There’s a lot happening in the air medical transport industry currently. With the state lawmakers and the feds trying hard to end surprise air medical billing practices, there is a high degree of lobbying that is taking place both by insurance and air medical transport industry. There is a huge amount of blame game going on. Both parties are trying to pin the blame on each other. Often, you’ll find articles that highlight high bills that patients are compelled to foot and on the other hand, articles that detail the plight of the air ambulance industry and the rising costs it is grappling with.
What is a Surprise Air Medical Transport Bill?
In order to understand what surprise air medical transport bill is, we should adopt an industry agnostic perspective. The problem is not just with the air ambulance industry, it is rampant throughout the medical world. In the United States, unlike other parts of the world, insurance is a matter of network coverage. If a provider is not covered by the insurance company, it is likely that the reimbursement is going to be rejected. This compels the patients to foot the bill all by themselves. This phenomenon, where a person is compelled to pay a medical bill, in spite of having medical insurance, is known as surprise bill. This is what the polity of the nation is currently trying to eliminate.
Why is Tough to Eliminate Surprise Billing?
There are several facets to this. Some air ambulance companies, in the absence of fair reimbursement by insurance industry, simply do not want to come in network. The question arises, “Why?” The answer is obvious – this move paves the way for balance billing where the patient becomes responsible to foot that cost which is not covered by the insurance provider. Then who is to blame? Well, both insurance and air ambulance industries: the insurance industry because it refuses to reimburse a fair amount and the air medical transport industry because it refuses to come within insurance networks. It’s a Catch-22 situation.
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.
Medical air transport professionals are usually the first to respond to emergency calls and trauma scenes are sometimes very stressful to handle with death and serious injuries being a part of it. Medical air transport professionals do not even get time to let the situation sink in as they are expected to act immediately. This can cause quite a lot of mental trauma to them. Added to this is the physical stress of the entire situation where they have to move the patient, equipment, etc., so that lives can be saved.
Common Mental Ailments among Medical Air Transport Personnel
Research shows that depression, PTSD or post-traumatic stress disorder, fatigue and anxiety are highly prevalent among medical air transport professionals. The tragedy of the matter is that they do not often get time to introspect into their mental wellbeing because of the situations that they often find themselves in where they are expected to be highly reactive to the surroundings. By the time they realize their mental state, they are already deep into these psychological ailments. While it is a shared responsibility of the employers and the personnel, here are some tips to stay mentally healthy.
Tips for Mental Health
- Increasing mindfulness through meditation: Meditation allows people to take a step back and introspect. All the deeply buried feelings come to surface and one becomes in-tuned with his or her own mental state. The ability to detach oneself from sufferings around is greatly increased.
- Confiding in others: Every person has friends or colleagues that they can talk to. Getting certain things out of our system can help. It’s a sort of an outlet. Medical air transport professionals can also make use of in-house psychologists to open up. Even keeping a journal can help.
- Exercising to reduce stress: Endorphins that result from exercise can get rid of stress to a huge extent. Air ambulance professionals must make physical activity of their choice a part of their daily routine.
Finally, it is vital that people speak out when they are under stress. There is nothing wrong in seeking help when it is warranted.
There’s no denying that an air medical transport pilot’s job pays well and is also quite exciting. Responding to emergencies and being amidst action all the time is definitely thrilling, but how does one get there? That’s what we explain here.
An Air Medical Transport Pilot Must Hold a Degree
It’s not necessary that you are an aeronautical engineer. Choose among subjects such as English, physics or mathematics. Holding at least a 2-year degree is mandatory, although it is preferred that you hold a 4-year degree.
Check Whether You Physically Qualify to Fly an Air Medical Transport Vehicle
Simply visit the Federal Aviation Administration website and look for an Aviation Medical Examiner close to the place that you stay. You will be given a medical test by this examiner and if you pass, you will be given a certificate stating the same. At least a class 2 certificate must be obtained as it is mandatory for commercial flying.
