Tough Decisions: When a Patient Isn't Fit to Fly
As an air ambulance provider, we often find ourselves arranging a transport for seriously ill patients – people who may have cancer, cardiac problems, severe burns, or other critical health issues. Despite that, many patients (even those with serious health problems) can safely travel via air ambulance. On rare occasions, however, we encounter a patient who isn't fit to fly. It happened recently.
While traveling in a third-world country, a man had a serious heart attack. The country had extremely limited medical facilities, and it was important that he get back home so that he could receive proper care. We were contacted to do the transport, but as we attempted to coordinate the trip, it quickly became apparent that we didn't have the information we needed to arrange the transport. The medical information we were getting from the discharging facility was of poor quality (partially due to language and translation barriers), which meant we didn't have the details needed to prepare for the flight.
To make matters worse, the man's condition seemed to be critical. Since even small changes in a patient's position, shifts in elevation or increased stress from flying has the potential to cause harm, we were afraid that a patient who was already in serious condition could take a serious turn for the worse during a long flight. Ultimately, a decision was made that it would be safer for the patient to stay where he was rather than to try to fly him home at that point in time.
In that situation, we realized before we arrived in the country that the patient wasn't fit to fly. But sometimes, we don't get all the information we need until we actually arrive on the ground. That's what happened recently with an air ambulance flight from Central American back to the U.S. A couple had been in a car accident while on vacation. The wife was admitted to the hospital; the husband was not, and he contacted us to set up a flight home for his wife. But when our crew arrived in the country, it quickly became apparent that the husband needed medical attention as well.
The husband began exhibiting head injury like systems while the crew was evaluating his wife. As a result, the crew began evaluating and eventually treating the husband as a second patient. Upon arrival into the United States, the husband was diagnosed with a brain bleed and a cervical fracture. The crew didn't know that going into the transport, but because of their experience and skill, they were still able to care for him and his wife on their long distance medical transport.
Both of these situations were unusual, but they illustrate some of the challenges we face as air ambulance professionals. We do everything we can to gather pertinent information before a trip, since having clear information about a patient's condition prior to the transport makes it easier for us to adequately prepare. But that's not always possible. Fortunately, because our staff and crews have years of experience, they can quickly adapt to changing circumstances.
As always, patient safety is our first priority. We make decisions about whether or not a patient is fit to fly as a team. Everyone – our medical director, our flight nurse, and our chief pilot – is involved, as well as the receiving and discharging facilities. We gather as much information as we can and we making a decision based on what's in the best interest of the patient, not us.
Want to learn more about MedFlight911's air ambulance services? Give us a call at 888-359-1911 or get a no-obligation air medical transport quote here.