Medical emergencies can happen anytime and anywhere. First responders like emergency medics have developed a variety of vehicles to get to the patient’s location. Responders providing air medical services use air ambulances like medical helicopters. Let’s cover these vehicles’ history, advantages over land vehicles, and what the industry looks like in the coming decades.

What is Air Ambulance?

An air ambulance is a flying vehicle designed to transport injured or severely ill patients to a medical facility for treatment. They may fly such patients from an accident scene or between such facilities. Air ambulances have also been used to move critical medical items like organs for transplant.

Air ambulances are either helicopters or fixed-wing aircrafts like prop planes and jet planes. The helicopters, also called medical helicopters and medic helicopters, are typically managed by hospitals, city, county, or state Emergency Management Systems (EMS). They are used for short-haul, trauma-related emergency flights when time is of the essence.

Airplanes used as air ambulances are called medical jets or medical flights. Companies that use them are usually privately owned. 

Phi Air Medical and Reach Air Medical are two well-known air ambulance companies in the US.

A Brief History of Air Ambulance

The treatment of patients while in flight originated in the military. Hot-air balloons were used by armies in 1784 to move ill and injured soldiers off the battlefield for medical treatment. During World War I, the US Army converted a Curtiss JN-4 biplane for use as an air ambulance. The Korean and Vietnam wars saw the massive use of air medical services.

Civilian use of air ambulances in the US first started in 1947. That year, the Federal Aviation Administration certified the Schaefer Air Service of Los Angeles as the first air ambulance in the country. The first civilian, hospital-based air ambulance took flight in 1972 when Flight For Life Colorado lifted off from Denver-based St. Anthony Central Hospital. 

Hospitals owned and operated most air ambulances until 2002. That year, Medicare increased its reimbursement rates for air medical services. Private companies began to add hundreds of new air ambulance bases and aircraft across the country. The US Government Accountability Office found, in its 2019 analysis of the report, Air Ambulance Use and Surprise Billing, that: 

  • 300 providers of air ambulance services.
  • 1,114 air ambulance bases in the US.
  • 1,461 total aircraft: 1,111 rotary-wing (RW) aircraft (helicopters) and 350 fixed-wing (FW) airplanes.
  • Approximately 60 percent of new RW bases and about half of new FW bases are located in rural areas across the country.

Air Ambulances vs Land Ambulances

Air medical services are used over land ambulances because they can travel faster and have a wider coverage area. These are vital in circumstances such as:

Patients suffering major trauma have the best chance of survival and recovery if treated within the first 60 minutes (the so-called “Golden Hour” in medicine.) A medical helicopter has a better chance to transport patients from accidents to a trauma center within that timeframe than a land ambulance van which must contend with traffic conditions, lack of access to a location, or long road trips. 

Populations in sparsely-populated rural areas tend to be widely scattered with few medical facilities as discussed in Battling the Unique Challenges Faced by Rural Hospitals. A major trauma center can easily be located over an hour away by car. Most air medical services flight plans are designed to be able to transport patients within 10 minutes to such centers.

Road access may be limited in rural areas. Or non-existent in cases of hikers on a mountain trip. Medical helicopters can reach such out-of-way places. 

Patients with severe medical conditions sometimes have to travel cross country to receive the best care. Medical jets such as AirMed can be chartered to transport them. Such flights can also be used to bring patients back to their home countries for medical treatment. This is called “repatriation.” 

Organ transplantation is very time-sensitive. While a kidney can stay viable outside the body up to 36 hours, a heart can only last around 6. A medical flight to bring the organ to the transplant recipient quickly may mean the difference between life and death. 

Flying ER or ICU

Like their land-based counterparts, air ambulances have been specifically equipped to deal with patients. Some of the standard equipment for a medical helicopter include:

  • CPR equipment
  • Stretchers. 
  • Breathing apparatus and monitoring systems 
  • Pacemakers 
  • Defibrillators
  • Blood transfusion equipment 
  • Medicines like adrenalin, propofol, and anticoagulants (blood thinners) such as heparin

Medical jets are similarly equipped. However, because they’re more spacious and have to support critical patients sometimes for hours on end, they may have additional features:

  • Required medications for the patient
  • Patient-loading utility system
  • Oxygen
  • Regulators, defibrillators, ventilators
  • Heart monitors and IV pumps

A medical box PC could also be found on such aircraft. Being medical grade, there’s little risk of electrical and radiation interference with the other medical devices on the plane. An antimicrobial casing prevents growth of microbes on the PC surface, while a fanless cooling system does not circulate the closed air around the cabin. It’s also quiet which allows patients to rest peacefully.  

A medical computer is also a possibility. With similar features as the box PC, this all-in-one could prove extremely useful for the EMTs on board in accessing important patient records.  

Speaking of EMTs, those on-board air ambulances are usually a critical care nurse and critical care paramedic. Others may include another nurse or respiratory technician. Occasionally a physician may be part of the team but this is rare. 

One of the reasons for such teams stems from the nature of the job. Air ambulance medical personnel are considered highly skilled compared to their land-based counterpart. They usually have greater autonomy to make medical decisions since there’s no guarantee of continuous contact with a medical center. Many can perform medical procedures usually reserved for providers. 

They also have to contend with the unique conditions of being up in the air. Crews in a medical helicopter face constant loud noises from the rotary blades, vibrations, and changes in atmospheric pressure. Cabin space can be very tight allowing for little movement. Equipment brought onboard like medical tablets should be designed to take such conditions into account.

Air Ambulances Join a Future of Crowded Skies 

Air medical services, like much of healthcare, sees an expansion of their services in the foreseeable future. As discussed in How EMR, mHealth, and Smart Homes Comfort Hospice Residents under Aging World, the proportion of the world’s population over 60 years old will nearly double from 12 percent to 22 percent between 2015 and 2050. This will most likely lead to a rising number of age-related accidents and life-threatening situations such as major strokes and heart attacks. 

To meet this challenge, sites like Fortune Business Insights projects the global air ambulance services market is to grow from $5.79 billion this year to $10.30 billion by 2029. Compound annual growth rate (CAGR) is estimated to be 8.56 percent during that time. 

Closing Comments 

Air medical services use a variety of air ambulances like medical helicopters to transport patients in difficult terrains. Evolved from military use, air ambulances are well-equipped to keep patients stable from the medical gear they carry to the well-trained crew. 

If your EMS agency, hospital, or medical company is looking for help adding air ambulances to your air medical services, contact a representative from Cybernet. As a true device manufacturer, Cybernet can customize products to meet your specific needs in a timely and cost-effective manner. 

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