Choose the Right Flight School
It is essential that you enrol in a flight school that is recognized by the Federal Aviation Administration. Look for the various accreditations that the school has. Keep in mind that the trainer too must be certified by the Federal Aviation Administration. During the course, you must gain enough instrument flying experience. Air medical transport pilots often have to fly in adverse weather conditions where visibility is poor. This is when flying with the aid of instruments comes handy. It is a mandatory skill for air medical transport pilots.
Garner Enough Flying Hours
Air ambulance pilots are expected to have a good amount of experience under their belt; however, paying for flight hours can be quite expensive. An easy way out is becoming an instructor. This will give you enough hours so that you can comfortably apply for the job.
When you’re a leader in air medical transport, you’re responsible for enabling progress and growth for your people and your organization. Unfortunately, not every leader is capable of fulfilling these responsibilities. That’s because real-life experience alone may not be enough to tackle some of the issues and conflicts that you’re experiencing within the organization. That’s why it’s crucial that air ambulance leaders pursue advanced degrees that equip them with the necessary skills to better themselves.
Enhance Your Existing Skill Set and Develop New Ones
Advanced degrees can provide you with necessary skill sets that every leader should possess. In addition to just learning how to make decisions, you can also learn how to frame them and communicate them in a way that would be understood by every member of your staff. This can ensure effective implementation of policies and changes within your organization.
Air medical transport leaders may also benefit from higher education that can help them develop political acumen. You need to have a better understanding of the environmental and political dynamics that’s necessary for navigating the landscape so you can continuously strive for improvement.
Drive Learning Among Air Medical Transport Staff
When an air ambulance leader is pursuing higher education to enhance their knowledge and skill set, they could serve as an example to their staff. It could encourage and motivate staff members to enhance their own skill sets and invest in higher education that could further their career. This increased value in learning could prove to be beneficial for the growth and development of the organization in the long run.
Some advanced leadership training programs can even help you improve your knowledge in terms of cost efficiency, communication, data analysis, and evaluation. All of this can serve to benefit your career and organizational growth.
If you work as an air medical transport paramedic, there’s a good chance you will respond to emergencies in which the patient requires a splint. This will usually be in situations where the patient has undergone some form of physical trauma and fracture. You may think you’re already an expert in splinting but there’s always room for improvement.
Tips for Better Splinting in Air Medical Transport Paramedicine
As a novice paramedic, you may still be nervous when you come across actual patients that require a splint. Here are a few tips that will make it easier for you to make great pre-hospital splints:
- Take your time if the patient is stable – There may be times when you need to splint an extreme fracture when you respond to a call. If the patient’s condition is stable, it’s important that you avoid rushing through the splinting process. Although you may get nervous, there’s no harm in taking a few extra minutes to carefully splint the fracture before taking them for air medical transport.
- Make the most of pillows – Pillows provide good padding when you need to splint a fracture. They also act as effective splints even on their own. So if your patient has a distal fracture, you just need to roll up the injured part in a pillow and tape it firmly. But make sure the toes or fingers are sticking out.
Opt to control the pain beforehand – Although splinting is intended to reduce pain, the splinting process itself can be very painful. If your patient is screaming in pain it may be difficult for you to concentrate on the splinting and you may end up making a mistake. So try to administer some analgesics beforehand if possible.
Acute coronary syndrome or ACS is a term used for describing different myocardial (heart) conditions caused by a sudden reduction of blood flow to the heart muscle. This could result in heart attacks, cardiac arrests, and more. The patients suffering from these conditions require immediate care, making ACS a time-sensitive condition. So as an air medical transport crew, you need to administer the necessary pre-hospital care aiming towards rapid reperfusion, which involves the suddenly blocked coronary artery.
Important Pre-Hospital ACS care Tips for Air Medical Transport Crew
When providing pre-hospital care to patients suffering from any kind of ACS, here are some important tips you can make use of:
- If the patient has a normal oxygen saturation level, it may be harmful to administer supplemental oxygen. So make sure you consider their SpO2 readings before you resort to supplemental oxygen use.
