Module Four Unit Six

Question 1

Describe some issues encountered in long haul retrievals.(5)

Answer 1

Lack of resources at referring facility - sicker pt
Staff fatigue
Resource issues - oxygen, battery, drugs
Prolonged immobilisation - DVT
Logistics - assistance and insurance systems, customs, refuelling

Question 2

Why do civilian international AME occur?

Answer 2

Transfer pt to higher level of clinical care
Repatriation

Question 3

What aircraft are used for international retrieval?

Answer 3

Turboprop or jet (pressurised)

Question 4

List the characteristics of a Turboprop

Answer 4

Short field take-off and landing capable
Unsealed airstrip capable
Range 1500 nm

Question 5

List the characteristics of a jet

Answer 5

High speed 450 knots
High altitude 41,000 ft
Range 2000-4000 nm

Question 6

What are the minimum requirements of medical coordinators in international AME?

Answer 6

Specialist in critical care discipline
AME experience

Question 7

What are medical coordinators responsible for? (5)

Answer 7

Assessing pt’s clinical requirements
Communicating with OMF and DMF
Briefing medical teams
Providing on-mission clinical management advice.
+/- providing clinical situational awareness

Question 7

What are medical coordinators responsible for?

Answer 7

Assessing pt’s clinical requirements
Communicating with OMF and DMF
Briefing medical teams
Providing on-mission clinical management advice.
+/- providing clinical situational awareness

Question 8

What does non-clinical mission support to international AME include? (12)

Answer 8

Flight planners
Aircraft availability
Aircrew duty hour planning
Fuel planning
Airspace clearance
Customs and immigration clearance for everyone
Ground handling
Passenger manifests
Contingency planning
Security support
Remote engineering support
Comms support

Question 9

What are specific equipment considerations for international AME? (11)

Answer 9

Adequate electrical power
Multiple batteries
Battery charging abilities on-board
115/240V AC aircraft power supply
O2 storage and use
Large volume cylinder storage
Liquid O2 systems
O2 concentrator
Turbine electrically powered ventilators
Pharmaceutical supply - authority to export/import
Follow cabin safety regulations and get permission for all equipment in commercial aircraft

Question 10

Specific patient care considerations in long haul flights? (2)

Answer 10

Pressure injury care - enhanced comfort mattress, frequent repositioning
Bowel and bladder care

Question 11

List the main stakeholders involved in international AME. (5)

Answer 11

International Assist Companies (client)
Mission Tasking Officer for air ambulance
Air ambulance provider
Pilot in command
Duty medical consultant

Question 12

What is the role of the international assist company?

Answer 12

~4 in Aus.
All comms and liaison with air ambo providers.
Act on behalf of international insurance companies.
24/7.

Question 13

What is the role of the international mission tasking officer? (4)

Answer 13

24/7 single central point for all comms.
Info integration and distribution.
Time management and mission scheduling efficiency.
Manage financial and legal risks.

Question 14

What is the role of the international air ambulance provider?

Answer 14

Supply air ambo and crew.

Question 15

What is the role of the international PIC?

Answer 15

Overall op management, planning, and execution of aircraft and crew, supported by First Officer.
Final authority on all aircraft op decisions.

Question 16

What is the role of the international duty medical consultant?

Answer 16

On call 24/7.
Clinical governance of case.
Specialist counsel for Duty Flight Physician.

Question 17

What info is critical to the international quote request? (7)

Answer 17

Referring and receiving facility/location
Task reference number
Pt name and diagnosis
Cabin sea level pressure requirements
Pt wt and height
Accompanying passenger requirements
Departure time

Question 18

What info is critical to the quote calculation? (4)

Answer 18

Liaise with aircrew to confirm flight hours, airstrip access, weather
Notify DMC of potential pt
Investigate if visas required
Obtain contact details for OMF

Question 19

What info is critical to the quote acceptance? (4)

Answer 19

Reconfirm mission acceptance with PIC - activate flight plan, establish base arrival time and ETD
Confirm DMC’s acceptance
DMC liaise with appropriate crew composition and notify base arrival time
TO check and confirm all details and ensure guarantee/confirmation of payment

Question 20

Who do the aircraft crew communicate with during the international mission?

Answer 20

TO

Question 21

Who do the clinical crew communicate with during the international mission?

Answer 21

DMC

Question 22

When does the TO update the assist company? (5)

Answer 22

Initial departure
On arrival to pt
After pt is loaded and updated ETA advised
On arrival into receiving port
If any changes occur

Question 23

What are the risks associated with long haul retrievals? (6)

Answer 23

No paper trail
No confirmation of payment
Getting destination wrong
No visas
No passports
Insurance coverage

Question 24

What are some things that can go wrong during international retrievals? (5)

Answer 24

No/inadequate ground transport
No comms.
Accompanying passengers and luggage
Dangerous places
Weather

Question 25

List some tricks of the trade for international retrievals. (6)

Answer 25

Call DMC once you have assessed pt
Change of clothes
Go to the bathroom before you leave
Be ready for anything
Charge your phone
Take a personal credit card

Question 26

What are the required characteristics for an international air ambulance? (7)

Answer 26

> 40,000 ft cruise
400 knots
Endurance 4-10 hrs
Range 1600 - 4000nm
Sea level cabin pressure capable
Door access
Stretcher landing ramp/lift

Question 27

What characteristics does the stretcher need? (6)

Answer 27

Integrated litter/base
Aircraft certified
Adjustable recline
Harness
Power/suction/medical air/lighting/O2
Litter bridge - certified