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Important Facts about Impaired Consciousness for US Air Ambulance Crews

If you are part of an air ambulance crew, it’s likely that you get through some days working overtime and having to respond to multiple calls in a day. While this is all part of the job, it’s important to remember that long shifts and over-exhausted can leave you feeling drained – both physically and mentally. The result will be impaired consciousness, which can prevent you from doing your job properly. This is why US air ambulance paramedics need to ensure that they get proper sleep whenever possible.

Signs US Air Ambulance Paramedics Should Watch Out For

Whether you work for an air ambulance or a ground ambulance, being an EMS provider means there is a high risk of chronic sleep deprivation. Maybe you are secretly proud of yourself for being able to perform well despite lack of sleep. While you may be able to do so for a few days, over time you’re just going to experience impaired consciousness. This can be dangerous for your job, for the lives of your patients, and for yourself.

As a US air ambulance paramedic, here are some signs you should watch out for telling you that you need to get some sleep ASAP:

  • Inability to remember the last call you responded to
  • Inability to distinguish one patient from the other
  • More than normal illegible writing
  • Strong smell of coffee and/or Red Bull while urinating
  • Impaired ability to read patients’ vital signs
  • Impaired ability to distinguish reality from dreams

These are just a few of the more common signs of impaired consciousness among EMS providers. It may be easy to be in denial, making it difficult for you to honestly assess yourself using these signs. Get help from a partner or a fellow crew member that you trust.

What Air Medical Transport Crews should know about Acute Coronary Syndrome

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.

Sepsis Care Tips for Medical Flight Paramedics

Sepsis is commonly referred to as blood poisoning. It takes more lives than cancer and is more common than a heart attack. In fact, more than 4,000 children die in the U.S. every year because of sepsis. This makes it crucial for medical flight paramedics to proactively assess and care for patients with suspected sepsis. So here’s a brief guide to help you understand how to care for patients with this condition.

Initial Assessment for Septic Patients

Properly assessing a patient is crucial for medical flight paramedics and EMS providers alike. This speeds up the medical treatment process and also ensures the administration of appropriate care. In order to assess a patient suspected of having sepsis, it’s important to measure the body temperature accurately. A fever or a body temperature lower than normal may be detected if a patient has sepsis.

Fevers, chills, and body aches are some common symptoms of an infection. But not all patients may experience this especially when it comes to older individuals. Enquire about recent procedures like diagnostic tests or surgery, which may expose the patient to an infection risk. In addition, it’s important to measure the lactate level of a patient. If it’s greater than 4 mmols, it could be a strong indicator of sepsis.

To further confirm your suspicion of sepsis, it’s important to measure the exhaled carbon dioxide level of a patient. While a normal capnography reading may range between 35 and 45 mm Hg, a patient with sepsis generally exhibits a reading lower than 25 mm Hg. If this level of reading coincides with other vital signs that drove your suspicion of sepsis, the patient may be in need of immediate medical care.

Sepsis Treatment for Medical Flight Paramedics

It’s crucial to initiate sepsis treatment by administering large amounts of fluid to the patient. While you initiate antibiotic therapy, you may also need to maintain vascular tone through vasopressors like dopamine or norepinephrine.

Medical Flight Crew Guide: How to Identify Stroke and Provide Essential Care

Stroke is one of the top causes of death and long-term disability in the United States. Leaving a stroke untreated for one minute would result in about 1.9 million neurons being destroyed. If it’s untreated for an hour, the brain loses neurons equal to neuron loss occurring from 3.6 years of regular aging. This makes it crucial for a medical flight crew to conduct thorough assessment and provide necessary care for stroke patients or suspected stroke patients.

Detecting Symptoms of Stroke

If stroke is suspected, it is crucial to rush the patient to a facility that can rapidly assess and diagnose the condition in addition to providing treatment. However, many patients deny the symptoms. As a medical flight crew responding to a call in such cases, it’s important that you try to determine if the patient experienced or is experiencing some or all of the following symptoms:

  • Sudden confusion
  • Sudden vision trouble (one eye or both eyes)
  • Sudden severe headache
  • Sudden trouble with walking
  • Sudden numbness or weakness around the face, arm, or leg
  • Dizziness/loss of coordination
  • Speech issues/trouble understanding

Providing Necessary Care to Stroke Patients as a Medical Flight Crew

Managing patients showcasing stroke symptoms requires team effort. With it being a time-dependent patient, you will need to have a protocol in place for providing organized and quick pre-hospital care to such patients. Although you may have a limited ability in terms of resources to provide care for a stroke patient, it would make a huge difference for you to alert a Stroke Team or make plans for rapid transportation to a stroke center.

