CMSA Communities

As an air ambulance provider, we are proud of our ability to assist in caregiving in a specific way at a crucial time. However, the journey of caregiving is long and requires aid from a variety of sources. In previous blogs we have discussed resources such as the Ronald McDonald House Charities, Stepping Stones of Hope and hospice.

There are many other resources available to caregivers, but consistently, the caregiver resource that brings the most confusion is the U.S. Department of Veteran’s Affairs, formerly and still commonly called the Veteran’s Administration or the VA. Caregivers often have many questions regarding services, eligibility, and how to prove eligibility after “that fire.” Here are some answers to help you make your way through the VA system – to get the benefits you or your loved one need.

What services does the VA provide?

The Department of Veteran’s Affairs has three main subdivisions:

1.      Veterans Health Administration, which is responsible for providing health care in all forms. The VA operates the nation’s largest integrated health care system with over 1,400 sites including hospitals, clinics, community centers, counseling centers and other facilities.

2.      Veterans Benefits Administration is responsible for initial veteran registration, eligibility determination and Home Loan Guaranty, Insurance, Vocational Rehabilitation and Employment, Education (GI Bill) and Compensation & Pension.

3.      National Cemetery Administration provides burial and memorial benefits.

Who is eligible for services?

This is the most common question asked about VA benefits – am I eligible? Eligibility for most VA benefits is based on discharge from active military service under other than dishonorable conditions. Active service means full-time service, other than active duty for training, as a member of the Army, Navy, Air Force, Marine Corps, Coast Guard, or as a commissioned officer of the Public Health Service, Environmental Science Services Administration or National Oceanic and Atmospheric Administration, or its predecessor, the Coast and Geodetic Survey. Generally, men and women veterans with similar service may be entitled to the same VA benefits.

Eligibility for health care benefits is limited to those who served in active military, naval or air service and who were discharged or released under conditions other than dishonorable discharge. Reservists and National Guard members may also qualify. Upon enrollment, veterans are assigned to a priority group to help the VA balance demand. There are 8 different priority groups; division into groups is determined by medical need, disability, and income. For example, a veteran with 50% or higher service-connected disability is a Group 1 and is provided comprehensive care and medication at no charge.

Qualification for certain VA benefits requires the veteran to have served during wartime. The VA recognizes these war periods:

·         World War I: April 6, 1917 through November 11, 1918. For veterans who served in Russia, April 6, 1917 through April 1, 1920.

·         World War II: December 7, 1941 through December 31, 1946.

·         Korean War: June 27, 1950 through January 31, 1955.

·         Vietnam War: August 5, 1964 through May 7, 1975. For veterans who served in Vietnam, the beginning date is February 28, 1961.

·         Gulf War: August 2, 1990 through a not yet determined end date.

How do I receive benefits?

A veteran seeking benefits for the first time must submit a copy of his or her service discharge form (DD-214, DD-215 or WD form). This form should document the service dates and type of discharge or give the veteran’s full name, military service number, branch, and dates of service.

For family members seeking benefits, the following documents are required:

·         Veteran’s marriage certificate for claims of a surviving spouse or children

·         Veteran’s death certificate (if the veteran died in a VA care facility, a death certificate is not needed)

·         Children’s birth certificates or adoption papers to determine children’s benefits

·         The veteran’s birth certificate to determine parents’ benefits

What about that fire?

When discussing veteran’s benefits the second most common question is “What if my records were lost in that fire?” “That fire” refers to a 1973 fire at the National Archives and Records Administration which caused the loss of approximately 16-18 million military personnel records. The records of 80% of U.S. Army personnel discharged between 1912 and 1960 and 75% of Air Force personnel discharged from 1947 to 1964 were lost and no duplicate copies existed. So, what does a veteran do if their records were lost in the fire?

·         If the veteran or beneficiary filed a claim before 1973, the VA should have records

·         Service information can often be found in organizational records including unit morning reports, payroll or military orders on file at the NPRC

·         Sometimes records can be obtained through the state veteran services offices

Dealing with an organization the size of the VA can be daunting. Keep careful notes, make copies of all records and never give away your original copy. 

