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    Please get me out of here: The difficult decision making in fit-to-fly assessments for international fixed-wing air ambulance operations

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    Publication Date
    2023-06-17
    Authors
    Veldman, Alex
    Diefenbach, Michael
    Taymans 3, Laurent
    Vadera, Bettina
    Lelo, Joseph
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    (5 total)
    Type
    Article, Journal
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    Citation

    Veldman A, Diefenbach M, Taymans L, Vadera B, Lelo J, Rouaud Y. Please get me out of here: The difficult decision making in fit-to-fly assessments for international fixed-wing air ambulance operations. Travel Med Infect Dis. 2023 Jul-Aug;54:102613. doi: 10.1016/j.tmaid.2023.102613. Epub 2023 Jun 17. PMID: 37331494.

    Abstract/Overview

    Introduction: With international travel for leisure and business almost back to pre-pandemic levels, demand for repatriation due to illness and injury abroad is increasing [1,2]. In any repatriation, there is considerable pressure on all involved to organize a rapid transport back home. Delay in such action may be perceived by the patient, relatives, and the public as an attempt by the underwriter to hold off on an expensive air ambulance mission [3-5]. Methods: Review of the available literature and analysis of assistance and air ambulance Companies' infrastructure and processes to identify risk and benefit of executing or delaying aeromedical transport for international travellers. Key findings: While patients of almost any severity can be safely transported over great distances in modern air ambulance aircraft, immediate transport is not always in the patient's best interest. Each call for assistance requires a complex and dynamic risk-benefit analysis with multiple stakeholders involved to achieve an optimized outcome. Opportunities for risk mitigation within the assistance team include active case management with clearly assigned ownership, as well as medical and logistical experience with knowledge on local treatment opportunities and limitations. On the air ambulance side, modern equipment, experience, standards and procedures as well as accreditation can reduce risk. Conclusions: Each patient evaluation remains a highly individual risk-benefit assessment. Optimal outcomes require a clear understanding of responsibilities, flawless communication and significant expertise among the key decision-makers. Negative outcomes are mostly associated with insufficient information, communication, inadequate experience or a lack of ownership/assigned responsibility.

    Subject/Keywords
    Air ambulance; Medical assistance; Risk-benefit assessment
    Further Details

    DOI: 10.1016/j.tmaid.2023.102613

    Publisher
    Travel Med Infect Dis
    Permalink
    https://repository.amref.ac.ke/handle/20.500.14173/991
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