During the transportation, try to carry out general neurological assessments as possible. Providing oxygen and, monitoring cardiac function, and drawing blood for labs, etc. should be quickly accomplished to streamline and expedite the care process.

Air Ambulance Transport for People with Altitude Sickness

High altitude can leave people with a certain type of sickness and edema, which may result in a call for air ambulance transport in many cases. Altitude sickness normally occurs at elevations higher than 8,000 feet. It is a combined result of genetic build-up, underlying conditions, and fitness level. The most common form of this condition is acute mountain sickness.

What Happens When a Person Has Altitude Sickness?

In your job as an air ambulance specialist, you may have come across a patient experiencing this condition. But not everyone knows how to determine whether or not someone has altitude sickness. In case of acute mountain sickness, the patient may experience symptoms like headache, decreased appetite, nausea, fatigue, vomiting, and general malaise.

In some cases, the patient may experience periodic breathing, which can be identified by irregular breathing that is mostly noticeable while sleeping. Many forms of altitude sickness may not be life-threatening although they may limit the body’s abilities. However, air ambulance transport may be crucial for patients with high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE).

Providing Air Ambulance Transport for Patients with Altitude Sickness

Acute mountain sickness doesn’t require a specific treatment, but it’s important for people to stop ascent until the symptoms subside. If the symptoms worsen, ensure proper hydration, which can significantly improve symptoms like headache. Descent can normally alleviate most symptoms of altitude sickness.

HAPE treatment requires the treatment of underlying pulmonary hypertension through descent. You will need to administer oxygen and other necessary medications. Even for patients with HACE, descent and oxygen usually help alleviate symptoms like irritability and headache. Many people make the mistake of getting such patients to descend alone. Instead of this, having an air ambulance chopper transport them back to safety is the best choice.

Tips for Spotting Brokers for Air Ambulance Transport

It can be a challenge to find the right provider for air ambulance transport especially when you have a lot on your plate. The good news is that you can always conduct a search online, which makes this task much easier. During this process, however, you may come across air ambulance brokers who may portray themselves so convincingly as actual air ambulance operators.

How to Differentiate Between a Provider and a Broker for Air Ambulance Transport

Although it’s common knowledge that air ambulance brokerage services aren’t a good idea, many people don’t realize this until it’s too late. So how do you spot an ambulance broker online? Here are a few basic tips to help you out:

  • If there are pictures of aircrafts on the website, look for the tail numbers and see if they correspond to the aircraft model on the FAA website. You can then identify the company licensed to operate that particular aircraft.
    Look for pictures where the aircraft doesn’t have a tail number or where the logos seem over imposed on the original photo. With decent photoshop skills, anyone can alter images.
  • Be cautious of careful wordings on the website content. For instance, they could be saying that they “have access to” a certain aircraft even if they don’t “own and operate” that aircraft. Instead of “providing” air ambulance transport, they could be “arranging” for such transport.
  • Look for the contact information and see if the company has a physical address. This is far more trustworthy than an anonymous P.O. box number. Additionally, local or geographic phone numbers are more preferable than a toll free number.
  • Find out if the website has a copy of the Air Operator Certificate on display. If not, then ask them to send you a copy because no company has the right to operate an aircraft without it.

While some brokers may provide valuable service, many of them may be just on the look-out for profits. That’s why it’s mostly recommended to be aware of air ambulance brokerage services when searching for air ambulance operators online.

How to be Prepared for Air Ambulance Flights

Transporting patients by air ambulance involves travelling long distances, which means that you need to make some preparations if you’re accompanying a loved one. You probably already know the complete process of availing air ambulance flights. However, you should also be aware of how to be the most comfortable and maintain your health during such flights.