As an air medical transport provider, we provide a crucial service for caregivers at a very specific time. There are many other resources available to aid caregivers on their journey. Our goal in writing caregiver resources blog posts is educate you on available resources. Please let us know if you have any questions or issues you would like us to address.

It may be hard to imagine if you live in a big city or suburban area, but if you become sick or are seriously injured in many parts of the U.S., you might need to rely on an air ambulance to get the treatment you need. As the number of rural hospitals shrinks, many patients who live in underserved areas and need a higher level or more specialized facility for care have no choice but to travel elsewhere for treatment. It's simply part of the new reality of healthcare in America, and it illustrates the critical role that MedFlight911 and other air ambulance services play in the delivery of that care.

Take the story of Sam, an 11-year-old boy living in rural Nebraska. Sam seemed active and healthy, but one day he developed serious shortness of breath during an after-school basketball game. His parents took him to the local hospital in their small town. The doctors there examined Sam, and during an X-ray they saw a large mass on his lung. They knew the situation was serious, and that Sam probably needed treatment right away. But the staff at the local hospital also realized that they simply weren't equipped to provide the kind of care Sam was likely to need. So they recommended that Sam be moved to a children's hospital in Omaha, where they had specialists who could diagnose and care for him.

The case manager at the hospital called us and we explored a range of medical transport options for Sam.  Transport by ground medical motor coach wasn’t an appropriate option because it would have taken too long to travel from Sam’s hometown hospital to the children’s hospital in Omaha.  Traveling by commercial airline with a medical escort wasn’t an option because we were all concerned that Sam could have significant respiratory distress at any time and the medical escort couldn’t bring the proper equipment aboard the commercial plane to adequately take care of Sam in that situation.  So, we all agreed that an air ambulance was the best medical transport option.

An air medical transport was quickly arranged. Sam was in Omaha the next day, where doctors at the hospital diagnosed him with cancer. It wasn't news anyone wanted to hear. But because an air ambulance was able to get Sam to the children's hospital right away, doctors were able to move fast with their treatment, which greatly improved Sam's odds of survival. Sam's not out of the woods yet. But thanks to the expert care he's receiving in Omaha, and the swift response from the air ambulance team, things are looking up.    

Sam's story is just one example of how air medical transport helps saves lives. Connecting patients with the care they so desperately need is what MedFlight911 does, and we're very proud of that. We think it would be great if every rural hospital and healthcare center had the resources to treat every kind of patient. But the fact is, that's simply not possible. Instead, we're there to get patients to the places that do have those resources, whether it's a pediatric cancer center, a hospital equipped to treat traumatic brain injury patients, a burn treatment center, or other specialized facility. Our job is to provide the kind compassionate, patient-friendly transport that people need during tough times.    

To learn more about MedFlight911's air medical transport services, give us a call at 888-359-1911 or get a no-obligation air ambulance quote here.

For patients who are stable and aren't in need of emergency transportation via air ambulance, medical transport via motor coach might be a good option. Transport via a medically equipped motor coach is often more comfortable and less expensive than traveling via an air ambulance or even commercial air medical escort. Since most people aren't familiar with the idea of traveling on a medically equipped coach, I thought I’d outline the steps in a typical motor coach transport.

Step 1: The coach, driver(s), and medical crew arrive at the departing facility

MedFlight911 provides bedside-to-bedside service on most of our transports. That means that our medical crew (which typically consists of a nurse and/or a paramedic) is with the patient from the moment they leave the departing facility to when they arrive at the receiving facility. When the driver(s) and the medical crew first arrive at the departing facility, they'll spend a few minutes getting to know the patient and any accompanying family members and answering their questions. That way, everyone is comfortable and informed before we begin the trip.

Step 2: We transfer the patient to the medical motor coach

Our crew will use a wheelchair or stretcher to transfer the patient to the medically equipped coach, where they'll either travel in a bed in the motor coach stateroom or in one of the passenger chairs (the final decision about seating arrangements is up to the medical crew). We'll also stow any luggage in the coach's storage compartments and demonstrate all the features and functions of the coach to any passengers who will be travelling with the patient. 

