An evacuation is not started when the plane takes off and is not over

when it's landed

Stages of aeromedical evacuation

• Receiving information, organization

• Evaluation, preparation, packaging

• Transfer to an airport

• A flight

• Ambulance transfer to the receiving hospital

How many times the patient should be moved after leaving the hospital bed?

• From hospital bed to hospital trolley

• Hospital trolley to an ambulance trolley

• Ambulance trolley to a stretcher in the plane

• From the stretcher to an ambulance trolley

• From ambulance to the bed in the receiving hospital

• Totally- 5 times or more

Effects of air and ground transport physiological parameters of critically ill patientsBudiansky V, De Jong R, Chesmochakova L, Gagarin A, Loginov A

191

125

99

52

0

100

200

300

400

500загрузка больного

скорая помощь

подготовкабольного

самолет

Potential problems with handling the patient

• The patient can be dropped

• Can be stacked

• ET can be dislodged, IV access can be lost etc.

• Decompensation of the patient

• Difficult to monitor, to ventilate

• Exposed to environment

Some statistics

Adverse reactions 75%

Equipment failure 35.6%

Dislodgment ET,IV loss

15.3%

Our data 33.4 % - equipmentfailure

Guidelines

• Systemic approach

• Thorough preparation

• Minimization of the patient movements

• Continuous monitoring

• The same level of support (treatment)

Systematic approach

A assessment situation

C control team leader, tasks

C communication TMO

E evaluation clinical information

P preparation safety, transport unit

T transportation care during transport

Transport unit

• Minimization of a patient movements

• Easy and safe handling at every stage

• Possibility of interventions and monitoring at every stage of evacuation

• Patients comfort

• Limitation of exposure to environment

• Possibility to carry of equipment

Creating a transport unit

• basket stretcher

• vacuum mattress

• scoop stretcher

• spinal board

Comparison

Size Comfort Protection

problems Handling

BS +++ ++++ ++++ size +++

VM ++ +++ +++ fragility ++

SS + ++ ++ Defib? +++

SB + + ++ P, P, R +++

Your safety

• Gloves

• clothes

• technic

Loading to the plane

• Ask permission

• Delegate responsibilities but be careful

• Communicate with pilots

• Belts

• Securing equipment

Key points

• Thorough preparation (plan, patient, equipment, personnel)

• Team leader

• Transport unit

• Safety

• Communication (don’t forget to explain to the patient what you are going to do)