Air medical services
Encyclopedia
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.
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 While the number of crashes may be increasing, the number of programs and use of services has also increased. Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, and postcrash fires.
Physician — An MD/OD or a Nurse Practitioner performing the Physicians role, directing all clinicians involved in the care of the transported patient.
. 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).
, 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.
with additional certification as a flight medic
. The flight paramedic is usually highly trained and has years of clinical experience in a high acuity environment. 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.
Propeller (aircraft)
Aircraft propellers or airscrews convert rotary motion from piston engines or turboprops to provide propulsive force. They may be fixed or variable pitch. Early aircraft propellers were carved by hand from solid or laminated wood with later propellers being constructed from metal...
or jet aircraft
Jet aircraft
A jet aircraft is an aircraft propelled by jet engines. Jet aircraft generally fly much faster than propeller-powered aircraft and at higher altitudes – as high as . At these altitudes, jet engines achieve maximum efficiency over long distances. The engines in propeller-powered aircraft...
.
The use of air transport of patients dates to World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...
, but its role was expanded dramatically during the Korean
Korea
Korea ) is an East Asian geographic region that is currently divided into two separate sovereign states — North Korea and South Korea. Located on the Korean Peninsula, Korea is bordered by the People's Republic of China to the northwest, Russia to the northeast, and is separated from Japan to the...
and Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...
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. Helicopter-based emergency medical service (EMS) also provides critical care capabilities during interfacility transport from community hospitals to trauma centers.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 While the number of crashes may be increasing, the number of programs and use of services has also increased. Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, and postcrash fires.
Medical Personnel
Medical personnel historically has been a Physician/Nurse combination or a Nurse/Nurse combination. The need for a Physician/Nurse combination has diminished with more protocol and evidence-based applications for care by nurses and other clinicians and so the inclusion of respiratory therapists in all modes of air transport is becoming more prominent.Physician — An MD/OD or a Nurse Practitioner performing the Physicians role, directing all clinicians involved in the care of the transported patient.
Flight Nurse
Flight Nurse — a specialized nurse with additional credentialing as a Certified Flight NurseFlight nurse
A Flight Nurse is traditionally a specialty where highly trained Registered Nurses 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.Flight Nurses are...
. 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
CEN
CEN may refer to:*Cen, or sen, is the currency of the fictional nation of Amestris of the anime/manga "Fullmetal Alchemist"As a three-letter acronym:* Cambridge Evening News, former name for the Cambridge News...
), Flight Nursing (CFRN
CFRN
CFRN may refer to:* CFRN , a radio station licensed to Edmonton, Alberta, Canada* CFRN-TV, a television station licensed to Edmonton, Alberta, Canada...
), 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 crewCrew
A crew is a body or a class of people who work at a common activity, generally in a structured or hierarchical organization. A location in which a crew works is called a crewyard or a workyard...
, 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
Safety
Safety is the state of being "safe" , the condition of being protected against physical, social, spiritual, financial, political, emotional, occupational, psychological, educational or other types or consequences of failure, damage, error, accidents, harm or any other event which could be...
.
Flight Nurses evaluate individual patient's in-flight needs and request appropriate medications, supplies and equipment
Medical equipment
Medical equipment is designed to aid in the diagnosis, monitoring or treatment of medical conditions.-Types:There are several basic types:* Diagnostic equipment includes medical imaging machines, used to aid in diagnosis...
, 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
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
for in-flight medical emergencies.
Flight Respiratory Therapist
Flight Therapist — A highly trained respiratory therapist, typically utilized in long-distance transport situations, though able to provide care in all situations. Flight Therapists may obtain Adult Critical Care Specialist (ACCS), Neonatal Transport Specialist (NPT) and Neonatal Pediatric Specialist (NPS).Flight Paramedic
Flight Medic — A licensed paramedicParamedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
with additional certification as a flight medic
Flight medic
A Flight Medic is a generic term used to describe a Paramedic that functions in an aeromedical environment. Typically the Flight Medic will work with a registered nurse, physician, Respiratory Therapist, or another Paramedic. The Flight Paramedic is usually highly trained and has years of clinical...
. The flight paramedic is usually highly trained and has years of clinical experience in a high acuity environment. Flight paramedics usually are either certified as a FP-C
FP-C
FP-C is an abbreviation indicating that an individual is Flight Paramedic-Certified. This certification is for paramedics who have demonstrated their knowledge of critical care medicine by successfully passing a two-and-a-half-hour exam consisting of 125 multiple-choice questions...
or a CCEMT-P. Most hold certificates as instructors in various fields and educational topics.
Associations and organizations
- Aerospace Medical AssociationAerospace Medical AssociationThe Aerospace Medical Association is the largest professional organization in the fields of aviation, space, and environmental medicine. The AsMA membership includes aerospace and hyperbaric medicine specialists, scientists, flight nurses, physiologists, and researchers from all over the world.-...
— 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. - Association of Air Medical Services (AAMS) — an international association which serves providers of air and surface medical transport systems.