Air medical services

It has been suggested that this article or section be merged into Air ambulance. (Discuss) Proposed since November 2011.

Air medical services is a comprehensive term covering the use of air transportation to move patients to and from healthcare facilities to improve their level of care. Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft.

The use of air transport of patients dates to World War I, but its role was expanded dramatically during the Korean and Vietnam conflicts. The first hospital-based air medical service began in Denver at St. Anthony hospital in 1972. Helicopters are used to transport patients between hospitals and from trauma scenes; fixed-wing aircraft are used for long-distance transports.

Advantages

The advantages of medical transport by helicopter may include providing a higher level of care at the scene of trauma and improving access to trauma centers.^[1] Helicopter-based emergency medical service (EMS) also provides critical care capabilities during interfacility transport from community hospitals to trauma centers.^[2]

Indications for air transport

Effective use of helicopter services for trauma depends on the ground responder's ability to determine whether the patient's condition warrants air medical transport. Protocols and training must be developed to ensure appropriate triage criteria are applied. Excessively stringent criteria can prevent rapid care and transport of trauma victims; relaxed criteria can result in the embarrassing and costly situation of transporting a patient by helicopter only to have the patient discharged in good condition from the emergency department.

Crew and patient safety is the single most important factor to be considered when deciding whether to transport a patient by helicopter. Weather, air traffic patterns, and distances (e.g., from trauma scene to closest level one trauma center) must also be considered.

Some have questioned the safety of air medical services^[3][4] While the number of crashes may be increasing, the number of programs and use of services has also increased.^[5] Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, and postcrash fires.^[5]

Medical Personnel

Medical personnel historically has been a Physician/Nurse combination, Paramedic/Nurse, or a Nurse/Nurse combination.^[2] The need for a Physician/Nurse combination has diminished with more protocol and evidence-based applications for care by nurses and other clinicians^[2] and so the inclusion of respiratory therapists in all modes of air transport is becoming more prominent.^[6]

Physician — A physician who directs all clinicians involved in the care of the transported patient, either in person or by way of communication devices.

Nurse practitioner — Nurse Practitioners often serve as the primary care provider, directing all clinicians involved in the care of the transported patient.

Flight Paramedic

Flight Paramedic — A licensed paramedic with additional certification as a certified flight paramedic (FP-C). The flight paramedic is usually highly trained and has years of autonomous clinical experience in high acuity environments of both pre-hospital emergency medicine and critical care transport. Flight paramedics usually are either certified as a FP-C or a CCEMT-P. Most hold certificates as instructors in various fields and educational topics.

Flight Nurse

Flight Nurse — a specialized nurse with additional credentialing as a Certified Flight Nurse. The Flight Nurse performs as a member of an aeromedical evacuation crew on helicopters and airplanes—providing for in-flight management and nursing care for all types of patients. Other responsibilities include planning and preparing for aeromedical evacuation missions and preparing a patient care plan to facilitate patient care, comfort and safety. Flight nurses may obtain board certification in Emergency Nursing (CEN), Flight Nursing (CFRN), or Critical Care (CCRN).

Civilian Flight Nurses

Civilian Flight Nurses work for hospitals, Federal, State, and Local governments, private medical evacuation firms, fire departments, and other agencies.

Military Flight Nurses

The military flight Nurse performs as a member of the aeromedical evacuation crew, and functions as the senior medical member of the aeromedical evacuation team on Continental United States (CONUS), intra-theater and inter-theater flights - providing for in-flight management and nursing care for all types of patients. Other responsibilities include planning and preparing for aeromedical evacuation missions and preparing a patient positioning plan to facilitate patient care, comfort and safety.

Flight Nurses evaluate individual patient's in-flight needs and request appropriate medications, supplies and equipment, providing continuing nursing care from originating to destination facility. They act as liaison between medical and operational aircrews and support personnel in order to promote patient comfort and to expedite the mission, and also initiate emergency treatment in the absence of a physician for in-flight medical emergencies.^[7]

Transport Respiratory Practitioner

Transport Therapist — A highly trained respiratory practitioner (also called a respiratory therapist), typically utilized in long-distance transport situations, though able to provide care in all situations. Transport Therapists may obtain Adult Critical Care Specialist (ACCS), Neonatal Transport Specialist (NPT) and Neonatal Pediatric Specialist (NPS) certifications from the National Board for Respiratory Care.

Associations and organizations

• Aerospace Medical Association — an umbrella group providing a forum for many different disciplines to come together and share their expertise for the benefit of all persons involved in air and space travel.^[8]
• Association of Air Medical Services (AAMS) — an international association which serves providers of air and surface medical transport systems.^[9]

Air medical organizations

• ALEA - Airborne Law Enforcement Association
• AAMS - Association of Air Medical Services
• AMOA- Air Medical Operators Association
• AMPA - Air Medical Physicians Association
• APFC - Association of Professional Flight Chaplains
• HAI - Helicopter Association International
• IAFP - International Association of Flight Paramedics (formerly NFPA)
• NAACS - National Association of Air Medical Communications Specialists
• NEMSPA - National EMS Pilots Association
• PFAAA - Patient First Air Ambulance Alliance

Air medical publications

• Air Medical Journal
• EMS Magazine
• Waypoint AirMed & Rescue

References

External resources

• Air & Surface Transport Nurses Association
• Flightweb

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