Name of the Procedure:

Rotary Wing Air Mileage (A0436)

Summary

Rotary Wing Air Mileage refers to the distance in statute miles traveled by a helicopter during air medical transport. This service is often utilized for patients in critical condition requiring rapid transport to medical facilities.

Purpose

The primary goal of rotary wing air mileage is to transport critically ill or injured patients quickly to receive advanced medical care. This can be crucial during emergencies such as severe trauma, cardiac events, or other life-threatening conditions where time is of the essence.

Indications

• Severe trauma or injuries
• Stroke or cardiac arrest
• High-risk pregnancies or neonatal emergencies
• Severe respiratory distress
• Situations where ground transport is impractical or too slow
• Remote area access requiring rapid medical evaluation and intervention

Preparation

• Patients or their families should provide the medical team with a detailed medical history and current medications.
• No specific fasting or medication adjustments are typically required, as these are emergent transports.
• Prerequisite diagnostic tests are determined on a case-by-case basis and may vary by condition.

Procedure Description

1. An emergency medical team evaluates the need for air transport.
2. A helicopter is dispatched and lands at a designated helipad or safe location near the patient.
3. The patient is stabilized and prepared for transport by the medical team, which may include immobilizing injuries or administering emergency medication.
4. Patient is carefully transferred to the helicopter.
5. During the flight, medical personnel continue to monitor and treat the patient.
6. The patient is transported to the nearest appropriate medical facility.

• Equipment Used: Helicopter equipped with emergency medical equipment, such as ventilators, monitoring devices, and medications.
• Anesthesia or Sedation: Typically not used unless absolutely necessary under pre-existing medical conditions.

Duration

The duration depends on the distance between the pick-up and drop-off locations but generally ranges from a few minutes to under an hour.

Setting

The procedure is initiated from the site of the patient's location (e.g., roadside, home, another hospital) and concludes at an appropriate medical facility.

Personnel

• Trained emergency medical technicians (EMTs) or paramedics
• Flight nurses or physicians, as needed
• Pilots licensed to operate medical helicopters

Risks and Complications

• Air turbulence or weather-related issues may pose flight risks.
• Limited space in the helicopter may restrict extensive medical procedures during transport.
• Potential for rotorwash (downward force from helicopter blades) injuries if not properly handled during patient transfer.

Benefits

• Rapid transport to specialized medical care can significantly improve patient outcomes.
• Immediate medical attention during transport.
• Access to remote or difficult-to-reach areas in emergencies.

Recovery

• Post-transport care is managed by the receiving medical facility.
• Follow-up appointments are dependent on the primary medical condition being treated.
• Patients are usually evaluated for any transport-related effects after arrival at the hospital.

Alternatives

• Ground Ambulance Transport: Slower but more suitable for less critical conditions.
  • Pros: More space, can carry more medical equipment, less expensive.
  • Cons: Slower, traffic delays, not suitable for remote areas.
• Fixed-wing Air Ambulance: Used for longer distances.
  • Pros: Faster for long distances, more stable in adverse weather, more space.
  • Cons: Requires runways, not suitable for very short distances.

Patient Experience

• Patients may experience noise and vibration from the helicopter.
• There might be anxiety due to the urgency and unfamiliarity of the situation.
• Pain management and comfort are priorities for the medical team during transport.
• Sedation or calming medications may be administered if the patient is agitated or in severe pain.