At this time, there are no established nationwide regulations that oversee Air Ambulance operations. The FAA regulates the aviation operations, but there is no oversight for the medical aspects of the operation. The following questions will help you select the most appropriate service for your client.
Q: Is the service utilizing an aircraft that is being operated under a valid FAA Part 135 air taxi certificate with air ambulance operations specifications?
A: Yes, MedFlight of Ohio holds a current Air Carrier Operating Certificate in accordance with the Federal Aviation Regulations (FARs) regulated by the Federal Aviation Administration (FAA). The FAA governs the operation of the aircraft and installation of the stretcher and other equipment.
Q: Is the aircraft multi engine and pressurized?
A: MedFlight of Ohio operates pressurized, all-weather aircraft, and is dedicated to medical transport use. This means all equipment necessary for transport is always checked and available in the cabin. Pressurized aircraft can fly above cloud level, ensuring a smooth ride in most weather conditions.
Q: Does the Air Ambulance Service maintain aircraft and medical malpractice insurance?
A: Yes, MedFlight of Ohio holds a current Air Carrier Operating Certificate in accordance with Federal Aviation Regulations (FAR Part 135). It is recommended that air ambulance operators carry a minimum of $50,000,000 in aircraft liability insurance and $1,000,000 in medical malpractice insurance. Upon request, operators should provide the patient and/or family with proof of insurance sufficient to meet the requirements of all US agencies or foreign governments within their operations.
Q: Is the air ambulance an operator or a broker?
A: A “Broker” refers to companies who are the “middle man” for arranging aircraft to perform medical flights. Brokers are agents who do not own or operate aircraft. They arrange ambulance flights and may add an additional fee. It is difficult to tell the brokers from the owner/operators based on the ads. Brokers rarely own the aircraft or employ a dedicated medical staff. They arrange contracts with other providers. They will then pass the additional broker fee to the customer.
Q: What is the expertise and qualifications of the transport team?
A: Our staff includes:
Our Aviation Staff:
MedFlight of Ohio’s Pilot-in-Command (PIC) holds their ATP (Airline Transport Pilot) license, the highest level of licensure a pilot can hold. The Captains attend Flight Safety every 6 months and the Second in Command pilots attend once a year. MedFlight requirements include a minimum of 3,000 total flight hours with at least 2000 in a multiengine aircraft. While the PIC’s are rated as single pilots, MedFlight strives on safety and promotes a two pilot operation.
Our Medical Staff:
MedFlight of Ohio strives on quality patient care an excellence. All medical members are highly trained and experts in their field.
All medical staff must be appropriately licensed, age-specific certified and current in their specialty; Advance Life Support (ALS, PALS, NRP). All medical personnel must have training in altitude physiology, infection control, stress recognition and management, patient care capabilities and limitations during transport, aircraft safety and procedures, including depressurization. A minimum of 2 medical personnel should staff all air ambulance flights.
Medflight of Ohio’s personnel meet the following standards :
Our flight nurses must have two or more of the following certifications:
Critical Care RN
Certified Emergency RN
Certified Flight RN
Emergency Medical Technician
All medical teams must have a minimum of 5 (five) years critical care experience or 5 years street experience for the paramedic.
All maintain current status in the following:
Basic Life Support
Advanced Life Support
Pediatric Advanced Life Support
Neonatal Resuscitation Program (NRP)
Pre Hospital Trauma Life Support (PHTLS)
Annual recurrent education to include Flight physiology and Air Medical Resource Management
Medical Director:
The medical teams at Medflight of Ohio practice under the direction of a physician, referred to as the Medical Director. The Medical Director is knowledgeable of the effects of altitude physiology on varying patient conditions and diagnoses. The Medical Director is also knowledgeable and has practiced in the transport environment in the delivery of patient care to the critically ill and injured. Patient care or medical control may be directed by verbal order, written order, or protocol (predefined standing orders). If necessary, the medical teams should have some method to contact the Medical Director during flight.
The medical Director is also responsible for a QA/QI program to critique care provided by the medical teams.
Questions to ask as it relates to the medical care are as follows:
- Does the service have a medical director with QI critique of care?
