There is no single “governing body” over medEvac services. Each service is independent, or could be part of a group of similar programs. There are however, several agencies that may have licensing or over sight for medEvac services. For the aviation components, medEvac services must adhere to rules and regulations established by the Federal Aviation Administration (FAA). They are also subject to periodic inspections by the FAA.
Minimal standards for reimbursement and/or licensing could also be established by third party payers (Medicare, Medicaid, managed care organizations) or by local legislation (state, county or city laws). Most states have minimum licensing requirements for medEvac personnel and the service.
In addition, medEvac services may also follow national or regional standards. For those services that are hospital based, if the hospital is accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHCO) or other such organizations, such as the American College of Surgeons for trauma verification, the medEvac service must also meet those minimum standards.
Level 1 Trauma Centers, Tertiary Care Centers, and Specialty Hospitals.
Pilots are limited to 12 hour shifts and medical crews typically work either 12 or 24 hour shifts.
No. Pilots are charged with the safe and efficient transport of the crew and patient without regard to what is happening ” in the back”. By isolating pilots from patient involvement, they can make crucial flight decisions without influence.
Helicopters do respond to accident scene when the pre-hospital personnel’s evaluation of the patient/scene meets local air medical transport guidelines.
54% Inter-facility transports (hospital to hospital), 33% Scene response, and 13% Other (organ procurement/transport)
Trauma, medical (seizure, pulmonary, etc) spinal, burn, pediatric, replant, neonate, organ procurement, High risk OB, non-trauma neuro, and cardiac.
Physicians, Nurses, Pre-hospital personnel, Law Enforcement and any other personnel determined by state or local protocols.
There are many but some of the most common are: Nurse/Nurse, Nurse/Paramedic, Nurse/Respiratory Therapist, Nurse/Physician, Paramedic/Paramedic.
Patients are flown by fixed wing for many different reasons. These can range from the stable patient involved in an accident, or with a long-term medical condition, wishing to relocate closer to family for rehabilitative care, to the critical heart failure patient requiring intensive care transfer to receive a transplant. The fixed wing environment differs from the rotor wing environment primarily in that fixed wing travels farther, faster and higher. The fixed wing is primarily a facility-to-facility transport, typically long distance in nature.
Secondly, there are typically more choices of different types of aircraft, and selections that are less expensive per mile and/or per hour to operate. With licensure and accreditation standards available and easily verifiable, the care provided in the fixed wing environment is the same as the helicopter. The fixed wing is typically not in competition with the rotor wing in that the rotor wing service typically is for moving a patient from a scene to a primary care facility, or a tertiary care facility to a primary care facility.