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.
Working in the air ambulance industry can bring to fore those hidden emotions that people tend to burry up and no person is impervious to such emotional shakeup. Take for instance Prince Williams. The Duke has been quite vocal lately about mental health issues. However, he has hardly spoken about the loss of his mother out in public, apart from one time when he was about 15 years old. He lately opened up about it in the context of his stint as an air ambulance pilot for the East Anglian Air Ambulance company. He had been a part of it for about two years.
Prince William, Air Ambulance and His Emotions
The Prince had previously been a part of the nation’s defense forces and had ever served in Afghanistan. However, what churned up his hidden emotions related to his mother, Princess Diana, was his job as an air ambulance pilot. He said, finding himself in situations where death was always a possibility was hard to take on a daily basis. He added that the job as medical flight pilot made him depressed and the memories of having lost his mother at a young age surfaced quite often. He made his revelation as part of a documentary.
William Sharing His Feelings Sheds Light on the Mental Status of Air Ambulance Personnel
Air ambulance services are availed for life-threatening emergencies most of the time. The suffering patients who are under a lot of distress and struggling to stay alive can be quite impactful on the minds of the personnel. All this, while the crew cannot let their emotions get the better of them. Suppressing emotions becomes a norm and this pent up feeling can eventually lead to anxiety, depression and other mental health issues. The industry needs to tackle this very seriously and focus towards having a mechanism that takes care of the mental wellbeing of the crew.
Air medical transport paramedics often encounter patients when they are in their worst possible physical condition. Many a times the victims are desperate out of pain or the sheer will to survive. With so much going on around them, air medical transport paramedics are expected to be stoic so that their actions and emotions do not get in the way of performing their life-saving duties effectively. Imagine a situation where you are the one who has to break the news to a family that there’s nothing more that can be done to save the life of the one they love. Imagine another situation where a murderer, while running away from the cops, injures himself gravely. The paramedic would still have to attend to this felon with equal professionalism without letting personal emotions getting in the way.
Air Medical Transport Paramedics Face Assaults too
Air medical transport paramedics sometimes have to treat people under the influence of drugs and alcohol who do not behave logically. This can lead to assaults and threats. They are expected to remain unaffected by such occurring and to carry out their duties. Also, in the field, there are protocols that need to be followed. This means a paramedic, despite knowing what treatment is to be provided, might not be authorized to administer such treatment. Situations like these can lead to a lot of frustration.
The Physical Aspects of the Job
Paramedics have to do a lot of heavy lifting and moving as part of their job. Injuries to the lower back, wrists and shoulders are not rare among paramedics for this reason. The long hours of work only add to these problems. The lack of rest during extreme emergencies can lead to a lot of physical fatigue which can manifest in mental irritation as well. The only solace through all this is the fact that the job actually makes a difference to people’s lives.
People with a flair for adventure and a want to do good for the society are the ones who usually choose a career in the air ambulance industry. Of course, money is a criterion too and, for the most part, remuneration too is considered good. We have, in the past, pointed out that there is going to be a continually huge demand for air ambulance technicians and pilots in the days to come and the demand will last for almost a decade or even more. However, not many people understand that the industry is at the cusp of a disruption for the good and technology is leading this change. In the days to come, innovation will drive the industry to bring about efficiency in cost, customer experiences and operations.
How Technology Drives Air Ambulance Flying Experiences
The way customer data is utilized by air ambulance companies will determine what kind of experience they ultimately provide to their customers. Their health needs can be taken care of more efficiently. This data also opens up ancillary sales opportunities. For example, the luxury that a patient is used to or the expectations of the person accompanying the patient can be gleaned through the various online tools at our disposal today.
There is also connected technology or IoT or Internet of Things, which connects the various parts of a flight to the ground staff for ongoing monitoring of its flight worthiness. The technology can even make predictive maintenance possible wherein an air ambulance organization can predict a problem that the aircraft might encounter and take anticipatory action to avoid the problem all together.
Newer Technology Means Newer Opportunities
With all these technologies proving useful for the air ambulance industry, the innovative digital skills needed for their implementation will be in high demand. People looking for a career in the air ambulance sector have a wider career option today.
