3 Air Medical Transport

Question 1

As a general rule, fixed-wing transport is considered when weather conditions are poor or when transport distances exceed _____ miles

Answer 1

150 to 200 miles

helicopters: 100-200 miles/hour
airplanes: >500 miles/hour

Question 2

TRUE or FALSE
As a safety issue, the pilot should be “blinded” to the nature of the call during mission planning.

Answer 2

TRUE
this eliminates the introduction of acuity-related subjectivity as the pilot considers whether the mission should be accepted

Question 3

the primary considerations regarding medical members of the flight crew are

Answer 3

crew configuration and training

Question 4

TRUE or FALSE
Most U.S. programs agree that physicians are not a ncessary component of helicopter EMS crew.

Answer 4

TRUE
a recent survey showed that 92% of programs use nurse-paramedic crews
- this would cover prehospital and hospital-based skills

Question 5

Helicopters generally transport patients at about what altitude?

Answer 5

1000 to 3500 feet above ground level (not necessarily sea level)

Question 6

A larger plane that can be pressurized can fly above what altitude?

Answer 6

10,000 feet (3000 meters)

Question 7

most important consideration for helicopter-transported patients

Answer 7

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)

Question 8

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:

Answer 8

supplemental oxygen alone

Question 9

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

Answer 9

Pressurized aircraft to maintain sea-level pressure

or transport at the lowest possible altitude in a nonpressurized craft, such as a helicopter

Question 10

target range of cuff pressure in ET tubes

Answer 10

20-30 cm H2O

Question 11

TRUE or FALSE
to minimize aspiration risk, gastric intubation should be performed for unconscious patients transported by air

Answer 11

TRUE
kasi nga magddistend yung air sa tiyan pag bumaba na pressure sa atmosphere

Question 12

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

Answer 12

TRUE

Question 13

constitutes the majority of helicopter transports

Answer 13

Trauma patients

Question 14

considered first in the use of helicopters

Answer 14

logistic issues

Question 15

consider helicopter use if extrication time is expected to exceed ______ minutes

Answer 15

20 minutes

Question 16

this group of trauma patients has essentially zero survival with air medical scene response

Answer 16

traumatic cardiac arrest

Question 17

largest single nontrauma diagnostic category of patients

Answer 17

cardiac

Question 18

TRUE or FALSE
Patients in cardiac arrest should still be loaded in an aircraft

Answer 18

FALSE
“Patients in cardiac arrest should be transported to the nearest hospital rather than loaded on an aircraft.”

Question 19

some air transport indications for scene trauma

Answer 19

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

Question 20

TRUE or FALSE
Transport for primary or rescue coronary intervention for STEMI can be done safely by helicopter

Answer 20

TRUE
also, cardiac patients with pacemakers or those who have received thrombolytic therapy can be transported safely and effectively by helicopter EMS

Question 21

TRUE or FALSE
helicopter transport of high-risk obstetric patients did not result in deliveries in the back of the helicopter

Answer 21

TRUE
and neonatal outcomes are NOT adversely impacted by transport

Question 22

Remarks on fixed-wing air medical transport

Answer 22

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