The Different Types of Medical Transportation

The role of medical transportation becomes very significant in an emergency situation, but the non-emergency transport services are equally important for certain population like elderly, people who could not take part in log-distant journeys, or people residing in areas where transportation remains a challenge. In a developing country like India, such situations are common.

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What are the modes of medical transportation?
The mode of medical transportation depends upon the type of service required that is emergency or non-emergency.
Below is a look at some of the different options in this wide-ranging service:

Road Ambulance
Road ambulance is used to transport patients in emergency situation who need immediate medical care and patients who have psychiatric conditions. Ambulances are equipped with paramedical staff trained in providing immediate care. It’s used to transport patients to hospitals during emergencies and to transport patients with psychiatric conditions.

Non-Emergency Ground Ambulance
These are the perfect mode for patients who can walk but are not well and also for patients who are physically impaired. Non-Emergency ground services also serve a good medium for people who need some travel assistance/supervision but does not need the care level of any emergency. These vehicles are equipped with all of the necessary tools required to make your ride comfortable and to provide you with a limited amount of medical care to and from the medical facility. Ambulances for transportation are staffed by trained medical professionals that are accustomed to assisting patients with a variety of different ailments and medical conditions.

Wheelchair Accessible Vehicles
These vehicles can be used by people who are wheelchair bound. Having lifts facility, they ensure that you and your wheelchair arrive at your final destination safely. With the use of an electric lift, the patient can be loaded while they are seated in the wheelchair and remain in the wheelchair for the trip.

Air Ambulance
Air medical dispatch is used to move a patient in emergency needs by an aircraft. It acts as a life saver for people seeking immediate medical care residing in remote areas or in urban areas where medical facilities are not adequate. The air ambulance transfer exposes the patient to additional risks besides involving huge expenses. There should be at least two competent care providers with the patient depending upon the critical care need of the patient.

Non-Emergency Air Ambulance
Used for domestic and international travel, this mode is best suited for patients who are in stable condition, but needs fairly involved transportation assistance and cannot for one reason another use ground transport.

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Guidelines for Air Ambulance Medical Dispatch

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What is Air Medical Dispatch?

Air medical dispatch is used to move patient in emergency needs by an aircraft. It acts as a life savior for people seeking immediate medical care residing in remote areas or in urban areas where medical facilities are not adequate.
Air medical dispatch involves a number of risks for the patient that may lead to worsening of the patient’s health status; hence, the discretion for air ambulance need should always be justifiable. There are standard International guidelines for air medical dispatch which is quite difficult to be followed in India mainly due to lack of standardization in medical care across the country. Nevertheless, there are some key guidelines that must be followed while implementing air medical dispatch.

Decision for air medical dispatch

As already discussed, the air ambulance transfer exposes the patient to additional risks besides involving huge expenses. This decision is usually done after an in-depth discussion within the hospital team and the family members.

Stabilization of the patient and adequate preparation for transfer

Before prosecuting any air transfer, it is very important to have the patient into a clinically stabilized condition. This reduces chances of any untoward medical event in the course of journey. Adequate preparation should be done to provide all the resuscitation facility required as per the patient’s condition including ABCDE approach or airway, breathing, circulation and disability approach to treat the patient.

Accompanying the patient

There should be atleast two competent care providers with the patient depending upon the critical care need of the patient. The following guidelines have been laid down to ensure complete safety of the patient:
Level 0: These patients are equivalent to hospital ward patients and do not need to be accompanied by any specialized person.
Level 1: These patients have chances of deterioration in their health condition during the transfer. An acute ward setting is required and they must be accompanied by a competent paramedical staff or a nurse.
Level 2: These include those patients who have single organ failure. They should be under complete observation of competent personnel during the transfer.
Level 3: These are highly critical patients requiring respiratory support and have witnessed two organ system failure. Such patient can only be transferred along with a competent doctor, nurse and paramedical staff.

Continuous Monitoring of the patient

It is very important to continuously monitor the patient and keep the craft equipped with the lifesaving drugs and equipment for resuscitation. This includes all patients within level 1, 2 and 3 critical care. A proper monitoring with the provision of all lifesaving drugs is mandatory for transfer of all patients with level 1, 2 and 3 critical care needs.

Patient Record or documentation

Proper record or documentation should be done for each and every step of the process. Since, this document may be required in case of any legal issues related to the air transfer, all details pertaining to the patient’s status and other details like reason for air dispatch, details of the referring doctor, details of the referred doctor or hospital, any adverse event during the transfer and the treatment given for that; all should be clearly documented.

Temperature

The inside of the aircraft is maintained at a low temperature using the air conditioners. This can lead to hypothermia or sudden fall in body temperature of the patient. Neonates are too susceptible for this condition. Hence, it is very important to cover the patients with blanket to keep their body warm during the air transfer.

Height or the level of the air ambulance

The more the altitude of the craft, lesser is the fraction of inspired oxygen level. The flying levels are different for rotor wing (2000-5000 feet above sea levels) and fixed wing (15000-40000 feet above sea level) air ambulances. The guidelines suggest there should be pressurized air cabins for crafts flying above 10,000 feet above the sea level.

 

First Aid and Basic First Aid Procedures

First aid training can be an important asset to everyone as an emergency situation is non-predictable. If you are able to handle an “emergency situation”, and help somebody in need, that will be the greatest moment in one’s life. But you cannot perform first aid unless you take proper first aid training and first aid without proper training may even make the condition of the victim worse.

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There are a few things which you can do until the medical rescue team arrives. These simple procedures would help the patient as well as paramedics who treat the patient.

Abdominal pain – Keep the patient in a position in which he/she is comfortable. Do not to give the patient anything to eat or drink.

Minor burns – Soak the wound area in cold water. Do not put creams, ice or butter in the affected area. Protect the burn by covering it with a non-adhesive bandage.

Chest pain – Rest the patient in a position in which they are comfortable. It is better if you could make the patient sit upright. Aspirin can be given only if the patient is an adult and not allergic to aspirin. Try to keep the patient calm.

Choking – Trouble in breathing, inability to talk or cough are the signs of choking. Ask the person to cough. If coughing doesn’t work, support their upper body with one hand and help to turn forward.  Using the heel of your hands, give five continuous blows between their shoulder blades. Start Heimlich maneuver only if you are trained or else get immediate medical help.

Convulsions/Seizures – Look around if the person is in a dangerous area. Clear the zone to keep the patient from harming themselves. Do not try to hold them still.

Bleeding – Bleeding from cuts and grazes can be controlled by elevating the wound and applying pressure.

Drowning – Check if the person is breathing or not. Perform pulse check for 10 seconds and if there is no pulse then start CPR if you’re trained, or get the immediate assistance of a medical dispatcher.

Suffocating – If the patient is not breathing, you can start CPR. Make sure the airways are clear. Place the individual on his back. If the patient cannot breathe by himself, start to give artificial breathing by mouth to mouth method. Continue it until the patient start to breathe himself. Get immediate medical help.

Electric Shock – Separate the person from an electrical source. Start CPR immediately, if the person is not breathing. Check for other injuries and call for medical help immediately.

Suspected broken bones or disengaged joints – Keep the injured body part from moving until you reach the hospital. This may ease the pain and protect from further damage.

Nosebleed – Keep the head tilted forward. Apply an ice pack to nose or the back of the patient’s neck.

Most of the accidental deaths occur due to the lack of proper first aid or emergency care. It is advisable for everyone to get a medical emergency training and never wait to support the victim to get an immediate medical support.