Step 3: We get on the road

Once the journey begins, the MedFlight911 medical crew is completely focused on caring for the patient. Our motor coaches are comfortable and spacious, and the patient and passengers are free to sit back, relax, and enjoy the scenery along the way to their destination. During longer trips, we'll stop to pick up catered meal(s), and snacks and drinks will be available on the motor coach. If it's a long trip, there will be two drivers to switch off, so that we can get you to your destination as quickly as possible (without having to stop for the driver to rest).

Step 4: We arrive at the receiving facility

When we reach our ultimate destination, our medical crew will transfer the patient from the medical motor coach to the receiving facility and unload any baggage. The MedFlight911 crew will then make sure the patient is comfortably settled in the new location and communicate with the staff at the receiving facility to let them know about any concerns or issues regarding the patient.

Medical motor coach transportation may be a good option if you need non-emergency medical transport. You can find out more about MedFlight911's medical transport services by giving us a call at 888-359-1911 or get a no-obligation medical transport quote here.

Lately, there's been a lot of talk in the healthcare industry about treating patients, including air ambulance patients, as consumers. In other words, patients are being encouraged to take a more active and informed role in their healthcare decisions, with medical professionals seen as providers who are selling a service.

What does that mean for an air ambulance provider like MedFlight911? More informed patients is a great goal – one we fully support. But as we move toward thinking of the patient as a consumer, it's also important to keep in mind that the patient is a person first, and a consumer second. 

At MedFlight911, our patients are more than just clients – they're like family. From the moment a patient or family member calls and speaks with one of our air medical transport specialists, we put their needs first. Our job is to make the medical transport process straightforward, handling all the details so that our clients have less to worry about during an already stressful time.

Why is it important to realize that a patient is more than just a consumer? Consider this excerpt from an opinion piece by New York Times columnist Paul Krugman:

"Medical care, after all, is an area in which crucial decisions – life and death decisions – must be made. Yet making such decisions intelligently requires a vast amount of specialized knowledge. Furthermore, those decisions often must be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping."

At MedFlight911, we understand that patients and their families aren't in a position to act as if they were car shopping. They may be scared, stressed, and confused, and they need more than just medical transport – they need support from skilled professionals who they can trust. That's why we see ourselves as more than just an air medical transport service provider, and our clients as more than just consumers.

Take for example a patient we transported by air ambulance recently. She had been seriously injured in a car accident; the doctors at her current hospital had been able to treat and stabilize her but she had to be transferred to another facility to receive the specialized care she needed to fully recover. When her family contacted us to arrange a transport, they had many questions, and we worked closely with them to get them the answers they needed. At the same time, we also took the lead in communicating with both the departing and receiving facilities in order to ensure a smooth trip for the patient. We did everything we could to make the transport process as simple as possible, so that the patient and her family were able to concentrate on what really mattered to them – her recovery.

That kind of one-on-one, personalized service is at the core of the services MedFlight911 provides. When you choose to work with us, you’re getting more than just an air ambulance medical transport. You're also getting a relationship with people who will serve as your partner and advocate through the entire transport process. Our service begins with you.

You can find out more about MedFlight911's air ambulance services in our earlier blog posts, or go ahead and give us a call at 888-359-1911 or get a no-obligation transport quote here.

On most MedFlight911 air ambulance flights, the medical crew consists of at least two people: a critical care nurse and a critical care paramedic.  Sometimes there is also a doctor, a respiratory therapist, and/or other specialist, depending on the patient’s particular needs. That medical flight crew is responsible for the patient from the moment they begin their journey with us to the time they arrive at their final destination.

With so much riding on their shoulders, it's critical that our crew has the expertise to respond to whatever situation may arise. And not only do our flight nurses need to be familiar with all standard nursing procedures, but they also must be able to care for patients in the unique air ambulance environment – an extra challenge.

Air ambulance flight crew training is key

Because the air ambulance medical crew works with a wide variety of patients, including newborns, pregnant women, cardiac patients, organ transplant patients, children, and the elderly, they need skills and training in all areas of critical care nursing and paramedics. Every member of the MedFlight911 air medical crew must meet certain qualifications; we all have certifications in, at the least: 

• Advanced Cardiac Life Support (ACLS)
• Basic Life Support (BLS)
• Neonatal Resuscitation (NRP)
• Pediatric Advanced Life Support (PALS)
• Pre-Hospital Trauma Life Support (PHTLS)

Our flight nurses may also have the following advanced certifications:

• Certified Critical Care Registered Nurse (CCRN)
• Certified Emergency Nurse (CEN)
• Certified Flight Registered Nurse (CFRN)
• Transport Nurse Advance Trauma Course (TNATC)

Each of our critical care nurses and paramedics also receives altitude physiology, pharmacology, toxicology, and survival training, and they learn how to recognize flight stressors, manage oxygen therapy during a transport, and use the specialized medical equipment that's found on our air ambulances.

