Effective teamwork is essential to patient safety in any healthcare environment.

Effective team performance for air ambulance transports or any medical transports relies on the interaction of many individuals from different regions and sometimes different continents with highly diverse backgrounds in terms of expertise, training, and experience.

There are many essential techniques for the successful coordination and well-programmed fixed-wing air ambulance. Based on my experience, in my opinion, this is the number one technique:

Closed loop team communication.

This consists of the team’s ability to exchange clear, concise information, acknowledge receipt of that information, and confirm its correct understanding while keeping everybody involved well informed.

Decision for transport:

The decision to send a patient on a flight transport is best made jointly with good on-time communication between the patient, family members, sending, receiving physicians, and the flight team.

Accurate and on-time documentation.

The patient’s current condition, medical requirements, and contraindications can change at any time. Having accurate medical transport information with enough anticipation makes a huge difference.

Accurate and on-time documentation is a part of a good closed loop communication allowing the sending, receiving hospitals and the flight team to plan based on the specific needs and contraindications to determine if the patient is Fit to Fly within the transport window.

Medical transport information documents, to name a few, include the patient’s diagnosis, current medical progress notes, treatment plans, test results, a medicine list, and transport equipment requirements. For international medical transports, travel documents are additionally required as well.

The receiving hospital can check the appropriate specialist and bed availability with proper communication. At the same time, the flight team can anticipate any special needs on permits and resource management like personnel, equipment, and supplies to program the flight adequately.

The more advance notice, the better

Long-distance and international fixed-wing air ambulances transports require more preparation and proper management of resources due to the following factors:

• International overflight and landing permits
• Adequate rested and available Fit to Fly Team (based on the FAA’s Pilot flight time limitations, rest requirements for safety, FAA § 91.1059)
• Adequate and closest available Fit to Fly Aircraft
• Safe to Fly weather along the entire Flight Plan

[We will cover in another post the basics factors that affect resource management for domestic and international air ambulance missions.]

Working together as a unified team for the same common goal

The sending and receiving physicians and the flight team have the same common goal: the patient’s safety and comfort to definitive care and treatment

Conclusion: Closed loop team communication allows for efficient use of resources. It is best to reduce errors, common mistakes, or assumptions by removing ambiguity from instructions, allowing timely questions if the information is not clearly understood. It enables everybody involved to know the proposed and best course of action.

Comment if you ever had any problem with the lack of close team communication on any coordinated medical transport before!

What other related topics you would like to see more in our blog?

References:

• Closed Loop Communication Training in Medical Simulation – StatPearls – NCBI Bookshelf (nih.gov)
• Closed Loop Communication: Operating Room Team Training (harvard.edu)
• Aeromedical Transport of Critically Ill Patients: A Literature Review (nih.gov)
• AC 135-15 – Emergency Medical Service/Airplane (EMS/A) – Document Information (faa.gov)
• CFR-2011-title14-vol2-sec91-1059.pdf (govinfo.gov)
• eCFR :: 14 CFR 91.1059 — Flight time limitations and rest requirements: One or two pilot crews.
• Meteorology (faa.gov)