In medical transport, it can be assumed the most advanced solution is always the best. The more complex solution, with larger aircraft, critical care facilities and rapid response, can seem to offer more security, especially to those in stressful circumstances. In reality, however, the best solution is often the simplest one that safely addresses the patient's needs, with affordability also playing a key role in overall feasibility.

The patient defines the solution

The solution to any medical transport requirement begins with the patient, rather than the aircraft. The solution cannot be determined solely by the diagnosis. The patient's stability, need for oxygen, level of mobility, risk of deterioration during flight, tolerance to altitude and vibration, and need for medical intervention during flight all help determine the solution.

A critically ill patient may require a highly equipped air ambulance and an accompanying medical team. A severely ill patient may be safely flown on a commercial flight with a medical escort, or even by ground ambulance if the distance is shorter and the other circumstances are right.

Another factor that can often be misunderstood is that faster can be safer. In reality, however, faster can sometimes be less safe, especially when you consider the physiological stresses that take-off, landing, altitude and even turbulence can impose on certain patients, especially those with cardiac, neurological, or respiratory problems.

A slightly longer flight can sometimes be less stressful. What matters most is safe door-to-door travel, rather than safe time spent in the air.

Capability vs necessity

There is a need to balance capability with necessity in the medical field. While air ambulances can serve as flying intensive care units, not all patients require such a high level of capability. Therefore, there can be additional logistical concerns. Simpler systems, when possible, can be more effective in providing a solution because they have fewer variables to consider.

There are other considerations when discussing air ambulances. Airport accessibility, runway lengths, curfews, weather, ground transfer times and border crossing times can affect the feasibility of air transport. A larger jet must use major airports, which are often located far from both the patient's origin and final destination, potentially resulting in longer ground transfers.

A smaller aircraft may be able to bring the patient closer to the objective. More variables mean more chances for something to go wrong. Simpler systems can be more effective at providing solutions.

Independence in decision making

The most important, but least visible, factor may be independence in decision-making. If a medical transport provider does not need to use its fleet of aircraft to complete a mission, it can consider all options objectively and without bias. There is no need to favour one aircraft simply to offset operational costs. The decision can be made purely on what is best for the patient.

This level of independence also allows companies like Medical Air Service to be transparent about which options are required and which are not. If air transportation is not required or affordability is a concern, alternative options should be considered. If flying on a commercial flight with a medical escort is the best option, that can be recommended. If ground transportation by ambulance is required, it can be arranged as well. There is no bias towards any one form of transportation.

Transparency can also be important to these patients and their families, as they are often entering unfamiliar circumstances and may be emotionally distressed. Explaining to them that flying on a commercial flight may be safer can help to alleviate anxiety about the situation. It also helps to ensure resources are used to improve the situation rather than to show off capabilities.

Another factor that cannot be overlooked is the need to communicate with the destination hospital, particularly to ensure the patient is admitted immediately upon arrival. Success is determined by the patient's immediate arrival at the destination, regardless of the level of care required during transport. There are times when the best approach is to wait, particularly when the right bed, medical crew, or time is not immediately available.

Conclusion

The most important aspect of medical transport is simplicity, particularly because families are often misled into thinking the best medical crew is the one most equipped or able to respond most quickly to their distress call. Medical crew expertise is not about responding quickly or being highly equipped, but about responding simply.

The best medical transport decisions are not made to show off capabilities, but to ensure the patient is delivered to the destination in the most efficient, safe and dignified manner possible. When all factors are considered, simplicity is not a matter of choice but of necessity, particularly when the patient's interests are paramount in the decision-making process.