Preparing Before the Flight

There are a number of things you need to do to ensure that you don’t suffer during the long flight:

  • The day before the flight, drink plenty of water to hydrate your body. This is one of the most basic tips that some people ignore or sometimes forget but it really helps in providing a better flight experience.
  • Do not consume any kind of alcohol or caffeine in the hours leading to the flight. The air inside aircrafts tends to be dry and since these substances act as dehydrators they can make your flight uncomfortable.
  • If you’re prone to sinus troubles, you might want to take a decongestant one day before the flight.
  • Enquire with the crew beforehand if they keep any drinks and snacks on board. If they don’t, ask if you’re allowed to bring some of your own. These can be especially useful in maintaining your hydration and blood sugar levels during long air ambulance flights.
  • Be prepared with multiple layers of clothing in case the temperature inside the aircraft gets too hot or too cold. You can easily control the temperate by adding or removing layers.
  • Start boosting your immune system with vitamin C supplements a few days before the flight. You can also use Echinacea supplements for this or have these with the vitamin C. A stronger immune system will help you fight off germs that are likely to circulate in the aircraft.

What to do During Air Ambulance Flights

During the flight, it’s crucial that you avoid sitting in positions that could be inhibiting to your blood circulation for long periods of time. This means that you should avoid keeping your legs crossed. You can avoid blood clots or deep vein thrombosis by stretching your legs. While the comfort and health of patients is of the utmost importance, attendants should also be able to travel comfortably for such flights.

A Compact and Comprehensive Guide on Air Ambulance Service

When availing any kind of medical service, it’s always a good idea to be armed with some knowledge about the service. Even when it comes to medical transportation via air, there are a number of facts and rules patients should know. That’s why we’re going to give you a brief yet comprehensive guide on some important facts about air ambulance service.

Checklist for air ambulance service

When you’re preparing for medical transportation by air, here are a few things you should not forget:

  • It would be of great help to be prepared with most of the basic patient information such as name, height, weight, date of birth, and medical condition. Additionally, you might want to specify details about special requirements such as diet and/or equipment (IV, ventilator, oxygen, etc.).
  • Further, it would be helpful if you can provide other specifics like the patients’ ability to sit or whether they would require a wheelchair or stretcher. This will help the medical team in quickly and efficiently providing appropriate assistance.
  • There are numerous myths surrounding air ambulance coverage, so it would be wise to read up on the facts about insurance coverage for such services. If the patient has health insurance, arrange for copies of insurance card and recent health and physical from a hospital or discharging facility. Also, keep a copy of the “face sheet” of the said hospital or facility.
  • Most medical aircrafts allow only one carry-on suitcase (maximum size 21”) per passenger. If you have any excess baggage beyond this, make sure you communicate with the flight coordinator as the aircraft may not have room to accommodate it.

What about international transfers?

In case of international transfers, when availing air ambulance service, you will need to carry copies of a current non-expired passport, necessary travel documents, and visa for each passenger. For those who don’t have a copy of their passport, you will need to be prepared to provide some personal information. The required information includes full legal name and date of birth along with passport number and expiration date, home address, and place of birth.

While it’s not always easy to arrange for all this in case of emergencies, it’s always a good idea to be prepared. This will ensure that you have a smooth transaction and pleasant experience if you need emergency medical transport service by air.

Understanding Medical Flight Dispatch

Contrary to popular belief, hospitals are rarely involved in dispatch of a medical flight. The decision is almost entirely taken by the ground crew and treating doctor who determine whether the patient would benefit from an air ambulance service or not. Of course, there are some protocols that are followed. Although the process and protocols vary depending on the jurisdiction, there are certain common determinants that we discuss here.

Time Taken for Medical Flight Dispatch

It must be understood that not all hospitals have a medical flight on standby. It takes a reasonable amount of time to get the flight ready for takeoff. If this time and the time required to transport the patient is too much when compared to ground ambulance transport, the latter may be chosen. There is also a cost consideration when the difference in time advantage is too small.

Location and Distance of Transfer

This is another important criterion. Sometimes the location is too far away from the hospital and the patient’s health does not permit long travel times. Also, the location may be inaccessible through roads. In circumstances like these, the decision is usually made to opt for a medical flight to keep the patient safe.

The Condition of the Patient

This is of extreme importance. A delay by half an hour can mean the difference between life and death for the patient. In scenarios like these, a decision is taken quickly to call for an air ambulance and the patient is transported. Near-drowning, prior history or suspected stroke, and severe trauma could be some of the conditions that could influence the decision.

The Weather Conditions for the Medical Flight

If there are adverse weather conditions that prevent the choppers from flying, the patient may be transported through other means. As a matter of policy, the lives of crew members are not put to risk knowing very well that taking off in bad weather could be fatal.

It is important to understand that the above are just a few of the reasons that influence medical flight dispatch decisions. It is always the competent medical authority that takes the final decision.