According to a recent report by Government Accountability Office, 69 percent of air ambulance flights are not covered by private insurance providers. That is more than two thirds of the air ambulances out there in the country. There are a total of about 20,700 medical flights in the United States of America to put a number to this fact. The median price that was charged by air ambulance companies when a helicopter was involved was about USD 36,400 in 2017. The price shot up to USD 40,600 when the need for medical transportation involved fixed-wing aircrafts in the same year. When the complaints pertaining to balance billing to Government Accountability Office were examined, it was seen that the balance billing amounts were at least USD 10,000.
Consider the Necessity of Air Ambulance Service Seriously
Unfortunately, air ambulance services are hardly a consideration when one opts for a private health insurance. The wise thing would be to ask the agent whether they cover air ambulance services. One needs to do this proactively. Moreover, one must specifically ask which of the air ambulance companies are in-network of the private health insurance provider. Once you come to know of the names, check whether these air ambulance companies offer service in your region specifically. There are a lot of regional medical flight companies in the United States of America. Avoid the off chance that the air ambulance companies covered by insurance do not serve your region.
Be Wise and Purchase Air Ambulance Memberships
Air ambulance memberships can be very cheap. The memberships are usually renewed annually. Find out the air ambulance companies in your region and check what kind of memberships they offer. Opt for a membership that covers your entire family. It would not be a bad idea to hold memberships with more than one air ambulance company. These memberships protect the end customers from balance billing. Another great idea is to suggest your employer to get group memberships for the staff of the company as this can get the price of memberships down significantly.
The common assumption, most often, is that a patient is always flow to the nearest treating facility when an air ambulance is employed. However, this is not always true, although the nearest facility is taken into consideration owing to the cost as the nearest one would obviously cost the minimum. What people need to understand is that air ambulance is a live-saving service and not a cost-saving service. The primary criterion is therefore not just the nearest but also the most appropriate treating facility. For instance, a burn victim may be carried by the air ambulance to the nearest burn care center, although a highly specialized trauma care is just a few blocks away. Again, the primary intent here is to save lives.
Other Considerations taken Into Account by Air Ambulance
The paramedics have a huge say in deciding the treating facility. Of course, they cannot suggest any specific hospital as this would give a leeway for bias but they can specify the kind of facility that the patient should be flown to. Typically, the choice is between the following during medical emergencies:
- Trauma Centers
- Burn Centers
- Cardiac Care Centers
- Stroke Centers
- Pediatric Hospitals
What Happens When a Patient is Involved in a Multi-Casualty Incident?
Natural disasters, for instance, can result in multiple people in need of urgent care. In cases like these, it is impossible for one hospital to take care of all the incoming casualties, no matter how close it is to the incident. An air ambulance in such a situation will look for appropriate facilities, regardless of the distance.
Does Patient Choice Come into Picture?
There might be instances where your health insurance covers you in one particular hospital but not the other; it is fair to request the air ambulance service provider in such instances to fly you to the one that will not affect your coverage. However, one has to mindful whether the cost of air ambulance service, in such cases, is covered or not. It is wise to consult your case worker in a situation like this.
Imagine this – you pay for a smartphone in full and then realize that you are only allowed to use certain features in it but not all. How would you feel about that? Would you have bought it had you know about this fact during the time of purchase? Now, take the case of air ambulance coverage provided by insurance companies. Don’t you deserve to know the kind of coverage that you get? Whether you would be monetarily covered in your neediest hour when your health demands urgent medical care? You need to be sure you will be taken to a well-equipped treating facility and that the expense of carrying you to that destination is covered by the insurance provider. Unfortunately, that is not the case today.
Not All Insurance Providers are the Same
There are several health insurance providers out there who cover the air ambulance charges at a fair rate but there are others who do not. On the other hand, it is not under the control of the air ambulance service providers to choose patients. They ask no questions; they simply respond to emergencies. When this act turns into a haggle for money, it becomes a problem. The result, often, is balance billing – the part of the bill that remains uncovered by the insurance provider. The balance bill, ultimately, becomes the responsibility of the patient to pay, despite having insurance coverage. The amount can be so huge sometimes that it can push a common man towards bankruptcy.
Patient Advocacy by Air Ambulance Service Providers
Most air ambulance service providers have a robust policy when it comes to patient advocacy. Such programs are mainly targeted towards helping patients course through the complexities of insurance. However, the question is, why should such programs be necessary. All that is needed is a fair rate at which insurance companies reimburse the air ambulance service providers. As the insurance companies and air ambulance companies sort this matter out, what ultimately comes out is something that we all need to keep an eye on.