Finally, because we want our medical crew to be up-to-date on the latest treatment approaches, we also require regular continuing education (100 hours per year, in fact) as well as advanced training in areas like hazardous materials recognition and response, infection control, emergency care, invasive procedures (such as intubations), and labor and delivery.

The medical crew must be adaptable

As a critical care flight nurse or paramedic, you’re responsible for treating a range of patients with a range of medical issues, so adaptability is key.  Our medical crew can respond to a range of situations, including burn, cardiac, neonatal, environmental and respiratory emergencies, and pediatric trauma.  Even during the trip situations can, and often do arise that require flexibility and adaptability that require the kind of experience and training our medical crew has. 

So being an air ambulance nurse or paramedic isn't a job for the faint of heart. Our medical transport team members face high-stress situations on a daily basis. But because of their skills and experience, they're able to do their jobs like the pros they are. At MedFlight911, we make sure our flight nurses and paramedics have the training they need to provide care in the unique air ambulance environment, because we know that's what it takes to best serve our patients.

You can find out more about MedFlight911's air ambulance services in our earlier blog posts, or go ahead and give us a call at 888-359-1911 or get a no-obligation transport quote here.

At MedFlight911, we provide assistance to caregivers and patients when they need air ambulance services. Many of our patients will require convalescent or hospice care and many have caregivers tending to their needs. As a result, we feel very strongly about helping caregivers with their needs. In previous blogs, we have discussed caregiver stress, depression, and burnout. Today, we will be discussing suicide.

Caregiving does not cause suicide, nor does it directly lead to it. However, caregivers are at increased risk for depression and burnout which can increase their risk factors for suicide. In fact, risk factors for caregiver depression and burnout, such as social isolation and serious physical and mental illness, are the same risk factors as for suicide.

More common than you think

Suicide is the sixth leading cause of death for all Americans and the 13th leading cause of death worldwide. On average, one suicide occurs every 16 minutes. According to Suicide.org, there are 750,000 suicide attempts and 33,000 suicide deaths each year.

Warning signs

• ·         Changes in eating and sleeping habits
• ·         Withdrawal from friends, family, and regular activities
• ·         Violent actions or rebellious behavior
• ·         Drug or alcohol abuse
• ·         Neglect of personal appearance
• ·         Marked personality change
• ·         Persistent boredom or difficulty concentrating
• ·         Loss of interest in once-pleasurable activities
• ·         Giving away favorite possessions, jewelry, pets, or money

What to do if you think a loved one is suicidal

Be direct. Ask the person directly if he or she is having suicidal thoughts, has a plan and has access to means. Asking someone if they have considered suicide will not put ideas into their head. Rather it will reduce their anxiety and give them an outlet. It will also give you information that indicates how strongly they have considered suicide.

Listen. Allow them to express their feelings without judgment. Accept their feelings. Their feelings are neither good nor bad, just feelings. Do not act shocked by their thoughts, this will only create emotional distance.

Look for red flags for suicidal behavior indicated by the phrase “IS PATH WARM?”

·         Ideation – Threatened or communicated?

·         Substance Abuse – Excessive or increased?

·         Purposeless – No reason for living?

·         Anxiety – Agitation/insomnia?

·         Trapped – Feeling there is no way out

·         Hopelessness

·         Withdrawing – From friends, family and society

·         Anger – Uncontrolled, rage, or seeking revenge

·         Recklessness – Risky acts, unthinking

·         Mood Changes

Take action. If you think the person might harm themselves, do not leave them alone. Remove any pills or guns. Recognize that you cannot single-handedly keep someone alive. Say, “I’m going to get you some help.” Then seek assistance from persons or agencies specializing in crisis intervention and suicide prevention.

