3 Air Medical Transport Flashcards
As a general rule, fixed-wing transport is considered when weather conditions are poor or when transport distances exceed _____ miles
150 to 200 miles
helicopters: 100-200 miles/hour
airplanes: >500 miles/hour
TRUE or FALSE
As a safety issue, the pilot should be “blinded” to the nature of the call during mission planning.
TRUE
this eliminates the introduction of acuity-related subjectivity as the pilot considers whether the mission should be accepted
the primary considerations regarding medical members of the flight crew are
crew configuration and training
TRUE or FALSE
Most U.S. programs agree that physicians are not a ncessary component of helicopter EMS crew.
TRUE
a recent survey showed that 92% of programs use nurse-paramedic crews
- this would cover prehospital and hospital-based skills
Helicopters generally transport patients at about what altitude?
1000 to 3500 feet above ground level (not necessarily sea level)
A larger plane that can be pressurized can fly above what altitude?
10,000 feet (3000 meters)
most important consideration for helicopter-transported patients
pressure-related problems related to Boyle’s law
(the volume of a gas increases when the pressure decreases at a constant temperature)
P1V1 = P2V2
For example, even the relatively low transport altitude range for helicopter EMS may affect patients with certain diagnoses (e.g., decompression sickness, cerebral arterial gas embolism)
Hyperbaric oxygen (HBO) therapy is the definitive treatment for decompression sickness and recommended for all cases of diving decompression sickness.
If HBO therapy is not available, patients with mild symptoms who are stable for longer than 24 hours may be treated with:
supplemental oxygen alone
Hyperbaric oxygen (HBO) therapy is the definitive treatment for decompression sickness and recommended for all cases of diving decompression sickness.
If a patient must be transported by air to a hyperbaric facility, use what transport
Pressurized aircraft to maintain sea-level pressure
or transport at the lowest possible altitude in a nonpressurized craft, such as a helicopter
target range of cuff pressure in ET tubes
20-30 cm H2O
TRUE or FALSE
to minimize aspiration risk, gastric intubation should be performed for unconscious patients transported by air
TRUE
kasi nga magddistend yung air sa tiyan pag bumaba na pressure sa atmosphere
TRUE or FALSE
Not all patients with small pneumothoraces who do not otherwise require tube thoracostomy require pretransport chest decompression simply because they are to be transported by air
TRUE
constitutes the majority of helicopter transports
Trauma patients
considered first in the use of helicopters
logistic issues
consider helicopter use if extrication time is expected to exceed ______ minutes
20 minutes
this group of trauma patients has essentially zero survival with air medical scene response
traumatic cardiac arrest
largest single nontrauma diagnostic category of patients
cardiac
TRUE or FALSE
Patients in cardiac arrest should still be loaded in an aircraft
FALSE
“Patients in cardiac arrest should be transported to the nearest hospital rather than loaded on an aircraft.”
some air transport indications for scene trauma
Open long-bone fractures
2 or more long-bone fractures
Rib fractures below the nipple line
GCS <10
Significant trauma in patients age <12 or >55y and pregnant patients
Trauma score <12
Burns >20% BSA
Unstable VS
Pneumothorax
Hemothorax
Death in same passanger compartment
TRUE or FALSE
Transport for primary or rescue coronary intervention for STEMI can be done safely by helicopter
TRUE
also, cardiac patients with pacemakers or those who have received thrombolytic therapy can be transported safely and effectively by helicopter EMS
TRUE or FALSE
helicopter transport of high-risk obstetric patients did not result in deliveries in the back of the helicopter
TRUE
and neonatal outcomes are NOT adversely impacted by transport
Remarks on fixed-wing air medical transport
Fixed-wing flights generally take longer to arrange and are uncommonly used for truly emergent patients.
(due to need for airports and ground ambulance connections)
On a per-mile bases, fixed-wing transports are less expensive than helicopter EMS transports
