Case Manager

WHY CHOOSE OUR SERVICE

Aeromedical transport is a specialty. Air ambulance transports fulfill a medical need for the emergent evacuation. During the recovery phase of an illness or a catastrophic event, many patients can be safely transported on a commercial airliner with the assistance of a skilled, licensed registered nurse. When it comes to a patient’s post-discharge or transfer needs, many facilities do not have an established travel assistance program. The results of minimal clinical expertise in assessing a patient’s transport needs are often unnecessary hospital stays and increased costs. Some patients or organizations have resorted to private air ambulance companies at an exceedingly high and unjustified cost. More often, patients requiring flight care are traveling home with family members who are medically untrained with little or no aeromedical transport experience. With over 20 years of commercial flight experience, we can offer an appropriate evaluation to determine how to safely transport your patient to their desired destination.

HOW WE CAN ASSIST YOU

Let us take the planning initiatives out of your hands and into ours. Our Nurse Coordinators are trained in assessing patients for travel, and will evaluate, make recommendations, and assist you and your health care team in implementing the transfer process. We coordinate all ground and commercial airline transportation from bedside to bedside. Safety is our FIRST priority. We are very conservative in our approach. We meet all FAA safety criteria and we have set up safety protocols for the well-being of our patients.

OUR SCOPE OF CARE

We assist patients with restricted ambulation and orthopedic injuries. We care for behavioral health disorders and neurological injuries. We administer supplemental oxygen and provide for complex respiratory needs. Many of our patients require full transfers from bed, to chair, to aircraft seat. We can administer IV fluids for hydration and oxygen therapy can be administered in-flight.  Numerous patients require fully dependent care and may be limited in communicating their needs.

HOW OUR PATIENTS TRAVEL

For safety reasons, patient comfort, and respect for other passengers, we require that our patients travel in the first class or business cabin. Our nurses travel in economy when not traveling with their patient. For long distance travel, most often associated with international transports, stretcher services can be evaluated but are rarely offered by airline carriers.  Stretchers are uncomfortable for the patient, offer little privacy, and are costly and generally not advised. As an alternative, some international carriers offer first class seats that lie flat. Requesting a stretcher may also alarm the airline that a passenger is less stable than they desire to transport. We will discuss all appropriate options with you.

LET US DO THE PLANNING

Contact us by phone, email or our website Transport Inquiry Form. We generally can be ready to travel within 48-72 hours dependent on patient needs and flight availability.

Preliminary Quote

We will review the patient’s medical requirements with you to determine if our service of commercial transport is appropriate. Next, we will put together a preliminary quote for your consideration. If we feel the patient is not quite ready for transport due to such things as mobility or oxygen impairments, we will advise you how to prepare your patient.

Initiating the transport planning

When you wish to proceed you will need:
The family and healthcare team in agreement, a receiving facility identified along with a proposed date of travel. From there, you will work with one RN Flight Coordinator.

The Coordinator will do the following

• Request an official medical report from the patient’s hospital records and a verbal nursing report from the health care member caring for the patient. The purpose of this is to ascertain if the patient is deemed fit to travel. After review, we will immediately make recommendations for the health care team to prepare the patient for travel.

• Begin securing a proposed airline itinerary for the date you desire. Immediate consideration is given to ordering airline oxygen due to a 48 hour minimum notice required by most carriers. We will speak with the medical department of the airline for oxygen and special medical requests. We have long-term trustworthy relationships established with most US and many international airline carriers.

• Confirm availability of our flight nurse staff and select a nurse to travel based on the location closest to the sending or receiving facility. The nurse is also selected based on the needs of the patient.

• Coordinate the channels of communication between hospital administration, family members, medical staff, interdisciplinary teams, case managers, insurance companies and financial institutions.

• Advise the health care team, patient and family as to the necessary steps to prepare the patient for a commercial flight and follow up that these steps are indeed being done.

• Request specific medical orders and medical clearance documents from the discharging physician.

• Organize each additional travel detail from ground transportation, layover assistance, ground and in-flight oxygen, specialized medical equipment, and offer guidance and assistance in obtaining international travel documents.

HOW YOU CAN HELP US, HELP YOU

Preparing your patient

• Oxygen: Begin weaning your patient’s oxygen level to the advised safe level for transport. Utilize your respiratory therapy interdisciplinary team. We generally request supplemental in-flight oxygen with any patient with a SAO2<95%.  This will be dependent on the baseline range of the patient along with the physician’s recommendation.

• Secretions: We can manage tracheotomy patients. However, secretions cannot be tenacious or frequent. Secretions drastically dry up at altitude causing mucous plugs. Utilize your respiratory therapy team. Cultures, antibiotic therapy and pulmonary regimen will be reviewed.

• Mobility: Begin getting your patient out of bed each day or several times a day to a reclining chair. Utilize your physical therapy interdisciplinary team. Your patient does not have to support themselves in an upright position. We have options to assist. What is crucial is that your patient does not have clinical compromise when sitting such as a drop in blood pressure, respiratory compromise or increased pain.

• IV’s: We can manage maintenance fluids. We cannot titrate drips for cardiac stability. This type of patient would be deemed too unstable for a commercial airline. TPN can be changed to D5 or D5/NS at physician’s discretion. Wean IVs if possible.

• NG/GT/J Tubes: They are accepted for travel. Any tube feedings will be stopped 8-10 hrs pre-flight with a bowel prep requested. During transport the patient can be hydrated with free water via these tubes or IV access.

• Pain Management: We can administer IV, PO, SQ or IM injections and IV bolus’ as needed. Mobility and pain management is a common reason to utilize our services. Begin finding a medication regimen that works with a trial in the hospital setting. The day of departure is not the time to suggest options.

• Equipment: All equipment must be portable and battery operated. Some of the larger aircraft have plug in options for primarily electronic audio/video equipment. This is NOT designed for dependent medical equipment.

OUR MEDICAL TREATMENT PLAN

Medical treatment is administered under the direction of the discharging physician’s medical orders. Medications are prescribed and dispensed by the sending facility in accordance with these medical orders. Fitness to Fly and Airline Medical Clearances are obtained from the discharging physician and the medical department of the airline carrier. In-flight emergency treatment is performed in accordance with the American Heart Association Basic Life Support standards.

CONTACT US

We are eager to offer any information that we may have in assisting you with this complex and timely process. We are available 7 days a week and can be ready to travel within 48-72 hours dependent on patient needs and flight availability.

*Flying Nurses International is not affiliated or otherwise associated with InteliStaf or its “Flying Nurses” travel nurse staffing division.*