What to do if you are thinking about suicide

Get help! Remember that suicide is final – once it’s done, there is no changing your mind. If you are feeling suicidal, you are in more pain than you know how to handle. There are ways to reduce the pain and better methods of dealing with it. You can learn both. Let someone help you.

For assistance, contact the National Suicide Prevention Lifeline at 1.800.272.TALK (8255). To find a crisis center nearby you, click here.

"What do you do to make sure that the patient’s air ambulance flight goes smoothly?" That's a question I often get from patients and their families, so I thought I'd take the time to review a few of the key elements of a successful air medical transport at MedFlight911.

A key element of a successful air medical transport is choosing and preparing the proper aircraft

When you call us for a no-obligation transport quote the medical information you provide about the patient will help us begin to plan for the proper aircraft (or other form of medical transport). At MedFlight911 we take a customized, individualized approach to medical transport (not a “one-size-fits-all” approach), so the form of transport we recommend – whether it’s a jet air ambulance, a commercial air medical escort, or a medical motor coach – is the one that best fits the patient’s needs.

Another key element of a successful transport: the right air ambulance equipment

At least 24 hours before the scheduled trip, we contact the patient's doctor at the departing facility to learn more about the patient's condition, vital signs, recent lab or other test results, concerns or potential problems. We use that information to ensure that our medical flight crew arrives prepared with the right medical equipment to keep the patient stable throughout the transport.

Each of our planes features an array of medical equipment, such as FAA-approved medical stretchers, defibrillators, ventilators, IV pumps, and critical care medications. Depending on the patient's specific condition and the recommendations of the doctor, we can also equip the air ambulance with additional specialized equipment, such as a fetal heart and tocodynamometer (toco) monitor for pregnant patients or ECMO (extracorporeal membrane oxygenation) for patients with severe heart and lung problems. Being prepared with the right equipment allows our medical team to deal with the issues that may arise while in transit.

Having the right air medical transport crew is a key success factor

While the right form of transport and the right equipment are critical, it is the medflight air ambulance crew that really determines the success of the transport. That’s why MedFlight911 works with only the most experienced medical professionals and requires ongoing training. Our medical crew have special knowledge of the unique air ambulance environment (such as how shifts in altitude may affect a patient's health) and they are prepared to respond quickly to any changes in the patient's condition during flight. They've also been trained to deal with a range of high-risk medical situations, such as burns, pediatric trauma, multi-trauma situations, cardiac emergencies and respiratory emergencies, and they have certifications in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Pre-hospital Trauma Life Support (PHTLS) and other areas.

Throughout the flight, our crew is able to focus exclusively on the patient because they're supported by the transport coordinators in the MedFlight911 home office. Those air medical transport coordinators are the ones who handle any behind-the-scenes issues that may arise during the transport (such as last minute changes at the receiving facility), which leaves the medical crew free to take care of their patient without any distractions. That means that the patient is able to get to their destination quickly and safely – the ultimate goal for everyone involved.

You can find out more about MedFlight911's air ambulance services in our earlier blog posts, or go ahead and give us a call at 888-359-1911 or get a no-obligation transport quote here.

Caregiving issues are important because many of the patients who use our air ambulance service require some form of convalescent care or end-of-life care.  For every patient we deal with there is always at least one caregiver involved.  Previously we have discussed tips to ease caregiver stress and caregiver depression.  Today I’d like to focus on caregiver burnout. 

Not all caregivers will experience burnout, just like not all will experience caregiver depression.  However, caregiving is hard work and it takes a toll.  The combination of loss, prolonged stress, and the physical demands of caregiving put you at higher risk for health problems, depression and burnout. 

In fact, according to the Family Caregiver Alliance, if you are a caregiving spouse and are experiencing mental or emotional strain, your risk of dying is 63 percent higher than that of others your same age.  Whether you’re taking care of a parent, a spouse, a child, or some other loved one, the fact is that being solely responsible for every aspect of a person’s care 24/7, no matter how much you love that person, can be really hard.