- If the patient doe not have an allergy towards aspirin or is suffering from active gastrointestinal bleeding, immediate administration of aspirin is highly recommended. In order to ensure that the aspirin enters the bloodstream more rapidly, make sure the pill is chewed instead of being swallowed whole.
- Although air medical transport crews can safely administer fibrinolytic therapy, it is not recommended if you can get the patient to a PCI center quickly. It is only recommended for use if the transport time is greater than 30 minutes.
- Transporting a cardiac arrest patient to a PCI center at least 24 hours after the arrest is essential for better chance of survival.
When you are a part of an in-flight medical crew, it’s highly likely that you’ll encounter patients with chest pain every now and then. This makes it crucial to educate yourself on the latest assessment and treatment guidelines for acute coronary syndrome.
As someone who provides air medical transport, you’re probably aware of how scary and challenging it can be to provide airway management. The task is especially daunting when you’re dealing with babies and children. Their smaller and delicate bodies make it extremely difficult for medical care providers to manage their airways effectively.
Important Facts and Tips about Pediatric Airway Management for Air Medical Transport Providers
Even when you’re a trained professional and have the necessary skills to carry out airway management, you may still make a mistake. This could be because of poor assessment, poor decision-making, fixation error, poor planning, or delayed fibreoptic incubation. Here are some useful facts you could make use of to help you carry out excellent pediatric airway management:
- Truly difficult laryngoscopy occurs rarely but the main issue is that you can’t intubate when the patient is awake. This can make your job especially daunting if the patient requires immediate airway management.
- In children, difficult laryngoscopy normally occurs if the child is younger than a year old with low BMI. It can also occur due to faciomaxillary and cardiac surgery, so it would be crucial for respiratory medical care providers to be aware of such incidences.
- In case of infants who are chubbier than normal, it may be tricky to determine the right IV access location during a gas induction. If it’s difficult to find IV access or to administer anesthetic for such infants, it would be ideal to have two experienced hands.
- Some infants may even experience laryngospasm, which is a common cause of hypoxia. It can occur due to various factors including secretions or blood in the airway, ENT and airway surgery, multiple attempts at airway instrumentation, and inexperienced anesthetist. It’s important for air medical transport providers to be aware of such incidents and avoid irritant volatiles.
Air ambulance transport can be a necessity when travelling abroad for medical treatment. Air ambulance transport can be easily arranged owing to the availability of such services throughout the globe today. What worries most people are other aspects such as:
- Arranging for postoperative care
- Arranging the paperwork to enter the country
- Arranging medical care
- Other aspects such as language and cultural change
Some vital decisions such as a fellow traveler, which is usually a family member, must be decided.
Traveling to the US through Air Ambulance Transport or Otherwise
There is no doubt that air ambulance transport to United States could be quite expensive. However, those who are willing to shell out the money also get the best possible care when the medical situation is complicated. It is well known that the US medical system is quite advanced and well organized, which is not the case in many countries around the world. It must be noted that there are other options than opting solely for an air ambulance transport.
For instance, if the patient is able to walk and take care of certain basic functions, an air medical escort may be enough. Even if the patient is not able to mobilize himself, a commercial airline stretcher may be enough, provided the patient does not need life support.
Air Medical Transport Needs some Planning
Most of the large hospitals in the United States are well equipped to receive foreign patients. Hospitals have help at hand, designed specifically for such patients. However, choosing an air medical transport provider can be quite tough. Careful consideration must be given to both costs, the make of the aircraft, and the quality of services offered. Most of the service providers have online presence so the preliminary research must be conducted online. Also, you must look at their testimonials. Once you zero down on a few, feel free to give them a call and talk to one of their representatives.
You may want to hire an air medical transport provider that takes care of everything from transit formalities to booking the hospital for you. This allows you to feel confident of the travel and relieves you of any travel anxiety that might be bothering you.
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.