- Do the air medical personnel have immediate communication capability with a dedicated Medical Director throughout the flight?
- Does the service provide the level of care you require (BLS, ALS, specialty care, critical care)?
- Is the medical team appropriately certified and licensed?
- Does the medical team have training specific to the flight environment (i.e. flight physiology)?
- Does the service have written patient care guidelines, procedures and protocols?
- Are all advanced life support drugs and equipment carried?
- Does the service complete a transport record documenting clinical care during the transport? Does the receiving facility receive a copy?
- Does the service have a quality assurance/improvement plan?
- Does the service have a dedicated critical care team with at least 5 years experience?
Medflight of Ohio answers yes to all of the above questions.
Q: Will the air ambulance service provide bedside-to-bedside care?
A: When a program provides bedside-to-bedside service the transport medical team accepts the patient at bedside in the sending facility and delivers the patient to the bed of the receiving facility. Some companies may consider arranging for a local ground ambulance to bring the patient to the airport and another to take the patient from the airport to the receiving hospital as bedside-to-bedside. The level of care provided during the ground transport should not be less than that being provided during the flight.
Medflight of Ohio provides a bedside to bedside service on all transports.
Q: What medical equipment does the team carry and will a full complement of drugs oxygen and monitoring equipment be provided during the transport?
A: In addition to the medical equipment available on the aircraft, duplicate life support equipment should be carried for use during ground transports to and from the hospitals and as backup equipment on the aircraft during the flight.
Medflight of Ohio provides all necessary equipment and supplies to care for the critically ill during the flight. Equipment and supplies are available for specialty pediatric teams, neonates, Intra aortic balloon pumps (IABP) for cardiac patients and obstetrics.
In addition to the medical supplies and equipment the air ambulance service should provide the following required equipment to conduct critical care transports.
FAA regulates the installation of the stretcher in regard to patient restraints and locking mechanisms .
One FAA approved stretcher and base for each patient
A medical oxygen system with the capacity to transport a ventilator dependent patient from the transport origin to the destination, including fuel stops, while maintaining a 25% reserve without service or refilling.
Q: Does the aircraft configuration allow for safe loading and unloading of the patient and allow access to the patient by the medical team during flight? Can definitive airway measures be performed without delay or constraints during flights?
A: Configuration of the aircraft should not compromise the ability to provide appropriate care or prevent medical crews from performing emergency procedures if necessary. Medical transport personnel must have access to the patient in order to begin and maintain basic and advanced life support treatment.
Medflight of Ohio aircraft’s are medically configured for patient care and emergency airway procedures and interventions. A Lifeport PLUS (Patient Loading Utility System) is used to safely move the patient form the hospital and into and out of the aircraft with minimal maneuvering of the patient. This also keeps the patient safe and secure during loading and unloading of the aircraft.
Q: What are the costs of an air ambulance?
A: Cost will vary depending on:
Type of aircraft
Mileage
Flight dispatching cost
Medical staff required by the patient
Medical supplies
Ground ambulances charges
International and long-range domestic transports may be subject to additional costs such as:
Foreign ground handling fees and taxes
Overseas air traffic control charges
Overseas flight permits
Crew overnight expenses
Relief pilot positioning via commercial airlines
The client should inquire as to what costs are included in the transport quote.
Medflight of Ohio will provide a quote at the time of call. Our quote includes aircraft and pilots, supplies, two medical team members, and ground ambulance charges on both legs of the transport. The client should receive only one bill. MedFlight does all the insurance billing for the clients. Currently, MedFlight requires no money up front for domestic transports. An interest free loan and payment plan is available for clients needing assistance with the balance of their bill that insurance does not cover.
Q: Will the appropriate aircraft be utilized and can the aircraft safely accommodate the patient?
A: The “appropriate aircraft” should be determined by the intended flight requirements. Jets should be used for transports exceeding 500 miles. For missions under 500 miles, a twin-engine pressurized aircraft flown by two pilots would be appropriate.
Medflight of Ohio owns and operates two King Air turbo prop twin engine pressurized aircrafts for transports under 500 miles. Lear jets are utilized for transports that exceed 500 miles.