Symptoms of burnout
Burnout doesn’t feel like a like a cold or the flu.  Much like the frog in boiling water, you may not even notice when you are experiencing it.  The following are symptoms of burnout that you may notice in yourself or others may indicate they see in you:

·         Feelings of depression

·         A sense of ongoing and constant fatigue

·         Decreasing interest in work or recreational activities

·         Social withdrawal

·         Increased use of drugs or alcohol

·         Change in eating or sleeping patterns

·         Inability to relax

·         Scattered thinking

·         Being on the verge of tears or crying a great deal

·         Feeling increasing resentful and increasing short-tempered

·         Increasing thoughts of death

What to do if you think you are experiencing burnout

Take care of yourself – On an airplane in crisis when the oxygen mask drops down, you are supposed to put on your own mask before helping others.  Only when we care for ourselves can we effectively care for others.  Caring for yourself is the most important, and most often forgotten, rule of caregiving.  Whether you go for long walks, meditate, golf, or get a manicure – do something for you!

Get support – Say “yes” to any and all offers of help.  If you don’t feel like you can get the support you need from family and friends, support groups can provide understanding and connection than friends often cannot.

Educate yourself ­– Learn as much as you can about your loved one’s illness so you can understand what is happening.  Attend workshops and support groups to learn caregiving tricks.  You need training for this job! 

Take a break – Without breaks, it’s easy to begin to question yourself and feel inadequate, increasing the likelihood of burnout.

Remember, it is not selfish to focus on your own needs and desires when you are a caregiver – it is an important aspect of your job.  You are responsible for your own self-care.  Focus on the following practices and make them part of your routine:

·         Learn and use stress-reduction techniques

·         Pay attention to your own health

·         Get proper rest and nutrition

·         Exercise

·         Take time off

·         Seek support

·         Identify and acknowledge your feeling and see a counselor if needed

Rosalyn Carter said once “There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.” Statistics support Carter’s comment. According to the National Family Caregiver Association, 29% of the U.S. population is currently providing care to a friend or family member, with 13% of caregivers providing 40 or more hours of care each week.

In our last blog, It Takes a Village to Care for a Patient, we discussed how to ask for help from family and friends. But, sometimes, the amount of caregiving required exceeds the amount of time or skills of family and friends can offer. So, a paid caregiver may be required. If that’s the case in your situation, how do you find a caregiver?

Defining Home Care

Home care is a general term that represents a wide variety of services available to individuals recuperating from acute situations or dealing with a chronic condition and on-going care needs. The skills and duties of home care personnel can vary. But their ultimate goal is to make it possible for care recipients to remain at home in a safe environment while providing caregivers with respite. Home care can be provided by the following individuals:

·     Registered nurses (RNs) who provide skilled medical care including giving medication, monitoring vital signs, dressing and caring for wounds, and educating family members on medical issues.

·     Home care aides who provide personal services like bathing, dressing, toileting, making meals and cleaning and transportation.

·     Companion caregivers help with household chores but do not perform personal care tasks.

Getting Started with Home Care

When you have determined what type of home care you need, you will need to make certain that both you and your loved one are comfortable with someone taking on tasks you have been doing. This is often easier said than done. Getting beyond the objections of your loved one is not always easy, but other caregivers or professionals may be able to offer direction and ideas on how to deal with the situation. Some caregivers find it helpful for their physician to act as the “bad cop” and order home care as a requirement for the patient to stay in their home. This way any resentment and anger are directed at the doctor rather than the caregiver.

Who Pays?

Once you know what kind of care your loved one needs, and your loved one has agreed to the situation (even if only begrudgingly), the inevitable questions arise: How much will it cost? And who covers the cost? Some federal and state funded programs and private insurance companies provide some home health care. But, the coverage may not fit your needs.

The majority of family caregivers need help with personal care tasks which are not typically covered by private health insurance or Medicare; it is often covered by long-term policies so it is imperative to review all insurance benefits. The reality is most, if not all the, costs of homecare services will come out of your pocket.

What do services cost? Some agencies charge a flat fee ranging from $100-$120 a visit. Other agencies charge by the hour with a two or four-hour minimum. The specific hourly rate will vary depending on level of services required and your location; generally it ranges from $13 to $35 an hour.

