Air Medical Transport: Then and Now - Research Paper Example

Air Medical Transport: Then and Now Travelling by plane is faster than travelling by land. There are also instances that certain locations can only be reached by riding a plane. In the field of medicine, there are conditions where a patient cannot endure long rough road trips and the most practical way of transportation would be through air. Air Medical Transport is also referred to at times as Aeromedical Evacuation (AME). Unlike the conventional helicopters or planes, instead of seats for passengers the interior of these air transport vehicles are composed of stretchers, first aid kits, oxygen tanks, ECG, ventilators, and CPR equipment (Austin, 43). Austin (43) stated that AME can trace its origin as a way of people responding to air crashes. It has been noted in less than a decade, 7 years to be exact after the first flight, 2 officers of the American Army modified the first plane in transporting a patient. The United States Army Air Corps in 1926 transported patients from a 150-mile distance from Nicaragua up to Panama in an Army Hospital (FARE, 1). It was during the World War I when the air medical transport emerged. Rapid developments were witnessed in the planning and further expanding the capabilities and capacities that aircrafts can contribute in the field of medicine and transport (Austin, 43). FARE (1) expressed that the theme which was repeated stated for air medical transport during the First World War was “stabilize the critically wounded soldier in the field, provide advanced care enroute, and get the patient to a trauma-qualified surgeon in less than an hour, and the extent and impact of injury, including the likelihood of death, can be reduced.” This scenario was adapted through the Vietnam War. However since it appeared that during this era, air medical transport is still in its experimental stage, its main objective was the “rescue and treatment of a small number of patients by a physician attendant (Austin, 43). Innovators of the air medical transport are still looking to broaden the service that an aircraft can carry and how it can be of immediate assistance to people who are badly in need of medical attention. The service that the primitive aircrafts used for medical transports were just giving basically transporting patients from one point to another. Exploring the circumstances, the aircraft medical personnel spanned the wings of the services it can bring and in between the 2 World Wars vast improvement and acceptance towards this manner of transport began to emerge. This statement however was contradicted by Davis et al (9) when they expressed a drop in the research of aviation medicine between the years of 1920 and 1935. However, it was in this period when the mechanism dubbed as the “automatic serial-action complex coordinator” was developed. The purpose of this device is to establish reaction times related to the pilot and decision and calculating process regarding travel times and conditions, probable age-related characteristics, and alcohol effects. With the broader public acceptance of this way of transporting patients, the Curtiss Eagle aircraft was transformed to be able to transport 4 litter and 2 seated patients within its enclosed cabin. Instead of having the regular physician on-board the plane, a surgeon sat beside of the pilot instead. Since there is an upgrade with regards to the medical team aboard the plane, the mission of the air medical transport changed from being limited to the function of crash-rescue to a more extensive air-route evacuation role. So far, in the United States it is noted that the Army is more involved with aeromedical transfers. This is the opposite in Australia where civilians are more involved with regards to this type of medical transportation compared to its Army (Austin, 43). During the Second World War, Germany emerged to be frontrunner in aeromedical transportation. The Germans were successful in transporting large-scale passengers in their aircrafts. The Americans did not allow themselves to be falling behind the Germans who were causing much trouble and violence. World War II marked a more advance and rapid changes in the world of aeronautics and medicine combine. Technological advancements started to emerge and it was very much helpful in modifying the aircrafts that would be used for transport (Austin, 44). According to Davis et al (358), that one of the advancements made in the aircrafts being used during this era was the usage of the red cockpit illumination. The change was pretty helpful especially during a rescue in a place with insufficient lighting or during nighttime when there is lesser to almost no visibility. In connection with the modifications of the visuals in aeromedical transport, ultraviolet (UV) light was introduced as an option for cockpit illumination. Davis et al described the use of UV light as “radiations produce a fluorescence of the crystalline lens in the eye, giving the pilot a sensation that he is flying in a fog.” However, the use of UV lighting created a perturbing side effect especially when redirected without delay into the eye. The disadvantage of the UV lighting was amended