If you are a patient who is in a medical serious condition and fighting for life, would you be okay with an air ambulance professional who is fatigued and has been working a shift of almost 24 hours? Would you perceive this condition to be grave for your life? Although air ambulance personnel these days are not expected to work abnormally long hours, this fact is something you should know about. In this context, one must note that 24-hour shifts were a practice, if not common practice, prior to 1997. We bring you a research conducted in this regard by the US National Library of Medicine National Institutes of Health, which is a part of National Center for Biotechnology Information, a US Government undertaking.
The Findings of the Report were Astounding and Contrary to Popular Belief
The primary objective of the research was to assess the psychomotor agility and skill performance of the air ambulance personnel when they worked 12-hour shifts versus 24-hour shifts. The data gathered pertaining to 24-hour shifts belongs to the pre-1997 era. The data collected was compared with times when the air ambulance industry was mandated to work for limited number of hours as against the time when shifts spanning 24 hours were not alien. Intubation – a critical task that is undertaken routinely – was used as a scale to measure the efficiency of the air ambulance professionals. Surprisingly enough, there was hardly a difference between ‘overworked’ professionals and the ones who worked reasonable hours.
How Do Air Ambulance Professional Manage to Work at Optimal Efficiencies?
The answer may lie in the fact that failure is not an option when lives are at stake. No matter what the level of fatigue, when people who are driven by passion and compassion are put in a situation where the outcome depends on how they perform, the chances are they will try their best and come out winners. The fact is also an ode to the dedication of the professionals belonging to the air ambulance industry.
Psychosis can be a real problem for air ambulance professionals as they try to offer the best possible care during transport. Most often, specialists are relied upon to care for such patients during air ambulance travel. However, there are often cases where psychosis is simply a result of the situation that the patient is in and not necessarily a pre-existing condition. Therefore, the air ambulance professionals do not necessarily have any means to expect a situation like this. The reasons for the condition may be several and the response can vary from case to case. We look at some of such scenarios and discuss the best way to handle them.
Drug-Induced Psychosis on Air Ambulance
Crystal meth, cocaine, and a few designer drugs can induce severe psychosis in patients where they exhibit paranoid and panicky behaviour. The first course of action in such cases is administration of an antipsychotic drug. Restraints are not usually necessary unless the patient needs immediate IV medication. In such cases, a mild manual restraint is, most often, enough. However, unexpected display of physical strength during psychosis can warrant more effective and long- lasting restraints until hospital care is made available. The air ambulance professionals, in such instances, must ensure that the pulmonary function of the patient is not compromised in any way owing to the restraints.
Handing Patients with Pre-existing Mental Ailments
An example would be a schizophrenic who might need both medications and restraints to ensure smooth air ambulance travel. Usually, a qualified medical professional accompanies the patient in such situations. Then, there are also those patients who suffer from mild psychosis. The first approach to handle them is simply soothing words. Keeping such patients calm is often a matter of saying the right thing. Accompanying family members who know how to handle the patient are a huge help in cases like these.
Far too many people stuck overseas are reaching out to the world for money through crowd funding. Some even might say that crowd funding for rescue is being viewed as ‘insurance’ coverage in case anything goes wrong, especially when the emergency involves air ambulance transport across borders. While the world community must be appreciated for showing concern and extending a helping hand, international travellers too must take precautions to avoid giving rise to such situations in the first place. Here, we touch upon certain details pertaining to travel insurance and air ambulance coverage that people travelling abroad must keep in mind.
Adventure, Insurance and Air Ambulance – the Three Main Factors
Most travel-related injuries occur when adventure activities go wrong. However, adventure, most often, is the motivating factor for international travellers. Even though most of the travellers understand the importance of insurance and go for one, certain nuances are sometimes ignored. For instance, if you are headed for a skiing adventure in the Swiss Alps, you must make certain that the travel insurance covers that sport in particular. Also, one needs to know whether the coverage is for local care or air ambulance evacuation too, and if the evacuation is covered, then to what extent.
Travellers Must Discuss Health Concerns with their Travel Agents
While online research is an excellent place to start, it should not be considered a substitute to the insight that a travel agent can provide. Discuss different insurances, the activity you plan to indulge in, the coverage and air ambulance evacuation. Go for the right balance of travel cost and health care assurance. While measures like crowd funding may rescue you, the hassles of raising money and the worries that come along, can be quite harrowing. The effort taken to research and purchase travel insurance goes a long way to bring you a tension-free adventure.