Air Ambulance Dispatch Criteria

[LondonMedic]

Does anyone use a dispatch criteria for air ambulances or just clinical / calltaker experience?

 

[johnrsemt]

start them early; if you think that there is any need for a bird, call them. depends: it may take up to 30 min before they even lift off.

 

[EMSLaw]

New Jersey's guidecards can be found here.

 

[LondonMedic]

start them early; if you think that there is any need for a bird, call them. depends: it may take up to 30 min before they even lift off.

30 minutes is pretty outrageous. The service I've worked with can (and does) fly from one scene pick up a crew from the hospital base and drop them to a second scene within 30 minutes.

(But then we use the helicopter to put a trauma doctor and paramedic on scene, transport is a secondary consideration)

 

[LondonMedic]

New Jersey's guidecards can be found here.

Those are pretty similar to ours, with the exception of transport criteria.

 

[lightsandsirens5]

Call NW MedStar for transport if:

>30 min to nearest Trauma Ctr. and one or more:

A: VS/LOC
1. Shock
2. Systolic BP<90
3. Resp distress following trauma: RR<10 or >29
4.GCS<13
B. Anatomy of injury
1 Penetration of head, neck, torso, or groin
2. Spinal injury w/paralsys or loss of feeling
3. Amputation proximal to wrist or ankle
4. Significant chest trauma
5. Two or more proximal long bone Fx
6. Burns >20% or involving the hands, face, airway, feet or genitalia
C. MOI
1. Death of same vehicle occupant
2. High speed rollover
3. Ejection from vehicle
4. Fall from > 20'/ 3x hight for peds
5. Pedsetrian hit @ >20 mph or thrown > 15'
6. Motercycle, ATV or bicycle crash
7. Significant crush injury
8. Extrication >20 min.
D. Gut feeling of EMS crew.

~~~~~~~~~~~

Yea, and 30 min is crazy, if that seriously is how long it takes, somone needs to investigate that service. I think Medstar will launch within less than 10 minutes. My experience has had them moving within 5 a good portion of the time and once they were airborne within 3. (But I'm guessing they were probably already out with the bird or something.)

 

[TccEMT]

We do not have a level 1 ER, Burn Center, Heart Hospital, etc. within a decent drive time from us (1 to 1 1/2 hours on a good day.) We can and do fly on either guidelines or experience.

A. Weather, location, road or traffic conditions would prolong patient's ground transport time to the closest appropriate care facility and would pose a threat to the patient's survival and/or recovery
B. Use of local ground transport team would leave the local area without adequate EMS coverage
C. Patients meeting specialty triage criteria or whose condition presents a high probability for complications or deterioration during an extended ground transport.

As far as "C" goes, the standing orders have a note: "Consider Air Transport" or "Shall Air Transport if Available / Air Transport Time NOT to exceed ground transport"

 

[lightsandsirens5]

We do not have a level 1 ER, Burn Center, Heart Hospital, etc. within a decent drive time from us (1 to 1 1/2 hours on a good day.) We can and do fly on either guidelines or experience.


As far as "C" goes, the standing orders have a note: "Consider Air Transport" or "Shall Air Transport if Available / Air Transport Time NOT to exceed ground transport"

We have a stroke center and cardiac hospital about an hour/hour and a half away. However, our nearest Lvl 1 Trauma Ctr. and nearest Burn Ctr are both a six hour drive away. In the winter sometimes they may as well be on the moon considering how accessable they are. So yea, any major burn or major, major trauma gets the bird to the nearest airport, than a fixed wing flight out to Seattle.

 

[medicdan]

From the most recent MA Statewide Treatment Protocols:

APPENDIX J: AIR MEDICAL TRANSPORT PROTOCOLS
Introduction:
The use of air medical services has become the standard of care for many critically ill or injured patients who require transport to specialized medical facilities such as Trauma Centers.
The purpose of these Guidelines is to establish a clinical framework for prehospital EMS personnel upon which to make decisions regarding when to access air medical support services. The following constitute the philosophical foundation for these Guidelines.
• EMS personnel should consider requesting ground advanced life support (ALS) and air medical support when operational conditions listed below exist and the following patient conditions are present;
• Patients with an uncontrolled or compromised airway should be brought to the nearest appropriate facility unless advanced life support (ALS) service (by ground or air) can intercept in a more timely fashion; and:
• Patients in cardiac arrest subsequent to blunt trauma should be taken to the nearest facility.
These guidelines have been established so that air medical support does not require prior Medical Control approval. However, Medical Control contact should be considered whenever appropriate for patient management issues.
OPERATIONAL CONDITIONS:
1. When a patient meets patient criteria defined below and scene arrival time to estimated arrival time at the nearest appropriate hospital, including extrication time, exceeds 20 minutes:
2. Patient location, weather or road conditions preclude the use of standard ground ambulance; or
3. Multiple casualties / patients are present which will exceed the capabilities of local hospital and agencies.
PATIENT CONDITIONS:
1. Physiologic Criteria:
a. Unstable Vital Signs -Blood Pressure less than 90.
-Respiratory Rate greater than 30 or less than 10.
2. Anatomic Injury:
a. Evidence of Spinal Cord injury including paralysis or paresthesia.
b. Severe Blunt Trauma:
-head injury (Glasgow Coma Scale of twelve [12] or less)
-severe chest or abdominal injury.
-severe pelvic injury excluding simple hip fractures.
c. Burns:
- greater than 20% Body Surface Area (BSA) second or third degree burns;
- evidence of airway or facial burns;
- circumferential extremity burns; or
- burns associated with trauma.
d. Penetrating injuries of head, neck, chest, abdomen or groin.
e. Amputations of extremities, excluding digits.
Special Conditions: The following should be considered in deciding whether to request
air medical transport, but are not automatic or absolute criteria:
1. Mechanism of Injury
a. Motor Vehicle Crash:
-patient ejected from vehicle.
-death in same passenger compartment.
b. Pedestrian struck by a vehicle and thrown more than 15 feet, or
run over by a vehicle.
2. Significant Medical History
a. Age greater than 55 or less than 10.
b. Significant coexistent illness.
c. Pregnancy.

 

[LondonMedic]

Who's air ambo gets dispatched by the call taker/dispatcher and who's gets called for by the responding service? Mixture of both?