eventually by proper adjustments of the UV lamps. Besides this modification, reducing the intensity of the lamp was another step that was made. Improving visuals and visual devices became the main theme of the modifications that undergone during the years in between the 2 World Wars. Though such attention was given to the improvement of the element in the air medical transportation, satisfactory results particularly for the night vision aspect were not achieved during these years. Even in recent years, night vision is still being tested and continuously modified for a better response of an aeromedical rescue and response team (Davis et al, 358). “Helicopter ambulances have not been adapted to civilian peacetime needs (FARE, 1).” This statement in 1966 boosted the emergency medical system (EMS) to further enhance the modifications being implemented in the field of aeromedical transportation. It was the National Academy of Science white paper who in a way pushed governments and civilian organizations alike to improve the services and devices that aeromedical transport offers and caters to. After the statement was made, in 1972, Denver, Colorado’s St. Anthony’s Hospital inaugurated the first civilian hospital-based medical helicopter service (FARE, 2). It was the start of a numerous transformation in this field. During the 1980s, medical facilities statewide acquired additional some 32 helicopter emergency medical system (HEMS). This was in addition to the 37 HEMS who already have the capacity to transport approximately 17,000 patients per year. At the turn of the 21st century, more than 200 medical facilities have acquired 400 aircrafts that transported an estimated of more than 200,000 patients. This number further ballooned to an approximate of 272 service facilities that operated more than 700 service helicopters in the year 2005 (FARE, 2). In recent years, HEMS are becoming more and more independent from the medical facilities. HEMS only became hospital-affiliated compared to the administration of HEMS during the latter decades of the 20th century. Aeromedical services evolved just like things present in this world. By means of the improvements made within the health care system, AMS also improved with regards to the services being offered and the devices that each aircraft carries. If not for the need of immediate transportation of injured soldiers during the wars, AMS may not have existed. With the recent closures or conversions of rural health centers, the gap between one point to another seems to be getting greater as time passes by. This opens up more opportunities for AMS in more locations statewide (FARE, 2). Whether it would be for the military or the civilians, air medical transport are being deemed to be more convenient way to travel patients compared to land travel. Besides the fact the air travel is faster, it also causes lesser trouble and difficulty for the patient themselves. The US Air Force stated that: The increasing incidence of small-scale military operations other than war has reduced the size and capability of the health facilities placed forward, and patients are now transported over long distances to receive resuscitative care. Unlike conventional warfare, where casualties are expected and deaths in combat are an accepted cost of achieving the objective, there is a strong political imperative to absolutely minimize casualty rates in military operations short of war. (Austin, 45) For both the civilian and military AMEs, promising innovations and modifications are expected to be seen regarding the quality of care that it will be giving to the patients. During the earlier years of the AME, only the fixed wing aircrafts are being used to transport patients. However, since the importance of AME has been noted by the government and private institutions, even helicopters are now being converted and used for a quicker and more immediate rescue and transport. These modifications and acquisitions in the field of AME are not going to be cheap. Financial troubles may hinder these plans of the aviation field. The costs of the investments are deemed to be all worth it as this might save thousands of lives in the future (Austin, 45). It is not just the aircrafts and devices within it are needed to be enhanced. Pilots and medical staffs should also be further evaluated and trained for this kind of medical attention and transport. Equipment present at the hospital facilities are different from the ones present inside the aircrafts, medical staffs should be able to make the most out of the devices that are present at a given time and location. Movements are also constraint in this type of facility yet regardless of everything that has been stated what is more important is that people’s lives are being saved whether on land or in air. Works Cited Austin, Tony K. Aeromedical Evacuation — The First 100 Years. ADF Health. Vol. 3. April 2002. pp. 43-46. Davis, Jeffrey R., Johnson, Robert and Jan Stepanek. Fundamentals of Aerospace Medicine. Philadelphia, PA: Lippincott Williams & Wilkins. 2008. Foundation for Air-Medical Research and Education (FARE). Air Medicine: Accessing the Future of Health Care. Alexandria, VA: FARE. 2006. Read More