importantly, there are not many medical flight provider groups that come together and offer comprehensive coverage.
What can Air Ambulance Companies Do?
There is a part that air ambulance companies too can play. For instance, REVA which is an international air ambulance company recently has increased its affiliations with private insurance companies. This will, in turn, rid the users of the worry of air ambulance costs. Even other providers now are veering this way, and as the web of coverage increases, the end users will benefit hugely.
Federal Intervention is an Option
The federal government has the authority to regulate the air ambulance industry. However, there is stiff opposition to any such move as it lays a huge financial pressure on the industry. It is the move that most state governments like Wyoming are pushing for, but so far, the move has borne no fruits. It is also unlikely that this route is going to be effective in the future.
Any move that brings insurance providers as well as air ambulance industry together is bound to be a success. Unfortunately, however, this is not happening at the present.
Recently a woman aboard a cruise ship called Norwegian Escape fell seriously ill. It went on to the extent that an air ambulance had to be called out. Lucky for her, the coast guard was reachable and quickly responded to the emergency by evacuating her. However, not all are as fortunate as this woman to find help when it is needed most while cruising through a fun vacation in high seas.
Often, while in international waters, with different national borders in place, the logistical problem can turn out to be a nightmare. The cost too can be quite high as evacuation is rather tough and involves huge distances. Insurance coverage is therefore of paramount importance.
Ask About Air Ambulance Coverage Beforehand
Not all travel insurance policies will cover air ambulance evacuation and you might have to shell out a huge amount for this purpose. There have been instances where people have even turned to crowd funding to pay air ambulance bills. The wisest thing, therefore, is to opt for a travel insurance that has comprehensive medical flight evacuation coverage. Moreover, you would not want to be treated in a foreign country if the treatment duration is long. Getting back to your home country among your loved ones would be among your top priorities.
Your Options without an Air Ambulance Coverage
If you have deep pockets, of course, there is absolutely nothing to worry but if you do not, it can be a problem. Minor ailments like broken bones, fever, and food poisoning is cared for onboard the cruise as each one hosts medical professionals. However, if the health condition is severe, the ship simply has to wait for the nearest port and admit you there. It would then leave with the remaining passengers once you are assured appropriate medical care. Sounds a little scary? That’s precisely the reason you need comprehensive air ambulance coverage.
The Right Questions to Ask a Medical Flight Company
Medical flights become a necessity when ground ambulances are not a choice. However, when the need for transport is not urgent, you have the time to make a sound choice, but first, you must know what questions you must pose to the medical flight company. Here, we discuss a few pertinent ones.
Does the Medical Flight Service Come Under My Insurance Network?
Health is important but cost is a factor too. Medical flight services can be quite expensive. When given a choice, you must exercise it to know what you are getting into. Air ambulance transport bills can run into the tens of thousands and in the hundreds of thousands, if the destination is across borders.
What Mode of Medical Flight is Right for Me?
Fixed-wing air ambulances are slightly more expensive than helicopters. However, they are quick and much more comfortable. In fact, preference must be given to fixed-wing flights if the journey is long. One major limitation, however, is its ability to land. Unlike helicopters, they need extended landing grounds.
Is the Air Ambulance Equipped Enough?
Today, one can hire air ambulances that suit the prevailing medical condition of a patient. For instance, you can hire one that is a flying neonatal care unit, if the patient is a newborn. Mission critical equipment like ECG monitors and the like must be available if the situation demands it.
Will the Organization Coordinate Care Beyond the Flight?
Most medical flight companies will offer you services that go beyond simply taking you from one place to another. They coordinate care with the receiving facility and keep in touch with ground ambulances if their services are required. If it is a cross-border transfer, the service provider may help you with the necessary formalities too.
These are some of the vital questions that one must ask before opting for a medical flight service to avoid any nasty surprises later.
Booking an international air ambulance sometimes becomes a necessity when you have to take your loved ones beyond the borders of the country you live in. In a country like the US or UK where the sector is heavily scrutinized and regulated, the chances of things going wrong is fairly small as long as you are financially sound enough to foot the bill. However, money is not the only criteria when you want to book an air ambulance in countries where regulations are slightly lax. In this context, one must understand that the industry is not that mature in most parts of the world, especially developing countries.
Fraud is a Possibility when You Book an Air Ambulance Across Borders
Take for instance, the case of an air ambulance company in the Indian capital of New Delhi. It is believed that an air ambulance company was booked by the authorities for purposely defrauding people after taking their money in advance and not offering medical flight services. The authorities only acted after the company had duped several people. One such person ended up losing his critically ill father owing to this fraud. He had paid the company in advance to transport his father from Johannesburg to India.
The Precautions One Must Take
- Accreditations are a good way to begin. Checkout whether the air ambulance company that you plan to hire is accredited by well known organizations. For instance, a company like REVA has multiple accreditations and is known to fly several patients internationally and has been doing so for quite some time.
- Another great way to check this out is by going through testimonials. Social medial channels like Facebook are a great start. See what other people are saying about the company to gain confidence.
- Referrals also matter. If you know someone who has used such a facility speak to them.
Finally, always keep in mind that internet should only be the first line of research. There is no substitute to speaking to air ambulance services first-hand.
Air ambulance operations are always critical. Among the critical operational aspects of a medical flight is handing off of the patient between medical flights and ground ambulances. If not done properly, it can lead to increased cost, loss of time and unnecessary lock down of valuable human resources. The efficiency at this juncture is all the more important because, usually, people from two different organizations have to come together to ensure a seamless transfer of the patient. In the event that each company has its own set of guidelines and procedures, things can get a bit complicated. It is for this reason that the Centers for Disease Control suggests a common methodology. Here we take a brief look at it.
The Planning of Hand Off between Ground and Air Ambulance
- Plan is the first thing that is to be put in place. It covers notifying each other of all developments. Beyond the ambulance companies, other organizations such as public health authority and law enforcement agency too might need to be notified.
- Communication of important aspects is another issue that must be taken care of – Does the patient have an infection? Is he or she ambulatory? Is there any special medical need? These are some of the questions, the answers to which both parties must have for communication to be effective.
- Location should be carefully chosen. It is not always about the nearest one. The patient may be a carrier of a highly infective virus. In a situation like this, the landing location should be such that the people in general can be easily isolated. The staff too must be aware that proper care should be taken to keep them from harm’s way. Adverse weather conditions are also important determinants of location. Media too can be an issue when it is a matter of national concern and can lead to a panic-like situation if information flow is not controlled.
There are several other aspects that must be taken care of. We will continue to focus on this subject in the coming days.