Choosing the Right Agency

There are several ways to find a home care agency. Organizations like the Area Agency on Aging and the Alzheimer’s Association offer lists of home care agencies. There are also Senior Care Guides that can be commonly found at grocery stores and senior centers. If the type of care you need is approved and covered by Medicare, the agency you choose must be Medicare certified. If you need only personal care or companion care, Medicare certification is not a factor. It is important to interview service agencies to get a feel for how they work and their level of customer service.

Questions to Ask

·    How long has the agency been in business? Are they a local or national company?

·    Does the agency provide an initial assessment to determine patient appropriateness and best caregiver fit?

·    Who performs the assessment – an RN or a social worker?

·   Does the agency provide all the services you need? As your loved one’s care needs change, will the agency still be able to accommodate your needs?

·    How does the agency choose and train employees? Do they background check employees? Do they fingerprint their employees? Do they perform regular drug tests? Do they provide on-going training to their employees?

·   Does the agency have arrangements in place for emergencies or for sick employees? Are caregivers available 24 hours a day?

When can service begin?

After you have selected an agency, they will work to find the most appropriate caregiver for your loved one. Now is not the time to be quiet about your loved one’s needs, desires, and personality quirks. If your loved one feels strongly that their caregiver be a specific gender, for example, speak up. Any information you can give the home care agency will make the entire process easier.

As an air medical transport service, we provide a crucial service for caregivers at a very specific time. We understand that caregiving extends after the air ambulance flight is over. Our goal in writing caregiver resources blog posts is to give you on direction on some of the issues you may face during your journey. Please let us know if you have any questions or issues you would like us to address.

In my last post, I began telling the story of MedFlight911’s air medical transport of a young burn victim from the Ukraine to the U.S. Because of the complexity of the situation, it took several days to figure out all the details of the transfer – which had to ensure that the pilots got the duty rest required by law (we used two sets of pilots to accomplish that), had to keep the planes running and the patients safe despite dangerously cold temperatures, and had to ensure a specially-trained medical crew for pediatric patients.  We were all deeply saddened by the fact that two of the three children passed away before we arrived in Lviv.

When our air ambulance crew arrived in Lviv, Ukraine, they found a community that had pooled all of its resources to save the life of the surviving child. Before our team could even think about moving the boy, they had to 1) ensure they understood his medical condition so that they could best treat him during the flight; and 2) ensure that he was stabilized for transfer to the air ambulance. That process, which involved running diagnostics, studying lab reports, and evaluating the boy's skin condition (he was burned over 99.5% of his body), took more than four hours (though it’s critical, as the flight medical crew must know everything about the patient’s condition before they assume full responsibility for his care until he arrives at the destination hospital).

Once the medical team – which included a doctor, nurse and respiratory therapist, all with pediatric training – completed their assessment, they began the process of moving the patient into the ground ambulance for the trip to the airport. Because the boy's severe burns made it dangerous to move him in cold weather, the hospital's staff had sealed off hallways and stairwells with plastic sheeting, creating a temperature-controlled tunnel so that he could be safely transferred from his room to the waiting ambulance. A similar tunnel was erected to move the patient from the ground ambulance to the airplane.

Once the boy was safely on the airplane, it was time to take off and begin the 14-hour journey to Boston. The trip involved landing in Scotland to switch pilots (due to the fact that pilots are limited by law to the number of hours they can be “on duty” at a time), as well as stops in Iceland and Canada to refuel. The whole time, the medical crew remained completely focused on the keeping the boy (who was in a medically induced coma) as stable as possible. Because of their dedicated efforts, they were able to deliver the patient to the medical team in Boston in stable condition, and the doctors there later told us how impressed they were with the level of care he'd received during the flight.

It has been several weeks since we completed the transfer – one of the most complicated I've been involved with in my career – and I'm happy to report that the boy is doing well. Though he's still in very serious condition, the doctors in Boston are optimistic about his chances of recovery. While this was a heartbreaking case in many ways, and we were devastated about not being able to save the lives of all three children, we are proud to have helped one child.

I'd of course be remiss if I didn’t recognize the efforts of everyone who helped make this transport happen, including the Ukrainian Ambassador to the U.S. and the U.S. embassy in the Ukraine, the Red Cross, the medical teams in both Lviv and Boston, and the people of Lviv. This truly was a case of people from around the world coming together to help someone in need, and we're proud to have been part of that effort.